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Are Rare Diseases Covered In Health Insurance Plans?

Published On Sep 15, 2022

The human body is able to both withstand extreme environments and be susceptible to a wide range of diseases. While some diseases, including diabetes and hypertension, are widespread, many people contract uncommon or rare ailments. You might be interested in learning more about these uncommon ailments and finding out if your health insurance coverage covers them. Let's investigate.

Are Rare Diseases Covered In Health Insurance Plans?

What Is A Rare Illness? 

Specific health issues known as rare diseases only impact a small portion of the population. A rare disease, as defined by the World Health Organisation (WHO), is one that affects one or fewer people out of every 1000. But in India, a rare ailment is one that affects less than one person out of every 2500 individuals.

According to research, inherited factors play a role in almost 72% of rare disorders. These illnesses are also deadly, and those who have them must live with them for the rest of their lives. Approximately 96 million Indians, or about one-fifth of the population, are said to be affected by uncommon diseases, according to reports. s Approximately 95% of rare disorders are untreatable, according to medical authorities. 

Patients endure great agony in addition to the lack of therapy because such diseases are not promptly diagnosed. Even if a rare condition has a treatment, it could be expensive.Additionally, because uncommon diseases are chronic in nature, therapy takes a long time and is consequently more expensive.

Are Rare Diseases Covered By Health Insurance Coverage In India?

Yes, the costs of treating rare disorders are generally covered by many Indian health insurance plans. You can submit a claim for the treatment costs under your insurance plan whether the uncommon disease is genetically predisposed or not. Typically, medical expenses including surgeries, hospital stays, diagnostic tests, pre-hospitalisation advice, post-hospitalisation recovery, etc. are covered by the majority of insurance plans.

Points To Remember While Buying Health Insurance For Critical Illness

Below are some points that must be remembered while buying a health insurance policy for critical illness.

  • Coverage Amount

Depending on your budget, you can select a health insurance plan for uncommon diseases. To ensure that you have adequate financial protection, it is preferable to choose a higher coverage amount. You should be aware that not all unusual diseases may be covered under  health insurance. Therefore, before you sign the insurance documents, make sure you review the list of uncommon diseases covered under he policy. 

  • Waiting Period 

Although a lot of health insurance plans cover unusual conditions, you might not get coverage right after purchasing the policy. Before you are qualified to submit a claim, there may be a waiting time.

Most health insurance plans include a 30- to 90-day initial waiting period, and coverage for rare conditions may become available after a two- to four-year wait. This means that before the insurance provider would pay for the expense of treating uncommon diseases, you must maintain the policy in force and faithfully pay the premium for a set amount of time.

  • Considered Pre-Existing Issue

The insurer will treat a rare disease as a pre-existing condition if it is discovered at the time you purchase the coverage or earlier. A pre-existing disease waiting period, which may last up to four years, will be applicable in such a situation. 


Even though they are not frequently encountered, rare diseases can be fatal. Due to the high expense of treating these conditions, purchasing a health insurance plan for rare diseases is the only way to protect your funds and receive high-quality healthcare without worrying about the associated expenditures. To discover the best coverage for your needs, be sure to compare the policies online.

Also read: Can I Pick A Preferred Room In Hospital With My Existing Health Insurance Plans?

Understanding The Common Terms Used In Health Insurance


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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