Is Covid-19 Treatment Covered In Your Existing Health Insurance Policy? Here's All You Need To Know

Amid the worldwide pandemic of Covid-19, there is quite a bit of confusion among policyholders as to whether or not they are covered for treatment for COVID-19. Check details here.

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Amid the worldwide pandemic of Covid-19, there is quite a bit of confusion among policyholders as to whether or not they are covered for treatment for COVID-19, how can one make a claim for a confirmed case, what is the coverage policy for quarantine, etc. Does my existing health insurance policy cover coronavirus? As per the Health insurance policies, the insurance cover all kinds of respiratory diseases, which means they cover coronavirus too, provided the affected person does not have COVID-19 at the time of purchasing the policy. Will the cost of testing for COVID-19 also be covered in the policy? No, the diagnostic expenses are generally not covered by health policies. However, if the patient is tested positive and hospitalized, diagnostic expenses will be covered under the pre-hospitalization extension. According to experts, in case, the policy covers OPD (outpatient department) expenses, then the cost of diagnostics can be covered depending on the policy terms. Is there any situation under which the policy will not cover COVID-19? Yes, there are certain limitations imposed on the coronavirus infection as well. According to PolicyBazaar, if the person is  already suffering from a respiratory infection in the past four weeks, then the Mediclaim under a basic health insurance policy or a coronavirus specific insurance policy might not get settled. Also, you may not be able to register a claim under the following conditions: i. If the policyholder and his family members have recent travel history to the worst affected countries ii. If the policyholder has been hospitalized for lesser than 24 hours iii. If the policyholder has pre-existing cold-like symptoms and were going for planned treatment iv. If the insured contracts the disease during the policy waiting period How can insurance for confirmed coronavirus be claimed? One can choose to go with a cashless claim facility or reimbursement facility depending upon the policy terms. For a cashless claim, one can choose to get admitted to a network hospital and take the necessary treatment by informing the third party administrator (TPA) within the hospital. In cashless claims, a patient does not have to pay any incurred expense for the treatment of an illness. While in the reimbursement process, one can take treatment at any choice of hospital after informing the insurer and pay the incurred bills. All these bills are later reimbursed to the policyholder up to the sum insured after proper verification from the insurer. In any form of insurance, there are terms and conditions, exclusions, or waiting periods as per which claims are settled or rejected. Are there specific policies for coronavirus too? If yes, what is the sum insured? Yes, many insurance companies have come up with insurance products that cover individuals specifically for coronavirus. GoDigit, built under Digit Health Care Plus is an insurance product that covers individuals on the detection of coronavirus, wherein 100 percent sum is insured in the form of a lump sum. If quarantine is advised, the policyholder is paid 50 percent of the sum insured in the form of a lump sum. You can choose from multiple sums insured options starting from Rs 25,000 up to Rs 2 lakh. Star Novel Coronavirus Insurance Policy, launched by 'Star Health and Allied Insurance' covers all those who test positive for COVID-19. It provides a lump-sum payment to any individual insured between age 18 to 65. The policy doesn't have any international travel history-related exclusions. It is available under two sum insured options of Rs 21,000 and Rs 42,000 at premiums of Rs 459 plus GST and Rs 918 plus GST, respectively. 'COVID-19 Protection Cover’ of ICICI Lombard also pays 100 percent of the sum insured to the policyholder in case they are declared coronavirus positive, irrespective of hospitalization expenses. Airtel Payments Bank recently said that it has partnered with Bharti AXA General Insurance to offer health insurance plans to provide cover and give financial protection against COVID-19. Under the tie-up, the companies are offering two health insurance plans -- Bharti AXA Group Health Assure which offers lump sum benefit of Rs 25,000, and Group Hospital Cash which provides daily benefit starting Rs 500 per day -- to provide protection against COVID-19.