Covid-19 Health Policies - What is covered and not covered

There seems to be no slowdown in the spread of the COVID-19 pandemic. It continues to affect more and more people in unfortunate ways such as loss of job, illness, and death. Therefore, it might be a small relief to people if they are financially covered. Some insurance companies have launched health policies specifically for COVID-19. Let us look at those -

Star Novel Coronavirus (nCoV) (COVID-19) Insurance Policy

Star Health offers the Star Novel Coronavirus (nCoV) (COVID-19) Insurance Policy. It is a one-year policy for individuals in the age group 18-65 years.  

Key Points

• Sum assured is either ₹21,000 or ₹42,000 with a premium of ₹353 and ₹706 respectively.
• It covers the positive diagnosis of coronavirus and individuals irrespective of international travel history.
• Dependent children are also insured.
• It has a 16-day waiting period. 
• A diagnostic report from a government authorized testing centre is required to file a claim.

Exclusions

People who get infected before buying the policy or get it during the waiting period.

ICICI’s COVID 19 Protection Cover 

ICICI Lombard offers a business insurance cover that companies can avail of to protect employees and their families. The sum assured and premium depends on the company and number of employees and dependents. Irrespective of expenditure incurred by the insured, the entire sum will be paid once the test is positive.

Key Points -

• Diagnosis has to be done by a government authorized laboratory. 
• People should be between the ages of 18-75 years.
• The scope of cover is within the geographical boundaries of India and for Indian nationals.
• There is a 14-day waiting period.

Exclusions

• People already diagnosed with the virus.
• People who have travelled abroad post 31 December, 2019.

Arogya Sanjeevani 

The government has mandated the coverage of COVID-19 under the Arogya Sanjeevani health insurance product that is offered by all insurers. 

Key Points

• An Indian national in the age group of 18-65 years can get health cover for a sum between ₹1,00,000 -  ₹50,00,000. 
• The premium is around ₹5,000.
• Covers many ailments including illness due to the novel coronavirus. 
• Covers AYUSH treatments. 
• Some critical ailments and conditions like maternity are not covered.
• To file for a claim related to Covid-19, diagnosis, and 24-hour hospitalization is required.
•  

IRDAI has announced that all insurance companies have to offer two standard Covid-19 health insurance policies. These products will have the names ‘Corona Rakshak’ and ‘Corona Kavach’. They will be launched by the insurance companies on July 10.

Corona Rakshak  

It is a standard benefit-based health policy.  An individual can acquire the policy for a sum assured amount between ₹50,000 and ₹2,50,000. Premium will be standard across India. Hospitalisation expenses and equipment expenditure related to Covid-19 will be covered based on the sum insured if the person insured is hospitalized for at least 72 hours once tested positive for Covid-19. The waiting period is 15 days.

Corona Kavach

It will be an indemnity policy with sum assured between ₹50,000 and ₹5,00,000. A fixed amount will be paid to the person insured in case of a claim for Covid-19. Premium will be the same all over India.

It will cover home care treatment expenses of up to 14 days, if there is active treatment based on a medical practitioner's advice. Corona Kavach will cover the treatment of related morbid conditions as well.  The tenure of the product can be from 3.5 months to 9.5 months. It covers expenses related to ventilators masks, etc. for patients and masks, PPE suits, etc. for medical personnel. The waiting period is 15 days and will be available as a family floater plan too.

Will my existing health insurance policy cover COVID-related ailments?

A regular health insurance policy should cover the costs incurred towards hospitalization due to Covid-19. Do check with the insurance provider about the terms and conditions. For example, most of the health insurance plans offered by the Aditya Birla group cover hospitalization expenses due to the virus. But related treatment expenses incurred abroad or expenses on diagnostic tests for COVID-19 are not covered. 

Should I buy a COVID-19 insurance plan?

How much health insurance do you have for yourself and your loved ones? Most health insurance policies should cover COVID-19 related medical conditions subject to policy terms. If your policy can cover hospitalization for illness or loss of pay due to missing work, you need not buy a separate plan. At the same time, regular plans may not cover home quarantine based treatments but COVID-19 specific policies can cover those. On the other hand, the amount you receive from a COVID-19 specific policy may not be enough to cover expenses that can arise due to ICU admission or intensive care. So a regular insurance plan will help in this case. Moreover some hospitals are not sure if the insurance company will accept claims of COVID-19 specific insurance policies, especially for patients with pre-existing medical conditions such as diabetes, so they ask the patients to pay up and claim later. 

A COVID-19 specific cover is good if you do not have health insurance and are at high risk (old age, medical professional) of contacting the virus. A regular plan covers more medical conditions. It can be renewed for as long as one wants and is portable across insurers. COVID-19 based insurance plans cover for limited periods and specific medical conditions and may have limitations on features like life-long renewability or portability. We will have to wait and watch for the benefits that will be provided by Corona Rakshak and Corona Kavach.

It is important to protect self and family members financially against medical conditions. A comprehensive insurance cover that covers many ailments, offers medical check-up, medical consultation and cashless treatment without too much waiting period should be considered.

Vidya Kumar

Dilzer Consultants Pvt Ltd 

9 July, 2020