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FAQs Regarding Covid-19 and Health Insurance

FAQs Regarding Covid-19 and Health Insurance

It’s no secret that Covid-19 has induced the importance of health insurance in our lives. Earlier we used to procrastinate purchasing a health cover but it has now become a top priority in our financial planning checklist. The second wave of the deadly virus has caused mayhem in India. Cases are spreading like wildfire every day and so is the number of people who are getting hospitalized. In such a scenario, there must be some important queries that you have as a consumer of health insurance and we have listed some of those for you:

Q1. Is Covid-19 treatment covered under health insurance?

Yes, all health insurance plans cover treatment for Covid-19. Last year, The Insurance Regulatory and Development Authority of India (IRDAI) had directed all health insurers to mandatory cover Covid-19 treatment in all health insurance policies. It will be covered in case the policyholder requires hospitalization and has to stay in hospital for more than 24 hours.

Q2. Is home care treatment for Covid-19 also covered under health insurance?

Yes, it is covered. A prerequisite is that the doctor should give a recommendation that you need hospitalization. If there is no availability of beds at most of the hospitals or if the patient is not in a condition to go to a hospital, home care treatment (or Domiciliary Hospitalization) becomes very pertinent. A few plans cover Domiciliary Hospitalization for Covid, which means in case a Home ICU or Home Treatment is needed, it will be covered by your health insurance policy. 
Claim for home treatment is in the form of reimbursement. The process is fairly simple and just needs some basic documentation which includes the Covid Positive report from an ICMR approved lab, all relevant bills, investigation file or line of treatment, and any relevant supporting which clarify that hospitalization was needed. Post this, insurers process the claim amount into your bank account as a reimbursement claim.

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Q3. How much sum insured is sufficient to cover the treatment cost of Covid-19?

Medical expenses for Covid-19 treatment at a hospital ranges between Rs 15-20 lacs. The number of days for hospitalization is usually between 10-15 days. Therefore, the minimum sum insured one must have is Rs 10 lacs if you are living in a metropolitan city. Though, one should buy a high-sum insured cover to get adequate coverage against not just Covid-19 but all kinds of diseases. A Rs 1 crore Super Saver health insurance plan from Max Bupa costs only Rs 916 per month for a 30-years-old person living in Delhi.

Q4. Are consumables covered under Covid treatment?

Consumables such as PPE kits and gloves are covered by some insurers for Covid-19 treatment and there are defined limits. Usually, it is one PPE kit per person per day. This is a key point to check at the time of buying your policy. A few insurers such as Care Health, Max Bupa, and Bajaj Allianz cover them. If you have an adequate sum insured comprehensive health insurance plan, then you are fairly protected against Covid-19.

Q5. What is the waiting period for Covid-19 coverage?

The waiting period for Covid-19 coverage varies from insurer to insurer. In some plans, there is 7 days waiting period while others have a 15 day waiting period. In a large chunk of plans, the waiting period is for 30 days. So, choose a plan assessing your needs and features required.

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Q6. If I had Covid in the past, will I be able to get a health insurance plan?

Yes, you can get a health insurance plan if you had Covid in the past. However, you will have to wait for a few months which can go as high as 6 months with some insurers. This becomes a key point for contemplation when buying health insurance. If you haven’t had Covid till now, then you should definitely buy a health insurance plan as soon as possible because you don’t want to be in a situation where you will have to wait to get a health insurance policy post-recovery.

Q7. What are the things to keep in mind to be claim ready in case any of the family members get infected with Covid-19?

First and foremost is identifying the network hospitals near your area which have Covid-19 treatment facilities. Only if admitted to a network hospital, you can make a cashless claim. It's advisable to shortlist at least three hospitals so that you have a Plan B in case of a shortage of rooms.

Then, depending on the policy you have bought, make sure you are aware of your eligible room category. Most policies allow single private rooms, while some policies also allow high-end rooms such as suites and deluxe rooms. Knowing this beforehand can help you make the right choice of the room.

Also, make sure that you know the waiting period for Covid-19 coverage in your health insurance policy beforehand. Keep a small docket or folder ready. It should contain your health insurance policy, health insurance card, ID proofs, any relevant past medical reports like previous discharge summaries. This is the ready reckoner needed in case you need to rush to a hospital.

Make sure that you have details of your Policybazaar relationship manager saved, and please inform them about your claim. In case this is for a planned illness, inform prior to hospitalization so that they can make all arrangements. In case of emergency hospitalization, please inform as soon as possible, so that they can assist with a seamless claims experience.

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Pro-Tips To Keep in Mind For Covid Vaccination Process

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07 May, 2021

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