Understanding COVID-19 Health Insurance In India: Types, Inclusions And T&Cs

Coronavirus pandemic has altered a lot in the world. From travel getting ceased, nations going under lockdown to businesses switching to remote work, the impact is evident in all walks of life. And India, too, has not been left unscathed by the wrath of COVID-19. With nearly 10 lakh cases as of July 2020, the spread of the pandemic in the country is uncontrolled. This has also had a direct impact on healthcare costs, especially for COVID-19 treatment. 

The average daily cost of the treatment of a normal COVID-19 carrier is anywhere between ₹20,000- ₹25,000. And this is for a patient who does not require intensive care of ventilators and life-saving equipment. So, a 14-day treatment would cost anywhere between ₹2,80,000- ₹3,50,000. 

In these challenging times where citizens are already anxious about their health and the risks that the pandemic involves, these costs add to the worry. Not to mention, this anxiousness gets doubled for those who are concerned about losing their jobs or have lost them already. The worry of how would they manage healthcare bills, if ever they are infected with Coronavirus is leading to high stress-levels across the population. 

Taking all this into consideration, the Insurance Regulatory and Development Authority of India (IRDAI), released guidelines for Coronavirus insurance, as an attempt to provide financial security to the citizens specifically for COVID-19 treatment costs. IRDAI has directed all health insurance providers to provide short term COVID-19 insurance plans based on the common guidelines. Under the guidelines, there have been two types of COVID-19 health insurance specified. 

Types of COVID-19 Health Insurance In India

The Indian Government through IRDAI has mandated insurers to provide two types of Coronavirus cover, depending on the need of the people. 

COVID-19 Health Insurance Type 1- Corona Kavach: 

Corona Kavach is the standard health insurance policy for COVID-19 treatment. It works in a similar fashion like any indemnity-based health insurance policy where there is the sum insured and you get the claim against the expenses you incur. For Coronavirus health insurance, these expenses range from diagnosis costs, hospitalization charges, and a lot more. 

What does Corona Kavach cover?

Taking into account the fact that at present, those diagnosed with Coronavirus are either hospitalized or many are advised home treatment too. Corona Kavach covers both of these scenarios. 

Corona Kavach for Hospitalisation

In cases of hospitalization, Corona Kavach policy will cover: 

  • Room, boarding, and nursing charges.
  • The fee of all staff involved in your treatment including surgeons, anaesthetists, medical practitioners, consultants, specialists, etc.
  • Cost of blood, oxygen, anaesthesia, operation theatre, surgical appliances, ventilator charges, medicines, drugs utilized in your treatment. 
  • Diagnostic, PPE kits, gloves, masks, and similar expenses.
  • Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) charges.
  • Ambulance charges of a maximum of Rs. 2,000.

Corona Kavach for Home Treatment

If you are advised by a medical practitioner to go for home treatment, then Corona Kavach insurance will cover the following expenses for you, upto 14 days of diagnosis:

  • Cost of the prescribed treatment by the Medical Practitioner.
  • Diagnostic tests underwent at home or at a diagnostic center.
  • Medicines prescribed in writing.
  • Consultation charges of the Medical Practitioner.
  • Medical procedures limited to parenteral administration of medicines.
  • Nursing charges.
  • Cost of oxygen cylinder(s), pulse oximeter, and the nebulizer.

[Note: Covering home treatment is tricky, and all these expenses would be covered against documented proof of these expenses.]

Ayush Treatment:

A policyholder may choose to go for Ayush (Ayurveda, Unani, Siddha, Homeopathy) treatment for Coronavirus. Any Ayush treatment expenses up to the sum insured in the COVID-19 health insurance policy are covered. 

Pre and Post Treatment charges: 

Any costs related to the treatment 15 days prior to the hospitalization or home care treatment, and expenses incurred 30 days after the discharge or completion of the home care treatment, will be covered. For instance, this includes the cost of COVID tests or swab test you would have taken for diagnosis. 

