The past five years have witnessed the outbreak of various dreadful diseases such as SARS, MERS, Ebola, Zika, and Nipah virus. Now in 2020, we are reeling with SARS Cov2 (COVID-19) outbreak that has brought the world on its knees.  Currently, there are more than 20 million cases (till August 2020) as per the WHO report and the numbers are increasing daily.

With the growing incidence of coronavirus cases, people across all the age groups are anxious about the expensive healthcare costs. Despite the lockdown, the increasing number of COVID-19 cases in India has put a lot of people confused regarding the health insurance coverage for the medical expenses incurred on the treatment of this new coronavirus borne respiratory illness.  

The average hospitalization for COVID-19 treatment is 5-7 days, and in severe cases, it can go beyond 10 days (with ICU charges spiking the bill). In such cases an average Indian family’s savings might not suffice without adequate health insurance cover.

To put things into perspective, the average cost of treatment in private hospitals in metro cities in an isolation ward is Rs 1.25 Lakh, ICU with a ventilator is Rs 1.96 Lakh, and ICU with a ventilator is more than Rs 2 Lakh.

Patients with co-morbidities the bill can shoot up to 6-7 lakh or even more in Super specialty hospitals  And these charges are exclusive of PPE kits, N 85 masks, disinfectants, foot cover, etc. which add 25% to the overall treatment cost. Therefore, existing policyholders should check the detailed list of consumables in their policy, which are non-payable items.

Undoubtedly, it seems quite inevitable to have a health insurance cover to deal with the ongoing ‘SARS CoV2 or Coronavirus Pandemic’.

Rising Awareness about Health Insurance: Survey

A recent Max Bupa Health Insurance COVID Survey among 1,700 respondents between 27 years and 35 years of the age group in 11 cities across India captured that the awareness among millennials about health protection is one of the rare positive outcomes of coronavirus pandemic.

Before the COVID-29 outbreak, only 37% of millennials were keen to buy a health plan that covers coronavirus as well, but now 60% want to buy a comprehensive health cover.

As per the Survey, Before COVID people use to buy Health Insurance for the following reasons:

• Critical Illness Cover- 86%
• Coverage for Regular Illnesses-53%
• COVID-19 Cover-39%
• Cancer Cover-28%
• Tax Saving- 28%
• To cover Cardiac Issues- 23%
• Maternity Cover- 17%

Post COVID-19 outbreak the reasons to buy health insurance have changed:

• Policy Coverage Amount- 66%
• Cashless Facility- 55%
• Illnesses Covered- 39%
• Availability of Family floater Option-
• Premium Amount- 30%
• Upper Cap on Hospital Room Rent-  29%
• Turnaround Time on Claims- 25%
• Wider range of Network Hospitals- 25%
• Coverage for Pre-existing Diseases- 23%
• Duration of health Coverage- 21%

Let's discuss how health insurance coverage can be the best bet to meet the huge COVID-19 hospitalization bills and the things that you should be aware of:

Important COVID-19 Medical Insurance Measures 

To counter the outbreak of Coronavirus in our country, several health insurers such as Max Bupa Health Insurance Company, Religare Health Insurance Company, and HDFC Ergo General Health Insurance have ramped up telemedical services with one of the leading Insurance intermediaries like Policybazaar health insurance in India. Amid the ongoing pandemic, people can seek medical consultation without visiting the doctor in person or waiting in the queue. In fact, the doctors would be able to establish communication with the patients over a call and suggest a treatment based on medical history, symptoms and this goes for both health and term insurance. 

Comprehensive Health Insurance Also Covers Coronavirus Expenses

To ease you up, all the health insurance plans, in general, cover all kinds of infections that lead to an illness. And coronavirus is also a kind of infection borne illness, so it is covered by almost every insurer. Nowadays a health insurance policy should cover both hospitalization expenses and out-patient expenses regardless of the illness.   

