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We all wish for good health all year round. At the same time, we try to be prepared for any kind of medical emergency. The disease caused by the novel coronavirus, called COVID-19, is a still a relatively new disease. Due to this, initially, everyone was confused about whether it would be covered in our existing health insurance plans or not. The disease spread rapidly in the world as well as in India, the number of infected people reaching from thousands to lakhs and then into crores very quickly. We must have a protection plan against such a contagious disease, especially when even the insurance companies are confused about what to cover. This confusion was also because there is no cure for this disease yet. However, there is no confusion in myUpchar Bima Plus - the disease is covered up to the sum insured under the plan.

At a time when the disease was spreading rapidly, some insurance companies came forward and announced insurance plans for the same. In this article, we discuss the types of policies available today that cover COVID-19 and what kind of protection they provide.

(Read more: What is critical illness insurance)

  1. Types of coronavirus health insurance policies
  2. What is coronavirus health insurance
  3. What is COVID-19 Protection Cover

There are two types of insurance plans associated with the current global pandemic available in India. They’re called COVID-19 Protection Cover and Coronavirus Health Insurance. However, different insurance companies have launched them under different names.

(Read more: What does health insurance cover)

Medical expenses incurred due to COVID-19 are covered under coronavirus health insurance. This policy has been designed in such a way that if the insured person has to be hospitalized due to COVID-19, then all their expenses will be borne by the insurance company. Almost all companies cover any kind of hospitalization due to viral infections. Since coronavirus is also a type of viral infection, it is covered under all comprehensive health insurance policies. It covers both inpatient and outpatient expenses, including pre and post hospitalization expenses.

Benefits of coronavirus health insurance

Following are some of the benefits of taking coronavirus health insurance:

  • Cashless treatment is available and you can also avail of add-on covers.
  • If you are found to be COVID-19 positive then you will get a full claim without any extra cost.
  • If the doctor suggests you stay at home for treatment, this is also covered by coronavirus health insurance.
  • Consumable expenses like PPE kits, ventilators, masks and gloves are covered under this insurance.
  • As far as co-payment is concerned, most policies do not ask for it.

(Read more: Which is the best cashless mediclaim policy)

What is included in coronavirus health insurance

Under the coronavirus health insurance, you get the claim of the following expenses in the plans of most companies:

  • Inpatient hospitalization expenses
  • Pre-hospitalization expenses
  • Critical illness hospitalization
  • Daycare procedures
  • Apart from these, road ambulance expenses, ICU room rent, organ donor expenses, daily hospital cash, home hospitalization, post-hospitalization expenses, alternative treatments like Ayurveda, homeopathy, Unani and other medical expenses and recovery benefits are also covered in this policy.
  • You can also include add-ons like maternity benefits and newborn baby cover to your policy.

(Read more: The difference between health insurance and life insurance)

What is not covered in coronavirus health insurance

Not all medical expenses are covered under coronavirus health insurance. Before making a claim or even buying a policy, you should understand the following exclusions (which are not covered):

  • Home quarantine: The expenses you incur during home quarantine are not covered under this policy.
  • Unrecognized quarantine center: If you are admitted to a center for the treatment of COVID-19 that is not recognized by the government, then it is not covered under the policy.
  • Pre-existing diseases: There can be no claim made under this policy for the treatment of any pre-existing diseases. However, these may be covered once the waiting period is over.
  • Pre-natal and post-delivery expenses: If hospitalization is not required, pre-natal and post-delivery expenses are not covered under the policy. (Read more: Pregnancy)
  • Hospitalization without doctor's advice: If you are admitted to the hospital without the advice of a qualified doctor, then the insurance company will not process your claim for any kind of expenses.

Claiming health insurance for COVID-19

Like any other health insurance, a claim can be made in COVID-19 health insurance in two ways. If you want, you can process a cashless claim by getting treatment at the company's network hospital, in which the insurance company settles the bill directly with the hospital. In such cases, you do not have to spend any money. The second process is that you get treatment in any hospital and pay the bill from your savings and later apply for the claim to the insurance company. This process is called reimbursement and the company checks all your bills and documents before they transfer your claim amount to your bank account.

