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Last Updated : Aug 13, 2020 08:17 AM IST | Source: Moneycontrol.com

Explained: Post-hospitalisation expenses covered by health insurance policies

Your health policy will pay for medicines and follow-up costs incurred up to 60-90 days after discharge from the hospital

The novel Corona Virus Disease’s (COVID-19) debilitating effects on health are fairly well-known. However, emerging evidence suggests that the pandemic can take its toll on patients’ vital organs such as heart and lungs even after they recover.

This could mean visits to the doctor or hospitals even after discharge, besides having to consume medicines for a longer period of time. These expenses can severely strain your finances, already reeling under humungous hospitalisation bills as also out-of-pocket expenses due to ongoing disputes between hospitals and general insurance companies.

However, you need not shoulder the entire burden on your own – you can tap your health insurance cover, which is not confined to hospitalisation expenses – for costs incurred after you return home.

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Will my health insurance policy pay for medical expenses after I am discharged from the hospital?

COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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Yes, these will be covered as part of post-hospitalisation expenses, up to your sum insured limit. In the case of standard Corona Kavach and Arogya Sanjeevani policies, these expenses will be covered for up to 30 days after discharge.

Insurance policies will pay for such expenses incurred up to 60 days after discharge. Some premium variants reimburse such amounts for up to 90 days. This would include medicines prescribed in the discharge summary, follow-up visits to your doctor or the hospital and even diagnostic tests during the period. If you need to take nursing care at home, that will be reimbursed too. Similarly, if you have undergone a spine surgery that necessitates post-operative physiotherapy sessions, you can claim the expenses under the post-hospitalisation cover.

If I get treated at home for COVID-19 after consulting a doctor at the hospital, will the expenses be reimbursed?

Such expenses will not be treated as part of post-hospitalisation costs. Only post-discharge expenses that are directly linked to the hospitalisation episode will fall in this category. However, if your policy covers domiciliary hospitalisation, or treatment taken at home under certain exceptional circumstances, your claim will be settled, as COVID-19-induced shortage of beds is a reality in many cities. These expenses will also be paid for if your insurer has explicitly taken the call to cover home treatment, given the extraordinary situation humanity is facing at present.

How should I go about making the claim?

Ensure that you preserve all your bills and receipts related to medicines, follow-up visits, diagnostic tests and so on carefully. Submit physical copies to the insurer soon after 60-90 days are over or as soon as the prescribed follow-ups come to an end. Usually, your insurer will give you a window of 7-15 days to submit these documents. However, some will consider the claim even in case of a delay as long as you can provide a justifiable reason. Unlike hospitalisation claims, this cannot be settled on a cashless basis. You will have to make the payment, which will then be reimbursed by your insurer.
First Published on Aug 13, 2020 08:17 am
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