As the dengue epidemic continues to grip Karnataka, many residents are concerned about the financial burden of medical treatment. With rising hospitalisation rates and costs, the question of health insurance coverage is becoming increasingly important.
Health insurance policies typically cover a wide range of medical expenses, including hospitalisation, doctor’s fees, and medications. However, the specific coverage for dengue can vary depending on the terms and conditions of the individual health policy.
Naval Goel, Founder and CEO of PolicyX.com say, “Usually, all health insurance policies provide coverage for hospitalization due to Dengue. There are some health insurance policies specifically designed to cover vector-borne diseases, these policies provide more wholesome coverage for diseases like dengue, malaria, chikungunya etc. offering benefits like cover for non-medical and medical expenses, home nursing, hospitalisation, and cashless home treatment.”
Dengue coverage
Plan names | Waiting period | Coverage amount | USPs |
Aditya Birla Activ Health Platinum Enhanced | 48 months | 2 Lakh – 2 Crore | Provides cashless home treatment for dengue upto sum insured |
HDFC ERGO Dengue Care | 15 days | 50,000-1 Lakh | Provides non-medical and medical expenses, home nursing, accommodation and hospitalisation cover |
Bajaj Allianz M-Care Policy | 15 days | 10,000-75,000 | Covers upto 7 vector-borne diseases like Dengue Fever, Malaria, Filariasis, Kala Azar, Chikungunya, Japanese Encephalitis, Zika virus |
Future Generali Vector Care | 15 days | 10,000-75,000 | Covers upto 7 vector-borne diseases like Dengue Fever, Malaria, Filariasis, Kala Azar, Chikungunya, Japanese Encephalitis, Zika virus |
Niva Bupa ReAssure 2.0 | 24 months | 5 Lakh – 1 Crore | Covered upto the sum insured for dengue |
Source: PolicyX.com
Key factors to consider when assessing dengue coverage:
Pre-existing conditions: If dengue is considered a pre-existing condition, it may not be covered under the policy. Some insurers may have waiting periods or exclusions for pre-existing conditions.
Policy exclusions: Certain policies may exclude coverage for communicable diseases, including dengue. It is crucial to review the policy’s exclusions carefully.
Sub-limits: Some policies may have sub-limits for specific conditions or treatments, which could limit the amount covered for dengue-related expenses.
Cashless hospitalisation: This feature allows for direct billing to the insurance company, eliminating the need for upfront payments. Check if your policy offers cashless hospitalisation at network hospitals.
Goel says, “Policyholders can get the sum insured ranging from Rs 2 lakh to 2 crores. Depending on the policy purchased, The waiting period is between 15 days to 48 months. Some of the insurance policies that offer cover specifically for Dengue are Aditya Birla Activ Health Platinum Enhanced, HDFC ERGO Dengue Care, Bajaj Allianz M-Care Policy, Future Generali Vector Care, and Niva Bupa ReAssure 2.0.”
Insurance covers with OPD facilities
Some health insurance policies offer OPD cover that can be helpful in managing seasonal illnesses that might require multiple consultations and visits to doctors without the need to get hospitalised. Siddharth Singhal, Head of Health Insurance, Policybazaar lists below some of the OPD options in policies that cover dengue.
Manipal Cigna’s Prime Advantage Health Insurance offers OPD coverage of Rs 20,000 per policy year, which covers doctor consultations, diagnostic tests and pharmacy costs. This is a feature in the base policy itself which costs Rs 11,534 per year for Rs 5-lakh coverage for a 35-year-old male policyholder in the metros.
For an additional cost of Rs 1,178 in Aditya Birla’s Activ Health insurance, policyholders can get unlimited cashless physical and virtual outpatient consultations by empanelled doctors, along with two references per year to specialist doctors. The base policy costs 9,782 for a Rs 5-lakh cover.
Niva Bupa also offers unlimited teleconsultations with doctors and Rs 10,000 cover amount for OPD-related consultancy and diagnostics under its rider, which costs 5,345 over the base policy cost of 8,428 for Rs 5 lakh cover.
Care’s NCB Supreme health insurance offers an 80% discount on Doctor Consultation & Diagnostic Tests but at exclusive diagnostic centres and hospitals. This add-on costs Rs 5,954 on a base policy of Rs 11,181 for a Rs 7-lakh cover.