Coronavirus Health Insurance

The outbreak of the novel Coronavirus (COVID-19) has been in the news for two years now. According to the latest figures, currently, the total confirmed COVID cases across the globe are 41,34,80,802 and 58,26,378 lives have been taken away so far (as of February 15, 2022). While multiple variants of Coronavirus have surfaced, the new omicron variant has been identified as the ‘variant of concern’ by the World Health Organization (WHO).

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      Coronavirus Cases in India and World

      Currently in India, as of February 15, 2022, there are 4,23,127 active cases of Coronavirus (COVID-19) while the total cases tally is 4,26,92,943. It is a matter of great concern for our vastly populated nation. However, about 4,17,60,458 coronavirus patients have been discharged and cured in the country. The total number of vaccine doses administered in the country till date are 1,73,42,62,440.

      Now it is again spreading widely in India as the highly infectious omicron variant has made its way to our country, like Europe and the USA. As of February 15, 2022, more than 10,050 cases of the new omicron COVID variant have been detected in India. Therefore, it is important to be prepared for any unfavourable circumstance in advance. But if you have a health insurance policy, the question is if the novel Coronavirus disease falls under the ambit of medical insurance coverage in India or not?

      What is Coronavirus?

      Novel Coronavirus (COVID-19) is a group of viruses that attacks the immunity of a human being causing diseases ranging from the common cold to Severe Acute Respiratory Syndrome or SARS. In late December 2019, a new strain of coronavirus originated in China, which was unknown to humans before. It came to be known as the novel Coronavirus disease or COVID-19. Several variants of COVID-19 have been detected ever since, including the delta variant and omicron variant.

      The coronavirus disease causes infection in the nose, upper throat and sinuses. In severe cases, the virus can lead to major respiratory illnesses such as pneumonia, kidney failure as well as multiple organ failure. Therefore, the 2019-nCoV or the novel coronavirus disease has been fatal largely for people above the age of 60 years and those who had pre-medical conditions.

      The symptoms of Coronavirus infection are similar to those of regular flu that includes sore throat, fever, dry cough, runny nose and sometimes a headache. Moreover, the new omicron COVID variant adds extreme tiredness and starchy throat to the list of symptoms. Despite being a new strain of the coronavirus, several COVID-19 vaccines have been developed across the globe, out of which Covishield, Covaxin and Sputnik V is available in India.

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      What is Coronavirus Health Insurance?

      Coronavirus Health Insurance refers to an insurance policy that covers the medical expenses incurred on the treatment of COVID-19. A coronavirus health insurance policy is designed to cover the hospitalization expenses of the policyholder, irrespective of the disease that he has been diagnosed with (unless it is a critical illness that is not covered). Almost all the health insurance plans cover hospitalization expenses incurred on the treatment of viral infections. Since Coronavirus is a viral infection, a comprehensive health insurance policy pays off pre & post hospitalization expenses including in-patient and out-patient expenses, incurred on the treatment of COVID-19 and its variants, including omicron.

      Health insurance for coronavirus cover will be available from the day the insured gets diagnosed with the disease. This is because COVID-19 is a new disease and therefore, does not come under the category of pre-existing illness.

      Key Benefits of Coronavirus (COVID-19) Health Insurance

      Some of the major benefits of Coronavirus Health Insurance are listed below:

      Coronavirus Treatment

      Covered with zero additional cost

      Home Treatment

      Covered if suggested by a doctor

      Consumable Expenses

      Cost of PPE kits, ventilators, masks, gloves,

      Co-payment

      Age based Co-pay is not there in most of the plans

      Cashless Treatment

      Available

      Add-on Covers

      Available

      Types of Coronavirus Health Insurance in India

      If you are looking for a specific health insurance cover for coronavirus (COVID-19) then you can consider standard health insurance policy that cover all medical expenses incurred during the treatment of COVID-19. These are two standard products that have been recently launched as per the IRDAI guidelines. And the policy terms remain the same across all the health and general insurance companies in India. Checkout out both COVID-19 health insurance plans types along with the policy benefits:

      • Corona Kavach Policy : COVID-19 Insurance Policy

        Corona Kavach Policy is a standard coronavirus health insurance policy that covers hospitalization expenses, home care treatment cost, ambulance charges, cost of PPE kits, medicines, gloves, masks, doctor fees, ICU charges incurred during the treatment of COVID-19 pandemic. The sum insured amount starts from Rs 50,000 and goes up to Rs 5 Lakh. You can get your family covered under this plan that also pays for Ayush treatment in India.

