Does Your Health Insurance Cover Coronavirus? Read The Fine Print
Coronavirus – what it is
The coronavirus, as is apparent from the term, is a virus, supposedly similar to a common cold. The disease is contagious, in that you can contact it through water droplets – sneezes or cough of a person suffering from it. What makes the virus deadlier than most other diseases is that although it has similar symptoms as that of a cold (sore throat, mild headache, cough and flu, and fever); it also has a longer incubation period. As such, you could develop the infection almost 5-6 days after having contracted the illness. The disease takes its worst form when it affects the upper respiratory tract, sometimes causing pneumonia and rendering the patient breathless
What COVID-19 isn't and insurance implications
To seek treatment against any illness, you need to understand whether or not it qualifies as per the guidelines of your insurance policy. For instance, asthma or diabetes is a disease, against which you can get insurance coverage only under a policy for pre-existing illnesses; that too after you've ridden out the waiting period. On the other hand, you can seek treatment against your general health insurance policy for unexpected but incredibly severe illnesses such as cancers, tumours, cardiac issues and other such critical illnesses. This is attributed to the fact that a critical illness cannot be deemed as a pre-existing illness – it can occur anytime.
The coronavirus, as we mentioned, has flu-like symptoms and can occur anytime; especially if one is in contact with a patient suffering from the disease. As such, it cannot be deemed as a pre-existing disease. This factor alone means that one can seek insurance coverage if diagnosed with this illness. At this point, it is also essential to mention that all health insurance providers are obligated to offer coverage against the treatment of COVID-19. This is because the Insurance Regulatory and Development Authority of India (IRDA), has also made it mandatory for insurance companies to provide coverage if one is diagnosed with the illness.
Coverage you can avail if you're seeking treatment for COVID-19
Like it does for any other non-pre-existing disease, your insurance policy covers you against a host of expenses incurred during the treatment of COVID-19, including but not limited to
- Pre and post hospitalisation
- Hospital room rent charges
- Costs borne to conduct laboratory tests
- Doctor's or surgeon’s fees
- Ambulance charges
Filing an insurance claim for COVID-19 treatment
While filing an insurance claim for COVID-19, you can follow either of the two methods mentioned below:
Cashless treatment at a network hospital
You can opt for cashless treatment at one of the hospitals listed in the insurance provider's network. You need to let your insurance company or its representative (PINC insurance, for instance) know that you would be seeking treatment in a specific hospital. The insurer's representative gets in touch with the hospital administration to complete the formalities related to the claim. The insurer files your claim on your behalf, while you can concentrate on seeking treatment.
Treatment at your preferred hospital followed by reimbursement
You also have the option to seek treatment at your preferred hospital and then file an insurance claim. However, you need to inform the insurer or their representative about your intent to file a claim as soon as, or before you seek hospitalisation. Upon completing the treatment, you can file your claim by submitting all original bills and receipts. The insurer verifies your documents and settles the claim by reimbursing the amounts, up to the sums assured as per your insurance policy.
The role of the IRDAI during the corona virus scare
Not only has the IRDAI issued a mandate asking insurers to offer coverage for COVID-19 treatment, but it has also issued various essential guidelines. As per the IRDAI guidelines, insurance providers are obligated to expedite the time taken to settle COVID-19 claims. This move by the IRDAI comes as a welcome relief in helping people with financial difficulties in these tough times when employment and income sources have become a challenge for the average low or middle-income families.
Think Insurance, think PINC
If you do not already have one, it is time to invest in a health insurance policy. At PINC Insurance, we can help you find the perfect policy for you and your family members. PINC Insurance representatives can assist you in purchasing policies as per your needs and budget.
We also help you file your insurance claims and provide all-round, end-to-end solutions for your insurance needs.