If you are hospitalized for a minimum of 24 hours for treatment of Covid, medical expenses will be covered in standard health insurance policies
The novel Coronavirus is on top of everyone’s mind now. The number of reported cases is increasing rapidly with around 10 per cent rise over previous day’s numbers becoming common. Several large countries have reported a prevalence of more than 1400 cases for every million population. It naturally poses a big challenge for the public health-care systems, and each government is reacting uniquely to address this new challenge. In this chaos, there is a lot of confusion around whether your health insurance policy covers the Covid-19 ailment. There have been all sorts of doubts, including the implications on insurance due to the disease’s pandemic status, coverage for quarantine and pricing impact. Here, some common queries related to the health insurance coverage of Covid are addressed.
Does my health insurance cover Coronavirus-related ailments?
Yes. If you are hospitalized for a minimum of 24 hours for treatment of Covid, medical expenses will be covered in standard health insurance policies. The Insurance Regulatory and Development Authority too recently came with a clarification that Covid-related treatment cannot be excluded in standard health insurance policies. This applies to both individual and group health insurance policies.
Frequently Asked Questions
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.
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.
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.
Is testing for Coronavirus covered by the insurance policy?
No. Diagnostic expenses are not covered by regular health insurance policies, unless there is a linked hospitalization for treatment. Only if the patient is tested positive and later hospitalized, will the diagnostic expenses be covered by the pre-hospitalization extension; otherwise diagnostic costs are excluded. However, if your policy covers OPD (outpatient department) expenses, then the cost of diagnostics can be covered depending on the policy terms. The government has restricted the pricing of the test to Rs 4500 in private laboratories, of which Rs 1500 is for the initial screening and Rs 3000 for the confirmation. This means your most likely out-of-pocket expense if you get tested is Rs 1500.
Would expenses for preventive quarantine be covered under insurance?
No. Quarantine that would have not required hospitalization for treatment will not be covered under standard health insurance policy. However, if there is a quarantine in a government-approved facility or hospital, where medical treatment is carried out that otherwise required hospitalization, then the same will be covered by a standard health insurance policy, provided a fee is charged by the hospital.
Do I have to pay extra for coverage of Covid within my existing health insurance?
No. There is no extra charge for the coverage of Covid. Benefits offered for Covid related treatment will be the same as that for any other ailment.
Have new insurance policies become more expensive?
No. Policies are available at the same price as earlier. However, insurers are working with limited capacity, as several cities have restricted travel and regular office operations. This may affect insurers’ ability to issue new policies within the same turnaround time as earlier. If you were planning to buy an insurance policy in the near future, it is advisable that you advance your purchase. Similarly, you may want to renew your policy in advance to ensure seamless coverage.
Are there special Covid plans available?
Yes. Some insurers are offering group plans for Covid specific coverage. Companies can buy these plans for their employees. Coverage will be triggered in case the employee is tested positive for Covid. At a cost of Rs 199 plus taxes, an exclusive sum assured of Rs 5 lakh for the treatment of Covid is available. Additionally, such plans would offer an OPD benefit of Rs 5000, and a daily allowance of Rs 1000 for up to two weeks, in case of a hospital quarantine. There are fixed benefit plans too that pay a lump-sum if you are tested positive.
Are flight cancellations and schedule changes covered in an overseas travel insurance?
Flight cancellations are covered for specific hazards only within overseas travel insurance policies. The list of these specific hazards varies by insurer, so you will need to check your specific insurance policy for this. There are some insurance covers that pay for delays as well as costs linked to quarantines.
Will expenses incurred overseas for Covid testing be covered in an overseas travel insurance?
In most policies, yes. Do make sure that there is a specific doctor recommendation suggesting that you get tested. Please do follow the protocols recommended by your host country completely.
More than 35,000 people die every day in the world due to communicable diseases. Seasonal flu claims more than 1300 lives daily. Coronavirus has so far claimed over 27,000 lives. Insurance covers treatment expenses linked to all these diseases.
Data source: worldometers.info
(The writer is Principal Officer & Managing Director, securenow.in)Follow our full coverage here.