      • Corona Rakshak Policy : COVID-19 Insurance Plan

        Corona Rakshak Policy is also a COVID-19 specific health insurance policy that pays for hospitalization of a minimum of 72 hours and more as required for COVID-19 treatment in India. The policy covers expenses incurred towards PPE’s, nebulizers, masks, oxygen cylinders, gloves, oximeters, AYUSH treatment, etc. that are limited under a regular medical insurance policy. This COVID-19 insurance policy is available to individuals between the age group of 18-65 years on an individual sum insured basis that ranges from Rs 2.5 lakh to Rs 5 Lakh. Applicants with co-morbidity can also get insured paying an additional premium.

      • Coronavirus Group Health Insurance

        If you are covered under a group health insurance policy, then you need to check with your insurer if it covers coronavirus treatment expenses. However, if your group health insurance policy is either Corona Rakshak or corona Kavach then you are surely covered for the COVID-19 hospitalization in India.

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      Health Insurance for Coronavirus (COVID-19) in India

      Since the outbreak of coronavirus, many insurers have been offering Covid-19 Health Insurance cover in their base plans. They are also providing specific Covid-19 Insurance Plans, Corona Kavach and Corona Rakshak are two such indemnity and benefit based plans that have been popular with people in India. All the hospitalization expenses, Ayush treatment expenses, and home treatment expenses are covered along with the cost of consumable items in these two mediclaim policies for coronavirus. 

      Insurance Companies Sum Insured (₹) Incurred Claim Ratio (2022-23)
      Aditya Birla Health Insurance Company Limited Min – 2 lakh
      Max – 2 crore
      64.68%
      Bajaj Allianz General Insurance Company Limited Min – 1.5 lakh
      Max – 1 crore
      74.27%
      Care Health Insurance (Formerly known as Religare Health Insurance) Limited Min – 1 lakh
      Max – 6 crore
      53.82%
      Cholamandalam MS General Insurance Company Limited Min – 1 lakh
      Max – 25 lakh
      67.88%
      Future Generali India Insurance Company Limited Min – 50,000
      Max – 10 lakh
      79.18%
      Go Digit General Insurance Limited Min – 2 lakh
      Max – 3 crore
      71.87%
      HDFC ERGO General Insurance Company Limited Min – 5 lakh
      Max – 2 crore
      79.04%
      ICICI Lombard General Insurance Company Limited Min – 5 lakh
      Max – No age limit
      77.33%
      IFFCO Tokio General Insurance Company Limited Min – 1.5 lakh
      Max – 30 lakh
      111.18%
      Liberty General Insurance Limited Min – 2 lakh
      Max – 15 lakh
      74.17%
      Magma HDI General Insurance Company Limited Min – 2 lakh
      Max – 3 crore
      72.10%
      ManipalCigna Health Insurance Company Limited Min – 2.5 lakh
      Max - 1 crore
      64.66%
      National Insurance Company Limited Min – 1 lakh
      Max – 10 lakh
      102.35%
      New India Assurance Company Limited Min – 2 lakh
      Max – 15 lakh
      103.33%
      Niva Bupa Health Insurance (Formerly known as Max Bupa Health Insurance) Company Limited Min – 5 lakh
      Max – 1 crore
      54.05%
      Raheja QBE General Insurance Company Limited Min- 1 lakh
      Max – 50 lakh
      138.67%
      Reliance General Insurance Company Limited Min – 3 lakh
      Max – 5 crore
      86.31%
      Royal Sundaram General Insurance Company Limited Min – 2 lakh
      Max – 50 lakh
      83.36%
      SBI General Insurance Company Limited Min – 3 lakh
      Max – 2 crore
      73.92%
      Star Health & Allied Insurance Company Limited Min – 3 lakh
      Max – 25 lakh
      65%
      Tata AIG General Insurance Company Limited Min – 5 lakh
      Max – 3 crore
      78.33%
      The Oriental Insurance Company Limited Min – 1 lakh
      Max – 50 lakh
      130.09%
      United India Insurance Company Limited Min – 3 lakh
      Max – 25 lakh
      89.57%
      Universal Sompo General Insurance Company Limited Min – 1 lakh
      Max – 50 lakh
      82.84%
      Zuno General Insurance Company Limited Min – 1 lakh
      Max – 1 crore
      89.59%
      Zurich Kotak General Insurance Company (India) Limited Min – 2 lakh
      Max – 25 lakh
      56.01%
      See More Plans

