Does Health Insurance Cover Zika virus Treatment?

Zika Virus Cover in Health Insurance

Despite the lockdown, the increasing number of infection cases has put a lot of people confused regarding the coverage of the healthcare expenses incurred on the treatment of this new Zika virus.  

Let's discuss how your health insurance policy will cover Zika virus hospitalization costs and what are the things that you need to be aware of:

Health Insurance Covers Zika virus hospitalization expenses

Yes, your health insurance policy offers protection against the Zika virus.

All the health insurance plans are designed to cover hospitalization expenses incurred on all kinds of illnesses and diseases unless it is a disease-specific plan. Nowadays a health insurance policy should cover both hospitalization expenses and out-patient expenses regardless of the illness.

To ease you up, all the health plans in general cover all kinds of infections that lead to an illness, and the Zika virus is also a kind of infection-borne illness, so it is covered by almost every insurer.

Where does Zika virus infection come from?

Zika virus name comes from the Zika Forest in Uganda in 1947. The first case of Zika virus was detected in 1953, and since then the outbreaks of Zika were reported in several regions around the world such as Southeast Asia, tropical Africa, and now in Kerala, India cases have been reported and the numbers are rising.

Will Zika virus be considered as a Pre-existing Illness?

Zika virus disease is mainly spread by mosquitoes; usually, it is a very mild infection and does not harm much. But it can cause serious illness in pregnant women, as it can lead to birth defects especially abnormally small heads (microcephaly).

It is another common doubt that concerns people if Zika virus will be considered as a pre-existing illness as it takes a few days to show the symptoms. But health insurance companies do not have a reason to reject Zika virus related claims in case it requires hospitalization.

Zika virus health insurance policy shall cover pre-hospitalization expenses, post-hospitalization expenses, OPD expenses, ambulance charges, etc. depending on your policy sum insured and the plan that you have purchased.

5 Things to Keep in Mind Regarding Zika Virus Health Insurance

Almost every health insurance company is offering coverage to the policyholders in the existing policy. Specifically designed health plans will offer a quick solution to people with no health coverage who are seeking protection against Zika virus.

Let's check out some of the important conditions regarding Zika virus health insurance coverage: 

• Almost all the general insurance providers in India offer coverage for Zika virus treatment
• The sum insured amount for Zika health insurance plans can vary from one insurance provider to another and one health insurance plan to another
• The policy term is one year only and is renewable just like a normal health plan
• All the Indian residents can avail of the coverage benefits, however, the benefits, and clauses regarding age criterion, travel history will be policy specific only.  
• Moreover, you can consider buying specific health insurance plans for vector-borne diseases including dengue, malaria, and Zika virus

Important Zika Virus Medical Insurance Measures 

To counter the outbreak of Zika virus in our country, several health insurers in India have ramped up telemedical services with intermediaries like Policybazaar health insurance comparison portal. This will involve examining customer applications along with doctor consultations over the telephone.

While the fear of COVID-19 looms, this would ensure that people can function without visiting the doctor in person and waiting in the queue. In fact, the doctors would be able to establish communication with the patients over a call and suggest a treatment based on the medical history, symptoms and this goes for both health and term insurance. 

The move will ensure that people can stay at home during such times. But the insurer can reject the claim in case of false claims or information and customers during a period when citizens have been advised to stay at home as much as possible. However, insurers hold the right to decline claims if customer disclosures are found incorrect.

Filing Hospitalization Claim for Zika Virus Treatment

Claims are an important part of health Insurance. And if you are wondering how to file a medical insurance claim for Zika virus treatment then this might be of some help:

Cashless Medical Treatment

If you have a health insurance policy you can seek cashless treatment by showcasing your health card in one of the network hospitals that are mentioned in your policy wordings. You can also check the list online on the insurer's site provider's network hospitals.

So, if you want to avail cashless treatment you can inform your insurer and mention the hospital where the treatment is undergoing. You need not pay the hospital bills; the insurer will settle the bill on completion of the paperwork. However, the compensation will be limited to the sum assured. And any additional costs such as medical masks, and non-medical expenses, need to be paid on your own.

Reimbursement Claim

If you seek treatment in a non-network then you can claim for reimbursement of the medical expenses. You also need to inform your insurance provider about your plan to seek medical treatment before filing the claim. On completion of the treatment, you claim the insurer for reimbursement. It requires you to submit all the reports, documents, bills, and then claim for reimbursement.

Usually, the claims are settled in a week or so, but it is better that you check with your insurance provider regarding the claim settlement period for Zika virus claims.

Over to You

We know these are trying times, but if you take precautions, and maintain hygiene you can prevent the spread of Zika virus. However, if you don't have health insurance you can buy it now as well. And if you already have one you can check with your insurance provider for the coverage benefits and procedures.