IS YOUR HEALTH PLAN COVID READY? HERE’S HOW TO CHECK
With COVID-19 infection numbers spiking again, it is better to be safe than sorry. With the case active cases toll touching 7,300 mark, it is good to be prepared this time around by ensuring that your health insurance plan offers comprehensive coverage including OPD (outpatient department) and consumables support as this becomes crucial during COVID-19. One should also assess the plan for home care or domiciliary hospitalisation.
What does an OPD cover ensure?
This means that the insured and his/her family members are protected even in cases where hospitalization may not be required. The OPD health insurance would cover diagnostic tests, doctor consultations, and medications which can be quite expensive as well. Alongside, this cover also includes non-medical expenses, like materials that are required during a COVID-19 crisis, gloves, masks, PPE kits and even room charges, as these can add up significantly in case of hospitalisation for COVID-19 treatment.It is also essential to examine that the health policy you have opted for has sufficient sum insured already to cover high treatment costs as well for COVID-19. These may include oxygen support, ICU charges and post-hospitalisation expenses. Most of the recent health insurance policies also cover telemedicine and home quarantine consultations, which can be value-additions when managing mild cases of COVID-19 at home.
Domiciliary hospitalisation
It means treatment at home where hospitalization is not possible as a result of shortage of beds or immobility of the patient. This is the treatment for COVID that is covered under most existing health insurance policies. For this, the insured must get a doctor’s prescription that recommends home treatment and should also inform the insurer immediately of his/herself or through the third party administrator (TPA).Claims
While claiming, the insured must submit the claims along with supporting documents and should also include the doctor’s certification to the insurer. This also needs to happen within a specified timeframe.Exclusions in policies
While most policies offer COVID-19 coverage, there are some exclusions in the policies one must take care of:- If the infection was contracted under specific circumstances or due to negligence, like travelling to a high-risk area
- If the virus is contracted during the policy waiting period of 15 to 30 days, the insurer may reject the claim
- If home quarantine happens without medical supervision, claim can be denied
- If underlying health conditions are not disclosed at the time of policy insurance