Best India health insurance for Novel Coronavirus (nCoV)

Covid-19 Indian health insurance review

• What health insurance policy should I buy to ensure coverage for Coronavirus (Covid-19)?

  All health insurance policies are designed to cover in patient hospitalization expenses of the insured individual for all ailments (except excluded ailments), that they have been diagnosed with. Many insurance companies have started providing health insurance plans for treatment of the Coronavirus for the proposer as well as his/her family. Hence it is advisable for the individual to go for a Covid-19 comprehensive health insurance plan that covers both in-patient and out-patient expenses incurred for all treatments including that of Coronavirus (Covid-19). Subject to crossing the mandatory waiting period of 30 days, the health insurance plan will pay all expenses, upto the policy limit, from the day of diagnosis of the disease. As in the case of almost all health insurance plans, the mediclaim coronavirus health insurance coverage should include but not be limited to:
  • In-patient hospitalization expenses that also include
    • ICU Room rent
    • Doctors/Surgeons fees
  • Pre and Post Hospitalization expenses
  • Restoration of Sum Insured Benefit
  • Day Care procedures
  • Ambulance expenses
  • Daily Hospital Cash
  • Organ donor expenses
  • YUSH Treatment
  • Maternity benefit with New born baby cover
  Apart from the coverage there are a couple of important aspects that an individual must keep in mind with respect to buying a Coronavirus India Health insurance policy:
  • Cashless Hospitalisation - Insured should ensure treatment at a Network Hospital of the insurance company to ensure Cashless Hospitalisation. If the treatment is at a non network hospital, the insured will need to settle the bills and then seek reimbursement from the insurance company.
  • Coverage/Sum Insured - Coronavirus is not just a respiratory illness, but impacts all important organs in the body, and hence its treatment can get very expensive and more so patients with existing medical conditions. There have been costs reported from ₹1.5 lacs and going upto ₹8lacs, and while the medical fraternity is trying to being some standardisation into the treatment costs for Coronavirus, it is advisable to opt for a relatively higher sum insured amount to ensure satisfactory coverage. One is recommended to have atleast a ₹10 lacs cover.
  • Waiting Period : While investing in a health insurance plan overall and especially for for the coronavirus, one must be aware that all health insurance plans come with a minimum waiting period of the first 30 days, post which if the Coronavirus is diagnosed, treatment costs are covered.

• What are the Limitations of the Health Insurance Plans relating to the Coronavirus?

  It is also important for all insureds to be aware of what are excluded and the possible limitations under the Health insurance plans they are likely to invest in for themselves and their families. Some of the key exclusions:

  • Filing a claim for reimbursement of expenses along with A Medical Report of Novel Coronavirus (nCoV) (COVID-19) confirming that the test results are negative.
  • Filing a claim if the medical report /quarantine due to the coronavirus is not issued by a Government Authorised Centre (private/public owned).
  • Expenses incurred during home quarantine.
  • Insured not hospitalised for 24 hours continuously – there may be some relaxation on this given the nature of the pandemic.
  • The individual has a travel history to any foreign countries after December 31, 2019.
  • The claim is filed for an insured who is located beyond the geographical boundaries of India.
  • Hospitalization without doctor’s recommendation.
  • Any claim for Novel Coronavirus (COVID-19) contracted before the commencement date of the policy or during the waiting period – will be treated as a pre existing condition.

• Claims Processing / Settlement for Coronavirus

  Step by Step Process for Coronavirus Health Insurance Reimbursement Claims

  1. Contact the Insurance Company’s Toll Free Number to report/register the mediclaim insurance for Coronavirus providing basic information regarding the illness.
  2. Insured can get admitted to the hospital of their preference, but preferably to a network hospital of the insurance company (All insurance companies inform the insured at the time of availing the policy, the list of network hospitals – this list keeps getting updated from time to time).
  3. Post receipt of treatment for Coronavirus, insured should then settle the hospital bills and retain the original bills/invoices/receipts for submission to the insurance company along with the claim form.
  4. On receipt of the complete set of claim documents, the insurance company will adjudicate the claims and make the payment to the proposer for the admissible amount, along with a settlement workings.
  5. Documents to be Submitted for a Reimbursement Claim
     • a.Duly Filled Claims Form.
     • b. Original Discharge Summary document.
     • c. Original Hospital Bill with detailed Cost Break-up + Original Paid Receipts.
     • d. All Coronavirus related reports + Doctor’s Consultation Reports.
     • e. All Investigation, Lab and Test reports from an authorised/approved medical.
     • f. Photo Identity of Patient along with Health Card.
     • g. KYC documents

  Step by Step Process for Health Cashless Claims

  1. Contact the Insurance Company’s Toll Free Number to report/register the claim for Coronavirus providing basic information regarding the illness.
  2. Insured must get admitted to a network hospital of the insurance company to be entitled for cashless treatment.
  3. The hospital will send the insurer the necessary preauthorization request form which contains details of Coronavirus diagnosis and treatment, medical history, proposed treatment approach and estimated cost. Based on the eligibility, the authorization letter is shared by the insurance company with the hospital.
  4. Post discharge of the insured, the hospital will send the original claim documents supported by the bills to the insurer. The claim will be assessed and payment will be made to the hospital accordingly.

• Novel Coronavirus (Covid-19)

  The Novel Coronavirus (Covid-19) has impacted thousands of people worldwide, at last count around 22 lacs with 1.54 lacs unfortunately dead. For those impacted, the stress goes beyond physical and mental health, involves high medical costs, maybe a loss of job/salary and associated financial stress. It is important for people to understand that even if they have a regular health insurance plan from any insurer paying for medical costs either through a cashless facility or reimbursement, all illnesses including Covid-19 are covered.
  
  Many India health insurance providers are working on designing a best Covid-19 comprehensive health plan that specifically treats the coronavirus disease. This product needs to be designed by taking into consideration the expenses incurred during the treatment. It also has to take the duration of the quarantine period, treatment, and post-hospitalization costs incurred by the patients.
  
  The existing health plans cover the pre and post-hospitalization charges. However, considering the pandemic and its impact, the new plan will be designed with respect to the treatment needed for this critical illness. Under the memorandum issued by the IRDAI, the features of the new plan should include:

  • The insurance providers will either have to design a comprehensive policy to comprehend the current COVID-19 situation in the country or cover the expenses of the treatment under its existing health policies.
  • The entire treatment cost of the infected person will be reimbursed.
  • Insurance providers need to review the claims carefully before reimbursement.

  The testing of the disease, quarantine treatment, and hospitalization charges will be reimbursed under the health insurance plan if one is tested positive for the virus.