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Why Health Insurance Is Crucial to Cover COVID-19 Pandemic?

The outbreak of Coronavirus has been affecting the lives of millions of people worldwide. It has created a life of uncertainty that has restricted the daily movement of a person. As the number of people affected by the virus increase, so do the questions surrounding it. The most common concern that we see among people today is how to protect oneself from the virus and if a health insurance policy is crucial to cover the COVID-19 related medical expenses?

The answer to the former part of the question is social distancing, and the latter part of the question will be discussed in detail in this article.            

What is Coronavirus (COVID-19)?

COVID-19 or Coronavirus is a family of viruses that results in acute respiratory disorders. When a person comes in contact with Coronavirus diseases, he or she may suffer from flu-like symptoms of pneumonia, impaired kidney, difficulty in breathing, and in worst cases, multi-organ failures.

The spread of Coronavirus has resulted in a life of difficulty. Families across the world have been confined to their homes with no jobs and less income. Financial problems are a likely effect of an outbreak. So in times like this having a health insurance policy will definitely come in aid for handling emergency medical bills.

What does a Basic Health Insurance Policy cover and doesn't cover?

A health insurance policy is created to cover the hospitalization charges of the person holding the policy. Let's take note of what a basic health insurance policy covers and doesn't cover.     

Inclusions

  • In-patient and out-patient care
  • Hospitalization charges due to infections and diseases
  • Prescription drugs coverage
  • Pregnancy and Child care
  • Mental health service.

Exclusions

  • Cosmetic procedures
  • Consumable Items like PPE kits, masks, oximeter etc.
  • Off-label drugs
  • Pre-existing illnesses or comorbidities unless specifically mentioned

Is Your Existing Health Insurance Policy Sufficient to Cover COVID -19?

No doubt, existing health insurance policy will cover medical expenses incurred during hospitalization of a person. Basic health insurance policies cover individual medical bills irrespective of diseases that they are suffering with. A health insurance policy is a great investment done by millions of people to aid them in times of emergency.

As mentioned in the earlier part of the article, a basic health insurance policy covers hospitalization expenses for various illnesses including viral infections. COVID-19 being a viral infection will be covered under the health insurance policy. Most insurance companies are providing coverage to policyholders from day one of their diagnoses with Coronavirus disease.

Further, as a Coronavirus disease is new, it doesn't fall under the category of pre-existing diseases. As a result, the COVID-19 viral infection will be covered under the base policy. Under a standard health insurance policy for people suffering from Coronavirus, diseases can claim in-patient expenses incurred on the post and pre-hospitalization, test, and diagnosis.

Even in Arogya Sanjeevani health insurance policy, which a standard product across the industry, COVID-19 cover is also provided at an affordable premium. The sum insured offered under this policy was Rs 5 Lakh earlier, but now there is no limit to it and the insurer can offer a higher coverage amount.

Features of Coronavirus Health Insurance Policy

Amidst the current situation in the world, many health insurance companies have come out with Coronavirus health insurance policy. This policy will cover all people who tested positive for the virus. Star Novel Coronavirus insurance policy, Digit healthcare, and ICICI Lombard's Novel Coronavirus policies are some examples of COVID-19 health insurance policies.

Yet, these plans come with certain conditions to be eligible for a claim. These conditions should be understood before investing in them. Some of the conditions of the policy are discussed in the latter part of the article.

Can I get coverage for COVID -19 by spouse corporate health insurance?

As long as you are covered under your spouse's health insurance policy, you can claim coverage for COVID -19 under the same. The reason behind this is simple COVID-19 being a viral infection that falls under the standard health insurance policy coverage to claim expenses incurred due to hospitalization.

Should you buy Coronavirus Specific Health Insurance Plans?

With millions being affected by COVID-19, the insurance companies have launched special Coronavirus Health Insurance policies as per the IRDAI guidelines. Two special products i.e. Corona Kavach Policy (family floater) and Corona Rakshak policy (individual sum insured) have been launched. These health insurance policies are specially designed to aid COVID-19 patients with their medical bills. Being a standard indemnity based products; the coverage features remain same across the industry.

Both the policies cover the cost of consumable items like PPE kits, masks, ventilators, oximeter, etc. that add to the major cost of the Coronavirus treatment. The policy coverage amount is up to Rs 5 Lakh, and the premium would vary from on insurer to another, which is quite nominal. Learn more about these policies in the next part of the article.

Procedure to Claim Coronavirus (COVID-19) Health Insurance Policy

The policy claims can be made broadly in two types; the patients can opt for cashless settlement from the insurer or apply for a reimbursement.

Before you opt for a method of claim, check your health insurance policy. A major portion of insurance policies will provide for cashless settlements provided the treatment for COVID-19 takes place in a hospital from a list of the insurer hospital network. But note that this approach of claim will not cover OPD expenses. In case the treatment for COVID-19 takes place at a hospital outside the network, then you have to pay for the treatment amount and then file for a reimbursement.           

Under What Circumstance My Health Insurance Policy will not Cover COVID-19?

As stated above, a standard health insurance policy will cover COVID-19. But in the below-mentioned cases, you may not be able to get a claim under the policy.

    • Hospitalized for Less than 24 hours or not Hospitalized

      The main condition for filing a claim under the policy for COVID-19 is staying in the hospital for at least 24 hours. The expenses incurred for the treatment of COVID-19 can be claimed only if the insured person stays in the hospital for a minimum of 24 hours. This is because the most standard health insurance policy doesn't cover OPD. So if you are not hospitalized, the policy will not cover the claim.

    • Planned Treatment will not be Covered

      In case you don't have a pre-existing health insurance policy and are suffering from the symptoms of COVID-19 before buying a policy, one cannot make a claim. A policy buyer prior to four to six weeks of his purchase should be suffering from symptoms of COVID-19 or planning to get treatment. In other words, in cases you already had COVID-19 diseases before purchasing the policy, then you are not eligible to claim medical expenses. This is because a newly bought health insurance policy will not cover previously planned treatments.

      Also, in case a person comes in contact with the COVID -19 diseases during the policy waiting period will not be eligible for a claim.

    • The policyholder or his family recently travelled to affected countries

      A person or his family member traveling from an affected country and tested positive for COVID-19 diseases will be covered under a standard indemnity health insurance policy. However, a Coronavirus health insurance policy will not cover people who travelled to Coronavirus affected countries like China, Thailand, the USA, Hong Kong, Italy, Taiwan, etc.

Bottom Line:

Coronavirus cases have been increasing day by day. Today the virus has reached every corner of the world. Health insurance policy is very important for any family. Millions of people are living in fear of deadly Coronavirus. Yet health insurance policies for Coronavirus are giving them a chance to fight the virus strongly and courageously. All those of you who never thought about health insurance policies consider them now.

Written By: PolicyBazaar - Updated: 07 December 2020
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Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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