Coronavirus Health Insurance: The Most Common Queries Answered

Q1. What is the current situation of Coronavirus disease in India?

With around 3.35 million affected people all over the world and 239,000 deaths so far (as of 2nd May 2020), the deadly Coronavirus has brought the whole world at a standstill. With more than 37,000 cases in India itself (as of 2nd May 2020), the densely populated country is in shock and panic. Several countries are now in complete lockdown, including India. With new cases emerging every day, that too, in huge numbers, the lockdown in India is being continuously extended, and extensive preventive measures are being taken to ensure the safety of the people. The applausive works of the police and doctors play a significant role in controlling the spread of COVID-19.

Unlike the majorly affected countries and nations like China, Italy and the USA, the condition in India, being the second-most populated country is comparatively less vulnerable than the others. With all these thoughts, the next question that comes to our mind is, does health insurance in India cover the novel Coronavirus?

Q2. What is Coronavirus?

A newly discovered novel coronavirus or the COVID-19 originated late in December of 2019 reportedly in China. This never before known virus since then became pandemic killing thousands of people all over the world since there hasn’t been discovered a vaccination or guaranteed cure till now. The symptoms range from fever, dry cough, tiredness, runny nose, nasal congestion to Severe Acute Respiratory Syndrome (SARS). In severe cases, it causes respiratory diseases like pneumonia or even kidney failure and multi-organ failure resulting in death. The rate of recovery is decent and mostly, people with underlying diseases like heart disease, diabetes and infants under the age of 10 or elderlies over the age of 65 are more likely to get to severe situation.

Q3. What are Coronavirus health insurances?

The health or medical insurances that cover the hospitalisation, treatment, and medicinal expenses of the COVID-19 disease can be referred to as Coronavirus health insurance. As a matter of fact, all pre-existing indemnity health insurance covers treatments for viral infections, and because COVID-19 is a viral disease, a comprehensive health insurance policy is enough to pay off the expenses incurred during pre and post-treatment of the disease.

However, one thing that needs to be considered here is that no health insurance policy covers the expenses that have incurred if hospitalisation is less than 24 hours.

The Coronavirus health insurance policy will be applicable right from the day the insured has been diagnosed with the disease and will not cover any pre-existing disease or illness.

Q4.  Should one opt for specific Coronavirus health insurance?

As all the pre-existing medical insurance packages cover the treatment and basic expenses for the disease, if you have any of them, you may carry on with them. Instead, you will have more cover with comprehensive health insurance as Coronavirus health insurance packages are of a limited amount; they might not be able to cover all the charges in severe cases. The treatments in public hospitals are comparatively at a lower cost and the coronavirus health insurance will most probably be enough to pay the charges.. However, in private hospitals, expenses might get a bit too much. Further, in case the patient needs to be put on a ventilator, the charges would go too high and the patient might need to spend from his pocket. Therefore any pre-existing health insurance plan of a decent amount is better in these scenarios.

However, if one is not covered with any kind of health insurance, then it is a good time to take a look at the coronavirus specific health insurance packages. With the increasing risks of health, these policies cover the basic treatment and medicinal charges in a limited amount.

Q5. What are the inclusions in the Coronavirus health insurance policy?

While the standard inclusion of the policy consists:

• Ambulance expenses
• Daily hospitalisation expenses
• ICU room rent
• Post-hospitalisation expenses
• Recovery benefit
• Alternative treatments

Some of the prominent inclusions of the policy are:

• Critical illness hospitalisation
• Accidental hospitalisation
• Day-care procedures and their costs

Moreover, the policies also include and offer maternity benefits with newborn child cover.

Q6. What are the exclusions in Coronavirus health insurance?

