Complete Guide To Vaccination Coverage In Health Insurance

Child vaccination is one of the essential cornerstones that fortifies immunity and potential health risks in preventive healthcare modalities. Seeking timely immunisation shields children against various illnesses and fatal diseases. Gladly, many health insurance companies have over a period of time realised this fact and have launched health insurance plans offering coverage for child vaccination. As per the stats figured out by World Health Organisation (WHO), in 2023 there were 1.45 million children pan-globe who were found to be missing on immunisation against critical illnesses. However, it is also very crucial to analyse the scope of coverage provided by various sought-after health insurance companies in India.

Benefits Of Vaccination Cover In Health Insurance

As per the data analysis by WHO, vaccination drives are robust vanguards preventing nearly 2-3 million deaths per year of children below the age of 5 years. It is a common misconception that prevails in our society that vaccines are costly, but the fact is that a well curated health insurance plan buffers the expenses incurred on preventive care for immunisation while providing you with suitable medical coverage. Highlighted below are some benefits of securing vaccination coverage in a health plan:

• Safeguards Against Health Risks And Diseases: ‘Prevention is better than cure’ for sure especially when it comes to safeguarding oneself and the loved ones against contagious diseases such as HPV infection, Tuberculosis, Chickenpox, Hepatitis B, Flu etc which can be prevented with vaccination. Therefore, an inclusive health plan that offers insurance cover for the same saves our financial resources and peace of mind is a wise investment option.
• Inbuilt Cover: Though many health insurance policies offer vaccination as an add-on feature which means you have to pay extra to purchase it and add to your existing health plan but many providers offer vaccination cover as an inbuilt option such as Tata AIG’s Medicare plan.
• Boosts Immunity: A comprehensive immunisation cover offered in medical insurance plans for children as well as adults ensures that we are protected against unforeseen health challenges which are rapidly rising across the world due to stressful work life compounded with environmental pollution.
• Financial Security: Since healthcare costs are mounting amidst economic instability and growing inflation rate, investing in an all encompassing health insurance plan covering vaccination helps to diversify your portfolio of financial investment.

Health Insurance Companies And Plans Covering Vaccinations

Insurance Companies Offering Health Policy Cover for Vaccinations in India

Almost all health insurance providers in India offer comprehensive maternity coverage benefits to the insured mother and her newborn offering child vaccination under the same cover plan. However, there are providers in the insurance market who have curated their family floater health plan to include greater scope of medical coverage for immunisation under preventive and wellness services as follows:

• Activ Assure Plan From Aditya Birla: Both Diamond and Silver plans of Activ Assure offer vaccination coverage upto Rs 10000 applicable on sum insured of 1 Cr and above. These plans by Aditya Birla health insurance company also cover for treatment expenses under AYUSH, no claim bonus, domestic air ambulance services etc.
• LifelineElite Health Insurance Plan By Royal Sundaram: It offers wider coverage benefits extending upto 1.5 Cr borne on medical costs related to vaccination cover of nearly Rs 7500 against animal bite, emergency domestic evacuation and global hospitalisation, AYUSH therapy. It has an OPD cover upto Rs 10000 under preventive and wellness benefits.  
• Family Health Protector Policy By IFFCO-Tokio: This broad spectrum health insurance policy covers a wide range of healthcare needs including vaccination for the entire family under the family floater plan and regular health checkups.
• Medicare Policy By Tata AIG: This health insurance covers for costs pertaining to Human Papilloma virus (HPV) vaccines and Hepatitis B after 2 years of continuous coverage and vaccination cover against Rabies and Typhoid without any waiting period.
• Pro Health Insurance from Manipal Cigna: This plan offers comprehensive coverage with a sum insured of Rs 1 Cr inclusive of worldwide protection for emergency illness, expenses related to maternity and newborn and vaccination.    

Types Of Vaccination Covered By Health Insurance

The Affordable Care Act (ACA) is an integrated healthcare reform law that has      implemented rules and general guidelines for health insurance providers and medicaid programs in the USA since March 2010. It mandates private insurance companies to offer coverage for vaccination and other preventive services’ without any co-payments, deductibles or coinsurance. Enumerated below are some of the most common immunisations covered under a well covered health plan depending on age criteria (below or above 18 years) as per ACA norms:

• Influenza (Flu): It is the common flu shot recommended as an annual service for everyone above six months of age
• Measles, Mumps, Rubella (MMR): All the three are fatal diseases and the MMR vaccine is advised as an infant 
• Hepatitis A and B: These boost immunity against the attack of viruses on one’s liver. Though, healthy food habits and hygiene practices prevent their spread
• Pneumococcal: This vaccine is generally recommended for young children to ward off Pneumonia and other ear borne infections and it comes in two different types
• Tetanus, Diphtheria, Pertussis: DTaP and Tdap as the two variants of vaccines generally referred to provides immune protection against Tetanus (lock jaw), Diphtheria and Pertussis (whooping cough). They’re recommended at 2, 4, 6, 15-18 months, and 4-6 years of age
• Varicella (Chickenpox): This vaccine is administered in 2 doses and is found to be 90% efficacious in delivering the results 
• Human Papillomavirus (HPV): HPV is known to cause cervical and throat cancers and HPV vaccine ensures safety against these critical illness.
• Polio: Vaccine for the serious condition causing body paralysis is administered in the first six years of life and covered under free preventive service and given in 4 doses
• Rotavirus: There are two Rotavirus vaccines options available that are recommended in the first six years of life. Rotavirus leads to severe infections draining out vital body fluids in infants and children

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Bottom Line

Thus a good number of insurance policies offer vaccination cover, but policyholders have to understand clearly the vaccines that are included and excluded. This will help to prevent claims rejection and helps policyholders to make an informed decision.

FAQs

Ques 1. Do all vaccinations get covered under health insurance plans?

Ans. Most of the major vaccination shots recommended by the authorised medical body in India do get covered by  health insurance plans however, coverage for specialised vaccines may vary therefore, it is always advised that the customer thoroughly explores the policy’s T&C before buying.

Ques 2. What is the age limit in procuring vaccination coverage in India?

Ans. Few health insurance providers may impose age restrictions or specific age band on getting vaccination coverage under the ambit of their health plan and it is absolutely necessary to browse your policy documents carefully to understand its T&C   

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.