Health Insurance for a Down Syndrome Child in India

Down Syndrome is one of the most common genetic disorders in India. Every year, about 23,000 to 29,000 children are born with Down Syndrome in our country. No wonder a lot of expecting parents want to know about health insurance for a Down Syndrome child in India. In this article, let’s know everything about Down Syndrome and if it is covered under health insurance.

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    What is Down Syndrome?

    Down Syndrome refers to a genetic disorder in which a baby is born with an extra copy of chromosome 21. It is caused due to abnormal cell division among unborn babies while they are still in their mother’s womb. The presence of this extra chromosome leads to physical abnormalities and delays in intellectual development in the baby.

    Down Syndrome cannot be cured and thus, is a lifelong condition. Moreover, people with Down Syndrome have more chances of developing health issues like congenital heart defects, leukaemia, Alzheimer’s, sleep apnea, immune disorders, gastrointestinal defects, obesity, vision problems, etc.

    Symptoms of Down Syndrome

    Down Syndrome symptoms comprise of the following distinct physical features:

    • Flattened face
    • Short neck
    • Small head & ears
    • Poor muscle tone
    • Small hands & feet
    • Tiny white spots on the iris of the eyes
    • Short stature
    • Bulging/protruding tongue
    • Eyes that slant upward
    • Loose joints

    Children suffering from Down Syndrome also suffer from a delay in learning and behavioural development, such as:

    • Poor judgement
    • Delay in speech & language development
    • Impulsive behaviour
    • Short attention span
    • Delayed toilet training
    • Sleep difficulties

    Is Down Syndrome Covered by Health Insurance Plans in India?


    Health insurance plans in India do not provide coverage for Down Syndrome. There is no medical insurance for a Down Syndrome child in India. This is because Down Syndrome is a type of external congenital disease and as per IRDAI guidelines, external congenital diseases are a permanent exclusion.

    Although, the cost of certain treatments and therapies required to treat the effects of Down Syndrome may be covered under some health insurance plans. For example, if a Down Syndrome child is facing challenges in speaking, speech therapies can be provided. In such a case, the cost of speech therapies may be covered by a few health insurance plans in India.

    Similarly, the treatment cost of leukaemia and Alzheimer’s resulting from Down Syndrome may be covered by some health plans in India. However, it is always better to check with your insurance company if they offer coverage for Down Syndrome or any treatment/therapies used to treat any of its symptoms.

    In case your health insurance policy covers the treatment cost of Down Syndrome, make sure to check the waiting period before raising a claim. This is because Down Syndrome is present from birth and hence, it will be considered as a pre-existing disease. As a result, health insurance plans may cover Down Syndrome after a waiting period.

    7 Facts About Down Syndrome that You Did Not Know

    Take a look at seven facts about Down Syndrome that you must know:

    1. 1 in every 830 children in India is born with Down Syndrome.

    2. In India, Down Syndrome is fatal among children due to a lack of awareness.

    3. The older is the age of the mother, the higher is the baby’s chances of suffering from Down Syndrome.

    4. There is no certain way of preventing Down Syndrome.

    5. People suffering from Down Syndrome are more prone to infections and diseases like Alzheimer’s.

    6. Social awareness and early treatment can increase the life expectancy of a Down Syndrome child to 50-60 years and improve their quality of life.

    7. Chances of developing Down Syndrome in a baby increase if the elder sibling already has it.

    Summing It Up

    Down Syndrome is a lifelong disease that can neither be prevented nor cured. However, the severity of the disorder varies from one child to another. The only thing that you can do is to provide the required treatment and therapy to the child as early as possible. Although medical insurance for a Down Syndrome child in India is not available, you can check with your insurance company if the coverage is available or not.

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

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