Insurance for Coronavirus? Here are questions to ask and products that will tide you through

Source :Sify
Author :Sify
Last Updated: Wed, Jun 17th, 2020, 17:34:12hrs

After an over two month long lockdown, an Unlocked India still remains a risky proposition for those keen on getting to work. A surge in cases is reported as arriving sometime in September/October. And, many leaders have already cautioned citizens on the need to learn to live with the virus.  

With no immediate cure in sight, an infection could leave a long-lasting hole in your wallet, not to mention the severe risk of your own life and your near and dear ones. If the premiums appear prohibitive one should understand the severe financial risk owing to Coronavirus. For beginners, the cost of treating the pandemic could run into a few lakhs.  

The cost at government-run hospitals and medical colleges is expected to range to a few thousands. Some states such as Maharashtra or even Kerala (for some medicines) have made them free and also put a cap on treatment in private hospitals. However, despite this, treatment cost at private clinics and super-specialty hospitals ranges in lakhs. The costs are prohibitive because of costlier per day ICU or even general ward rents that are 3-10 times expensive than government run hospitals. Also, costs for Ambulance, fluid charges, PPE Kits, Ventilators, Oxygen tanks, antibiotics, other treatment costs and even consumables are added to the total tally.  

A 15 day treatment is estimated to cost anywhere from Rs 1.60 lakhs and could even go up to Rs 10 lakhs. These costs vary from state, hospital, the treatment type and even quarantine needs of the patient. Patients with chronic diabetes, cardiac or chest-related ailments could see their treatment cost go as high as Rs 18-20 lakhs. These costs do not include the cost of testing. After a recent SC ruling, cost of testing has been capped at Rs 4,500. But a single test is ruled out as evident in the case of Singer & actress Kanishka Kapoor who took six tests before testing negative. An insurance policy that at least addresses the basic hospitalization costs should hence be your objective in the event travelling out of house is completely unavoidable.  

A health insurance policy is also the trend these days with a majority of netizens searching Covid 19 insurance online. Here's a look at what questions one should ask when it comes to a good Covid-19 insurance policy.  

Will my existing Mediclaim or Existing Health Plan keep me covered against Coronavirus?

Mediclaim policies are a comprehensive health package offered by most insurers that covers basic hospitalization costs for major diseases including coronavirus. Most vanilla mediclaim policies cover hospitalization charges unless they are specific to an existing ailment such as cardiovascular or cancer diseases. In case your mediclaim is specific to a particular ailment it is better to seek opinion on whether coronavirus will be covered under the same policy. A reading of the policy document for clause on treatment for epidemics/pandemics should clarify doubts related to whether the policy covers coronavirus. For those keen on buying a fresh mediclaim policy should ask questions such as coverage, cashless network, policy ailments covered, and the waiting period.  

Wil Aarogya Sanjeevani Policy help?

The Aarogya Sanjeevani is the standard insurance policy product proposed by the Insurance regulator to be effective from 1st April 2020.  

The standard plan offers a basic health insurance coverage of Rs 1 lakh to Rs 5 lakhs. Premium for a 25 year old male with no negative health conditions is expected to be approximately Rs 3,316 per year. 29 insurers are offering the product with differences arising out of minor differences in service rendered.  

Here are benefits of the Aarogya Sanjeevani Policy:  

Covers hospitalization for coronavirus in addition to Dental treatment, Plastic Surgery, Cataract Surgery, Immunotherapy, Stem Cell therapy, and even Ayush therapies.  

People in the age bracket of 18-65 are eligible to buy this.

The policy can be auto-renewed for life.  

Covers pre and post hospitalization charges including for Coronavirus.  

Hospital room rents are capped at 2% of sum insured value. For ICUs rents are capped at 5% of Sum Insured or Rs 10,000 per day. The policy covers theatre charges, surgical appliances, anaesthesia etc and has a waiting period of 30 days.  

Do other medical Health Plans cover coronavirus?

The Insurance Regulatory and Development Authority of India has asked all insurers to make claims related to COVID-19 treatment and associated quarantine period to be covered under their standard health plans. Therefore any existing health plan will keep one covered for coronavirus since it is not a pre-existing ailment.  

Some questions that to ask while researching or buying an insurance product are as follows:

1. Is Death due to coronavirus covered by health plans?

No. Deaths by coronavirus will not be covered by a regular health policy unless the policy has specifically mentioned so. A term plan or a life insurance policy will cover the eventualities of loss owing to death.  

2. Should I opt for a standalone Coronavirus policy or a comprehensive health insurance plan.

The answer lies in your own assessment and research on your perception of risks and existing medical conditions. The decision should also depend on whether you are getting a good quote for covering family, senior parents, dependent kids etc. While premiums for a standalone policy may be lower, a comprehensive health policy is better geared to cover those with existing health ailments such as Diabetes, Cardiovascular or Kidney diseases.  

3. Will buying a health insurance plan offer me additional tax benefits?

Under Indian tax laws, tax payers are allowed to claim a deduction of Rs 25,000 every financial year on medical insurance premium instalments. The premiums can be paid towards self, wife, and dependent children. For insurance premiums towards parents the deduction stands at Rs 25,000 while in the case of senior citizens it is Rs 30,000 every year. For premium paid by citizens over the age of 60, the deduction is kept at Rs 60,000. The premiums must be paid in electronic mode since the tax agency does not accept cash payments for passing benefits.  

4. What should be my ideal coverage plan?

There is no universal and ideal coverage plan. Over insuring can result in costlier premiums while under-insuring could result in insufficient coverage.  

