Health Insurance for Omicron COVID Variant

The recent surge in COVID-19 cases in South Africa has raised concerns from all over the world. A new variant of the coronavirus – Omicron - is said to be the reason behind the sudden rise in cases. This raises doubts over the efficacy of COVID-19 vaccines on the new omicron variant. While the omicron virus has already spread to more than 150 countries so far, the world is struggling to stop the transmission of this potentially highly infectious variant of coronavirus.

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    Omicron Cases in India and World

    As of 27th January 2022, India has detected about 4,03,71,500 cases of COVID-19 in the country. Amongst these, about 4,91,700 people have lost their lives due to the disease. Moreover, over 10,050 omicron India cases have been reported so far.

    On the other hand, more than 5,50,000 cases of the omicron variant have been reported by over 150 countries across the world as of 10th January 2022. Besides South Africa, the omicron virus has spread to Australia, Canada, the United States, France, Japan, the United Kingdom, Italy, Spain, Germany and Denmark amongst others. As of 27th January 2022, the total tally of global coronavirus cases is 36,25,23,525 while more than 56,26,879 people have lost their lives.

    What is Omicron?

    Omicron is the new variant of SARS-CoV-2 or coronavirus, which has more than 30 mutations on its spike protein. Also known as B.1.1.529, this variant was first identified in South Africa on 22 November 2021. This heavily mutated COVID variant is being considered more contagious than even the Delta variant as it contains more than twice the mutations. In fact, the COVID-19 cases in South Africa have increased up to four times over the last two weeks due to the new omicron virus. On 26th November 2021, the World Health Organisation (WHO) declared ‘omicron’ as a coronavirus variant of concern.

    The omicron symptoms are mostly the same as the other coronavirus variants except for scratchy throat and extreme tiredness irrespective of the patient’s age. Besides, people diagnosed with the omicron virus do not complain of loss of taste or smell. Moreover, most omicron COVID positive people have recovered without the need for hospitalization as no major drop in oxygen saturation levels have been reported.

    However, the omicron variant of COVID-19 has been discovered recently and thus, the details on the severity, transmission and impact of this variant on the COVID-19 tests, treatments and vaccines will unfold in the coming weeks. Keeping the devastation by the second COVID-19 wave in mind, it is wise to stay prepared for sudden medical emergencies due to the omicron variant by buying a health insurance policy.

    Health Insurance for Omicron COVID Variant

    Health insurance for the omicron COVID variant covers the treatment expenses resulting from getting diagnosed with the omicron variant of coronavirus. It refers to the coronavirus health insurance plan that provides financial aid to pay for the medical expenses incurred on hospitalization or home treatment in case the insured is diagnosed positive with the omicron virus. Since omicron is a COVID variant, it is covered by all health insurance plans available in India just like coronavirus.

    A health insurance policy for the omicron variant provides comprehensive coverage to the insured once the initial waiting period is over. Also, it will cover the treatment cost of the omicron virus immediately as coronavirus is not a pre-existing disease.

    Key Benefits of Health Insurance for Omicron COVID Variant

    Take a look at the benefits of buying a health insurance policy covering COVID-19 variants, including omicron below:

    • Hospitalization Expenses – It covers the insured against any medical expenses incurred on hospitalization due to testing positive for the omicron virus.
    • Home Treatment Expenses – It pays for the medical expenses incurred on availing treatment for the omicron variant at home as long as it has been advised by a doctor.
    • Consumables Expenses – It covers the cost of consumables, such as masks, gloves, PPE kits, oxygen, etc., used during the treatment of the omicron COVID variant.
    • Cashless Hospitalization Facilities –It allows the insured to avail cashless hospitalization facilities for the treatment of omicron virus at a wide network of hospitals affiliated to the insurance provider.  
    • Co-payment – It usually does not come with any co-payment based on the age of the insured at the time of claim settlement as in the case of COVID health insurance plans.
    • Add-on Covers – A few add-on covers can be used to enhance the policy coverage against the omicron virus under this policy on the payment of an additional premium amount.

    Is Omicron Covered under the Existing Health Insurance Policy?

