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Is Corona Virus Covered by your Health Insurance Policy?

The outbreak of Coronavirus has been in the news for a while now. With the virus making an entry into India, it has become a matter of great concern for our vastly populated nation. There have been outbreaks of many deadly viruses earlier in the world such as Zika, Ebola, MERS, Nipah, and now COVID 19 Coronavirus. With the increasing cases in Mainland China and around the world, India also needs to be prepared. It is reported that the symptoms of Coronavirus infection are similar to common cold, sore throat, fever, which can lead to pneumonia in severe cases. Being a new strain of infection there is no vaccination or cure available as of now. The 2019-nCoV virus has been fatal largely in the case of people above the age of 60 years and those who had pre-medical conditions.

Though it is not vastly spread in India, it is important to be prepared in advance. And if you are covered under a health insurance policy, the question that arises is that if the Noval Coronavirus falls under the ambit of medical insurance coverage in India or not?

Coverage under Health Insurance

A health insurance policy is designed to cover hospitalization expenses of the insured person irrespective of the disease that is diagnosed (unless it is a critical illness that is not covered). Usually, all the health insurance plans cover hospitalization expenses incurred on the treatment of such infections and the Coronavirus is one such viral infection. A comprehensive health insurance policy (that is not disease specific) pays off hospitalization expenses including in-patient and out-patient expenses, irrespective of the disease that is diagnosed.  And the coverage will be available from day one of the infection in all the health insurance policies.

And because a new infection like Coronavirus does not come under the category of pre-existing illness it should be covered by your basic health insurance policy. Thus, your basic health plan should compensate for expenses incurred on pre-hospitalization, post-hospitalization, in-patient treatment, OPD and ambulance expenses should you seek treatment for COVID 19 Coronavirus. Recently, digit health insurance launched a coronavirus specific health insurance product.

How to Claim Health Insurance for Coronavirus?

There are two ways of filing a health insurance claim - reimbursement and cashless (where the insurer settles the payment directly with the network hospital).

Nowadays most health insurers provide cashless treatment. It does not require the policyholder to make the payment and then file the reimbursement. If the treatment is taken in a network hospital then the hospital claims can be cashless.  

One thing to note is that not every health insurance scheme offers cashless coverage, and the facility is only available in the insurer specific network hospitals.  Also, a cashless claim settlement might not be available for OPD expenses. However, there are health plans that provide cashless OPD coverage too.  You can always check the list of network hospitals on the policy wordings and the insurer’s site.

And if you take treatment of coronavirus in a non-network hospital, you will have to pay the entire treatment cost. Then fill the reimbursement form and claim for it. But before that, it is important to focus on hygiene and follow the advisory that is issued to contain the spread of Noval Coronavirus in India.

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