Topic 2: Having trouble with your health insurance? Find all your COVID-19 health insurance queries answered

The COVID-19 pandemic is currently on top of everyone’s mind. Until now, the global pandemic has infected millions of people across the globe and increasing in numbers every hour. In India, the total number of cases reported has crossed 20 per cent of the global tally. These difficult times pose a great challenge to the public health-care system and the government, with both trying beyond their capacity and fiscal limitations to address this unique situation. During these times, insurers are being flooded with queries from anxious customers trying to know the coverage offered, the waiting period, if any, the cost implications, and the claim process.

Here are some of the common health insurance questions related to COVID-19, faced by most customers:

Is it essential to opt for a COVID health policy?
Given that there is still no clarity on the shape of recovery or recurrence for the pandemic and the vaccine is still many months away, to avoid getting your lifetime or retirement savings completely diluted due to a Covid hospitalization, it is absolutely critical that the first and foremost financial security and investment that you should do is to buy Health insurance or increase your insurance coverage right away.

Is Quarantine covered in the Policy?
The COVID-19 treatment has led to the creation of a special situation consisting of quarantine at a government-approved facility that is not a hospital or even isolation in your own home. Even if the policyholder is isolated at a government-approved facility on being tested positive, the expenses, including pre and post-hospitalization, will be compensated, as it will be considered equivalent to hospitalization, as per the terms and conditions of the Health Insurance Product. Quarantine only for isolation without any treatment, is not covered.

What is the average waiting period of a COVID policy?
Every health insurance policy comes with a clause of the waiting period of 30 days for regular hospitalization and 2 to 4 years for pre-existing diseases. Considering the Covid related difficulties being faced by the general public and as per the regulator’s guidelines, a few insurers have reduced the initial waiting period from 30 to 15 days for the policyholders for COVID-19 related inpatient hospitalization claims.

As per the advisory of IRDAI, several insurers are offering COVID-specific fixed-benefit plans such as Corona Rakshak/Kavach. These are disease-specific plans that provide a lump-sum amount on a positive diagnosis and hospitalization due to COVID-19 infection. However, it is advisable to purchase these plans along with the regular indemnity-based health plans that offer comprehensive coverage against all ailments up to the total sum insured.

What is the extent of coverage offered?
The coverage for COVID-19 infection is similar to that of any other ailment. To avail of treatment through your medical insurance, hospitalization for at least 24 hours is required. All your expenses will be covered for treatment, during your hospitalization. Besides this, pre and post hospitalization expenses will also be covered that include the test for COVID-19, regular blood tests, x-ray, and ambulance expenses. It is necessary to keep in mind, that pre and post-hospitalization expenses cover only up to 30 days before and after hospitalization.

What is Home Treatment Benefit?
Considering the safety and wellbeing of customers and the shortage of beds at the hospital, a few insurers are offering a Home Treatment facility to policyholders as per the ICMR Guidelines. This Home treatment facility would be provided on a cashless basis through Network Providers and Empanelled Service Providers.

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