4 frequently asked questions about insurance cover during the pandemic

Dr. Sneha Ganatra
July 11, 2020

The effect of the COVID-19 outbreak, which ultimately resulted in a pandemic, continue to be felt on a global scale, negatively affecting the health of millions along with markets and industries. In some countries, the spread of the infection overwhelmed the existing healthcare infrastructure. As a result, much-needed specialised care became increasingly scarce. Naturally, given the severity of the situation, adopting a more cautious lifestyle was soon the norm.

As such, seeking medical care is now more of a priority, but one that often comes at a hefty cost. This is particularly true for COVID-19 treatment, especially in private hospitals. Depending on the medical care administered, you can expect to pay in lakhs, especially if you need emergency treatment. Keeping high medical expenses in mind, many have taken their concerns to insurance providers, inquiring about the extent of their coverage along with other doubts. To shed some light on the frequently asked questions about the coverage offered by insurance policies during the pandemic, read on.

Do you get coverage for a COVID-19 infection under a standard health insurance policy?

With regards to a standard health insurance policy, the Insurance Regulatory and Development Authority of India guidelines state that all claims for COVID-19 treatment are liable to avail coverage. The funding is available for hospitalisation of any viral infection, including the COVID-19. Further, this applies to any other features or benefits that are part of the policy, which includes quarantined expenses as well.

It is also important to note that in order to avail coverage under a standard health insurance plan, you may be required to be hospitalised for at least 24 hours. It is only then can you claim these expenses, which will include all pre-and post-hospitalisation charges.

How much is the treatment cost for a COVID-19 infection?

The cost of treatment differs based on the healthcare centre you seek aid at. In tier 3 cities, the cost for private hospital rooms is around Rs.2 lakh. In tier 2 cities, private rooms can go up to Rs.3 lakh, but in super-speciality hospitals, it can cost Rs.7 lakh going up to Rs.9 lakh if the ICU and ventilators are required. In metros, the cost is the highest with a private hospital room starting at Rs.5 lakh. In super-speciality private hospitals, this cost can amount to Rs.8 lakh and go up to Rs.12.5 lakh if the ICU and ventilators are needed. Generally, treatment lasts 15 days, but with a pre-existing disease, this expense can exceed Rs.18 lakh.

Do you have to pay for COVID-19 testing or is it covered under health insurance?

Availing coverage for testing varies across lenders and policies. Certain policies may cover diagnostic testing as part of their offering and in such cases, you should get coverage. However, for many others, coverage for COVID-19 testing is only payable if the expense is a pre-hospitalisation cost. Meaning, these are only covered if you need hospitalisation based on the results. Take note of this distinction as COVID-19 testing can be quite expensive depending on where you opt for it. In private super-speciality hospitals, these costs would go up to Rs.4,500 but many state governments have now capped it at Rs.2,500.

Can you buy life and health insurance during lockdown?

Yes, you can still purchase health or term insurance policies during the lockdown. The best ways to do so are via online provisions, which can either be the insurer’s official website or other options like online aggregators. In fact, due to the lockdown and social distancing protocols, buying insurance policies has become simpler than it used to be. Earlier, to get insured, undergoing a physical medical test was an important part of the process. However, due to the pandemic, this is quite difficult to arrange and so, insurers have opted to use telemedicine provisions instead.

Here, you no longer have to undergo a physical medical test but rather a tele medical consultation. In such an arrangement, you will be required to provide basic information regarding your health to a doctor. The doctor will then assess your condition and you can proceed to purchase a policy. Currently, 20 private life insurers and 6 general insurance companies are permitted e-KYC provision by the GOI. With it, you can buy up to Rs.2 crore and up to Rs.1 crore sum assured for health and term policies respectively.

Given the particularly restrictive predicament brought on by the pandemic, insurance policies definitely offer much-needed financial respite. However, the pandemic has made many previously-reliable systems unpredictable. For instance, given the social distancing norms, you may find it difficult to secure an appointment at a network hospital, leading to loss of coverage. This leaves you vulnerable and you should do all you can to prevent it. Thankfully, the Bajaj Finserv Health app serves viable as solution and works in your favour.

This digital tool grants access to several telemedicine provisions, ensuring you get the care you need, in time. With it, you can find the right doctors and clinics in your area and book appointments completely online. You can also maintain and send digital patient records to specialists for thorough remote medical assistance. These are just a few of the many benefits you can avail with the Bajaj Finserv Health App. To get started, simply download the app for free on Google Play or on the Apple App store today!