Diseases Covered Under Health Insurance

With medical debts becoming a major reason for poverty in India, health insurance offers a reliable solution to avoid emergency medical expenses. If you're considering buying a health plan, take a look at the list of diseases covered under most health insurance policies in India.

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    What are the Diseases Covered by Health Insurance?

    The list of diseases covered under your health insurance policy will vary from insurer to insurer and the type of plan, whether it is a mediclaim policy, individual health insurance plan or senior citizen health insurance. The following diseases are usually covered under major health insurance plans in India:

    High Blood Pressure

    Also called hypertension, high BP is a serious condition that can lead to lethal health conditions like stroke, heart attack and other cardiac diseases. The treatment consists of prolonged medication or surgery, which is a considerable financial burden for many people and their families. Most health plans cover the treatment expenses for high BP and the complications caused directly.


    Cataract surgery is among the most common surgical procedures in India, with over 14 million surgeries conducted annually. The surgery can cost anywhere between 15,000 and Rs. 1 lakh depending on the procedure and complication. Most health insurance plans cover cataracts after an initial waiting period.

    Heart Diseases

    The heart is among the most important and tricky organs of our body. Cardiovascular diseases hamper the normal function of your heart and affect the whole body, which can often be fatal. Most medical insurance plans in India cover several medical expenses for heart diseases including cardiomyopathy, refractory heart failure, etc. Many policies also cover cardiac health checkups.


    Cancer is a deadly disease threatening many people. Medical advancements have improved the chances of recovery from many types of cancer but the cost of these treatments continue to skyrocket. Luckily, several types of cancer and their treatment expenses are covered by many health insurance plans. Coverage can range from hospitalisation, chemotherapy, medication and other procedures as per the policy terms.


    As per the International Diabetes Federation, India had ~72.9 million diabetic patients in 2017. A silent killer, diabetes is a lifestyle disease that affects the whole body. It can lead to fatal conditions like damage to blood vessels, strokes, kidney failure, and problems with eyes, nerves, feet etc., leading to several chronic disorders and premature deaths. It is covered by several insurers in India.


    Who hasn't been affected by the coronavirus? COVID-19 is an extremely contagious disease caused by the SARS-CoV-2 virus. The effects can range from mild flu-like symptoms to life-threatening conditions including pneumonia, multiple organ failure and more. Many plans offer coverage for hospitalisation, and other medical expenses if you get infected with the coronavirus.


    People suffering due to HIV/AIDS have to live with a compromised immune system and are prone to several issues. Treating it can burn a hole in any middle-class Indian's pocket. Luckily, many insurance plans in India provide financial support for the treatment of HIV/AIDS. Hospitalisation expenses, treatment costs, day care treatment and several other expenses are covered under different comprehensive health insurance plans.

    Critical Illnesses

    There are special health insurance plans to cover the high expenditure risks in case of critical disease. These diseases are not only life-threatening but also extremely time and money consuming.

    Many lifestyle and genetic conditions have increased the probability of such risks and cost tremendously. Opting for a critical illness health insurance plan is an affordable way to cover a variety of serious diseases such as cancer, multiple sclerosis, Parkinson's disease, paralysis, myocardial infarction etc.

    What are the Diseases Not Covered by Health Insurance?

    With so many health insurance companies in India, you can opt for any policy depending on your needs. However, there are certain cases and diseases that aren’t covered by health insurance plans. Some of these are listed below:

    • Cosmetic surgery, unless for reconstruction purposes
    • Health issues caused by consumption of alcohol, drugs etc.
    • Infertility treatments such as IVF
    • Self-inflicted injuries
    • Pre-existing illnesses, unless the insurer provides coverage through additional premium or add-ons

    Wrapping it Up,

    As per a study, around 80% of the medical costs in India are paid out of pocket. Lack of financial backup or sufficient funds often proves fatal to the patient. This plunges 4 to 6 crore Indians into poverty due to healthcare debts every year. Having a comprehensive health insurance plan will secure people from such financial catastrophes, loss of income, the demise of the earning member. The plans can be purchased at a nominal premium and offer protection against medical emergencies.

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

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