Coronavirus Health Insurance

The outbreak of the novel Coronavirus (COVID-19) has been in the news for months now. With the latest figures shared by the World Health Organization (WHO) currently, the confirmed cases across the globe are 144,481,916 and have taken away 3,072,592 lives so far (as on April 22, 2021). 

Currently, in India, as on April 22 2021, there are 2,291,428 Active cases of Coronavirus (COVID-19). It has become a matter of great concern for our vastly populated nation. About 13,454,880 coronavirus patients have been discharged and cured in the country. The total number of people vaccinated till date is 13, 23,30,644.  

Though it has not spread in India as widely as most developed nations, such as Europe and the USA, it is important to be prepared for any unfavorable 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?

What is Coronavirus?

Novel Coronavirus (COVID-19) 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.

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.

What is Coronavirus Health Insurance?

Coronavirus Health Insurance refers to an insurance policy that covers the medical expenses incurred on the treatment of COVID-19. A coronavirus health insurance policy is designed to cover hospitalization expenses of the policy holder, 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 pre & post hospitalization expenses including in-patient and out-patient expenses, incurred on the treatment of COVID-19.

Health insurance for coronavirus 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.

Key Benefits of Coronavirus (COVID-19) Health Insurance

Some of the major benefits of Coronavirus Health Insurance are listed below:

Types of Coronavirus Health Insurance in India

If you are looking for a specific health insurance cover for coronavirus (COVID-19) then you can consider standard health insurance policy that cover all medical expenses incurred during the treatment of COVID-19. These are two standard products that have been recently launched as per the IRDAI guidelines. And the policy terms remain the same across all the health and general insurance companies in India. Checkout out both COVID-19 health insurance plans types along with the policy benefits:

• Corona Kavach Policy : COVID-19 Insurance Policy

  Corona Kavach Policy is a standard coronavirus health insurance policy that covers hospitalization expenses, home care treatment cost, ambulance charges, cost of PPE kits, medicines, gloves, masks, doctor fees, ICU charges incurred during the treatment of COVID-19 pandemic. The sum insured amount starts from Rs 50,000 and goes up to Rs 5 Lakh. You can get your family covered under this plan that also pays for Ayush treatment in India.

• Corona Rakshak Policy : COVID-19 Insurance Plan

  Corona Rakshak Policy is also a COVID-19 specific health insurance policy that pays for hospitalization of a minimum of 72 hours and more as required for COVID-19 treatment in India. The policy covers expenses incurred towards PPE’s, nebulizers, masks, oxygen cylinders, gloves, oximeters, AYUSH treatment, etc. that are limited under a regular medical insurance policy. This COVID-19 insurance policy is available to individuals between the age group of 18-65 years on an individual sum insured basis that ranges from Rs 2.5 lakh to Rs 5 Lakh. Applicants with co-morbidity can also get insured paying an additional premium.

• Coronavirus Group Health Insurance

  If you are covered under a group health insurance policy, then you need to check with your insurer if it covers coronavirus treatment expenses. However, if your group health insurance policy is either Corona Rakshak or corona Kavach then you are surely covered for the COVID-19 hospitalization in India.

Health Insurance for Coronavirus (COVID-19) in India

Since the outbreak of coronavirus, many insurers have been offering Covid-19 Health Insurance cover in their base plans. They are also providing specific Covid-19 Insurance Plans, Corona Kavach and Corona Rakshak are two such indemnity and benefit based plans that have been popular with people in India. All the hospitalization expenses, Ayush treatment expenses, and home treatment expenses are covered along with the cost of consumable items in these two mediclaim policies for coronavirus. 

Disclaimer : *Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

Is Coronavirus Covered Under Your Existing Health Insurance Policy?

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.

Coronavirus Health Insurance Inclusions

The following table shows the list of inclusions under coronavirus health insurance:

Coronavirus Health Insurance Exclusions

Not all medical expenses are covered under your coronavirus (COVID-19) health insurance policy. Take a look at the list of exclusions under your coronavirus insurance:

• Home Quarantine – This policy does not cover any expenses that you incur while staying in quarantine at your home
• Non-recognized Quarantine Centre – If you quarantine at a non-recognized centre for coronavirus treatment, the medical expenses incurred will not be covered under your policy
• Pre-Existing Diseases – Any medical expenses incurred on the treatment of any pre-existing diseases will not be covered under this policy unless the waiting period gets over
• Pre-Natal & Post-Natal Expenses – This policy will not cover any pre-natal or post-natal expenses incurred by the insured unless it leads to his hospitalization.
• Hospitalization without Doctor’s Recommendation – If you get hospitalized without the recommendation of a qualified doctor (as mentioned on a prescription), then this policy will not cover the hospitalization expenses arising out of it

Difference between Social Distancing | Self-Isolation | Quarantine

How to Claim Health Insurance for Coronavirus (COVID-19)?

There are two ways of filing a health insurance claim for Coronavirus disease. The claim settlement process for Coronavirus health insurance & the other health insurance policy like Arogya Sanjeevani Policy is almost same. 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:

• Cashless Claims

  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 (COVID-19) 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

  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.

Important Facts on Coronavirus Insurance Cover

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 which covers COVID-19:

• Sum Insured: Coronavirus has claimed several lives across the world and thousands of people have been critically ill due to contracting the disease. Since COVID-19 can lead to severe respiratory illness and impacts overall body functioning, its treatment can get very expensive especially for people with underlying diseases. Therefore, it is advisable to opt for a higher sum insured amount for your coronavirus health plan so that you are appropriately covered for any circumstance.
• Coverage: It is important to carefully go through the coverage provided by the COVID-19 health insurance before you choose a plan. Most policies offer coverage for in-hospitalization expenses, post-hospitalization care, ICU charges, OPD charges, ambulance charges, etc.
• Waiting Period: While buying health insurance for coronavirus, it is important to check the in-built waiting periods under the policy. Almost all health insurance plans come with a waiting period of the first 30 days. However, some insurance providers, such as Star Health & Allied Insurance, is offering 16 days waiting period only under their Star novel coronavirus health insurance policy. And the waiting period in Corona Kavach and Corona Rakshak policy is 15 days. During this period, none of the claims filed by you will be covered under the policy. Thus, make sure to check the initial waiting period that your coronavirus insurance comes with before buying.

FAQs About COVID 19 Health Insurance Policy in India

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