    Yes. All existing health insurance plans in India will cover the expenses incurred on the treatment of the omicron virus because omicron is a variant of coronavirus and not a new disease. As per the direction of the Insurance Regulatory & Development Authority of India (IRDAI), all existing health insurance plans are liable to provide coverage for COVID-19 irrespective of its variant as it is an infectious disease. Therefore, all plans offering coverage for COVID-19 will automatically cover the treatment cost for the omicron variant.

    If a person owns a health insurance policy before getting diagnosed with the omicron virus, the insurance company will pay for all his/her treatment expenses. On the contrary, if a person does not have an existing health insurance plan and purchases it after testing positive for the omicron variant, then his/her policy will not cover the resultant treatment cost.

    Moreover, no additional waiting periods are applicable to avail the coverage for omicron treatment costs under existing health insurance plans. But if someone is diagnosed with the omicron variant of coronavirus during the initial waiting period of their health insurance plan, then the medical expenses incurred on the treatment will not be covered.

    Inclusions of Health Insurance for Omicron COVID Variant

    Some of the most common coverage offered by a health insurance plan for the omicron COVID variant are as follows:

    • In-patient Hospitalization Expenses
    • Home Treatment Expenses
    • Road Ambulance Expenses
    • Pre-hospitalization Expenses
    • Post-hospitalization Expenses
    • Day Care Procedures
    • Organ Donor Expenses
    • AYUSH Treatment
    • Critical Illness Hospitalization
    • Recovery Benefit
    • Daily Hospital Cash
    • Maternity Benefit (Can be an add-on cover)

    Exclusions of Health Insurance for Omicron COVID Variant

    Certain medical expenses incurred during the treatment of the omicron COVID variant will not be covered by insurance companies. Check out the expenses excluded under health insurance for the omicron variant below:

    • Quarantine Expenses at a Non-recognized Centre – It does not cover any medical expenses incurred on the institutional quarantine undertaken at a non-recognized quarantine centre after testing positive with the omicron virus.
    • Home Quarantine Expenses – Any medical expenses incurred by the insured on home quarantine due to the omicron variant will not be covered.
    • Omicron Positive Test Conducted at an Unauthorized Centre – It will not cover the treatment expenses if the omicron COVID positive test was conducted from an unauthorized diagnostic centre.
    • Hospitalization Without the Advice of a Doctor – If the insured gets admitted to a hospital for omicron treatment without any doctor’s recommendation, then resultant hospitalization expenses will not be covered.
    • Travelling to Restricted Countries – It does not cover any treatment expenses if the insured gets diagnosed with omicron virus while travelling to a restricted country despite the travel ban.
    • Unproven Treatment – It will not pay for the cost of availing any unproven treatments taken to cure the omicron virus.
    • Dietary Supplements – This policy will not pay for the expenses incurred on the dietary supplements purchased to boost the immunity against the omicron COVID variant.

    How to Claim Health Insurance for Omicron?

    There are two ways to claim a health insurance policy covering the omicron variant of coronavirus. Take a look at them below:

    1. Cashless Claims – Under cashless claims, the insured will not have to pay for the hospitalization expenses resulting from testing positive for the omicron COVID variant if admitted to a network hospital of his/her insurance company. This is because the insurance company will directly settle the bill amount with the network hospital. The insured only has to fulfil a few formalities to avail cashless claim benefits.

    All health insurance companies come with a network of affiliated hospitals where cashless claims can be raised. The list of network hospitals can be found on as well as the website of the insurance company.

    2. Reimbursement Claims – Reimbursement claims can be raised if the insured receives treatment for the omicron strain of the coronavirus at a non-network hospital. In this case, the insured will be required to pay the entire hospital bill at the time of getting discharged and later raise a reimbursement claim with the insurance provider. Once all the required documents have been submitted, the insurer will verify them and pay the claim amount.

    Precautions to Stay Safe from the Omicron COVID Variant

    Take the following precautions to stay safe from the new omicron variant of the coronavirus:

    • Get fully vaccinated against COVID-19
    • Wear masks when stepping outside the house
    • Maintain social distancing
    • Wash your hands with soap and water or sanitize them regularly
    • Gather at well-ventilated places
    • Sanitize frequently-touched surfaces often

    Health Insurance for Omicron COVID Variant - FAQs

    Written By: PolicyBazaar

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