Medical Insurance During COVID-19: What Should You Know?

It has been a long two months of lockdown in India. Every discussion, thought, and action is focused around the COVID-19 outbreak. With over 1.8 lakh people in India already infected with the virus and more than 5000 deaths, these are unprecedented and challenging times for people. This period has seen over-strained healthcare systems and over-worked government employees as the country battles to address this situation. People are glued to their TV screens and internet newscasts as they try to make sense of this chaos. One common question that most people have is surrounding their health insurance and if they have adequate coverage against COVID-19. Today, we will talk about medical insurance during this pandemic and everything that you need to know about it.

Will your existing policy cover COVID-19?

The Insurance Regulatory and Development Authority of India (IRDAI) has mandated all health insurance companies to cover all claims pertaining to COVID-19 even under regular medical insurance plans. Hence, if you have an active medical insurance policy, then you can claim reimbursement for COVID-19 treatment.

The insurance companies will treat coronavirus like any other ailment for providing cover. Therefore, typically, you will need to be hospitalized for at least 24 hours before you can raise a claim. Further, all treatment-related expenses are covered unless your policy specifies otherwise. Also, policies that offer pre and post-hospitalization coverage like ambulance costs, tests, X-rays, etc. will also apply for COVID-19 infection. It is important to know what benefits your policy offers for other ailments. Similar benefits will be available for COVID-19 too.

Can you buy a medical insurance policy now to cover COVID-19?

Yes. Leading insurance companies like Tata AIG are offering medical insurance policy for coronavirus, as well as, all other ailments. If you are specifically looking for protection against the treatment costs associated with COVID-19, then you need to keep two important things in mind:

  1. You should not be suffering from COVID-19. The insurer will ask you to go through a medical test to ensure this.
  2. You will not be able to raise a claim within 30 days of buying the insurance policy. This is in sync with the terms and conditions of most insurance companies where you need to wait for 30 days to start raising a claim for any new ailment and 2/4 years for pre-existing medical conditions.

Ensure that you read through all the fine print before buying COVID-19 insurance.

30 days! Are there any policies that offer COVID-19 coverage from day 1?

Some insurers have designed fixed-benefit plans focused on the COVID-19 ailment. Being disease-specific plans, they offer a fixed amount as reimbursement if you are diagnosed with COVID-19. There are two variants currently available:

  • The pre-decided fixed amount is paid if you are diagnosed with the coronavirus infection to help you manage treatment costs and/or loss of income.
  • 50 percent of the pre-decided amount is paid if you are sent to a quarantine centre under advice from the government to help manage the loss of income.

There can be a waiting period that needs to be confirmed with the insurer before you buy such a plan. While these plans can offer coverage against the coronavirus infection, they do not cover any other ailments. Hence, we recommend that you buy these plans as an add-on to your existing comprehensive health insurance plans.

Do you need health insurance for COVID-19?

The core idea of purchasing health insurance is to protect yourself financially from treatment costs in case of an ailment or an accident. Hence, the cost of treatment plays an important role in determining if you need a medical insurance cover for a specific ailment or not.

While many people catch the coronavirus infection and get cured without realizing that they were ever infected, those who show severe symptoms need hospitalization. If you are below the age of 50 years, then at a private hospital, you can expect the bill for coronavirus treatment to cross ₹5 lakhs. Also, since the virus poses a bigger threat to people above 50, the average hospitalization costs can double since the patient tends to need ventilator support.

Summing Up

Although there has been a lot of fear associated with COVID-19, most of it is due to the speed with which it has been spreading across the globe and the lack of a vaccine or a specific treatment regime to fight it. Hence, it is prudent to cover yourself financially against the treatment costs of COVID-19. While traditionally, insurance companies did not offer coverage during pandemics, the government has ensured that everyone with a medical insurance policy receives insurance protection against the coronavirus infection too. If you do not already have a health insurance policy, then you might want to reconsider your decision and buy one today! With the virus still spreading at a fast rate and a vaccine not yet in sight, it will protect you in the unfortunate event of catching the infection. Stay safe!