How to choose health insurance in times of coronavirus pandemic

Dr. Sneha Ganatra
July 11, 2020

As cases of COVID-19 surge across the world, it is important to know how well your health insurance policy will cover you in the event that you test positive. Many insurance products do cover the cost of inpatient treatment for those infected with COVID-19. In certain health care plans, the insurance payout begins from the moment the patient is diagnosed with COVID-19; and since it is a novel coronavirus, it does not qualify as a pre-existing condition.

However, it is important to check your policy to see whether it provides you adequate protection during this pandemic—and if it doesn’t, to search for one that does. Here are some pointers on what to look for in your health insurance plan.

Know your benefits

The best way to know whether your health insurance will cover the cost of COVID-19 care is to stay informed about the various types of treatments and costs that are involved. Firstly, check whether your policy offers outpatient (OPD) benefits, starting with coverage for a COVID-19 diagnostic test. A majority of the people who test positive for COVID-19 are asymptomatic, and do not require inpatient treatment, so a good policy should cover the cost of any OPD treatment or medications.

It has been reported that immunocompromised people, such as the elderly, or those with pre-existing conditions like diabetes or asthma, are likely to require inpatient care to treat a COVID-19 infection. While inpatient expenses are covered under most insurance policies, it is important to check the fine print for exclusions in the case of pandemic diseases. If you do happen to suffer from a pre-existing condition, make sure to check whether your policy has a waiting period based on those conditions.

Find the right coverage

It is difficult to accurately gauge the total cost of inpatient treatment for COVID-19, because extenuating circumstances make each case very different. While the average cost is around Rs. 1-2 lakh for a hospital stay, those with co-morbidities might have to pay up to Rs. 7 lakh or more for treatment. It is also important to note that more than one person per household may test positive at the same time, because of the immensely contagious nature of the disease.

covid 19 test insurance coverage

To ensure that you and those who live with you are adequately covered, it is best to find a policy with a payout of at least Rs. 10 lakh. It is also important to ensure that your co-pay burden isn’t too high. For instance, a 10% co-pay might be reasonable for smaller hospital bills, but COVID-19 care could cost you as much as Rs. 1 lakh in co-pay, so choose wisely.

Check for room rent limits

The primary cost of COVID-19 care is room rent, which can be especially steep if you’re being treated in a private facility. Many health insurance policies put a cap on room rent, either by limiting it to a percentage of the sum insured or restricting it to a particular price category.

Research the price of room rent before selecting your policy, and make sure you will be adequately reimbursed.

Cover your consumables

Protecting yourself and your family against infection requires a lot of consumable products intended for one-time use. These range from masks and gloves to sanitizers and disinfectant wipes, and the costs can add up over time. While most health insurance policies don’t cover the cost of consumables, there are a few that do. In the long run, coverage for consumables could significantly lower your healthcare bills, so make sure you look for a plan that will offer you the most comprehensive coverage possible.

Coverage beyond COVID-19

Some policies are specific to COVID-19 and do not offer payout for any illnesses other than the novel coronavirus. The benefit of these policies is that they are tailored specifically towards the treatment of coronavirus and hence do not require any pre-acceptance medical screening. They also have a much shorter waiting period. However, they may only offer coverage for inpatient treatment, and not cover OPD or consumable costs.

Based on your specific health conditions, it may be prudent to invest in a policy that offers more extensive coverage than to buy a policy that is restricted to inpatient treatment. If you’re young and healthy, for example, you are more likely to only require outpatient treatment, and it is important to have your health insurance policy reflect those needs. Compare all available options thoroughly to see which one works for you.

Making informed decisions about your health insurance policy can help you get through the pandemic with minimal financial costs. While plenty of new, specialized policies are being presented every day, your old policy may also be good enough to cover your COVID-19 expenses. To find the right policy for you, learn about the costs involved and see which ones are most likely to apply to you.

Staying informed is the key to staying safe. One way you can do this easily and conveniently is to check the health plans offered by Bajaj Finserv Health. These offer personalised and preventive means of healthcare via health check-ups, consultations with doctors, insurance as well as easy access to the best specialists near you via the Bajaj Finserv Health App. Download it today via the Google Play or the App Store and benefits from tools like the COVID-19 Symptom Checker!