Health Insurance for Influenza

What Does Influenza Treatment Cost in India?

Most people get influenza treatment on an outpatient basis. In-patient hospitalisation is required only when influenza causes complications such as pneumonia, acute respiratory distress syndrome (ARDS), or breathing difficulties. These complications significantly increase influenza treatment costs.

Depending on severity, the average cost of influenza treatment ranges from ₹2,000 to ₹5,000 for mild cases and ₹50,000 to ₹2 lakh for severe cases.

Here is a breakdown of various expenses related to influenza treatment in India:

Another important cost to consider during influenza treatment is diagnostic costs. These tests usually increase the overall cost of influenza treatment, especially if they are not covered under medical insurance.

Let us look at some influenza diagnostic test costs:

Note: The costs mentioned above for treatment and diagnostic tests may vary depending on the hospital, city and severity of your condition.

Having medical insurance can help you save on out-of-pocket expenses related to influenza treatment. You can easily avail cashless treatment where your insurer directly settles your medical bills, lowering the financial burden so you can focus on getting better.

Does Medical Insurance Cover Every Stage of Influenza?

Yes, comprehensive health insurance plans cover every stage of influenza treatment. Early-stage or mild influenza is usually treated on an outpatient basis, which involves regular doctor visits, home care medicines and self-treatment. These are covered under your health insurance plan only if you have an OPD benefit.

Severe influenza that causes symptoms to escalate and require in-patient hospitalisation is also covered under medical insurance plans. It provides coverage for room rent, ICU care, oxygen support and ventilators, depending on your policy.

If your influenza leads to complications such as pneumonia, bronchitis, severe dehydration or any other secondary bacterial infection, it will be covered by your health insurance policy.

You can also buy critical illness insurance plans to cover life-threatening complications of severe influenza, such as permanent loss of lung function, subject to the policy terms and conditions.

Which Type of Health Insurance is Best for Influenza?

Comprehensive health insurance plans or family health insurance plans with in-patient hospitalisation and OPD benefit are the best options for influenza.

• Standard mediclaim policies can cover hospitalisation costs for severe flu cases that require more than a 24-hour stay. With outpatient department cover, you can extend your health insurance policy coverage to doctor consultations, diagnostic blood tests, and medicines.
• You can also opt for critical illness insurance plans to cover end-stage lung disease that may be caused by severe influenza. It pays a lump sum amount that you can use for treatment or income replacement.

Let us have a close look at which health insurance is best for influenza:

Note: The above details may vary depending on your health insurance policy for influenza.

What is Covered by Health Insurance for Influenza?

The following expenses are covered under a health insurance plan for influenza:

• In-patient treatment such as room rent, ICU, specialist fees, etc.
• OPD charges
• Pre-hospitalisation expenses
• Post-hospitalisation expenses
• Day care procedures
• In-patient diagnostic tests
• Road ambulance
• Hospital daily cash
• Advanced respiratory care including ventilator and oxygen support
• Teleconsultations

Note: The exact coverage depends on the health insurance policy for influenza and the severity of your condition.

What is Not Covered by Health Insurance for Influenza?

Here is a list of expenses which are not covered by health insurance for influenza:

• Preventive flu shot
• Treatments in hospitals outside India
• Expenses arising out of hospitalisation that are not medically necessary
• Untested and experimental treatments

Note: The exact list of exclusions depends entirely on the health insurance policy you opt for influenza.

Benefits of Buying Health Insurance for Influenza

Buying health insurance provides financial protection against influenza and its highly contagious types such as H1N1 (swine flu) and H3N2. Check out the key benefits of health insurance for influenza:

1. Diagnostic Tests Coverage

   Influenza treatment involves several diagnostic tests to guide targeted antiviral treatment and detect flu from other illnesses like COVID-19. All these test costs are absorbed by your medical insurance while you get optimal medical care.

2. Protects Against Severe Influenza Complications

   Many people with influenza (flu) recover at home or with outpatient consultations with rest and fluids. However, the virus can cause several serious and life-threatening complications, including pneumonia or ARDS, which can increase treatment costs to up to ₹12 lakh. With health insurance plans, you can manage the unexpected financial burden and focus on improving health.

3. Coverage for Intensive Care for Influenza

   Severe complications of influenza that cause acute respiratory distress or respiratory failure require intensive care unit (ICU) monitoring, oxygen therapy and ventilator support. All these combined can skyrocket your influenza treatment cost. If you have health insurance and have completed the waiting period, all these inflated intensive care costs are covered as in-patient costs.

4. Tax Benefits

   Health insurance premiums qualify as a tax deduction (under the old regime) of the Income Tax Act. You can claim a deduction for up to ₹25,000 (or ₹50,000 for senior citizens) under section 80D.

Why Should You Buy Health Insurance for Influenza Before Diagnosis?

Here are reasons why you should buy health insurance before you are diagnosed with influenza:

1. Waiting Period

   Most health insurance plans come with an initial waiting period of 30 days for influenza treatment. Before this waiting period is over, you cannot submit any claim for the treatment. So, it is always recommended to buy a mediclaim policy before influenza is diagnosed so that you can complete the waiting period before you need to file a claim.

2. Lower Premium

   When you buy health insurance before getting diagnosed with influenza or its variants, you are required to pay a lower premium. At this time, you are evaluated as a low-risk applicant because the likelihood of the insurer paying out an immediate claim is low, which directly translates to an affordable premium for you.

Can You Buy Health Insurance After Being Diagnosed with Influenza?

Yes, you can buy medical insurance after being diagnosed with influenza. It is an acute, temporary infection rather than a lifelong chronic condition. So, most insurers do not permanently deny coverage or classify it as a long-term pre-existing disease.

If your influenza has led to severe complications including pneumonia or ARDS, insurers might label secondary conditions as pre-existing diseases (PED). This can limit your coverage and increase your premium rate.

However, you still have to complete the initial waiting period of 30 days before filing a claim for influenza treatment. Once the 30-day window is complete, your in-patient hospitalisation for influenza or any other respiratory disease is covered.

How to Choose the Best Health Insurance for Influenza?

Here are some ways you can choose the best health insurance for influenza treatment:

• Sum Insured: If you are young and healthy, you can go for a sum insured of ₹5 to ₹10 lakh. However, if you have a family history of respiratory disease, opt for a higher coverage of ₹15 lakh to ₹20 lakh.
• Opt for Critical Illness Cover: If you have a medical history of severe respiratory illnesses, opt for critical illness insurance plans to get a lump sum payout.
• Policy Inclusions: Check whether your policy covers influenza treatment, its variants and its severe complications.
• Waiting Period: Opt for a medical insurance plan that offers a lower waiting period or an option to reduce it.
• Diagnostic Cover: Get health insurance with OPD cover to get coverage for diagnostic tests such as doctor visits, medications and others.
• ICU Limits: Select a plan that offers ICU charges, ventilators and oxygen therapy, without any sub-limits in case your condition turns serious.
• Cashless Treatment: Make sure your insurer offers cashless treatment options to multi-specialty hospitals near your residence or at pulmonary hospitals (for severe cases).
• Pre and Post-Hospitalisation: If your flu requires a 24-hour stay, make sure your mediclaim policy provides for medical expenses before hospitalisation and covers follow-up visits, rehab, and recovery drugs after hospitalisation.