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Are Rare Diseases Covered By Health Insurance Plans?

Published On May 07, 2022 10:00 AM By InsuranceDekho

Medical professionals are continuously attempting to understand the human body. Our bodies have the power to both fight and cause a wide range of ailments. While some diseases, such as diabetes, are widespread, a substantial percentage of people have unique disorders. You may be wondering what unusual diseases are and whether or not they are covered by Indian health insurance.
Health insurance acts as a financial safety net in the event of a medical emergency. Health insurance will cover any medical expenses incurred as a result of an accident, illness, or injury. It is simply a contract between you and your health insurance provider. It indicates that the insurer will cover all or most of your medical expenditures in exchange for a premium (premium). Continue reading to learn more about health insurance coverage for uncommon diseases.

Are Rare Diseases Covered By Health Insurance Plans?

About Rare Diseases

Rare diseases are illnesses that afflict only a small percentage of the population. According to the World Health Organization, a rare disease is one that affects one or fewer people per 1000 people (WHO). In India, however, rare diseases are those that impact fewer than one person out of every 2500. Approximately 72% of rare diseases are inherited, which means they can affect a person as early as childhood. As a result, rare diseases are often fatal, and people who suffer from them must live with them for the remainder of their lives. An uncommon disease affects over 96 million people in India or roughly one-fifth of the population.

What Are the Treatment Options for Rare Diseases?

The vast majority of unusual illnesses do not have a cure. Approximately 95% of unusual diseases have no approved treatment. Not only is therapy for such ailments delayed, but the diagnosis of such conditions is also delayed, leading the patient to suffer much more. Even if a treatment exists for a rare ailment, it is prohibitively expensive. The treatment of Gaucher Disease, for example, may potentially cost more than Rs 40 lakh. Similarly, Pompe treatment may cost you more than Rs 35 lakh.
In addition, rare illnesses are frequently chronic. As a result, their rehabilitation will take a long time and will cost you a lot of money. Patients may also be required to undergo routine diagnostic testing and be prescribed medications for a lengthy period of time. Because medicines for the treatment of rare diseases are developed by a small number of pharmaceutical companies throughout the world, they are exceedingly expensive. This is why rare diseases are referred to as 'orphan diseases,' and the therapies used to treat them are referred to as 'orphan pharmaceuticals.'

Is Health Insurance Covered for Rare Diseases?

Yes. Some health insurance policies in India cover the cost of treating a rare illness. Whether or not a rare ailment is inherited, you will be able to claim treatment costs via your health insurance. Hospitalization, surgeries, post-hospitalization consultations and diagnostic tests, daycare treatments, and other medical expenses will be covered by the coverage. Depending on your budget, you may purchase health insurance for unusual illnesses with a protection value of up to Rs 6 crore.
However, in India, not all unusual diseases are covered by health insurance. Furthermore, not all health plans provide the same level of coverage. As a consequence, before getting health insurance, you should look over the list of unusual diseases that are covered. Also, select a health plan that will adequately cover your medical expenditures if you are born with a rare disease.


Although rare diseases are less prevalent than common diseases, they can be lethal. Because uncommon sickness treatments are expensive and time-consuming, getting health insurance is the only way to ensure that your funds do not run out. However, check around for health insurance on the internet to get the greatest deal that fits your budget.

Also read- Which Is Better For Me: Short-Term Or Long-Term Health Insurance

Health insurance covers variety of illnesses.


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.

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