Health Insurance in Kashmir

Kashmir, often considered as "Heaven on Earth," is famous for its stunning landscapes, peaceful lakes, and majestic mountains. Its natural beauty and rich cultural heritage draw visitors from around the globe. However, the medical infrastructure in the valley remains underdeveloped, leading to high prices for quality medical facilities. With such healthcare challenges, having health insurance is essential for every resident of Kashmir.

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      Why Do You Need Health Insurance in Kashmir?

      Here are some of the many reasons why health insurance plans are a must-have in Kashmir:

      1. Poor Air Quality in Winters

        During winter, air quality in Kashmir worsens significantly, posing health risks for people in the valley. The polluted air can lead to respiratory issues, especially asthma, affecting children and older adults most severely. According to a January 2023 report, 4,750 per 100,000 people in Kashmir suffer from chronic obstructive pulmonary diseases, largely due to air pollution. Buying health insurance for asthma can be beneficial in covering the high treatment costs for these respiratory conditions.

      2. Prevalence of Lifestyle Diseases

        Lifestyle diseases like thyroid, diabetes, and fatty liver are becoming widespread in Kashmir. A September 2022 report from Sher-e-Kashmir Institute of Medical Sciences (SKIMS) Soura revealed that 90 out of every 100 patients have lifestyle disease in Kashmir. While some cases are manageable at home, severe conditions may require hospitalisation, leading to high medical expenses. By investing in health insurance for diabetes and health insurance for high blood pressure, people in Kashmir can manage these treatment costs effectively.

      3. Rising Cancer Cases

        The cancer rate is increasing in Kashmir, with a particular rise in lung, gastrointestinal, and breast cancers. According to an official report, SKIMS Soura and Government Medical College (GMC) in Srinagar registered around 1700 cancer patients in 2024 in less than three months. Since cancer treatments are costly, buying health insurance for cancer patients can remove financial burden and ensure access to necessary medicare as and when needed.

      4. Limited Access to Quality Healthcare Facilities

        The healthcare infrastructure in Kashmir is limited, with advanced medical facilities concentrated in cities like Srinagar, Anantnag, and Baramulla, and are priced high. Given the weather, it is not always possible for people to travel from remote areas to cities to obtain the required treatment. This often forces Kashmiris to choose treatments available locally. With comprehensive health insurance, people in the valley can receive the best medicare services in these cities while availing emergency medicare through teleconsultations when travelling to a city is not possible.

      5. Increasing Medical Costs

        Medical inflation is a nationwide issue, and Kashmir is also experiencing a rise in healthcare expenses. For example, an angioplasty with angiography in Srinagar) starts at ₹1 lakh, which can be financially burdensome for many families. To stay prepared for any unforeseen medical emergency, it is important for the people of Kashmir to invest in a mediclaim insurance policy of at least ₹5-10 lakh.

      Major Health Problems in Kashmir

      Take a look at some of the major health issues in Kashmir:

      1. Cancer

        Cancer is a growing concern in Kashmir, with lung and breast cancer being the most common among men and women, respectively. A report from March 2024 reveals that approximately 850 cancer cases have been reported at SKIMS Soura in Kashmir since January 2024. The high cancer rate in Kashmir is majorly due to obesity, poor food habits, unhealthy lifestyles, tobacco use, and limited access to advanced diagnostic facilities.

      2. Diabetes

        Diabetes, particularly type 2 diabetes, has shown a notable rise among adolescents and young adults in Kashmir. According to an official report from September 2022, over 700 cases of type 2 diabetes have been recorded among Kashmir adolescents under the age of 25 years since 2020. Poor lifestyles and eating habits are the most likely reasons for this rise in diabetes cases. In fact, doctors recommend lifestyle modifications over medication for managing diabetes.

      3. Hypertension

        Hypertension is another major health issue in Kashmir. In May 2024, the Head of the Department of Community Medicine at GMC Srinagar pointed out that every third or fourth adult in Kashmir suffers from hypertension. Alarmingly, almost half of them are unaware of their condition, which increases the risk of serious complications like heart attacks, strokes, and kidney failure. The rise in hypertension is largely attributed to lifestyle changes, including sedentary habits, minimal physical activity, smoking, stress, and substance abuse.

      4. Asthma

        Asthma cases are also on the rise in Kashmir. On World Asthma Day in 2023, the Principal of GMC Srinagar said that around 5-10% of the population in Kashmir suffers from asthma. Air pollution and fast food consumption are major contributors to the spike in asthma cases in the valley.

