Diagnosed with a heart ailment? Here’s your guide to health insurance coverage

How health insurance for policyholders with heart ailments works.

Suresh Malhotra, a 45-year-old father of two, recently started experiencing persistent chest pains during his morning walks. On the insistence of his concerned family members, he consulted a doctor and was diagnosed with coronary artery disease.

Adding to this shock, Malhotra encountered another pressing concern – his ability to secure health insurance coverage. As he explored different insurance policies through several agents, he came across multiple roadblocks due to his pre-existing heart ailment.

Malhotra is not alone. According to the Indian Heart Association, over 50 percent of all heart attacks are reported in patients below 50 years. Half of those are even below 40 years of age. So it is fair to say that heart attacks and heart ailments are common among young Indians.

There are several reports that post Covid-19 the cases of young people being diagnosed with heart ailments are rising as well. Many of those do not have a health insurance policy. And if one has suffered a heart attack, it is tougher to get a health insurance policy.

Health insurance for heart patients

However, now certain plans in the market cover heart patients.

These plans are specifically designed to cover those with a family history of heart ailments and even those who have a past medical history of heart conditions. The coverage in these plans starts from Rs 5 lakh and one can choose a higher sum insured.

A higher sum insured surely reduces the financial burden of expensive heart surgeries and other expensive procedures that the patient may need. Apart from the sum insured, the plans also offer once-in-a-year cardiac health checkup.

The plans not only cover those who diagnosed with heart ailments but even those who may have undergone cardiac surgery in the past such as the placement of stents in the heart. The plans offer lifelong renewability and include the facility of automatic recharge of the sum insured once in every policy year.

The plans cover ICU charges with no limits. There are plans now that do not have any maximum age of entry, so senior or super-senior citizens can also apply. The waiting period of pre-existing ailments starts from two years and can be reduced to even Day 1 (after an initial wait period of 30 days).

Some plans in this category offer coverage even for ailments that are not related to cardiac issues up to the sum insured. Albeit with certain sub-limits, the plans also cover heart transplantation, cardiac devices and rehabilitation and pain management expenses, which are particularly relevant to heart patients.

For a person aged 55 years, the premium of these plans with coverage of Rs 10 lakh comes to around Rs 30,000-35,000 per annum.

Also read: How not disclosing pre-existing ailments can affect your claim, policy renewal

Cardiac ailments on a rise

Irrespective of whether one is suffering from any heart ailment or not, one must have a comprehensive health insurance that covers them against them. After all, the number of cases of cardiovascular diseases like strokes, heart attacks and high cholesterol level are rising rapidly in the country. Data shows that India could record the highest number of cardiac deaths across the world by 2030.

To make matters worse, the cost of treatment of cardiac diseases is also rapidly increasing. That is natural given the pressure on the health infrastructure due to the rising number of cases. Given these circumstances, it is a must to have a proper health plan. Those who have a healthy heart can rely on comprehensive health insurance with critical illness coverage. And those who have a history of heart disease can go for a tailored health plan for heart patients.

Also read: Moneycontrol-SecureNow Health Insurance Ratings: Your guide to picking the right policy 

Remember that cardiac ailments can affect anyone in any age group. So the sooner you get yourself covered, the better. Especially if you have a family history of such ailments. While there are plans that can provide coverage after you are already diagnosed with a heart ailment, they come with a waiting period of two years or more and with other restrictions. Therefore, it is always wiser to get covered before that happens.

*The name in the example has been changed to protect identity.