COVID-19 Health Insurance

Pandemic declared coronavirus (COVID-19) has impacted the lives of many across the globe. In India, the total number of people affected with the disease has crossed 5.1 million (as of 16 Sept, 2020) and is still counting. Keeping in consideration the number of cases going up and no news of a successful vaccine yet, the Insurance Regulatory and Development Authority in India (IRDAI) had issued a circular asking the insurance providers to come up with health insurance plans to offer protective coverage for expenses related to the coronavirus disease. Let us learn more about coronavirus and coronavirus insurance to analyse its need in the current times.

What is Coronavirus (COVID-19)?

Novel coronavirus (COVID-19) is a group of viruses that attack the immune system of a person that results in diseases as mild as the common cold to as severe as Severe Acute Respiratory Syndrome (SARS). It is an infectious disease that originated in China’s Wuhan in late December 2019. COVID-19 is a highly contagious virus that shows symptoms similar to those of regular flu. These include fever, dry cough, tiredness, and sore throat. However, the disease affects different people in different ways. It has been fatal for people aged above 60 years and those with pre-medical conditions. As stated above, it is a new strain of the virus that does not have any cure as of now.

What Does Coronavirus Health Insurance Mean?

Coronavirus health insurance policy is a customised health insurance policy aimed at covering hospitalisation, pre-hospitalisation and post-hospitalisation expenses, and other medical expenses arising due to the treatment of COVID-19. Almost all health insurance policies now offer cover for the treatment of coronavirus in India. The cover is available from day 1 after the insured is tested coronavirus positive. SInce COVID-19 is a new disease, it does not fall under the category of pre-existing diseases.

Coronavirus (COVID-19) Health Insurance Plans in India

If you are looking for a health insurance policy with comprehensive coverage, then you can purchase a standard health insurance policy that covers all medical expenses including those related to the treatment of novel coronavirus. One can also choose from two short-term health insurance policies recently launched by the IRDA that are designed to cover coronavirus treatment expenses only. View two COVID-19 health insurance plan types:

1. Corona Kavach Policy: COVID-19 Insurance Policy

Corona Kavach Policy is a single premium standard health insurance policy that covers treatment expenses related to COVID-19. It is an indemnity based health insurance policy that covers both individuals as well as families at an affordable premium. You can cover self, dependent children, parents, and parents in law under this policy for a period of 3.5 months (105 days), 6.5 months (195 days), and 9.5 months (285 days). Offered by both private and general insurers, the policy offers cover against AYUSH treatment expenses, homecare treatment expenses, pre-hospitalisation expenses, post-hospitalisation expenses, and road ambulance expenses. The best thing about the policy is that it comes with a short waiting period of 15 days, which means that you can start availing policy benefits soon. Also, you can opt for daily cash benefit by paying an extra premium. 

2. Corona Rakshak Policy: COVID-19 Insurance Plan

Corona Rakshak Policy is a standard health insurance policy especially designed to cover treatment expenses related to COVID-19 is Corona Rakshak Policy. Unlike Corona Kavach Policy, it is a benefit based health insurance policy that pays the insured a lump sum benefit equal to 100% of the sum insured if he/she is tested positive for COVID-19. The policy offers coverage on an individual basis for sum insured options ranging between Rs. 50,000 and Rs. 2.5 lakh in the multiples of Rs. 50,000.

The policy can be purchased by people aged between 18 years and 65 years. Available for short policy terms of 3.5 months, 6.5 months and 9.5 months, the policy gets terminated upon the payment of benefit. But the insured can avail policy benefits only he/she is tested COVID-19 positive at a government recognised center and gets hospitalised for at least 72 hours continuously. The policy comes with a short waiting period of 15 days but does not offer lifetime renewability benefit, it being a benefits based policy.

Health Insurance Companies Offering Coronavirus Health Insurance Plans

Tabulated below are health insurance companies that offer Corona Kavach Policy and Corona Rakshak Policy to the customers.

What is Covered Under Coronavirus Health Insurance?

Coronavirus health insurance policies offer cover against the following medical expenses:

• Hospitalisation Expenses: Coronavirus health insurance policies cover hospitalisation expenses arising due to COVID-19 if it exceeds more than 24 hours.
• Quarantine Cover: COVID-19 specific health insurance policies also cover the insured individuals who are quarantined in government identified authorities.
• Additional Coverage: Some coronavirus specific health insurance policies like that offered by Go Digit General Insurance Ltd offer add-on covers that the insured can opt for by paying an extra premium. For instance, expenses related to alternative treatment (AYUSH), maternity benefit with newborn baby cover, and so on. 

What is Not Covered Under Coronavirus Health Insurance Policy?

Coronavirus health insurance policy do not offer cover against the following medical expenses:

• Home Quarantine: Expenses incurred during the quarantine period spent at home is not covered under COVID-19 specific health insurance policies.
• Non-Recognised Quarantine Center: Medical expenses incurred when the insured is kept in quarantine for at a non-recognised center for the treatment of COVID-19 are not covered.
• Pre-Existing Diseases: Any expenses arising due to treatment of pre-existing illnesses are not covered until the waiting period is completed.
• Hospitalisation Without Doctor’s Recommendation: If the insured gets hospitalised without the recommendation of a qualified doctor as specified on the prescription, then he/she will not be covered for the expenses arising due to treatment.

How to Make a Claim Under Coronavirus Health Insurance Plans?

The claim settlement process for coronavirus (COVID-19) health insurance policies is similar to that for regular health insurance policies. Under coronavirus health insurance policies, claims can be made in two ways, namely cashless claims and reimbursement claims. As talked before, cashless claims can be availed if the treatment is taken at a network hospital. Whereas, reimbursement treatment facility can be availed even at a non-network hospital. Read below to understand the process for both in detail:

• Cashless Claims: All the insurance companies today offer cashless treatment facility. The process offers you quality medical treatment without having you pay anything at the hospital. It keeps you at ease even in difficult times. To avail the benefit, you are just required to avail treatment at a network hospital and inform the insurance company about the same. The insurance company, after verifying the details, will settle the medical bill directly at the hospital. But before availing treatment and making a health insurance claim, make sure if your health insurance policy covers treatment related to coronavirus or not.
• Reimbursement Claims: Reimbursement claims require you to avail of medical treatment for coronavirus (COVID-19) at any non-network hospital. You are then required to settle the bills out of your own pocket at the time of discharge after informing the insurer. Later when you make a claim, the insurance company transfers the amount in your bank account. But the insurance company settles the claim only after verifying medical bills and other documents.