5. How should I choose the best insurance plan?

Research on the service provider - waiting period, network of hospitals, cashless facilities, add-ons, their claims ratio and documentation required during claims processing.  

6. What is a waiting period?

A health insurance service provider could suggest X number of days for the first claim, usually, to discourage claims made over wrong intentions or unethical practices. The waiting period could differ from insurer and their products. Some of the coronavirus packages mentioned towards the end of this story explains policies that offer a waiting period ranging from 16 days to 30 days.  

7. Will the insurance policy pay for Covid tests?

Not all policies will cover costs incurred on Covid tests or even X-rays and other diagnostic tests. There are policies that offer claims on diagnostic tests. In most cases it has been found that the insurance policy may not bear the cost of consumables such as PPE kits. It is hence advisable to  seek expert opinion from your financial advisor or the insurer.  

8. I have tested Covid positive. Can I buy insurance now?

You can buy a comprehensive insurance policy, but doing so may not provide any cover for hospitalization should you need one immediately. Insurance for Covid should be sought only if it is not a pre-existing ailment.

9. Will insurance pay for home quarantine?

Most insurers will pay for only hospitalization charges, hence insurance will not pay for home quarantine. However, it is advisable to check if the insurer covers medical reports, tele-medicine, or other consummables as may be required during the home quarantine stage. As a rule, several insurers refrain from covering in the event insured and doctor are relatives or share the same address.  

10. Will I be eligible to utilize my insurance in the event of foreign travel or travel to the country from overseas?

90% insurers do not cover coronavirus during overseas travel. Although, there exists comprehensive mediclaim products with specific policies that covers international travel. Most health and coronavirus related plans have a pan-India chain of hospitals and thereby a pan-India coverage is offered to the customer.

Here are some insurers, and their health plans. Readers are advised that this is not a ranking. Readers are also advised to conduct individual research, compare products, and seek opinions from registered financial practitioners. Prices mentioned are indicative and could vary from gender, age and other existing conditions.

Aditya Birla Coronavirus Package

ABHI (Aditya Birla Health Insurance) offers several packages that offers tenors from a number of days to a few years and coverage from lakhs to crores. ABHI's Active Health Platinum policy for a sum insured of Rs 6 lakhs could cost an annual premium slightly upwards of Rs 8,500. The actual cost will depend upon age, and number of policyholders (one could opt for self, wife, kids, and parents). The policy covers pre and post hospitalization cover up to 60 and 100 days respectively. It offers road ambulance cover on actual at network hospitals.  

HDFC Ergo:

The Health Suraksha plan from HDFC Ergo offers a cover of Rs 15 lakhs for a premium of Rs 11,462 exclusive of taxes for a 30 year old male. HDFC Ergo has specific health insurance plans for family, parents, senior citizens, women, and its website claims offering insurance for all age groups.  

ICICI Lombard Covid Protection Cover:

Responding to an FAQ on hospitalization, ICICI Lombard clearly states that it does not reimburse OPD/Hospitalisation bills but pays "the entire Sum Insured provided irrespective of your bills."

The insurer launched an insurance policy for group insurance in March. For a base plan of Rs 149, insurer is covered for a sum of Rs 25,000 which includes value added benefits, ambulance assistance, and even tele-consultation as part of the policy. The policy covers only those between age group of 18-75. The waiting period is 14 days. ICICI's website strictly seeks documentation of the insurer's travel history to countries.  

iHealth Plus, iHealth Value, and iHealth Budget are some of the policy names. The budget policy for a sum insured of Rs 7 lakhs does cover coronavirus in addition to pre and post hospitalization charges. Premiums for this policy could start from Rs 7,200 per annum.  

Religare Health Insurance

Religare health plans offer coverage of Rs 4 lakhs and up to Rs 6 crores. Some health plans from Religare such as Family Health Insurance Plan offers minimum entry age of 91 years. Some products such as CARE come with a waiting period of 30 days. The CARE policy offers a coverage of up to Rs 75 lakhs as sum insured with an in-built maternity cover of up to Rs 1 lakh with sum insured of Rs 50, 60 and 75 lakhs. Religare's Care Safe plan with coverage of Rs 10 lakhs costs a premium slightly upwards of Rs 9,000. Insurers can also add other benefits such as Daily allowance to the base policy for an additional sum. Doing so would enable a daily allowance of a fixed amount (varies with the plan) for "non-medical" expenses such as food, transportation, etc incurred during hospitalization.

Star Health Insurance

Star's dedicated Novel Coronavirus Insurance Policy offers a sum insured of Rs 21,000 and Rs 42,000 at premiums of Rs 299 and Rs 598 exclusive of GST for a tenor of one year. Age limit of this policy is between 18-65 years. The comprehensive health insurance policy with Star for a coverage of Rs 7.5 lakhs should cost a premium of Rs 10,000 and upwards. This amount is subject to change in age, number of co-applicants and other factors.  

Tata AIG Insurance Package

Tata AIG's Medicare health policy covers Coronavirus' pre and post hospitalization charges. The waiting period on this policy is 30 days. A cover of 7.5 lakhs should cost an annual premium of Rs 7,490. The policy includes accident death benefit and excludes GST component. Actual cost may vary according to age and gender.

Before finalizing a health plan you should also check for benefits from health plans offered by insurers such as SBI General Insurance, Bajaj Allianz, Max Bupa Health Insurance, Apollo Munich, Cigna TTK Healthcare, New India Assurance Company Ltd, etc.

Disclaimer: Lead image is attributed to fernando zhiminaicela for Pixabay.