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Health Insurance Policies TB patients in India Can Rely On

By Juhi Walia
01 September 2022, 11:31 AM

Mycobacterium tuberculosis bacteria can wreak such havoc in the human body that the person it attacks may even die in a few months. The bacteria causes tuberculosis, or TB, one of the world's top 10 fatal diseases, according to the World Health Organisation (WHO). If not contained, the highly-contagious disease that causes pulmonary or lung infection can rapidly affect other parts of the body, including the spine, ovaries, and even the brain — when it's called cerebral tuberculosis. The disease's severity and complication make its treatment course long-term, making the costs pretty steep, mainly because the sufferer also needs medical care to treat the side effects of medication. Fortunately, though, health insurance companies provide comprehensive and critical illness plans that can ensure timely and high-quality medical care and financial support. Here's all you need to know about this ailment and health insurance policies that benefit a patient. 

Why is TB a Cause for Concern?

Tuberculosis infects the lungs, a vital organ, and causes severe respiratory symptoms. Furthermore, the infection can quickly spread to other organs such as the spleen, liver, kidneys and brain. The patient requires intensive care and a long-term treatment plan. The disease is also debilitating and causes fatigue, loss of appetite, weight loss, weakness, persistent bouts of cough, night sweats, and painful breathing. Though these are common telltale signs, the condition can often be asymptomatic (called latent TB when the bacteria remain dormant) or present itself through different symptoms in different sufferers. 

Exorbitant Treatment Costs

Even though a bacterial infection, TB takes much longer to cure. While other bacterial diseases resolve in a few weeks, the treatment for tuberculosis can stretch up to 6 to 9 months. After the diagnosis, you need to be on an antibiotic course for a long time for the infection to clear completely and ensure it doesn't relapse. Even after the medication course is completed, you will need a follow-up checkup with the doctor, and if the infection persists, you may need to be on medication for at least 3 more months. Since the TB bacteria is resistant to specific meds, the course requires a combination of several drugs. 

How Health Insurance Helps

One can prevent TB with vaccination. For Indians, including children, the Bacillus Calmette-Guerin (BCG) vaccine protects one from TB strains. To protect yourself financially, compare health insurance policies and buy the most suitable one from Paytm Insurance. Since the treatment is a long-drawn process and you will be out of action due to the symptoms and because TB is contagious, a health insurance plan will minimise the financial distress.  

If you have a persistent cough and other symptoms, consult a doctor pronto and undergo tests for TB infection. These would include: 

  • Blood test to detect a TB infection
  • TB screening  
  • Tuberculin skin testing 
  • AFB (Acid-Fast Bacillus) smear and culture 
  • Chest x-ray  

If the reports are inconclusive, you may have to get a chest CT scan or a lung biopsy. Getting tested on time is crucial as TB spreads rapidly and can be fatal unless one receives a timely intervention.

Health insurance plans significantly benefit senior citizens and those with a compromised immune system, as they are at a much higher risk of getting infected. Recovery for such patients is also slow and arduous as their immune system is already weak. So, the treatment may be longer and costlier as it will mean managing TB and their existing conditions. The average cost of treating TB is estimated to be INR 1 lakh minimum and could go up to INR 5 lakh. But if it affects your brain and you need surgery, it could even touch INR 10 lakh.  

What Does Health Insurance for TB Include?

Health insurance benefits in comprehensive and critical illness plans cover many requirements. These are:

  • Hospitalisation Expenses — You may be eligible for reimbursements to treat specified conditions. Check with your policy provider the set amount for the same.
  • Pre-hospitalisation Charges — Expenses for all kinds of tests during or before the policyholder is admitted to a hospital.
  • Consultation Fees — Policies cover doctor's consultation fees pre, during and post-hospitalisation. 
  • Medication Expenses — Expenses you incur on medicines before, during and after hospitalisation.
  • Room Rent — The policy will cover the hospital's daily room rent. Following the room rent restriction, providers have fixed coverage for daily room rent for general and ICU wards.
  • Treatment expenses include physician consultation fees, diagnostics, room rental, ICU charges, transfusion, medicines, and more. 

Top Health Insurance Companies That Offer Policies for TB

Many insurers provide coverage for TB. It would be best to choose a reliable health insurance company with a good health insurance claim settlement ratio (CSR) for a seamless process. You could consider: 

  • Niva Bupa Health Companion
  • Bajaj Allianz General Insurance
  • Future Generali Future Health Suraksha
  • Aegon Life Insurance Company
  • ICICI Lombard Insurance Company
  • Royal Sundaram General Insurance
  • Aditya Birla Activ Assure Diamond Plan


Tuberculosis is a dreadful and expensive disease; its treatment course can last 6 to 9 months. Health insurance can bail you out of financial distress and ensure you get timely and high-quality treatment. Several insurers offer comprehensive and critical illness plans to cover all the expenses of TB from pre, during to post hospitalisation. 

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1. Does health insurance cover pre-existing tuberculosis?

Yes, health insurance plans cover pre-existing TB but only after a waiting period of usually 4 years, which may differ from policy to policy. So, do check out the waiting period before you buy a plan. 

2. Do health plans also cover latent TB?

Yes, health insurance policies also provide cover for latent TB. The coverage amount will depend on the overall sum insured. 

3. Do family floaters also provide coverage for TB?

Yes, whether an individual policy or family floater, comprehensive or critical illness plans will provide TB coverage. It might still help to ensure this with the provider and compare policies to buy one. 

4. As with other critical illnesses, does the policyholder get a lump sum for TB?

If you have a fixed benefit health insurance policy, then you will get a lump sum when diagnosed with TB. The amount will depend on the coverage. However, do verify this with your provider. 

5. Can the claim for TB treatment be rejected for any reason?

If you apply for a claim before the waiting period ends, the insurer may reject your claim. Smokers may also have their claims rejected, as smoking adversely affects your lungs and immunity and increases the risk of contracting TB. 

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