      Health Statistics of Kashmir

      Some of the recent health statistics of Kashmir are as follows:

      • Nearly one in three people in Kashmir suffers from lifestyle diseases.
      • Type 2 diabetes cases have risen by 20% in recent years in Kashmir.
      • The rate of diabetes and pre-diabetes in Kashmir exceeds the national average.
      • Most people in Kashmir report cancer of breast, lung, gastrointestinal, ovarian, and leukaemia.

      How Much Health Insurance Coverage Do You Need in Kashmir?

      To ensure financial protection during health emergencies, insurance experts recommend purchasing a medical insurance policy with a sum insured of at least 50% of your annual income. But ideally, your mediclaim policy should cover the cost of obtaining treatment for critical illnesses, such as cancer, heart disease, etc.

      In Kashmir, where healthcare expenses are high due to limited access to quality medical services, choosing an individual health insurance policy of ₹5-10 lakh is advisable. For those seeking a single policy to cover the entire family, a family health insurance policy with a minimum coverage amount of ₹20 lakh is recommended.

      Additionally, senior citizens in Kashmir should consider a dedicated senior citizen health insurance plan with a sum insured of at least ₹15 lakh.

      Health Insurance in Kashmir for NRIs

      Non-Resident Indians (NRIs) from Kashmir can purchase mediclaim insurance from any health insurance companies in India. The policy will cover all healthcare expenses during their visits or stays in Kashmir. In fact, if NRIs plan to return to Kashmir permanently after a few years, they can continue with the same health insurance for NRIs policy without serving any additional waiting periods.

      Furthermore, NRIs can also buy health insurance for parents residing in Kashmir, offering them financial protection against potential medical emergencies. Additionally, NRIs can claim an 18% GST refund on premiums paid for health insurance as long as they meet tax obligations in their country of residence abroad.

      People also read: GST Refund on Health Insurance for NRIs

      Is Government Health Insurance Enough to Cover Medical Expenses in Kashmir?

      No.

      The Prime Minister of India introduced the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT scheme to provide health insurance coverage to all residents of Jammu and Kashmir. This scheme offers free cashless treatment at any empanelled public or private hospital across the valley. Although the scheme covers secondary and tertiary hospitalisation, it still falls short of providing comprehensive coverage to the people of Kashmir.

      Take a look at the table below to understand why Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT may be insufficient to cover all healthcare needs in Kashmir:

      Category Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) SEHAT Scheme Personal Health Insurance
      Sum Insured The AB-PMJAY SEHAT scheme provides free medical insurance coverage of up to ₹5 lakh per family each year on a floater basis. Personal health insurance policies can offer coverage of up to ₹6 crore, depending on the specific plan selected.
      Scope of Coverage It covers hospitalisation expenses for secondary and tertiary medical care. These policies cover various surgeries and procedures, including in-patient care, mental health disorders, modern treatments, pre and post-hospitalisation expenses, day care procedures, up to 100 critical illnesses, outpatient treatments, etc.
      Pre and Post-Hospitalisation Expenses The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana SEHAT scheme covers up to 3 days of pre-hospitalisation and 15 days of post-hospitalisation expenses. Most personal health insurance policies cover up to 60 days of pre-hospitalisation and up to 120 days of post-hospitalisation expenses, depending on the chosen plan.
      Hospitals Covered This scheme provides cashless treatment only at empanelled public and private hospitals. Personal health plans typically offer cashless treatment at all hospitals in Kashmir.

      Wellness and Prevention Tips in Kashmir

      Check out some of the useful wellness and prevention tips for Kashmir residents:

      • Eat a diet rich in fruits, vegetables, and whole grains.
      • Avoid sugary drinks and limit salt intake in Kashmir.
      • Keep a healthy weight in Kashmir to reduce stress on your heart.
      • Exercise regularly to keep your body strong and balanced.
      • Avoid smoking and reduce alcohol intake in Kashmir.
      • Sleep for at least 7-8 hours each night to let your body recharge.
      • Practice stress management in Kashmir through activities like yoga, meditation, or deep breathing.
      • Stay physically active to lift your mood and reduce anxiety problems in Kashmir.
      • Wear masks to avoid allergens and pollutants that can trigger asthma attacks.
      • Keep your home dust-free and well-ventilated in Kashmir.
      • Make time for outdoor activities in Kashmir to boost your mood and immunity.

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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.

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