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Critical Illness Medical Insurance Policies Which Cover Dialysis

By Vikas Chandra Das
14 November 2022, 12:19 PM

Most standard health insurance plans take care of hospitalisation expenses in case of illness and accidents. However, there are certain illnesses, which health insurers term as critical illnesses, which are usually not covered by standard health insurance policies. These critical illnesses include paralysis, heart attack, stroke, cancer, major organ transplant, multiple sclerosis, kidney failure/dialysis and many others. It is estimated that such critical illnesses account for almost 60% of the deaths in India.

The good news is that there are several health insurance plans that are tailor-made to take care of these life-threatening conditions. These critical illness insurance plans will help you pay for expenses that standard health insurance policies generally do not. By paying you a lump sum, once the insured is diagnosed with a critical illness, she or he can take care of debt, hospitalisation expenses, lifestyle changes or loss of income.

Dialysis, as a result of end-stage kidney failure usually requires regular, frequent and life-long day trips to the hospitals or medical facilities, as many as three or more times a week. Each visit could cost you between INR 1000/- to INR 5000/- apart from transportation, attendant fees, loss of income, etc. This adds up to INR 20,000/- to INR 100,000 a month depending on frequency, the treatment facility.etc. Without a critical illness policy that specifically covers dialysis, it would be difficult if not impossible to tide through such a situation. There are several health insurers such as Bajaj Allianz, Bharti AXA, HDFC Ergo, SBI, Tata AIG, Chola MS and many others that offer to cover critical illnesses including dialysis. Let us look at some of the plans briefly.

ManipalCigna Lifestyle Protection – Critical Care Health Insurance

This provides a maximum sum insured of INR 25 crores. It covers a total of 15 illnesses under the basic plan and 30 illnesses under the enhanced plan and may be opted for by anyone between 18 to 65 years of age. You may opt for a lump sum payment or a staggered payment over 60 months after diagnosis. The latter offers a 10% additional benefit.

Bharti AXA Smart Super Health Insurance

With the sum insured ranging from INR 5 lakhs to INR 1 crore, this policy also offers an additional lump sum pay-out for certain illnesses over and above the sum insured. It also has a substantial network of hospitals which support cashless treatment.

HDFC Ergo Optima Vital Health Insurance Plan

Formerly known as Apollo Munich Health Insurance, this covers a total of 37 critical illnesses including dialysis. It offers a lump sum pay-out irrespective of the cost of treatment. It offers this on confirmed diagnosis with defined severity of the illness or the date of undergoing specified surgery. With a maximum sum insured of INR 50 Lakhs, this becomes INR 20 Lakhs after the age of 55. It has a waiting period of 90 days.

HDFC Ergo Critical Illness Policy

HDFC Ergo Critical Illness Policy offers coverage of 15 critical illnesses such as heart attack, cancer, multiple sclerosis, Parkinson’s Disease, Alzheimer’s Disease, kidney failure and others. The sum insured is paid as a lump sum as in the case of most critical illness cover insurance policies. This plan has two variants – the Platinum Plan and the Silver Plan. Both cover kidney failure and dialysis.

Chola MS Critical Healthline Insurance

Available in two variants – standard and advanced, this offers a sum insured per person between INR 3 Lakhs to INR 10 Lakhs for up to 12 critical illnesses. Apart from dialysis it also covers Parkinson’s disease, cancer, stroke resulting in permanent symptoms and others.

Niva Bupa Critical Illness Cover

Offering a coverage of INR 3 Lakhs to INR 2 crores, this plan offers coverage on 20 critical illnesses including dialysis, deafness, loss of speech, major burns, open chest CABG, etc. It also offers a tenure discount if you opt for a 2 or 3 year policy. Added features promised include free look period, assured renewal and direct claim settlement.

To Sum Up 

There are several plans that cover critical illnesses not covered by standard health insurance plans. While choosing the critical illness cover plan, study it well and ensure that it complements and balances the existing standard health insurance policy under which you are covered. In this way, you can obtain the maximum benefit with the least stress and at a reasonable price. Read the fine print however. In many cases the cover comes with a clause regarding the specified severity of disease. In other cases, clauses may include pre-existing disease.


1. What is a critical illness?

A critical illness is generally meant to be an illness which is life-threatening as a result of which the person diagnosed with it may need to make several lifestyle changes, adjustments and adaptations from the lifestyle he or she enjoyed previous to diagnosis. It also refers to corrective measures. Diseases or conditions such as cancer, kidney failure, bypass surgery, total blindness, stroke are some of those referred to as critical illnesses. Treatment costs and the related financial burden due to loss of the ability to work etc can put a crippling financial burden on the victim and his/her family.

2. Why do standard health insurance plans not cover dialysis?

Dialysis costs are recurring and usually a lifetime expense. Thus the coverage of a standard health insurance policy may not be sufficient to cover the costs. It is thus classified as a critical illness by most insurers and covered by separate plans.

3. What is the “waiting period”?

This is the period between the start of the policy and the time before you can avail any benefits from the policy. This waiting period may be for any claim related to all illnesses, or only for claims related to some specific illnesses, pre-existing conditions such as diabetes etc., or special conditions, such as pregnancy and childbirth. 

4. What is the “free look period”?

Most insurers allow the purchaser of the policy to return the same within 15 to 30 days from the date of receipt of the policy, if she or he feels that the policy is not suited to her or his needs. This period is called the free look-up period. The premium paid is refunded to a major extent – usually this is the cost incurred till then for health check-ups, stamp duty etc. Some may charge a flat rate of 20% or more.

5. What is a pre-existing medical condition?

Any medical condition, ailment or injury for which there were signs and symptoms or which was diagnosed within 48 months prior to the first policy issued by the insurer and also renewed continuously thereafter is termed as a pre-existing condition as per the IRDAI.

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