      *Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. This list of plans listed here comprise of insurance products offered by all the insurance partners of Policybazaar. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in.

      Is Coronavirus Covered Under Your Existing Health Insurance Policy?

      Coronavirus disease or COVID-19 may be a newly discovered disease but all existing health insurance policies will provide coronavirus health insurance cover. This means that if you purchased a health insurance policy before testing positive for the coronavirus disease, any medical expenses incurred on its treatment will be covered under it (provided you don’t get diagnosed during the initial waiting period). You can avail coverage for coronavirus under your existing health insurance policy irrespective of the variants i.e. omicron or delta variant.

      Since the coronavirus is not a pre-existing ailment, it will be covered as part of the basic hospitalization expenses under a health insurance plan that includes in-patient hospitalization expenses, ICU charges and diagnostic test charges amongst others.

      However, if you don’t already have a health insurance policy and decide to buy one after testing positive for COVID-19, then coronavirus treatment expenses will not be covered under the policy.

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      Coronavirus Health Insurance Inclusions

      The following table shows the list of inclusions under coronavirus health insurance:

      Important Covers Standard Covers Add-on Covers
      • In-patient hospitalization expenses
      • Pre-hospitalization expenses
      • Critical illness hospitalization
      • Accidental hospitalization
      • Daycare procedures
      • Road ambulance expenses
      • ICU room rent
      • Organ donor expenses
      • Daily hospital cash
      • Home hospitalization
      • Post-hospitalization expenses
      • Alternate treatment
      • Recovery benefit
      • Maternity benefit with newborn baby cover

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      Coronavirus Health Insurance Exclusions

      Not all medical expenses are covered under your coronavirus (COVID-19) health insurance policy. Take a look at the list of exclusions under your coronavirus insurance:

      • Home Quarantine – This policy does not cover any expenses that you incur while staying in quarantine at your home
      • Non-recognized Quarantine Centre – If you quarantine at a non-recognized centre for coronavirus treatment, the medical expenses incurred will not be covered under your policy
      • Pre-Existing Diseases – Any medical expenses incurred on the treatment of any pre-existing diseases will not be covered under this policy unless the waiting period gets over
      • Pre-Natal & Post-Natal Expenses – This policy will not cover any pre-natal or post-natal expenses incurred by the insured unless it leads to his hospitalization.
      • Hospitalization without Doctor’s Recommendation – If you get hospitalized without the recommendation of a qualified doctor (as mentioned on a prescription), then this policy will not cover the hospitalization expenses arising out of it
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      Difference between Social Distancing | Self-Isolation | Quarantine

      Social Distancing

      Self-Isolation

      Quarantine

      Avoid going to crowded places, meeting people, social gatherings like marriage, funeral, visiting someone’s home, public place or a medical facility until it’s necessary

      If you think you have met someone who is COVID-19 positive or feel unwell or have a travel history to affected countries then you can take protective measures and isolate yourself from others to limit the transmission of the virus

      Anyone who has mild symptoms that can be treated at home is Quarantined at home or if serious is quarantined in a hospital and is kept under medical observation. The patient can do it himself or can be done by Government Authorities those who have a travel history overseas or have been in contact with a COVID positive person

      How to Claim Health Insurance for Coronavirus (COVID-19)?

