Illnesses that you didn’t know your health insurance policy covers

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The scope of your health insurance policy has increased manifold. It is no more limited to cover the cost of general hospitalisation. From mental illness to robotic surgeries the ambit of health insurance policies has been widened to give maximum benefit to policyholders. Here are some of the benefits your health insurance policy offers which you might not know about:

Robotic surgery

As technology is advancing so are the medical treatments. Given the rise in high precision treatments the insurance regulator recently mandated that robotic treatments must be covered by all insurers. Currently, all insurers have to offer it but it might come with different sub-limits and conditions, which a customer should read carefully before buying a policy.

Mental illness

Due to growing cases of mental illness including depression, the Mental Healthcare Act (2017) came into force on 7 July 2018 stating that every insurer should provide medical insurance for treatment of mental illness as it provides for other illnesses. Following this, the insurance regulator directed all insurers to compulsory cover mental illness from October 1, 2020, onwards.

Ayush

Ayush stands for Ayurveda, Yoga, Unani, Siddha and Homeopathy treatments. Generally, health insurance policies cover only the allopathic treatment but now many health insurance policies cover alternative treatments as well. Recently, Insurance Regulatory and Development or IRDAI also mandated that Arogya Sanjeevani Policy, a standard health insurance product offered by all insurers, should cover Ayush treatments.

Alzheimer’s and Parkinson’s

With increased life expectancy and an ageing population, there is a growing number of people suffering from Alzheimer’s and Parkinson’s. The good news is the regulator in the year 2020 brought welcoming changes after which insurance companies cannot deny coverage for 17 critical diseases including Alzheimer’s and Parkinson’s. They can either make it as a permanent exclusion or can bring in sub-limits and restrictions according to the underwriting practices of the company. The insurer cannot deny the coverage to the patient anymore.

HIV

Similar to Alzheimer’s and Parkinson’s, insurance companies are now bound to cover HIV patients as well. Just like mentioned above they can either make it as a permanent exclusion or can bring in sub-limits but cannot deny the coverage to the patient.

Home care

Domiciliary hospitalisation or home treatment can also get covered by your health insurer provided it is a feature in your policy. Here the onus lies on the policyholder to prove that the individual cannot be moved to the hospital or there was no hospital bed available. It is important to know that domiciliary hospitalisation covers treatment that lasts for more than 72 hours providing a continuous line of treatment to the patient during the period.

Daycare treatments

Not all illnesses require 24 hours hospitalisation now. There are many surgeries that require hospitalisation for just a few hours. Insurers generally have a list of surgeries that are covered under daycare treatments. These approved procedures are covered under your health insurance policy even if the treatment is for less than 24 hours.

One should read the policy documents carefully before buying the policy so that one knows in advance what it includes and excludes.