Health Insurance for Anaemia

What Does Anaemia Treatment Cost in India?

The cost of anaemia treatment depends heavily on the type of anaemia diagnosed. Mild to moderate anaemia is treated on an OPD basis, which involves affordable outpatient consultations, diagnostics and medications. However, life-threatening anaemia, including aplastic anaemia, thalassemia, hemolytic anaemia, and sickle cell anaemia, might require hospitalisation.

The average cost of anaemia treatment ranges from ₹500 to ₹3000 per month for mild anaemia, depending on the underlying cause and severity of your condition. However, for other types of anaemia that involve a bone marrow transplant or any other modern treatment, the treatment cost can range from ₹15 lakh to ₹40 lakh.

Take a look at the various components of anaemia treatment cost in India:

Note: The cost of anaemia treatment varies depending on the severity of your condition, the type of anaemia and the therapy recommended.

Anaemia is also managed through various diagnostic tests to check the level of hemoglobin before and after treatment. These diagnostic costs add up to the average cost, which increases your out-of-pocket expenses, especially when you do not have medical insurance.

Here is a breakdown of diagnostic expenses required for anaemia:

Health insurance plans can help you manage the cost of treating severe anaemia and provide cashless treatment at hospitals, which lowers your upfront expenses.

Does Medical Insurance Cover Every Stage of Anaemia?

Yes, medical insurance covers every stage of anaemia. If you are diagnosed with mild to moderate anaemia, your routine doctor consultations, iron/vitamin supplements and diagnostic tests are covered with an OPD cover.

Most comprehensive health insurance plans cover severe anaemia when it requires in-patient hospitalisation, and day care procedures such as IV iron infusion, diagnostic investigations and blood transfusion.

However, chronic and severe anaemia, including aplastic anaemia, are covered under critical illness insurance plans. They provide a lump sum benefit to the insured when aplastic anaemia is diagnosed for the first time.

Which Type of Health Insurance is Best for Anaemia?

Anaemia is covered under comprehensive health insurance plans and critical illness insurance plans (if it is a life-threatening condition). However, the right mediclaim policy depends on the severity and type of anaemia you are diagnosed with.

Take a look at the table below to understand which type of medical insurance is best for anaemia:

Note: The above-mentioned details vary depending on the health insurance policy.

For someone with mild to moderate anaemia, or severe anaemia that requires hospitalisation, health insurance plans or family health insurance plans are the best option. However, if you are at high risk of aplastic anaemia, critical illness cover can be added for additional layers of protection.

What is Covered by Health Insurance for Anaemia?

Here are the medical expenses covered under health insurance for anaemia:

• In-patient hospitalisation, such as intravenous fluids, blood transfusion
• Modern treatment such as stem cell therapy or bone marrow transplant
• Day care procedures
• OPD charges
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• In-patient diagnostic tests
• Ambulance charges
• Hospital daily cash

Note: Coverage depends on the health insurance policy you opt for anaemia.

What is Not Covered by Health Insurance for Anaemia?

The following expenses are not covered by health insurance for anaemia:

• Unproven or experimental treatments that are not recognised under standard medical protocols
• Managing anaemia through diet or oral supplements without clinical hospitalisation
• Hereditary or congenital variants of anaemia

Note: Exclusions in a mediclaim policy depend entirely on the severity and stage of anaemia and when it was diagnosed.

Benefits of Buying Health Insurance for Anaemia

Here is why buying health insurance for anaemia is beneficial:

1. Diagnostic Test Reimbursement

   One of the major costs of anaemia treatment involves diagnostic tests. Tracking red blood cell count, hemoglobin levels, and underlying bone marrow health requires frequent blood tests, which increases the treatment costs. However, when these tests are covered by your health insurance, your out-of-pocket expenses are reduced.

2. Lump Sum Payouts

   For severe anaemia such as aplastic anaemia, critical illness insurance is beneficial as it offers a lump sum payout. You can use the amount to cover your treatment costs or utilise it to compensate for loss of employment due to long-term treatment.

3. Modern Treatment Coverage

   Chronic and severe anaemia, including hemolytic anaemia and sickle cell anaemia, requires modern treatment. These usually include specialised therapies, including stem cell therapies or bone marrow transplant, which increase the treatment cost to ₹40 lakh. With health insurance plans, your modern treatment costs are covered by the insurance company, lowering your financial burden.

Why Should You Buy Health Insurance for Anaemia Before Diagnosis?

Buying health insurance before an anaemia diagnosis can help you avoid serving a longer waiting period for coverage.

If severe forms of anaemia are diagnosed before purchasing a policy, they are considered pre-existing condition. As per IRDAI guidelines, pre-existing diseases may have a waiting period of up to 3 years. During this period, you cannot file claims for treatments related to the condition.

But if you purchase health insurance before getting diagnosed, you will be able to submit claims for hospitalisation and modern treatment, and the insurer will settle the claim with a low risk of rejection.

Moreover, if you buy a mediclaim policy before diagnosis, your premiums are also lower as you are a low-risk applicant for the insurer.

Can You Buy Health Insurance After Being Diagnosed with Anaemia?

Yes, you can buy health insurance after being diagnosed with anaemia. However, the severe forms of anaemia will be treated as a pre-existing disease (PED), which impacts policy coverage.

Not only does it increase the waiting period to up to 3 years, but it also affects your premium rates. Usually, individuals who have anaemia as a PED have to pay higher premium rates. This is because they are considered a high-risk applicant who is more likely to file a claim. Once the insurer evaluates your medical history, test reports and severity, your premium rate is decided.

Moreover, acquired anaemia caused by nutritional or iron deficiency is generally covered under standard health insurance, subject to a waiting period. However, hereditary or congenital blood disorders may require specialised plan requirements for coverage, based on your policy inclusions.

How to Choose the Best Health Insurance for Anaemia?

Here are a few ways to choose the best health insurance for anaemia:

• Sum Insured: For chronic and severe anaemia, you might need a higher sum insured of up to ₹50 lakh.
• Day Care Procedure Coverage: Opt for a mediclaim policy that provides coverage for day care procedures, including IV iron and blood transfusion.
• Coverage for Modern Treatment: Choose a medical insurance that covers the cost of modern treatment, including bone marrow transplant and stem cell therapy.
• Shorter Waiting Period: Make sure to choose a health insurance plan for anaemia that comes with a shorter waiting period or an option to reduce it.
• OPD Cover: Get an OPD cover as mild to moderate anaemia relies heavily on diagnostic tests and outpatient consultations.
• Cashless Treatment: Check whether your health insurance policy covers multi-speciality hospitals near your residence and offers cashless treatment facility for emergencies.
• Sub-Limits and Co-Pay: Opt for a plan that offers no sub-limits on room rent or zero co-pay.
• Organ Donor Expenses: Make sure your medical insurance covers eligible organ donor hospitalisation expenses.
• Pre and Post-Hospitalisation: Choose a health insurance policy that covers medical expenses incurred before hospital admission and after discharge.
• Critical Illness Benefit: If you are opting for a critical illness insurance, check the survival period, payout process, and renewal conditions.