Special Care to be Taken While Choosing a Coronavirus Health Insurance Policy

The second wave of COVID-19 has weakened but the threat of a third wave has already started to emerge in several states. The trend is not just limited to India, even other countries including the USA are witnessing severe spike in cases among the unvaccinated people. China too has imposed new curbs as it is grappling with sudden surge in cases. If the virus continues to actively spread, then the threat of new severe strains of the virus could also rise in coming days.

Recently, Mr Samiran Panda, Head, Division of Epidemiology and Communicable Diseases, the Indian Council for Medical Research (ICMR), while speaking to media said "the COVID-19 virus may gradually become an endemic from its current state of being a pandemic". Meaning, the COVID-19 virus is here to stay and will continue to spread in pockets of the global population for the years to come, just like the influenza virus.

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Therefore, it is important for everyone to have an adequate health insurance cover for self and family members. Health insurance helps you to tide over the financial hardship during medical emergencies without burning a hole in your savings.

It is important to note that all regular health insurance policies cover the treatment for COVID-19, once the initial waiting period (usually 30 days) has passed. However, since COVID-19 is highly transmissible, there is a possibility that multiple members of a family may require treatment simultaneously. If such situation arises, your existing health insurance cover may fall short in meeting the entire cost of the treatment of all the family members.

So, if you do not have a health insurance cover then buy one immediately. Meanwhile, if you find that existing sum insured is not enough to cover such expenses, then you should consider buying additional coverage. One way to get additional cover is to opt for a COVID-19-specific health insurance policy.

As mandated by the Insurance Regulatory and Development Authority of India (IRDAI), insurers offer two types of COVID-19-specific plans viz. Corona Kavach and Corona Rakshak.

The Corona Kavach is an indemnity-based plan that covers hospitalisation expenses such as room rent, nursing expenses, consultation fees, ICU charges, ventilator charges, etc. The policy covers cost towards consumables such as PPE kit, gloves, and mask which is usually not covered by regular health plans.

Here are the other benefits of Corona Kavach:

1. Covers cost of treatment for any co-morbid conditions triggered due to COVID-19.

2. Covers home care expenses for treatment of COVID-19 at home for a maximum period of 14 days.

3. Covers pre-hospitalisation expenses such as consultation, check-up, diagnostic cost and other medical expenses related to COVID-19.

4. Covers post-hospitalisation medical expenses incurred during 30 days after hospitalisation or completion of home care treatment.

5. Ambulance expenses are covered up to Rs 2,000 per hospitalisation.

6. Expenses incurred for Ayurveda, Unnani, Sidha, and Homeopathy (AYUSH) treatment are covered.

Corona Rakshak, on the other hand, is a benefit-based plan that offers a lump sum payout of the sum insured on diagnosis of COVID-19. The sum insured is paid in full if you get hospitalised for a minimum of 72 hours, irrespective of the actual expenses incurred on treatment of the disease.

Apart from COVID-19 health policy there are other ways to increase your insurance coverage, if you feel that your health cover will fall short in case of severe COVID-19 complications. Here's how you can improve your insurance protection:

- Opt for higher sum insured when you renew your policy

- Buy a new comprehensive health insurance for self and/or family members

- Opt for a top-up plan

Understand the pros and cons of each option depending on your needs and make an informed decision. But whether you opt for a comprehensive health insurance plan or a COVID-19 specific plan there are several important factors to look into to choose the best health insurance policy:

• Expenses covered

  Health insurance covers a range of expenses such as hospitalisation expenses, medicines, room charges, etc. However, there could be sub-limits or a co-payment clause on certain expenses. In this case you may have to pay a portion of the expenses out of your pocket. Given the rising cost of medical expenses, it is important to compare the various expenses covered and limit if any. Opt for a plan that offers maximum coverage at affordable premium.

• Network hospitals

  Ensure that your insurer has tie-ups with a wide range of hospitals (known as network hospitals) so that you can avail cashless facility during medical emergencies. Also make sure that network hospitals are well equipped with vital equipments required for COVID-19 treatment.

• Claim settlement ratio

  Claim settlement ratio is the number of claim settled by the insurer as against the total claim received. The higher the claim settlement ratio, the better is the insurer. Check the claim settlement ratio of the insurer when opt for an insurance policy, so that you do not face rejection during a medical emergency.

• Waiting period

  The standard waiting period for health insurance is 30 days, while it is 15 days in case of COVID-19-specific insurance. However, it can be different for different insurers. Any claim for treatment can only be claimed after completion of the waiting period. Therefore, compare the waiting period of different insurers and choose wisely.

• Coverage for co-morbid conditions

  An insurer may not offer you health insurance if you suffer from certain pre-existing conditions such as heart illness, pulmonary diseases, diabetes, hypertension, etc. However, some insurer may still offer health insurance for a higher premium amount. So, if you suffer from one or more pre-existing disease check for insurers that offer insurance cover to such person.

To conclude...

The COVID-19 pandemic has disrupted lives globally. However, having the right insurance plan can make sailing through this difficult time less stressful. Therefore, it is crucial to select a suitable and adequate health insurance plan based on your needs.

Finally, when you have shortlisted a policy, carefully go through the fine prints to understand the terms and conditions and exclusions. Reach out to an advisor, if you find it difficult to select a suitable policy or if you find the terms and conditions difficult to understand.

Warm Regards,
Divya Grover
Research Analyst

Frequently Asked Questions (FAQs)

Who is eligible to buy Corona Kavach and Corona Rakshak Plan?

Adults between the age of 18 years to 65 years can avail Corona Kavach Plan. You can also avail the plan for your spouse, parents, parents-in-law, and dependent children between day 1 to age 25.

What is the policy tenure for Corona Kavach and Corona Rakshak Plan?

You can avail Corona Kavach Plan and Corona Rakshak for a tenure of 3.5 months, 6.5 months, or 9.5 months including the waiting period.

What is the sum insured available for Corona Kavach and Corona Rakshak Plan?

You can avail coverage of minimum Rs 50,000 and maximum of Rs 5 lakh under Corona Kavach Plan. For Corona Rakshak the minimum sum insured you can opt for is Rs 50,000 and maximum Rs 2.5 lakh.

How can I buy health insurance plans covering COVID-19?

You can easily buy health insurance plans covering COVID-19 online by visiting the website of the insurer.

Is pre-medical check-up required while buying Corona Kavach and Corona Rakshak Plan?

No, you do not have to undergo pre-medical check-up.

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