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Diseases Covered Under Health Insurance

Published On Aug 26, 2023, Updated On Aug 29, 2023

Today, a number of health insurance policies with various add-on choices and advantages are offered by insurance firms in India to give policyholders the highest amount of coverage. You can be well prepared to cover the costs if you have health insurance on hand.

It's important to know that your health insurance covers the bulk of the costs associated with your hospitalisation. Understanding which disorders are covered by health insurance is important. If you're considering purchasing a health plan, see the list of diseases often covered in India's health insurance plans.

Please be aware that coverage and exclusions may vary from one plan to the next, and it is also based on the medical history of the policyholder and the amount guaranteed by the plan. 

List of Diseases Covered Under Health Insurance:

COVID- 19:

  • The new Coronavirus has affected every country on the planet, putting a financial strain on many affected people. Many individuals lost loved ones during the worldwide pandemic due to a lack of effective treatment and financial restrictions. 
  • As a result, health insurance carriers have launched COVID-19-specific programs to assist people in overcoming such situations. 
  • The health insurance plan will cover not only the coronavirus hospitalisation expenditures but also the pre and post-hospitalisation charges during a brief waiting time. 

Diseases covered under health insurance


  • High blood sugar is a symptom of a specific form of metabolic disease known as diabetes mellitus, or diabetes for short. Diabetes can result in a number of problems, including Heart condition, kidney diseases, Skin problems, eye injury.
  • Most Health Insurance plans cover diabetes in their list of covered diseases.

High Blood pressure:

      • High blood pressure, often known as hypertension, is a dangerous condition that raises the risk of fatal illnesses, including heart disease, stroke, and other cardiac problems. 
      • Although many potential causes of high blood pressure exist, stress-related lifestyle choices or underlying medical issues are the most common culprits.
      • Without having to consider the cost, a health insurance plan enables you to receive prompt care.
      • Most health insurance policies pay for both direct problems from high blood pressure and its treatment costs.


  • One of the serious diseases that has been impacting a large number of individuals in India is cancer. In general, cancer therapy takes a long time and can be highly expensive.
  • A lot of people are at risk of the fatal illness of cancer. Numerous cancer kinds now have better recovery prospects because of medical progress. 
  • Fortunately, a variety of cancer types and related medical expenditures are covered by many health insurance programs. 
  • According to the provisions of the insurance, coverage may include hospitalisation, chemotherapy, medications, and other treatments.

Cardiovascular Diseases (Heart Attack):

  • Cardiovascular disorders are conditions that affect the heart and blood arteries simultaneously. 
  • Heart attack and stroke are the two well-known forms of heart problems observed in India. 
  • This problem is caused by plaque building within our arteries. When one or more of your coronary arteries are clogged, you might experience a heart attack. These blockages are caused by fatty deposits resulting from too much cholesterol. 
  • Heart disease incidence has significantly increased in India as a result of sedentary lifestyles, poor diets, and rising stress levels. 
  • Most insurance providers cover heart problems, and some even include heart health screenings.

Mental Illness: 

  • Nowadays, people are more likely to suffer from mental disorders, including dementia, bipolar disorder, schizophrenia, and depression.
  • These illnesses require lengthy, sometimes costly treatments. Plans from Health Insurance protect you from the expense of receiving treatment for mental diseases.

Serious Illness

  • Critical diseases can be life-threatening ailments that need prolonged medical care. 
  • With health insurance, you may receive coverage for a variety of serious illnesses that could incur high medical costs. 
  • Critical conditions, including brain tumours and renal failure, are among them. It is advisable to confirm whether a waiting time for health insurance is necessary.


  • Cataract is an eye condition that causes a person's eyesight to become hazy.
  • With over 14 million operations each year, cataract surgery is one of India's most popular surgical treatments. 
  • Depending on the method and complication, the operation may cost between 15,000 and 1 lakh rupees. 
  • After an initial waiting period, the majority of health insurance policies cover cataracts.


  • HIV/AIDS is a deadly disease caused by a virus that affects a person's immune system.
  • HIV cannot be permanently cured but may be managed with the right medical attention. 
  • There are several health insurance options that give policyholders the much-needed financial support they need for treatment with the least amount of difficulty.

Birth defects in newborn babies:

  • Birth problems like Down's Syndrome and cerebral palsy can occur in certain newborns. 
  • Their medical care may be costly and prolonged. However, some insurance plans will cover the expense of treating your offspring for these birth abnormalities.


Different forms of health insurance cover different diseases depending on the type of coverage you choose. It is essential that you be familiar with the list of diseases covered by the plan and the accompanying terms and conditions for coverage before you sign the policy papers. This will enable you to purchase insurance policies with knowledge and prevent you from submitting a fake claim.


Q1. Does health insurance coverage cover medical conditions that already exist?

The underwriting policy of an insurer must be followed when providing health insurance coverage to anyone who is currently suffering from or has previously suffered from any sickness or ailment. Additionally, it should be noted that the insurers' policy designs may prevent them from covering those who have recovered from a particular ailment or disease.

Q2. Is a proposal or medical check necessary at the renewal stage?

When a policy is being renewed, and the provided Sum Insured has not changed, no insurer may use fresh underwriting by requesting a medical exam, new proposal form, etc.

Q3. Will purchasing a pre-existing health insurance policy have any effect on the coverage amount?

No. The quantity of coverage is unaffected. However, the policyholder will have to wait a specific amount of time before making a claim.

Q4. What should you be aware of while purchasing health insurance in India if you have a pre-existing health condition?

  • Determine the diseases you have
  • Fill out every detail about pre-existing diseases
  • Before purchasing health insurance coverage, consider getting a check-up
  • Examine the waiting period, then buy for premium.

Q5. What happens to my sum insured once I submit a claim? What if the cost surpasses my hospital insurance coverage?

For the remainder of the insurance year, the total covered is decreased by the amount of the claim paid. If your claim exceeds the amounts covered, you must pay the difference.

Also Read: 

Are Accidental Injuries Covered by Health Insurance in India?


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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