While the hospitalisation and treatment expenses are covered, here are some of the exclusions of the Coronavirus health insurance policies:

• Home quarantine - In cases of home quarantine, the policies will not cover the expenses incurred while staying at home, which includes food, medicines, etc.
• Pre-existing diseases - Coronavirus health insurance will not cover any treatment for the pre-existing diseases or any other medical expenses incurred during this time till the waiting period get over.
• Any non-recognized quarantine centres - Coronavirus treatments or medical expenses incurred in any of the non-recognized quarantine centres will not be covered in the Coronavirus health insurance policy.
• Hospitalisation without recommendation - If anyone with the policy gets hospitalised without an authorized recommendation, then the charges incurred shall not be covered.
• Hospitalisation for less than 24 hours - Applicable in almost all of the policies, the insurer needs to be hospitalised for 24 hours or more than that to claim the expenses incurred in the process.

Q7. What is the process to claim Coronavirus health insurance?

• Cashless claim facility - With everything being digitized, most of the insurance companies nowadays provide the cashless transaction facility where the insurer or the policyholder does not need to make any payment incurred during treatment at the network hospitals. In these cases, the insurance companies directly handle the transactions with the hospital. This makes the process hassle-free and less complicated. Note that the cashless facility is only applicable to the network hospitals of the insurance provider. To check a list of the network hospitals or the availability of cashless claim facilities of any desired insurance provider, one can check the official websites or the policy wordings.
• Reimbursement claims - This method works in cases where the insurer is admitted to any non-network hospital where a cashless claim facility is not applicable. In these cases, the insurer needs to pay the whole amount of the expenditures incurred during treatment at the time of discharge.

Later on, one needs to fill the reimbursement claim form with the necessary attachments like the doctor’s prescription, hospital bills, test reports, and proper bills and receipts of the other expenditures that took place and are supposed to be covered in accordance with the policy.

After the claim is verified and accepted by the insurance provider, the amount of money spent shall be delivered directly to the insurer’s bank account.

Must-known facts about Coronavirus health insurances:

With the increasing rates of risks, the variety of Coronavirus health insurance increases, this is offered in the country right now. Here is a list of important facts that need to be kept under consideration before buying the Coronavirus health insurance policies:

• Sum insured - Given the high risks factors of COVID-19 disease especially for elders and infants and people with underlying diseases, it is beneficial to have a high sum assured family insurance policy that covers the expenditures incurred in severe cases as well as the normal treatment expenses.
• Waiting period - It is essential to check the given waiting period of the coronavirus health insurance policies before buying them. The waiting period varies from 60, 30, and even 16 days in some cases. This usually means that any hospitalisation or treatment charges incurred during this period will not be covered by the insurance provider.
• Coverage - It is important to check the details of what a policy offers in terms of coverage and financial benefits before buying it. Several policies offer a variety of coverage, which include pre and post hospitalisation charges, ICU and OPD rents, medication charges, ambulance charges, etc. and one need to select the insurance in accordance with their requirements.

Some more Quick questions:

Q8. Is Coronavirus specific health insurance better than indemnity plans?

No, the sum assured in COVID related insurance is lower than the normal health insurance. It is not enough to cover expenditures in severe cases.

However, if one does not have any health insurance, it is an excellent time to have one of the Coronavirus specific plans to get a minimum coverage or to stay at the safe side. 

Q9. Does the insurance cover expenditures incurred during self-isolation/home quarantine?

No. None of the insurance packages cover the expenditures incurred during the home quarantine situation. However, quarantine in any recognized or authorized centres is covered in these policies.

Q10. How to buy Coronavirus health insurance policies?

It is really simple to buy one online. One needs to find out the best suitable plan for them and opt for the policy. After filling out the details and information required, one can pay the premiums online via debit/ credit card or net banking.

Q11. What are the benefits of a Coronavirus health insurance policy?

Given the circumstances, the risks of catching the virus are high and are proven deadly for people above the age of 65, infants and people with underlying health diseases. Therefore it is always beneficial to get covered by any health insurance plan that can provide any amount of expenditures for the treatment.

In the case of COVID-19 related insurances, it usually covers 50% of the expenditures incurred during severe cases and are proven enough for low-cost treatment in normal cases.