Health Insurance for Covid-19

Coping with the numerous challenges caused by COVID-19 has taken a serious toll on people all over the world. In India various measures have been taken, some of them quite stringent, to help slow down the spread of coronavirus.

Due to the outbreak, there has also been a notable shift in the attitude of people about the need for health insurance. In a recent online survey conducted by Max Bupa, it was discovered that before the outbreak of COVID-19, a mere 10% of the population showed an inclination towards buying health insurance. However, almost 70% of the entire population considers health insurance to be a necessary shield against the pandemic.

In light of the conditions that are prevailing, the government has also taken into consideration the need for easing the immense pressure on the healthcare system. The health insurance companies have been instructed by the Insurance Regulatory & Development Authority of India (IRDAI) to deal with health insurance claims within 2 hours.

Why Covid-19 Outbreak Made Health Insurance a Priority Product Among Indians?

The modern world has been divided into three timelines, pre-COVID, COVID and post-COVID though the post-COVID days seem to be nowhere in the near future. Despite the lockdowns, and government guidelines the cases are increasing by the minute, and the risk of infection has brought the spotlight on health insurance. Let's take a look at how the Covid-19 outbreak has made Health Insurance a priority product among Indians:

1. Growth in Number of Cases
   As per most recent data, India’s COVID tally crossed the 6.14 million mark. Thousands of cases are being added every day as more and more people are coming in contact with the virus. That is a huge reason for more people wanting to buy health insurance, so as to cover their finances even if they fall prey to this disease.
2. Loss of Jobs & Income
   The lockdown had a massive effect on the economy. So many people lost their source of income, many lost their jobs, many are facing pay cuts, every member of the society has been affected by a coronavirus, in some way or the other. 
   Thus, depending only on your corporate health care plan might not be a great idea. You need to have your own individual health insurance plan in order to cover emergency situations.
3. Quality Healthcare Facilities
   The government is treating all COVID-19 patients either free or at a negligible charge, yet there are many people who still prefer private hospitals, despite them being expensive. Even for a patient with minor symptoms, the daily charges of being in a decent hospital can be between INR 25,000 to 50,000. A few days at the hospital will surely make a big dent in your savings. 

These reasons have made health insurance a top priority. Everyone wants to safeguard their hard-earned money and investing in a health insurance policy seems to be the most prudent way to ensure not just financial savings but also quality treatment.

Will My Health Insurance Cover My COVID-19 Treatment?

All health insurance plans, top-up as well as super top-ups will pay for your expenses for treatment of COVID-19. As per the IRDAI’s notification, no insurer should reject a COVID claim without properly examining it. Thus, most COVID claims are being accepted as best as possible by insurers to date, as long as it is within the terms and conditions of the plan.

Point to Note: But remember, during hospital treatment, consumable items and surgical accessories like PPE Kits, bandages, foot covers, tissue papers, disposable gloves, sheets, syringes, gowns and masks are included in your bill. In a standard health insurance policy, such consumables are usually not covered. In the pre-COVID time, this was never too big an issue, but it isn't like that anymore. 

A PPE kit, which is compulsory in treating a COVID patient in a hospital, consists of a single-use coverall, a face shield, goggles, and nitrile gloves. The additional cost could be only around INR 1,200 but nurses, doctors and support staff need to wear the PPE kits all day long. Based on 5 PPE suits at about INR 1,200 per PPE kit comes to INR 6,000 per day. The charges are similar across patients.  

A lot of consumables are used in the treatment of COVID-19,  and a normal treatment can cost around INR 50,000 to INR 1 lakh. While the insurance cover will cover a part of it, PPE Kit and other consumables may sum up to almost 50% of a hospital bill, which is usually excluded in a health insurance claim.

There has been a surge in the cost of COVID-19 treatment, because of the increasing cost of consumables and also because of patient distancing, the treatment may now cost between INR 6 to 7 lakhs or even more. Most existing health insurance policies would not cover the PPE kit costs and other such consumables and you may have to pay them from your own pocket.

What is Coronavirus Specific Health Insurance?

Keeping these circumstances in mind, it is only necessary to have Coronavirus-specific health insurance, as it alone can help you safe from a financial meltdown. Realising the concern of the general public, the Insurance Regulatory and Development Authority of India (IRDAI) has designed and introduced specific COVID-oriented health insurance plans that will help in meeting the demands for health insurance plans for coverage of COVID-19. Let us take a look at these plans 

1. Indemnity Oriented Health Insurance Plans
   Indemnity plans are offered by health insurance companies and they cover expenditures incurred during hospitalisation. So if you get hospitalised due to COVID-19, the related treatment will receive coverage under your health insurance policy, as per the terms and conditions of the policy.
2. Fixed Benefit Health Insurance Plans
   Many insurance companies have launched health insurance plans with specified fixed benefits. Introduced on a trial basis these plans come under the Sandbox initiative of IRDAI. For example, if you get hospitalised for treatment of  COVID-19, your insurance company will pay you the sum insured as a one-time lump sum payment. 
3. COVID-19 Specific Health Insurance-short Term
   As mentioned above hospitalisation is covered under your health insurance policy but consumables are not. But because the consumables themselves can form almost 50% of the total bill, IRDAI has asked health insurance companies to introduce short-term health insurance policies that would give coverage only the costs that are incurred in case the policyholder suffers from COVID-19. 
   This directive has led to the foundation of 2 health insurance plans, Corona Kavach and Corona Rakshak. Both the plans are ‘short-term’ and will be valid till 30 September 2021. 

