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Health insurance provides crucial financial support for unexpected medical expenses, including accidents and illnesses. Understand the coverage details to make informed healthcare decisions.
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Sunita, a working woman from Delhi, had recently purchased an individual health policy. Within a few months, she underwent a dental treatment procedure and decided to claim on her policy. When she contacted her insurer, she realised that the medical condition for which she made a claim was on the list of diseases covered under health insurance.
While health insurance offers comprehensive coverage for expenses beyond hospitalisation, mediclaim policies, on the other hand, provide cover for hospitalization-related costs for a specified time limit. Despite this difference, health policies regarding a predefined sum insured are highly beneficial. However, when buying such a policy, it is essential for the policyholder to thoroughly read the policy details to know the diseases covered under health insurance and diseases not covered under health insurance.
The list of diseases covered under health insurance depends on the plan chosen by a person. However, health insurance policies generally cover the following medical conditions:
Health policies provide coverage for treatment or injuries caused by accidents. Accidents are medical emergencies that require immediate hospitalisation. So, the expenditure incurred by an individual during hospitalisation is covered under health insurance policies, subject to policy terms and conditions. Moreover, cashless health insurance is a feature with such policies wherein the insured can avail treatment at any of the insurer's network hospitals and opt for a cashless claim facility.
The coronavirus battle is still ongoing for everybody! But, with vaccination and health insurance, you can stay protected. Thankfully! Our indemnity-based health insurance policies cover coronavirus treatment as well. Further, some of these plans are available as individual and family floater policies to ensure comprehensive coverage. You can enhance the policy coverage with COVID Care and Care Shield add-ons. These add-ons include hospitalisation, medicines, home quarantine expenses, consumable items like gloves, masks, etc. With extensive policy coverage, you can keep yourself and your family at bay from the lethal virus.
Undoubtedly, medical advancements bring new hopes to many. Cancer insurance is the finest investment an individual can make for timely treatment and recovery from this deadly disease. However, the treatment cost is skyrocketing, but the one good thing is that the health insurance policy also covers cancer treatment expenses. Whether it is hospitalisation, medication, chemo, or radiotherapy, policyholders get complete coverage to avail of timely treatment for various stages of cancer.
Diabetes, high blood pressure, and high BMI are diseases that require prolonged treatment, creating a financial burden for many. Thus, our health insurance works as a financial cushion. It covers the treatment expenses related to these ailments and their direct complications. Using a BMI calculator can help you assess your health category and understand your potential risk factors. People who have diabetes, high blood pressure, or high BMI as pre-existing diseases can also get coverage with health insurance for diabetes after completing the waiting period of 24 months.
Health insurance brings a big sigh of relief for people suffering from life-threatening diseases like HIV/AIDS. They can also get a policy that covers their hospitalisation and treatment expenses. From daycare treatment domiciliary hospitalisation to ambulance expenses, AYUSH treatment policyholders will get comprehensive coverage that helps them to get the best medical facilities and live healthy lives.
Due to a sedentary lifestyle, work stress, bad eating habits, alcohol, etc., lifestyle diseases take a toll on health. If not treated timely, it can be fatal. But, as medical inflation is skyrocketing, it is not easy to get treatment until you have health insurance. Our critical illness insurance covers 32 types of critical illnesses. You can get it at a low premium with high coverage.
Your heart is your body's most vital organ, so you should regularly check its beat. We have health insurance for heart patients that covers different cardiac problems and pre-existing ailments. Under this policy, you will get an annual cardiac health check-up, AYUSH coverage, and more.
Generally, every health policy has a waiting period of 30 days from the date of policy issuance. However, some diseases, such as Arthritis, Osteoporosis, Gout, Spinal Disorder, Joint Replacement, Ligament Repair, Cataract, Hernia, etc., have a specific waiting period of 24 months. These are covered under the policy, but policyholders can file a claim after completing the waiting period.
The waiting period for health insurance is for a specific pre-existing disease, as listed in the policy document. Here are some of the 2 years waiting period disease lists in Health Insurance:
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The policy exclusions are medical conditions/treatments/procedures not covered under health insurance plans. The list of diseases not covered under health insurance are:
The list of diseases covered under health insurance varies based on policy and its coverage. Therefore, it is wise to carefully read the policy terms and conditions to know what diseases are covered and not covered under health insurance. It will help you to get the best healthcare facilities and hassle-free claim settlements.
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Insurance plans have a list of slow-growing diseases that they offer coverage after two years of initial policy purchase. Ailments such as Piles, Arthritis, Cataract, Varicose Veins, Ulcers, etc., come under the category of named ailments.
If piles are diagnosed after policy purchase, the insured person can file a claim after two years of continuing the policy. However, for a pre-existing condition of piles, the insured member may have to wait for up to three years.
Hospitalisation incurred due to diseases such as dengue, typhoid, pneumonia, cancer, gastrointestinal issues and piles are covered under health insurance.
Yes piles is covered under health insurance offered by Care Health Insurance.
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Disclaimer: The above information is for reference purposes only. For more details about the health insurance plans, please refer to the sales prospectus, policy terms, and conditions.
^^Number of Cashless Healthcare Providers as of Feb 2025
**Number of Claims Settled as of Dec 2024
^10% discount is applicable for a 3-year policy
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