Cardiac Care and Heart patient health insurance

About Cardiac Care / Heart patient insurance

Rising cases of cardiovascular disease have rapidly increased in India. The number of cases within the country has more than doubled from 1990 to 2016. In comparison, heart disease in the United States decreased by 41% in the same time period. Death as a result of cardiovascular disease has increased by 34 percent in India in the past 26 years alone.In 2016, 28.1% of all deaths in India were caused by heart disease accounts for nearly 60% of the global impact of cardiac health even though India accounts for less than 20 percent of the global population.The India Heart Association is committed to increasing awareness of the severity of heart disease in India. This organization is nongovernmental and launched by individuals who have been personally affected by heart disease. The organization’s major goals include increasing awareness of heart disease in India through online campaigns and grassroots activities.

The organization has been appointed to the Thoracic and Cardiovascular Instrumentation Subcommittee of the Bureau of Indian Standards by the Indian government. Efforts are multi-faceted, operating through partnerships with local governments, hospitals, and programming with donors. Organizations like this one are making effective strides in addressing the burden of heart disease in India.

Not only in India, but there is an alarming increase in the number of cardiac cases across the world and given the lifestyles of the current generation, this is likely to keep on increasing. Even if diagnosed early, it is important to be aware that the treatment can be pretty expensive for any individual/family and the stress is physical, mental and financial. While the physical and mental stress and anxiety is something that each individual/family needs to be prepared for, the financial burden is one that can be planned for and this is where Cardiac Care Insurance comes in handy.

What is covered under Cardiac Care / Heart Care plans?

• Coverage for In Hospitalization expenses : This covers expenses that will be incurred during hospitalization as an inpatient. One can use the cashless facility or get the costs reimburse depending on where the treatment is taken.
• Pre - hospitalization and Post - hospitalization benefits : Medical expenses are not just restricted to the hospitalization costs, but the insured remains covered for pre-hospitalization (normally 30 days) and post-hospitalization (mostly 60 days) expenses as well.
• Ambulance expenses : Coverage for Ambulance expenses is a built-in feature of the plan, normally upto ₹2,000.
• Domiciliary Hospitalization / OPD Treatment : If one is not in a condition to shift to the hospital for treatment, or there is no vacant bed in the hospital, or there are certain procedures which can be done as an outpatient, then you can avail domiciliary hospitalization/OPD treatment.
• Recharge/Restoration of Sum Insured : The insured will get an automatic recharge of Sum Insured (upto 100% of base sum insured) if your claim amount gets exhausted due to a claim during the policy period. You can use this amount for the treatment of any other insured family member (under family floater plans) or yourself but the treatment should be for different ailments.
• Annual Health Check-Ups / Wellness Programs : An annual health check-up for all the insured members covered under the same policy, or specific Wellness program aimed at improving lifestyle and dietary habits are also part of some plans.
• Tax Benefit : According to section 80 D under Income Tax Act 1961, the premiums paid for health insurance for self, dependent parents, children, and spouses are exempted from tax.

Exclusions under the Cardiac / Heart Care Policy

• Benefits will not be available for any Pre- Existing conditions or related condition(s) or any complications arising thereof for which Insured has been diagnosed, received medical treatment, had signs and / or symptoms, prior to inception of Insured’s first Policy, unless such a condition is stated in the Proposal form and specifically accepted by the Insurer and endorsed thereon
• Insurer shall not be liable to make any payment under this Policy in connection with or in respect of any Insured Event during the Waiting Period as defined under the Policy
• Any congenital Illness/Conditions
• Any Covered Critical Illness arising from Birth control procedures and/or hormone replacement therapy and any complications arising thereof from
• Any treatment/surgery for change of sex or any cosmetic surgery or treatment/surgery /complications/illness arising as a consequence thereof
• Use/Abuse of drugs, alcohol, or other intoxicants or hallucinogens unless properly prescribed by a Medical Practitioner and taken as prescribed
• War, invasion, act of foreign enemy, hostilities (whether war be declared or not), armed or unarmed truce, civil war, mutiny, rebellion, revolution, insurrection, military or usurped power, riot or civil commotion, strikes
• Any diseases causing the death of the Insured within the stipulated Survival Period, measured from the date of incidence of the illness
• Participation in winter sports, skydiving/parachuting, hang gliding, bungee jumping, scuba diving, mountain climbing (where ropes or guides are customarily used), riding or driving in races or rallies using a motorized vehicle or bicycle, caving or pot-holing, hunting or equestrian activities, skin diving or other underwater activity, rafting or canoeing involving white water rapids, yachting or boating outside coastal waters (2 miles), participation in any Professional Sports, any bodily contact sport or any other hazardous or potentially dangerous sport for which Insured is untrained
• Nuclear contamination, the radioactive, explosive or hazardous nature of nuclear fuel materials or property contaminated by nuclear fuel materials or accident arising from such nature
• Genetic disorders and stem cell implantation / surgery/storage
• Any medical procedure or treatment, which is not medically necessary or not performed by a Medical Practitioner
• Any Covered Critical Illness arising from Treatment by a family member and self medication or any treatment that is NOT scientifically recognized and any complications arising thereof / there from
• Sexually transmitted conditions, mental or nervous disorder, , Acquired Immune Deficiency Syndrome (AIDS), Human Immune deficiency Virus (HIV) infection
• Failure to seek or follow medical advice following the diagnosis of any illness/disease/injury
• Serving in any branch of the Military or Armed Forces of any country, whether in peace or War
• Participation in a criminal or unlawful act with a criminal intent.
• Attempted suicide (whether sane or insane) or intentionally self inflicted Injury or Illness