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Is COVID-19 covered under Health Insurance in India?

3 Mins 17 May 2021 0 COMMENT


According to The Insurance Regulatory and Development Authority of India (IRDAI), general and health insurance companies must offer COVID-19 in existing policies. In its circular, IRDAI has directed all health insurance companies to provide medical cover for COVID-19, where hospitalization is covered in a health insurance policy.

Two choices for new policy holders

If you are looking to buy a new health insurance plan, you can choose from a wide range of health plans or products. But if you are seeking a COVID-19 related plan, there are two specific insurance plans for COVID-19.

  • The Corona Kavach Policy :

    This is a COVID-19-specific indemnity health policy provided by general and health insurance companies only. The minimum sum insured for the policy is Rs 50,000, and the maximum is Rs five lakhs. You can buy this policy on an individual basis as well as a family floater. It requires hospitalization for a minimum period of 24 hours.

  • The Corona Rakshak Policy :

    This is a COVID-19-specific fixed benefit-based health policy offered by all insurers, including life insurance companies. The minimum insured is Rs 50,000, and the maximum limit is Rs 2.5 lakhs. You can only purchase this policy on an individual basis. It offers benefits equal to 100% sum insured payable on being diagnosed with COVID-19. It requires hospitalization for a minimum continuous period of 72 hours.

The window to buy either or both policies has now been extended to 30 September 2021.

Get adequate coverage

Treating COVID-19 can be quite expensive. So, if you are looking for an individual health insurance policy right now, you may want to buy a Rs 5 lakh or more coverage.

If you're looking to buy a family floater policy, ideally a coverage of at least Rs 10 lakh sum insured can be a good start.

On your existing health insurance, you could try maximizing the sum insured by buying a top up plan above your existing health coverage.

How to go about the claims procedure

To enjoy a smooth claims experience, follow the exact claims process as laid down by your insurance provider. The process to file a claim for COVID-19 remains the same as any other claim, but some points should be look into. These are:

  • Know whether you want to make a cashless claim at a network hospital or a hospital of your choice
  • If you opt for cashless treatment, the hospital bill will be settled directly with your insurance provider.
  • If you choose the reimbursement process, where you pay upfront for hospital expenses and later file for reimbursement, you must ensure that you first pay all the hospital bills on your own. Subject to approval, the insurance company will reimburse the expenses to you.
  • For both cashless and reimbursement claim processes, you must inform your insurance company about your hospitalization to file a claim request. IRDAI has directed every insurance company that any decision on authorization for cashless claim for COVID-19 must be processed within two hours of filing the claim request.
  • If you hold a health insurance policy, your insurance company may have set up a dedicated claims desk to look only into claims under COVID-19. You can contact this desk to process your claim request in the shortest time possible.

On availing treatment for COVID-19

To get hospital treatment for COVID-19, you will need to be tested by the hospital for the infection through the RT-PCR test. According to government guidelines, NABL-accredited private labs must provide standardized test prices. If you are admitted to the hospital to be treated for the infection, all hospital expenses that you incur 30 days before hospitalization and 60 days post-hospitalization will be usually covered under the health insurance policy as specified in the pre-and post-hospitalization clause of your policy.

Be aware of all the exclusions and inclusions in your health insurance policy to avoid confusion when filing a claim request.

In Conclusion

With the virus once again spreading its tentacles far and wide, every individual must hold a health insurance policy. Look into the right health plan based on your healthcare and financial needs. Evaluate the many choices available to you to make the right decision today.

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