Optional Cover in Corona Kavach:

Corona Kavach also provides an additional “Hospital Daily Cash” wherein the insurer provides 0.5% of the sum insured per day to the policyholder for continuous hospitalization for COVID-19 treatment. This is payable for a maximum of 15 days during the policy period. Needless to say,  “Hospital Daily Cash” adds additional cost to your premium. 

What is the tenure of Corona Kavach health insurance?

According to government guidelines, insurance providers must keep the term of COVID-19 health insurance short. This helps in keeping the premium costs for the insurance affordable. 

There are three options for the tenure are 3.5, 6.5, and 9.5 months payable with a single premium.

What is the Sum Insured for Corona Kavach health insurance?

The minimum sum insured amount is Rs.50,000, while the maximum is Rs.5 lakhs for the COVID-19 health insurance under the Corona Kavach policy. 

How much will the premium for Corona Kavach health insurance be?

The premium cost for Corona Kavach varies for different insurance providers. It must be noted though that you pay the premium for Coronavirus policy only once. The premium cost can vary from ₹500- ₹5000 depending upon sum insured and the tenure of the policy. Here’s a comparison of the premiums provided by different insurance providers: ‍

Source: Mint

COVID-19 Health Insurance Type 2- Corona Rakshak: 

Another option of COVID-19 health insurance to cover specific requirements is Corona Rakshak. This does not work like a standard insurance policy. Instead, the insurer provides you with a lump-sum amount of the sum insured after 72 hours of continuous hospitalization. This will be paid to you irrespective of the treatment expenses. Once this payment is made, your policy will cease to exist. 

What does Corona Rakshak cover?

As the Corona Rakshak plan is benefit-based and ensures you a lump-sum, the details of what is covered are insignificant. You get the entire amount after 72 hours of continuous hospitalization due to coronavirus. 

What is the tenure of Corona Rakshak health insurance?

Similar to Corona Kavach, the three tenure options are 3.5, 6.5, and 9.5 months payable with a single premium.

What is the Sum Insured for Corona Rakshak health insurance?

The minimum sum insured amount is ₹50,000, while the maximum is ₹2.5lakhs for the COVID-19 health insurance under the Corona Rakshak policy. 

How much will the premium for Corona Rakshak health insurance be?

Similar to Corona Kavach, the premium cost for Corona Raksha too can vary from ₹500- ₹5000 depending upon sum insured and the tenure of the policy. The nitty-gritty of Corona Rakshak is still being discussed and formulated by IRDAI and insurance providers so exact premium costs are yet not public. 

Comparing Corona Kavach and Corona Rakshak Insurance

Comparing COVID-19 Insurance Plans and Health Insurance Plans That Cover COVID-19 

Another consideration that people have is whether to add COVID-19 cover to their existing Health insurance plan as an added benefit or to buy separate COVID-19 health insurance, essentially Corona Kavach. Here are the differences between the two to help you make a better choice:

Understanding Waiting Period For COVID-19 Health Insurance Policy

Taking into account the possibility of adverse selection, IRDAI mandates a 15 day waiting period for all Coronavirus health insurance. This is required because there is a chance that someone chooses to go for the insurance post-diagnosis of COVID-19. To ensure that this does not happen, a mandatory 15-day waiting period is added to all COVID-19 insurance. 

Plum COVID-19 Health Insurance For Your Employees

In these uncertain times, the concern and anxiety of soaring COVID treatment costs and the lack of financial security are probably irking your team too. As an employer, providing COVID-19 Health Insurance to your team not only gives them a sense of security and peace of mind but also conveys that they are valued at the company and their health matters to you. 

At Plum, we offer group Corona Kavach COVID-19 Health Insurance for your employees, with upto ₹3,00,000 as the sum insured. We’ve kept the option of extending the coverage to the families of your employees too, with premiums starting at just ₹443 per member per year.

We also realized that more often than not, the first cause of worry related to Coronavirus starts when a person observes some symptoms. So, our COVID-19 Health Insurance includes a free doctor consultation for your employees regarding their Coronavirus symptoms. 

If you are considering providing COVID-19 insurance cover to your team, explore our Coronavirus Cover now.