Which COVID-19 Home Treatments Are Covered Under Various Health Insurance Plans in India?

By now, the word ‘Coronavirus’ has struck a chord of fear amongst us all — so much so, that the moment we hear somebody we know has it, we fear the worst. Even more tellingly, we are extremely paranoid about developing any of the signs of the virus, from coughing to body pain and fever, among others. After hearing news reports and personal accounts of how scores of virus-affected persons could not procure medicines, oxygen and even hospital beds owing to an acute shortage, you are frightened at the possibility of the virus striking you or a family member.

First of all, relax. Not every form of the infection is severe enough to become fatal. Many serious infections can also be treated safely at home, provided you follow the doctor’s medication, quarantine as directed and undergo testing to rule out the presence of the infection. Second, there are health insurance plans in India to account for Coronavirus treatment specifically, even those administered at home. So you are not expected to bear the financial brunt of the disease as well. The health insurance policy can pay the costs so you or your loved one can focus on getting better.

The health insurance that matters

The Corona Kavach policy was introduced in June 2020 to meet the needs of those affected by the virus, and particularly those that required hospitalisation for the same. The plan provides insurance to meet the costs that most regular health plans do not, from buying PPE kits and masks to sanitisation costs.

However, most beneficiaries remain confused about whether the Corona Kavach policy covers at-home treatment costs or not. As a policy holder, you will be delighted to know that it does. Consider the following facts about at-home treatment coverage under this plan:

It protects against prescribed home medical care up to 14 days from detection of the virus using an RT/PCR test. However, this is in line who are recommended treatment by empanelled or registered doctors only.

The policy does not impose a sub-limit on the amount of money you may claim for at-home treatments. You can claim the entire sum assured amount only for home treatments.

The policy further has a coverage for COVID-specific tests and costs that other health insurance plans in India would normally not cover. These are: tests and diagnosis confirming COVID, testing at home for the virus, medicine costs when tablets are prescribed by a registered doctor, procedures not administered orally at home, cost of buying medical equipment to treat the virus (pulse oximeters, nebulisers, oxygen cylinders, thermometers, etc.) and doctor’s consultation and nursing fees.

Some important riders to know about

· Though the plan does cover at-home treatment costs, you must note that it does so ONLY on the written certification of the doctor that the policy holder was to be admitted to hospital but could not do so due to a bed shortage.

· When filing the claim, you will need to show a COVID-19 positive RT/PCR test. Leading health insurance providers like ManipalCigna Health Insurance accept the antibody test too, but will still ask for the RT/PCR test. Make sure the report carries the SRF number and ICMR authorisation of the testing authority.

· A doctor must monitor you or the affected family member regularly and show their observations in writing, with any treatments and procedures prescribed. You will need to submit their daily monitoring chart and related prescriptions and procedure proofs to avail of the insurance cover.

· Please inquire with the insurance provider if you need to get the at-home treatment costs and plan approved in advance.

· Meanwhile, if you don’t have a Corona Kavach policy and are seeking coverage under your regular health insurance plan, you must first check for the list of exclusions in the policy. Most regular health insurance plans in India will not cover the costs of at-home treatment for COVID, nor the purchase price of treatment equipment or devices.

Be sure to get all your doubts cleared from your insurance provider about any aspects of the Coronavirus health plan that you have purchased. Being aware of all the facts helps you file claims in a more informed manner.