An Insurance Cover For COVID-19

One of the rare positive outcomes of the ongoing pandemic has been the rising awareness about health and how to stay safe. The galloping infection rate has led to worries about treatment costs, in addition to the escalating medical costs in general. The importance of keeping yourself safe with an insurance cover at the earliest cannot be overstated. Also, that health insurance can be the best possible means for financing any future health-care expenses is the writing on the wall.

Besides the rise in demand for health insurance plans, the COVID-19 outbreak has boosted a demand for such plans with higher sums insured. However, for salaried individuals who have experienced lay-offs or salary cuts, it is best is to buy a basic health-insurance cover, with sufficient sum insured to stay protected against COVID-19, with a plan to upgrade the policy later, when financial situations improve.

New IRDAI Regulations

In light of the prevailing conditions, the Insurance Regulatory and Development Authority of India (IRDAI) has drawn up several new regulations. Keeping consumer welfare in mind, the IRDAI has directed insurers to process health-insurance claims within two hours from the time of receipt of an authorization request. What’s more, they have allowed coverage for health-insurance policies for medical consultations via telemedicine. Also included in the regulations are guidelines for introducing a standard COVID-19-specific health-insurance plan—a fixed-benefit one, where the insurer will be liable to pay the entire sum insured, if the insured person tests positive for COVID-19.

Picture used for representative purposes only. (Courtesy Pixabay)

Buying a COVID-19 Plan

While choosing a health insurance policy covering COVID-19, it is important to be aware of the following key factors. It has been observed that several COVID-19 patients only need a diagnostic test and basic medication at the outpatient department (OPD) instead of a hospital admission. Before buying a health plan, ensure the policy has an OPD cover so that these expenses are taken care of. Most insurance policies will cover expenses if hospital admission is necessary.

According to reports, the average claim by a COVID-19 patient under-going in-patient treatment is expected to cost between ₹2 lakhs to ₹5 lakhs. Moreover, due to its highly infectious nature, chances are that more than one person in the same family may contract the virus. If you are a senior citizen or are buying insurance for one, keep in mind that they are more susceptible to COVID-19 and treatment costs are significantly higher for them. Therefore, it is important to have insurance coverage with an adequate sum insured. Do check if your policy has a co-pay clause and the quantum required for it.

In COVID-19 cases, a large part of the treatment cost is the hospital room rent, especially if the insured person is treated at a private hospital. Ask your insurer questions regarding any room rent sub-limits that the policy may have, since those could result in large out-of-pocket expenses. Make sure that your health insurance covers the cost of consumables too—items that are intended for one-time use—largely due to reasons of sterility and infection prevention. You should remember, most health insurance products do not cover consumables, whereas they could make for a major part of the hospital bill during COVID-19 treatment. 

Amit Chhabra is head of the health insurance division at Policybazaar.com.