(Read more: Which is the cheapest health insurance)

Important facts about coronavirus health insurance

Before you buy a COVID-19 health insurance plan, it is very important for you to have some information regarding this type of policy. Consider the following things before taking COVID-19 health insurance:

  • Sum insured: Millions of people have lost their lives worldwide due to COVID-19. The people who have had to be admitted to hospitals due to it are having to bear the heavy burden of the bill in addition to fighting for their lives. This disease attacks your respiratory system and can make you seriously ill. So if you are taking coronavirus health insurance, then opt for a high enough sum insured keeping this in mind. 
  • Get complete coverage: Do a thorough investigation about the plan you’re thinking of buying. Check if it, like most other policies, covers in-hospitalization expenses, post-hospitalization care, ICU expenses, OPD expenses, ambulance and oxygen charges. Ask about the relevant add-ons. 
  • Waiting period: You must also understand all the particulars of the waiting period. Most health insurance plans have a waiting period of one month before they cover medical conditions like diseases and not just emergencies like accidents. However, some companies cover COVID-19 after a waiting period of two weeks.

(Read more: Which is the best health insurance)

Will COVID-19 be covered under my health insurance policy

COVID-19 is a completely new disease and so there was some confusion at the beginning about it. It is clear now though that COVID-19 is a viral infection and every type of viral infection is covered under health insurance policies. So rest assured, you will be able to claim COVID-19 even in your old health insurance policy. Despite this, to overcome your concern, you should reach out to customer care for your health insurance company and ask for clarification.

(Read more: What is a mediclaim policy)

The COVID-19 Protection Plan was introduced as group insurance. Under this, companies provide security to the employees working for them, so that they do not have to struggle financially in case they contract COVID-19. Aggregators like Paytm, PhonePe and EtMoney have also extended the benefit of such group insurance plans to their customers.

Benefits of COVID-19 Protection Cover

If a person gets COVID-19 during the policy period, then the full sum insured is given to them on the detection of COVID-19 for the first time. The sum insured decided by you while taking the policy will be transferred by the company to your account after checking the necessary documents. In this, sum-insured options like Rs 25,000, Rs 50,000, Rs 1,00,000 and Rs 2,00,000 are available.

(Read more: What is not covered in health insurance)

Other benefits of COVID-19 protection cover - Coronavirus Health Insurance Inclusion in Hindi

Different insurance companies may offer a variety of add-ons, in which the insured gets additional benefits such as:

  • Teleconsultation: The insurance company can provide free teleconsultation facilities that are available 24 hours to each of its customers for the duration of their cover.
  • Ambulance assistance: The insurance company can also help in arranging an ambulance at the time of need. However, it may also happen that the insurance company only helps make ambulance arrangements but you have to bear the cost of it.

(Read more: What is family floater health insurance)

How to claim COVID-19 protection cover

If you have a COVID-19 protection cover and you begin to show symptoms of COVID-19, then the first thing you should do is get the test prescribed by the government. Keep in mind that you will have to get the test done from a government hospital or government COVID-19 center. If you are found to be COVID-19 positive by the test, then you will have to make a claim with the necessary documents to your insurance company. Every company demands a separate set of documents along with the COVID-19 positive report. Your sum insured amount is transferred to your bank after your claim is verified.

What cannot be claimed under COVID-19 protection cover

In the following situations, you will not be able to make a claim: 

  • As there is a waiting period of 14 days, you will not get the claim if the COVID-19 report comes positive within 14 days of taking the policy. 
  • You cannot make a claim if you have had COVID-19 before taking the policy.
  • If you have been quarantined due to the coronavirus, then the company will not process your claim.

(Read more: What is self-quarantine)

Documents required for claiming COVID-19 protection cover

If your COVID-19 test comes positive, then you should make a claim with the insurance company with all the necessary documents. It is mandatory to make a claim within 30 days from the date of diagnosis or the claim may get rejected. The documents required for the claim are as follows:

  • Completely filled claim form
  • Lab report of positive COVID-19 result, signed and stamped by the lab officials
  • A report from the lab prescribed by the government in which it is clear that your test has come positive
  • Certificate of your being COVID-19 positive by a government medical officer or a government authorized doctor
  • Cancelled check of your bank account or completely filled NEFT mandate form

Other terms and conditions of COVID-19 protection cover

Following are some more particulars of a COVID-19 protection cover to keep in mind:

  • For this insurance, your minimum age is 18 and the maximum age is 75 years.
  • The policy will be valid for one year.
  • If nothing happens to you during the policy term, no amount will be refunded to you.
  • You will not get the benefit of the policy when you go out of the country.