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Will COVID-19 vaccine be covered under health insurance policies?

The COVID-19 pandemic has infected millions of people across the globe, with a 2 per cent fatality rate and an increase in numbers every hour. To fight the disease, most people have started opting for insurance policies. According to industry experts, insurers have also been flooded with queries regarding insurance policies from anxious customers, such as trying to know the coverage offered, the waiting period, if any, the cost implications, the claim process, etc. To help customers during such a time, the insurance regulator has also introduced various rules and regulations.

Mayank Bathwal, CEO, Aditya Birla Health Insurance, says, “The regulator has enabled the launch of standard short-term Covid covers that can provide indemnity or fixed benefit covers for Covid infection and hospitalization including home and alternate forms of treatment.” In an exclusive interview with Priyadarshini Maji, he addresses various insurance-related queries faced by policyholders.

1. Will a Regular Health Insurance Policy offer Coverage against COVID-19?

As per the guidelines of the regulator, Insurance Regulatory and Development Authority of India (IRDAI), all health and general health insurance companies are required to cover COVID-19 associated hospitalization claims under regular health insurance indemnity plans. For instance, an individual who has an active health insurance policy can file a claim for coronavirus hospitalization, under his/her policy.

The regulator has also enabled the launch of standard short-term Covid covers that can provide indemnity or fixed benefit covers for Covid infection and hospitalization including Home and Alternate forms of treatment under AYUSH.

2. Could you purchase a new policy now to cover COVID-19, if you don’t have a health insurance policy?

Yes, you can certainly purchase a new health insurance policy to cover yourself not only against COVID-19 but all other infirmities as well. However, before purchasing a policy you must be well aware of two important aspects. First, you or your immediate family members won’t be issued a policy if you are already suffering from the COVID-19 infection. It is important to ensure that before purchasing a policy, you are not suffering from any such illness. Second, after purchasing the policy, you need to serve the waiting period before filing a claim for coronavirus infection.

3. Will the test for COVID get covered in the policy?

Insurers will cover COVID-related tests as part of pre-hospitalization expenses under regular, indemnity-based health policies if you get hospitalized for the treatment of COVID-19 after being tested positive. This will be subject to certain conditions.

4. Will the COVID-19 vaccine be covered under the health insurance policy?

Vaccines are generally preventive in nature, and these are not covered in regular policies as they do not qualify as treatment procedures. However, should your plan have an OPD cover, then the vaccine cost would be covered under the same.

5. What is the average cost of the treatment of COVID-19? 

The total cost of treatment of coronavirus infection is dependent on several factors such as the severity of the infection, choice of hospital, and also the age of the patient. For an average adult aged between 30 and 45 years taking treatment at a normal private hospital, the cost of treatment is approximately Rs 1 to Rs 2 lakh.

However, if the patient is a senior citizen i.e. above 55 years of age and the infection is severe (as senior citizens are more vulnerable), the cost of treatment escalates up to Rs 3 to Rs 4 lakh as the person might require ventilator support and Intensive Care Unit where the daily charges are comparatively higher.

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