Corona Kavach Insurance Policy in Details

An indemnity based health insurance plan, Corona Kavach will cover the expenses that are incurred if and when you are hospitalised for the treatment of COVID-19 for 24 hours and above. The main features of this plan are as follows:

Features of a Corona Kavach Health Insurance Plan:

1. Since this is a short-term plan, life-long renewability benefit is not available with this plan
2. You need to pay a single 
3. premium to buy the plan
4. There is no cap on the room rent
5. Coverage for being home quarantined too
6. Doctor’s fee, nursing fee are covered
7. Consumables like medicines, PPE kits, masks, surgical appliances are covered
8. It would also cover pre-existing diseases and co-morbidities
9. Ambulance service is covered (up to company specified limit)
10. Under section 80D, you can avail tax benefits on the health insurance premium that you pay

Remember, this is a COVID-19 specific plan and it would only cater to the expenditure made for the treatment of COVID-19. 

Exclusions of Corona Kavach Health Insurance Plan:

Certain other exclusions that should be kept in mind are:

• Unprescribed medications and hospitalisation
• Treatment in a foreign country
• Hospitalisation less than 24 hours

How can I Buy Corona Kavach?

These days, the best way to buy anything is online. So, if you are planning to buy Corona Kavach, buy it online. You can easily compare the plans being offered by different health insurance companies. The comparison becomes uncomplicated and easy to understand. 

A table is given below showing the premium details of the Corona Kavach offered by different insurance companies, for a 35-year-old non-smoker male, for a sum insured of INR 5 lakhs (the premiums are subject to change).

Corona Rakshak Insurance Policy

Unlike Corona Kavach, Corona Rakshak is a benefit-based health insurance plan that offers you 100% of the sum assured, as a lump sum amount, in case you are diagnosed with COVID-19 and are hospitalised for 72 hours or more. Once the amount is paid the policy will lapse. The plan is available only as an Individual plan and does not come as an option in a Family Floater health insurance plan.

Let us take a look at the main features of this plan:

Features of Corona Rakshak Health Insurance Plan:

• A very reasonable health insurance policy, as you pay only a  small percentage of the sum assured
• It covers the cost of ICU
• You can avail of a discount on the premium if two or more of your family members invest in this plan
• Prescribed home care treatment for a maximum period of 14 days
• Under section 80D, you can avail of tax benefits on the premium that you pay

Exclusions of Corona Rakshak Health Insurance:

Remember, just like Corona Kavach, Corona Rakshak is also a COVID-19 specific plan and it would only cater to the expenditure made for the treatment of COVID-19. Certain other exclusions that should be kept in mind are:

• Any other treatment apart from COVID-19
• If your travel history shows that you travelled to a restricted country, you won’t be able to make a claim
• Unprescribed treatment
• Treatment outside India

How to Buy Corona Rakshak Health Insurance?

Surfing the company websites makes it easy to draw a comparison between companies and the benefits that they are offering and thus buying Corona Rakshak health insurance online would be the best option.

To get an idea of the premium amount you would have to pay to buy this plan, take a look at the table given below, (the premiums are subject to change). These rates are for a 35-year-old non-smoker male.

Difference Between Corona Kavach and Corona Rakshak Health Insurance

Finally, if you are contemplating buying a Corona specific health insurance and want to draw a comparison between the two plans, let us take a quick look at the differences that have been discussed above.

How to File a Claim for Corona Specific Health Insurance?

The process of claiming Corona specific health insurance is quite similar to that of any other health insurance policy. You can opt for reimbursement or go for a cashless claim, depending on whether you get hospitalised in a network or a non-network hospital. 

Steps for a Cashless Claim Process for Corona Specific Health Insurance

The steps to be followed are:

• Inform the insurance company as soon as possible, preferably within 24 hours of diagnosis/hospitalisation
• You can simply present your Health/Policy Card at the hospital help desk and fill in the Pre-Authorisation/Claim Form
• Pre-Authorisation/Claim Form along with certain other documents are required by hospitals
• Fulfil all the company-specific formalities timely and carefully

List of Documents for a Cashless Claim of Corona Specific Health Insurance Plan

Your health insurance company may also ask for the documents listed below:

• A COVID positive test by an approved organisation
• Photo Identification document of the insured member who has been hospitalised
• Policy Papers
• Claim Form-filled and signed
• Doctor’s certificate that advises hospitalisation

Documents that  Would be Sent by the Hospital to the Insurer:

• Bills and receipts of the treatment
• Investigative Test Reports
• Doctor’s prescription of tests, medicines and consultations
• Ambulance Bill, if used

Steps for a Reimbursement Claim Process for Corona Specific Health Insurance Plan

For reimbursement of the expenses that you have made for the treatment of COVID-19, the steps to be followed are:

• First, you have to pay the bills yourself and then you will be reimbursed by your health insurance company. 
• You will have to fill in the Pre-authorisation/Claim Form and submit the same with a list of documents and certificates, such as -
  • Discharge Summary
  • Bills and receipts of the treatment
  • Investigative Test Reports
  • Doctor’s prescription of tests, medicines and consultations
  • Ambulance Bill, if used
  • These steps can be followed to file an online claim as well

Corona Kavach or Corona Rakshak Insurance Policy - Which one should you buy?

There is absolutely no denying that Corona Kavach and  Corona Rakshak both cover the financial perils that this pernicious disease can lead to. Each comes with its own share of benefits and you would have to decide which plan is more suitable for you. Treatment-related expenses like room rent, nursing, boarding, etc. will be covered by Corona Kavach. However, if you do not have health insurance, you may want to invest in this policy as it would take care of the treatment. 

Corona Rakshak plan, on the other hand, will pay the complete sum assured if you are COVID positive and are hospitalised for 72 hours or more. Rakshak is more fitting if you are the main earner in your family. This plan would also be suitable for you if your aim is replacement income. 

Thorough research and understanding will help you weigh the pros and cons of both plans and select the one that is right for you.