Health Insurance

Does Health Insurance Cover Pneumonia and Dengue?

By Vikas Chandra Das
22 November 2022, 12:22 PM

Constant rain, stagnant water, and flooding create ideal circumstances for the spread of diseases like dengue and pneumonia. Both disorders have one thing in common- appropriate rest and treatment are required for healing. While most dengue and pneumonia cases respond to home treatment with medicine, nutrition, and rest, some severe cases may necessitate hospitalisation.

With illness comes high medical expenses and the stress of paying them. In such times, health insurance is a lifesaver. However, insurance does not always cover all diseases. Let's see if it covers monsoon-related ailments like dengue fever and pneumonia.

Let us first comprehend diseases' symptoms and treatment possibilities before going on to the nuances of health insurance coverage.

Dengue

Dengue fever is a frequent disease in subtropical and tropical countries that has grown 30 times over the past 50 years. It is a viral disease spread by the Aedes Aegypti mosquito bite.

Dengue fever is characterised by fever, joint and muscle aches, nausea, rashes, headaches, and eye pain. The symptoms can appear in the first phase. Internal bleeding, dizziness, a weak pulse, and persistent vomiting are a few more severe symptoms that signal the disease has progressed to a critical stage that may necessitate hospitalisation. The presence of dengue is determined by a poor count of white blood cells, platelets and metabolic acidosis.

Pneumonia

Pneumonia is an infection that brings the inflammation of the lungs. It could be viral, fungal, or bacterial. Although it strikes people of all ages, it's especially harmful to children and the elderly. Symptoms include fever, headache, coughing, nausea, green or rusty sputum, chills, short breath, chest pain, elevated heart rate, and vomiting.

Over-the-counter medications and keeping the patient hydrated are sufficient treatments in most cases. However, if your disease has advanced, your health is critical, or your immune response is already compromised, you may need to be hospitalised.

Do Health Insurance Policies Cover Pneumonia and Dengue?

If you have comprehensive health insurance, it will cover all hospitalisation costs, including room rent and pre and post-hospitalisation care. The policy also covers dengue fever and pneumonia. The worry is that most dengue and pneumonia patients do not necessitate hospitalisation. One might conclude that insurance is unnecessary if it does not necessitate hospitalisation. Wrong!

Your expenses are not tied only to hospital bills. Recovering at home can result in a big cost, involving the ones below-

Diagnostic Investigations - Your doctor will need to run a few tests to verify the presence of the disease. Once validated, you may have to redo the tests to track and ensure your recovery.

Medicines - If you are being treated at home, you will be given antibiotics and medications to help manage your fever. You can also seek therapy using alternative treatments such as Ayurveda, Siddha, or Homoeopathy.

Income Loss - Dengue and pneumonia are contagious infections that necessitate total bed rest for a good recovery. Without proper rest, the symptoms can worsen, increasing the degree of illness to the point where you may require hospitalisation. In addition, you will have to skip work during this time, which may result in a loss of earnings.

Home Health Nurse - The symptoms of dengue and pneumonia call for bed rest. This suggests you'll need assistance throughout this stage. In addition, you may need to employ a home nurse, which is an additional cost.

All these fees can be pretty substantial. It can impact your finances because it is an unforeseen and unexpected expense. Your health insurance policy may not cover all these costs. However, specific dengue or pneumonia insurance, or an add-on to a current policy, will cover these costs and far more.

So, What Does Dengue and Pneumonia Insurance Cover?

Dengue fever and pneumonia are more common nowadays. In 2018, there were approximately 1 lakh dengue cases. Pneumonia is still claiming the lives of lots of children. Insurance companies have recognised the necessity for coverage that covers the treatment of diseases like these, primarily treated at home but resulting in a significant medical expenditure. Insurers such as DHFL, Bajaj Finserv, and Apollo Munich have developed Dengue-specific insurance policies. These can be added on to your current health insurance or purchased as a separate policy. Some of the characteristics of such policies are as follows:

  • They have inexpensive insurance premiums. For a year, the premium ranges between INR 400 and INR 600. 
  • These cover the costs of hospitalisation as well as home care. There is coverage for hospital-related charges ranging from INR 50000 to 1 lakh, as well as INR 10000 for outpatient care. 
  • A claim under this policy will not affect your regular health insurance. Even if you use your dengue policy, you are still eligible for the No-Claim Bonus when you renew your health insurance policy the subsequent year.
  • There is no age restriction for such rules because infections can affect everyone, regardless of age.
  • The companies consider the nature of the progression of the disease, therapy, and other factors while creating specific coverage plans. As a result, the requirements for cost reimbursement are typically less strict, and applications have a better possibility of being approved. I

In a dengue health insurance policy, for instance, a claim for a hospitalisation lasting longer than 24 hours but less than 48 hours might be accepted, but not under a comprehensive policy, which may need hospitalisation for 48 hours or more.

Conclusion

Should you then purchase dengue or pneumonia insurance? The answer varies based on whom you ask. Obtaining only dengue or pneumonia insurance is not advisable as it covers only the specific illness. However, while residing in an area where you are at risk of catching these diseases, getting additional coverage for these ailments is a good option. It is always preferable to be secure rather than sorry.

FAQs
1. How do I stay away from dengue?

You can wear long sleeves and pants, apply insect repellent, and keep mosquitoes at bay both inside and outside of your home. 

2. Does HDFC ERGO health insurance cover dengue?

Yes. It covers consultations, diagnostic testing, home nursing for dengue therapy administered at home, and pharmacy.

3. Can we ensure pneumonia?

Comprehensive health insurance covers dengue and pneumonia, offering coverage of room rent, pre and post-hospitalisation costs etc.

4. How long does it take to cover pneumonia?

Recovery from pneumonia may take some time. Some individuals feel better and can resume their everyday routines within 1 to 2 weeks. Others might have to wait a month or more. However, the majority of people remain weary for around a month.

5. How can I get over pneumonia more quickly?

Have hot drinks, steam baths, and a vaporiser to open your lungs and make breathing easier. Avoid smoking so that your lungs can recover. Smoking, passive smoking, and wood smoke are all included in this.

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