The outbreak of Coronavirus has been in the news for months now. More than 19 million people around the world have tested positive of this disease that has claimed over 1 million lives so far (as on 14th April 2020). With more than 10,000 people in India testing positive with the disease (as on 14th April 2020), it has become a matter of great concern for our vastly populated nation. There have been outbreaks of many deadly viruses in the past, such as Zika, Ebola, MERS, Nipah, etc, But the novel Coronavirus disease (COVID-19) has brought the whole world to a standstill with several countries under lockdown, including India.
Though it has not spread in India as widely as most developed nations, such as China, Italy and the USA, it is important to be prepared for any unfavourable circumstance in advance. But if you have a health insurance policy, the question is if the novel Coronavirus disease falls under the ambit of medical insurance coverage in India or not?
Coronavirus is a group of virus that attacks the immunity of a human being causing diseases ranging from the common cold to Severe Acute Respiratory Syndrome or SARS. In late December 2019, a new strain of coronavirus originated in China, which was unknown to humans before. It came to be known as the novel Coronavirus disease or COVID-19. Ever since the disease has spread across the globe killing over 1 million people (As on 14th April 2020).
The coronavirus disease causes infection in the nose, upper throat and sinuses. In severe cases, the virus can lead to major respiratory illnesses such as pneumonia, kidney failure as well as multiple organ failure. Therefore, the 2019-nCoV or the novel coronavirus disease has been fatal largely for people above the age of 60 years and those who had pre-medical conditions.
The symptoms of Coronavirus infection are similar to those of regular flu that includes sore throat, fever, dry cough, runny nose and sometimes a headache. Being a new strain of the coronavirus, there is no vaccination or guaranteed cure available as of now.
Coronavirus Health Insurance refers to a health insurance policy that covers the medical expenses incurred on the treatment of COVID-19. A health insurance policy is designed to cover hospitalization expenses of the insured person, irrespective of the disease that he has been diagnosed with (unless it is a critical illness that is not covered). Almost all the health insurance plans cover hospitalization expenses incurred on the treatment of viral infections. Since Coronavirus is a viral infection, a comprehensive health insurance policy pays off hospitalization expenses including in-patient and out-patient expenses, incurred on the treatment of COVID-19.
The Coronavirus health insurance cover will be available from the day the insured gets diagnosed with the disease. This is because COVID-19 is a new disease and therefore, does not come under the category of pre-existing illness.
The following table shows the list of inclusions under coronavirus health insurance:
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Not all medical expenses are covered under your coronavirus mediclaim insurance policy. Take a look at the list of exclusions under your coronavirus insurance:
There are two ways of filing a health insurance claim for Coronavirus disease. You can file a cashless claim or a reimbursement claim. Let us read in detail about both types of claims for coronavirus health insurance cover:
Most health insurance providers today provide cashless treatment facility. As part of this facility, the insured is not required to make any payment for the treatment taken at one of the network hospitals of the insurer. Instead, the insurance company settles the treatment bills directly with the hospital.
So if you receive treatment for coronavirus disease at a network hospital of your insurance provider, you will be able to avail cashless treatment facility and would not be required to make any payment for the treatment received.
Make sure to check if your health insurance for coronavirus offers cashless claim facility. You can find the list of network hospitals of your insurer on the policy wordings or at the official website of your insurance provider.
Reimbursement claims are meant for policyholders who get hospitalized and receive treatment at a non-network hospital of his insurance provider. If you obtain treatment for COVID-19 at a non-network hospital of your insurer, you will be required to pay all the hospital bills in full at the time of your discharge.
Once you get discharged, you need to file a reimbursement claim with your insurance provider. To do so, you’ll have to fill up the reimbursement claim form and submit the required documents including the hospital bill payment receipts, investigation & test reports and doctor’s prescription to the insurer within the specified time limit.
The insurance company will verify your claim and post that the reimbursement amount will be transferred to your bank account.
Coronavirus diseases or COVID-19 may be newly discovered disease. But all existing health insurance policies will provide coronavirus health insurance cover. This means that if you purchased a health insurance policy before testing positive for the coronavirus disease, any medical expenses incurred on its treatment will be covered under it (provided you don’t get diagnosed during the initial waiting period).
Since the coronavirus is not a pre-existing ailment, it will be covered as part of the basic hospitalization expenses under a health insurance plan that includes in-patient hospitalization expenses, ICU charges and diagnostic test charges amongst others.
However, if you don’t already have a health insurance policy and decide to buy one after testing positive for COVID-19, then coronavirus treatment expenses will not be covered under the policy.
Before you buy a coronavirus insurance India is offering, you should be aware of a few facts related to the policy. Here are some important facts that you should know before buying a coronavirus health insurance cover:
In a recent hearing on May 15, 2020, the Indian Government told the Bombay High Court to extend the health insurance coverage offered under Pradhan Mantri Garib Kamgar Package, to essential services, civic workers working in contract, and people who may encounter Coronavirus positive patients. The scheme offers coverage of Rs 50-lakh to Health Workers.
This health insurance scheme will cover every person on Covid-19 duty, who get infected from other COVID positive patients. This scheme shall benefit all the frontline healthcare workers in both public and private establishments and for both contractual and permanent employees. It also offers death cover. Therefore, the scheme will also cover eligible contract employees of NMMC.