The only drawback is that a basic health insurance policy may not cover the cost of consumable items, like PPE kits, ventilators, and therefore out-of-pocket expenses even for an insured person remain a cause of concern. 

To address this concern, the Insurance Regulatory and Development Authority of India (IRDAI) has asked all the Health and General Insurance Companies in India to provide two standard Coronavirus health products namely: Corona Kavach and Corona Rakshak health plans.

The two uniform products will help people pay for the exorbitant treatment cost including the cost of PPE kits, ICU and ICCU expenses, oximeter, ventilators, masks, gloves, and medicines, and ultimately reduce their out-of-pocket expenses. Those who do not have insurance can definitely buy any of these plans or buy it along with their existing health plans.

5 Things to Keep in Mind Regarding COVID-19 Health Insurance

Almost every health insurance company is launching Coronavirus-specific insurance policies or is offering coverage to the policyholders in the existing policy.  Whereas, specifically designed health plans will offer a quick solution to people with no health coverage who are seeking protection against Coronavirus.

Let's check out some of the important conditions regarding coronavirus health insurance coverage: 

1. Some of the general insurance providers in India that have introduced specific health plans covering Novel Coronavirus are Star Health Insurance, ICICI Lombard, Digit Insurance to name a few.
2. If you have a comprehensive health insurance policy you can still buy a Coronavirus specific medical insurance plan to be able to pay for the cost of consumable items like PPE Kits, Gloves, masks, ventilators, as mentioned above, it can increase your overall hospital bill

2. There are two standard Coronavirus health insurance products i.e. Corona Rakshak and Corona Kavach Policy that every health insurance company in India is providing to help people meet the treatment costs in a private hospital.
3. The sum insured amount for COVID health plans ranges from Rs. 50,000 to Rs 5 lakh and the premium is quite nominal starting from Rs 200
4. All the Indian residents can avail of the coverage benefits, however, the benefits, and clauses regarding age criterion, travel history will be policy specific only.  

Are diagnostic Expenses Covered?

Usually, diagnostic tests are excluded from a comprehensive health plan unless it is a part of the hospitalization expenses. And in case of coronavirus mostly the government is conducting the tests, however, if you have outpatient expenses cover in your policy your insurer will compensate the cost incurred. In private labs the cost is Rs. 4500 for novel coronavirus test and for basic screening it is kept at Rs. 1500. 

Is Quarantine Covered?

Quarantine expenses are not covered under a standard health plan unless it requires hospitalization or is quarantine in a government-approved center where the patient is undergoing treatment and is charges fees. You can check with your insurer if your specific Coronavirus health insurance plan covers the same.

How tricky is it to file Coronavirus Hospitalization Claims?

Claims are an important part of health insurance. And if you are wondering how to file a medical insurance claim for coronavirus treatment then this might be of some help:

Cashless Medical Treatment

If you have a health insurance policy you can seek cashless treatment by showcasing your health card in one of the network hospitals that are mentioned in your policy wordings. You can also check the list online on the insurer's site provider's network hospitals.

So, if you want to avail cashless treatment you can inform your insurer and mention the hospital where the treatment is undergoing. You need not pay the hospital bills; the insurer will settle the bill on completion of the paperwork.

However, the compensation will be limited to the sum assured. And any additional costs such as medical masks, and non-medical expenses, need to be paid on your own.

Reimbursement Claim

If you seek treatment in a non-network then you can claim for reimbursement of the medical expenses. You also need to inform your insurance provider about your plan to seek medical treatment before filing the claim. On completion of the treatment, you claim the insurer for reimbursement.

It requires you to submit all the reports, documents, bills, and then claim for reimbursement. Usually, the claims are settled in a week or so, but it is better that you check with your insurance provider regarding the claim settlement period for COVID-19 claims.

Over to You

If you have not invested in a good health insurance plan for your family now is the time to do so. It will make it easier for you to avail proper medical treatment and healthcare facilities and also, save you from draining your financial reservoirs.