In the wake of the COVID-19 pandemic and the number of growing cases, the treatment cost is the greatest concern among the common people. Even if you are not tested positive, the out-of-pocket expenses starting from the corona testing and all can burn a big hole into your pocket. A great relief that health insurance providers in India cover COVID-19. However, you should always keep a check on the list of inclusions provided by your insurer, when it comes to covering COVID-19, in order to keep your finances intact.
Coronavirus Treatment and Health Insurance Coverage
It is not certain that how much coverage is enough for treating COVID-19. While there is a cap on lab tests, the hospitalisation expenses can go beyond one’s expectations, depending on the condition of the patient. However, as per the recent claims filed, coronavirus treatment can cost between Rs 50,000 to 4 lakh.
Let us take an example to understand medical insurance for individuals. Mr. Sinha, a 53 years old resident of Delhi, was tested positive for COVID – 19 on 25th May 2020. On the morning of 26th May, he was admitted to a reputed hospital in Delhi for the treatment. He was discharged from the hospital on June 7th, 2020 after his successful treatment that went on for 13 days. The total bill of the hospital came around Rs 3.33 lakh.
Mr. Sinha was fully relaxed before paying the bill as he was insured with a medical insurance for individuals with the sum insured of Rs 10 Lakh. He was quite sure that the entire amount will be taken care of by his health insurance provider and he will not have to pay even a single penny for his treatment. This is because his health insurance was not having any clause of co-payment. However, at the time of claim settlement with the hospital’s TPA desk, he was shocked to listen that his insurance provider will pay only Rs 2.10 lakh of the total bill amount and rest he has to pay from his pocket. From the remaining Rs 1.23 lakh approximately 40% was billed under the column of ‘Medical Consumables’.
Like many of us, even Mr. Sinha was unaware of the fact that the health insurance plans do not cover the cost of medical consumables that are used for the treatment of disease or some condition in the hospital. Most of the time, these consumables are 10% of the total medical cost but in the case of a novel coronavirus, this cost has increased to approximately 40% of the total medical bill. This is because, in the treatment of COVID – 19 the list of non-payable items or medical consumables increases as it includes N-95 mask, PPE kits, shoe covers, and
Coronavirus and Rise in Hospitalisation Expenses
In case of hospitalization in this time of novel coronavirus pandemic, even those who are not tested positive has to pay thousands of rupees from their pocket as the insurance policies are not willing to pay for the cost of medical Personal Protective Equipment or PPE as they are considered as non-payable items. In this way, the COVID– 19 patients have to pay approximately half of their medical bills under these medical consumables, and non-COVID- 19 patients have to pay approximately one-fourth of their bills during their hospitalization. The reason for the same is the highly contagious nature of this coronavirus. Due to this, the hospitals have made it compulsory for all its staff to wear PPE kits, which indirectly adds to patients’ pockets.
Moreover, it is not only the cost of PPE kit, but other medical consumables are not calculated in the health insurance plans. Along with PPE kit, the use of other surgical accessories such as crape bandages, slippers, tissue paper, disposable gloves, foot covers, masks, syringes, etc has also added up to the cost.
The compulsory quarantine period of 14 days and mandatory social distancing also has reduced the number of patients in one ward. The wards which earlier have beds for 20 patients now consume 10 people for maintaining social distancing. This has also increased the cost of treatment. Therefore, to keep a check on your hospital bills, you should check with your insurance provider about the inclusions and exclusions in your medical insurance for individuals.
As per the guidelines of the Insurance Regulatory and Development Authority of India, it is entirely the decision of the insurer to exclude or include medical consumables like PPE kits and accordingly charge a premium. It is observed that most of the medical insurance for individuals with even low premium cover the charges of some of the medical consumables and if the plan is priced well, then the insurer is covering almost all types of accommodation and a maximum number of consumables that are needed in the treatment during hospitalization.
Purchase Medical Insurance for Individuals Wisely
Buying insurance involves a considerable amount of research and making a careful decision. There is no point of buying a health cover that is insufficient in the time of needs. Here’s why you should always buy insurance only after comparing the policies. And here comes insurance aggregators like policybazaar into the picture, which helps you compare various health insurance plans offering coronavirus insurance and pick the right deal.
With rising COVID-19 patients in India, the IRDAI has come up with a number of initiatives to address the situation. IRDAI has made it mandatory for all the insurance providers to offer coronavirus treatment cover in their health plans. Apart from that, the ArogyaSanjeevani policy was introduced to cover COVID-19 treatment costs up to a sum insured of Rs 5 lakh.
Digitalisation is a Boon!
There is no doubt that many business entities are seeking innovative approaches to thrive amidst coronavirus pandemic by adopting various technological transformations. Digitalisation in the insurance sector being the most effective way in terms of buying insurance this time. When maintaining a social distance is a must these days, the online business helps the insurers to keep their business going, on the other hand, offers required safety to the consumers.
Lastly, it is suggested to check with your policyholder before purchasing a policy whether it is covering the medical consumables or not. Presently, only very limited health insurance policies are covering the consumables used in the treatment of COVID – 19. And the online comparison is the best way to find out which policy is offering what.