We all already know the importance of health insurance at the time of an illness or accident. Apart from this, health insurance companies also offer some special policies to woo more customers with specific needs, such as critical illness insurance, cancer insurance, senior citizen insurance, pre-existing illness insurance etc. Similarly, health insurance companies also offer health insurance for heart patients, in which coverage is provided for cardiovascular diseases including severe heart disease.

According to the Indian Heart Association, more than 50% of all heart attack cases are reported in people below 50 years of age. Not only this, 25% of heart attack cases occur in people below 40 years of age. These startling figures prove that heart disease is just as much of a risk for everyone, despite their age, making it essential for people to take better care of their hearts. This is the reason cardiac health insurance is also important. Heart health insurance protects the insured from rising medical costs since this disease can wipe out one's entire savings in a jiffy.

A cardiac health insurance plan provides coverage in acute heart diseases like refractory heart failure, myocardial infarction or heart attack and cardiomyopathy. It is extremely important for heart patients to take health insurance so they can deal with this type of medical emergency without any stress and financial worries. Most health insurance companies offer cardiac health insurance plans.

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  1. Importance of cardiac health insurance in India for heart patients
  2. Key features of cardiac health insurance plan
  3. What is covered under cardiac health insurance plan
  4. Treatments covered under cardiac health insurance
  5. What is not covered under cardiac health insurance
  6. Who needs a cardiac health insurance plan

The increasing incidence of heart diseases such as heart attack, stroke and high cholesterol levels as well as the rising cost of treatments has increased the importance of health insurance for heart patients in India. A cardiac health insurance plan is specially designed for heart patients and is beneficial for those already suffering from and at high risk of developing heart disease. The main objective of this type of health insurance plan is to reduce the financial burden from the head of the insured. Along with this, the insured gets the benefit of the best treatments related to the heart like Coronary By-Pass Surgery (CABG), angioplasty, etc.

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There are many features and benefits of heart health insurance. Some of them are:

  • Hospitalization cover: Under this policy, coverage is available for the treatment of and other expenses related to heart diseases as well as hospitalization expenses.
  • Financial help: In case of a heart-related problem like a heart attack, having this policy would mean that you would not need to arrange any money. You can get your treatment done and claim the expenses with confidence.
  • Lump-sum payment of sum assured: If the life insured is diagnosed with any heart disease then the insurance company pays the sum insured amount in a lump sum.
  • Loss of income cover: Under a cardiac care health insurance plan, you get a lump sum amount with which you can cover your other expenses along with the treatment.
  • Treatment abroad: Many cardiac health insurance policies also provide coverage for treatment abroad. However, this depends on the coverage of the policy.
  • Tax exemption on payment of premium: Under Income Tax Act 1961, there is a deduction of up to Rs 25,000 in income tax on taking a health insurance policy.

All of these benefits of cardiac health insurance are subject to various terms and conditions.

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One of the best benefits of a cardiac health insurance plan is that the insured gets a lump-sum amount from the insurance company. Below are some expenses that are commonly covered under a heart insurance policy:

  • Coverage of in-hospital expenses: This includes many hospitalization expenses including ICU charges. If you are getting treatment in a network hospital of the insurance company then all these expenses will be covered cashlessly, else you can settle the bill yourself and claim reimbursement later.
  • Expenses related to pre and post hospitalization: Patients are not instantly admitted to the hospital as soon as the first symptoms appear. Therefore, doctor's fees, medication and diagnostic tests before hospitalization (usually up to 30 days prior to hospitalization) are covered under cardiac health insurance. Not only this, medicines and doctors are still needed once you’re discharged from the hospital. That is why most policies also provide post-hospitalization coverage of up to 60 days after discharge. In this, you can get reimbursed from the insurance company for follow-ups, medicines, tests etc. 
  • Home treatment and OPD treatment facility: Under some cardiac health plans, the insured also gets the facility of home treatment or OPD treatment. The primary condition for this is that it should be prescribred by a qualified doctor.
  • Myocardial infarction (first heart attack) coverage: When the heart does not have an adequate supply of blood, its muscles begin to collapse, causing the first heart attack. Coverage for this is available under most heart health insurance plans. A first heart attack can be diagnosed by clinical symptoms such as chest pain, electrocardiogram and other biochemical markers.
  • Refractory heart failure: There is also coverage for refractory heart failure under a cardiac health plan. The condition for it is that it should be diagnosed by a cardiologist, have biomarkers pointing to it or have symptoms as per the policy wordings.
  • Annual cardiac-health checkup: The facility of annual cardiac health checkups is also available in the cardiac health insurance plan for heart patients. This helps the insured in proper diagnosis.
  • Alternative treatment: Health insurance for heart patients also covers alternative medical treatments like AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy) treatment.

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Cardiac health insurance plans mainly cover the following:

  • First heart attack (up to a certain intensity)
  • Pericardectomy
  • Balloon Valvotomy or Valvuloplasty
  • Open chest coronary artery bypass graft
  • Surgery to install a ventricular assist device
  • Surgery for cardiac arrhythmias
  • Minimally invasive surgery of the aorta
  • Open heart replacement or heart valve repair
  • Primary pulmonary arterial hypertension
  • Implantable cardioverter-defibrillator (ICD)
  • Angioplasty
  • Heart transplant
  • Inserting a pacemaker

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The following expenses are not covered under health insurance plans for heart patients:

  • Self-injury or suicide attempt
  • Pregnancy and childbirth, abortion, treatment for miscarriage and other congenital diseases
  • Hospitalization due to an illness caused by the use of drugs or alcohol
  • Infertility and IVF treatments and tests are not covered
  • If there is hospitalization due to war, riots, strikes or nuclear weapons, then coverage is not available.

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In today's fast-paced world, cases of heart disease aren’t limited to the elderly and can develop in people of all ages. Heart disease is not an easily curable disease, and so it can affect the finances of the sick person very badly. Hence, cardiac health insurance is a must for every person who is at risk of developing lifestyle-related cardiovascular diseases like heart attack and heart failure. People who already have heart disease or a history of heart disease in the family should definitely opt for a cardiac health insurance plan. Treatment of heart-related diseases can cost a lot. If you have adequate health cover under cardiac health insurance, then you can get the treatment done right away without worrying about the cost of the treatment.

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