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Coronavirus Effect On Health Insurance

Coronavirus now has infected over 40000 people & hence it is essential to know if your health insurance covers coronavirus.
Feb 13, 2020 / 07:21 PM IST

We're living in an increasingly scary world. In the last five year alone, we've heard of outbreaks of increasingly dreadful viruses like Zika, Ebola, MERS (Middle East Respiratory Syndrome) and Nipah. And now there is this new virus called the coronavirus that is causing fear and panic. The dreaded virus, which originated in Wuhan, China, has already affected thousands of people globally and claimed several lives too.

At last count, three new cases of coronavirus have been reported in India too. And, although these are isolated incidents, many people are confused whether their health insurance covers them against this monstrous disease that is spreading like wild-fire. Let's understand what coronavirus is and whether you can seek treatment for the same under your existing general health insurance plan.

What is Coronavirus? What are its Symptoms? 

Said to have originated in Wuhan, China, the coronavirus has come from animals. Many people who were initially infected with the virus either worked or frequently shopped in the Huanan Seafood Wholesale market in Wuhan, China. The market also sold newly slaughtered and live animals. 

According to doctors, coronavirus is akin to a common cold. The infection typically affects the patient's upper respiratory tract and can even cause pneumonia. Sore throat, cough and flu, mild headache and fever are some of the most common symptoms of the infection. Fever caused due to the infection can last for two days or more. In case one is severely infected, they may need medical attention, including hospitalisation. But the question remains; can one seek health insurance coverage for the treatment of coronavirus? The answer is yes, you can!

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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Your health insurance policy covers you against treatment for coronavirus

Typically, most health insurance policies are general policies. This means that you can avail coverage against all kinds of illnesses or treatments; including diseases that aren't yet discovered. General health insurance policies, which are the most common types of health policies, are not disease-specific. As such, you can avail coverage against hospitalisation as well as OPD (out-patient department) expenses, irrespective of the disease you're suffering from. General health policies offer coverage against all kinds of infections, and since coronavirus is a type of infection; you can avail coverage from the first day of your insurance policy. 

Coronavirus is not considered a pre-existing disease

Coronavirus is not considered a pre-existing illness. It is the kind of illness that can affect one without any prior warning. Insurance providers, therefore, have no reason to reject coverage for the disease, and you can file an insurance claim if you need treatment for the same. As such, you can claim coverage against all expenses – be pre-hospitalisation, in-patient treatment, ambulance cover, OPD charges, and post hospitalisation, and so on; depending upon the coverage you are entitled to, under your policy. 

Filing an insurance claim for coronavirus treatment

You can file health insurance claims for treatment against coronavirus in two ways

  1. You can seek cashless treatment

You can seek cashless treatment in one of your insurance provider's network hospitals. You just need to inform your insurance provider about the hospital where you'll be seeking treatment. Remember to take your policy documents and health insurance card provided by your insurer. If you opt for the cashless facility, you do not have to pay the hospital bills upfront. A representative of the insurance company directly settles the bills with the hospital. However, the insurer will only cover you up to the sum assured amount. You may also need to bear the costs associated with any non-medical expenses, such as soaps, shampoos, medical masks and other apparatus you need to use to prevent the virus from spreading. 

  1. You can file the claim and seek reimbursement later

If you wish to seek treatment in a hospital not listed in the insurance provider's network; you can do so and file for reimbursement of expenses. However, you need to intimate the insurer about your intention to seek treatment and file an insurance claim, before you seek admission in the hospital. Once the treatment is completed, you can file a reimbursement claim. You must submit all the documents – reports, hospital and medical bills, and so on and then file the reimbursement claim. Typically, most insurance providers reimburse claims within 21 days. However, before filing a claim, you must check what is and isn't covered. 

Preventive measures

Although the number of coronavirus cases reported in India are very few; it does not hurt to take certain, preventive measures. Here are the precautions you can take:

  • Follow good respiratory hygiene

Use tissue papers or handkerchiefs to cover your cold and sneezes. If you're using tissues, make sure to discard them appropriately, without fail. 

  • Wash your hands properly

You must wash your hands as frequently as possible, especially if you have a cold or cough. Choose a liquid soap as opposed to a soap bar and follow up with a hand sanitiser.

  • Maintain distance

It is better to maintain your distance from people if your cough or cold is mild or severe. Take an off-day or two from work or school, to avoid infecting others.

  • See a doctor

If you've been coughing, sneezing or feeling unwell for more than a day, make sure to visit your doctor and seek treatment immediately. Immediate treatment prevents the infection from becoming severe, wherein you may need hospitalisation.

  • Avoid animal products

It is recommended to avoid consuming meat products or even animal products like dairy for the time being, especially if you're getting your provisions from wet markets. Consider using vegan products (almond milk, for instance) to fulfil your dietary needs.

Final word: There is no reason for your insurance provider to deny your insurance claim for coronavirus treatment. However, if you have any confusion about whether or not are eligible for treatment, you can always call on your insurance provider's customer care helpline and get all the details you need. 
Moneycontrol News
first published: Feb 13, 2020 07:21 pm

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