      There are two ways of filing a health insurance claim for Coronavirus disease. The claim settlement process for Coronavirus health insurance & the other health insurance policy like Arogya Sanjeevani Policy is almost same. You can file a cashless claim or a reimbursement claim. Let us read in detail about both types of claims for coronavirus health insurance cover:

      • Cashless Claims

        Most health insurance providers today provide cashless treatment facility. As part of this facility, the insured is not required to make any payment for the treatment taken at one of the network hospitals of the insurer. Instead, the insurance company settles the treatment bills directly with the hospital.

        So if you receive treatment for coronavirus (COVID-19) disease at a network hospital of your insurance provider, you will be able to avail cashless treatment facility and would not be required to make any payment for the treatment received.

        Make sure to check if your health insurance for coronavirus offers cashless claim facility. You can find the list of network hospitals of your insurer on the policy wordings or at the official website of your insurance provider.

      • Reimbursement Claims

        Reimbursement claims are meant for policyholders who get hospitalized and receive treatment at a non-network hospital of his insurance provider. If you obtain treatment for COVID-19 at a non-network hospital of your insurer, you will be required to pay all the hospital bills in full at the time of your discharge.

        Once you get discharged, you need to file a reimbursement claim with your insurance provider. To do so, you’ll have to fill up the reimbursement claim form and submit the required documents including the hospital bill payment receipts, investigation & test reports and doctor’s prescription to the insurer within the specified time limit.

        The insurance company will verify your claim and post that the reimbursement amount will be transferred to your bank account.

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      Important Facts on Coronavirus Insurance Cover

      Before you buy a coronavirus insurance India is offering, you should be aware of a few facts related to the policy. Here are some important facts that you should know before buying a coronavirus health insurance which covers COVID-19:

      • Sum Insured: Coronavirus has claimed several lives across the world and thousands of people have been critically ill due to contracting the disease. Since COVID-19 can lead to severe respiratory illness and impacts overall body functioning, its treatment can get very expensive especially for people with underlying diseases. Therefore, it is advisable to opt for a higher sum insured amount for your coronavirus health plan so that you are appropriately covered for any circumstance.
      • Coverage: It is important to carefully go through the coverage provided by the COVID-19 health insurance before you choose a plan. Most policies offer coverage for in-hospitalization expenses, post-hospitalization care, ICU charges, OPD charges, ambulance charges, etc.
      • Waiting Period: While buying health insurance for coronavirus, it is important to check the in-built waiting periods under the policy. Almost all health insurance plans come with a waiting period of the first 30 days. However, some insurance providers, such as Star Health & Allied Insurance, is offering 16 days waiting period only under their Star novel coronavirus health insurance policy. And the waiting period in Corona Kavach and Corona Rakshak policy is 15 days. During this period, none of the claims filed by you will be covered under the policy. Thus, make sure to check the initial waiting period that your coronavirus insurance comes with before buying.
      Read More

      FAQs About COVID 19 Health Insurance Policy in India

      News Related to Health Insurance for Coronavirus

      • Insurers to continue Selling and Renewing COVID Health Plans: IRDAI

        Amid the rising numbers of COVID-19 cases in the second wave, people who are looking for health insurance cover deserve to get the same. They should not be denied the coverage benefits in this crucial time of the pandemic, said the IRDAI in a Press release issued on 10 May, 2021.

        The Insurance Regulator further advised all the insurance providers to make sure that wherever Corona Specific standard health insurance products have been filed and approved by IRDAI, they should be provided to the applicants as per the insurer’s underwriting policy. Also, where the Corona health plans enable the policyholder to renew the policy, the insurance companies have to renew such plans subject to the underwriting policy of the respective insurance providers.

      • COVID-19 warriors: Health insurance scheme extended for another year

        On Monday the Union Health Ministry had announced that the insurance scheme for healthcare workers will be in effect for a year starting from March 20. The Pradhan Mantri Garib Kalyan Package scheme offered a safety net to the families of health workers in case of COVID-19 related adversities. But now the scheme was to end on April 24, which would have led health workers without any insurance support.

        The PMGKP scheme provides Rs 50 lakh health cover to the health warriors who lost their lives to the COVID-19 disease. As per MoHFW health insurance cover of up to Rs 50 Lakh is provided under the scheme and nearly 287 claims have been paid by the Insurer so far. Now the date has been extended for another year to ensure that the healthcare workers have a safety insurance net.

        Moreover, the insurance companies also arrange to vaccinate their employees and agents as well.

      • Insurers to assist their Policyholders for COVID-19 Vaccination- IRDAI

        The Insurance Regulatory and Development Authority of India (IRDAI) recently released a circular to all the Insurers to arrange COVID-19 vaccination to all the eligible policyholders. The regulator has also asked them to make special arrangements to get maximum people inoculated.

        In a letter to the insurance providers, IRDAI has asked them to make special arrangements for vaccinations for their policyholders either as a group or individual at a government facility or a private facility as per their policy option. IRDAI said the insurers can create awareness regarding the vaccination by sending SMS or email to the policyholders.

        And, they should also assist the policyholder to get vaccinated as a group in an orderly manner by pre-booking slots in advance. Also, they should provide them with the second vaccine shot.

        Moreover, the insurance companies also arrange to vaccinate their employees and agents as well.

      • Validity of COVID Health Insurance Plans extended till Sept 30- IRDAI

        The Insurance Regulatory and Development Authority of India (IRDAI) recently announced the extension of the date the validity of sale and renewal of short term COVID-19 specific medical insurance policies i.e. Corona Rakshak and Corona Kavach policies. The decision is being taken amid the second wave of the Coronavirus pandemic. The coverage now remains valid till 30 September, 2021. There will no changes in policy guidelines and all the terms and conditions to remain same.

        The information is based on the IRDAI’s circular issued on March 24, 2021. Corona Kavach is a Standard Indemnity based products and Corona Rakshak is a Standard benefit-based product dated 26 June, 2020. All the insurers will now offer renewal up to 30 September 2021.

        Currently, these coronavirus health insurance products can be purchased for tenure of 3.5 months, 6.5 months and 9.5 months, i.e. 105, 195, and 285 days respectively.

      • Reaction from COVID-19 Vaccine to be covered under Health Insurance- IRDAI

        The Insurance Regulator and Development Authority of India (IRDAI) mentioned that any adverse reaction from Coronavirus injection will be paid by the insurer. The policyholders can file claims for hospitalization cost and the treatment cost under the health insurance plan. The claim settlement will be just like the other health insurance plans, and all the procedures and documentations will remain the same.
      • Coronavirus cases has led to increased awareness of health insurance in India

        Based on a consumer sentiment survey conducted by Policybazaar, 80% of the respondents said they are aware of the importance of health insurance specially during the times of a pandemic like COVID-19. And nearly 51% of the respondents considered buying a health insurance policy for coronavirus in India. Nearly 47% considered this as a good investment period. The online survey was conducted to analyse the consumer sentiments towards insurance, investment and household during COVID-19. Though the awareness has increased the penetration in health insurance remains low.
      • PM Insurance Plan to Cover Contract Staff in contact with COVID-19 Patients

        In a recent hearing on May 15, 2020, the Indian Government told the Bombay High Court to extend the health insurance coverage offered under Pradhan Mantri Garib Kamgar Package, to essential services, civic workers working in contract, and people who may encounter Coronavirus positive patients. The scheme offers coverage of Rs 50-lakh to Health Workers.

        This health insurance scheme will cover every person on Covid-19 duty, who get infected from other COVID positive patients. This scheme shall benefit all the frontline healthcare workers in both public and private establishments and for both contractual and permanent employees. It also offers death cover. Therefore, the scheme will also cover eligible contract employees of NMMC.

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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

      ~Source: Google Review Rating available on:- http://bit.ly/3J20bXZ

      ##On ground claim assistance is available in 114 cities

      Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

      Policybazaar is a registered Composite Broker |Registration No. 742, Valid till 09/06/2024, License category- Composite Broker| Visitors are hereby informed that their information submitted on the website may be shared with insurers.

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