what are congenital diseases
Health Insurance

Congenital Diseases: Are they Covered by Health Insurance?

A congenital disease is a severe condition prevalent in infants at birth. According to a World Health Organization (WHO) report, an estimated 6% of babies are born with congenital disorders globally. Per another WHO report, congenital disorders have caused the deaths of over 170,000 children under five years of age, with the conditions occurring in babies in the prenatal state. Let’s learn more about congenital diseases and whether a health insurance policy can cover the conditions.

What are congenital diseases?

Congenital diseases or congenital malformations are the disabilities prevalent in infants at birth. These conditions are typically genetic and usually inherited. Congenital defects can develop when the baby is still in the womb. Children born with congenital disorders may suffer various health problems throughout their lifespan, including disability and heart diseases.

When planning a pregnancy, it is crucial to check your family history. You can reduce your child’s risk of congenital diseases by maintaining a balanced diet, taking the supplements prescribed by the gynaecologist, and avoiding smoking alcohol consumption. Common congenital disorders include congenital heart disease, down syndrome, cerebral palsy, cystic fibrosis, spina bifida, and cleft lip and palate.

What causes congenital diseases?

A specific cause cannot be linked with congenital defects. Experts believe the following to be the possible causes:

Genetics: Discrepancies in the genes affect growth and development. The genes may carry too many or too few chromosomes, causing abnormal development.

Consanguinity: Congenital anomalies typically occur in babies whose parents are blood relatives (first cousins, second cousins, etc.). A child born from such a union may suffer from several disabilities and fatal conditions.

Environmental causes: Certain medicines, recreational drugs, and alcohol consumed during pregnancy can cause congenital disabilities in children. Congenital disorders may also occur due to intrauterine constraint, i.e., the mispositioning of the baby in the womb.

Treatment for congenital disorders

Congenital disabilities treatment depends on the severity. For instance, some babies are born with defects that heal with time. Babies born with heart diseases may undergo open–heart surgery to fix the holes, widen blood vessels or repair heart valves. The baby might need a heart transplant if the disease is too complex. Other disorders like cerebral palsy and cystic fibrosis cannot be cured. Therefore, they require long–term medical care.

Does health insurance cover congenital diseases?

Yes. The Insurance Regulatory and Development Authority of India (IRDA) guidelines states that all regular insurance plans should cover congenital diseases. However, policies may not cover all congenital disorders. That said, most policies cover internal congenital disorders like heart disease and cystic fibrosis. Health insurance policies covers diagnostics, hospitalisation, and other medical expenses.

Most health insurance plans generally come with a waiting period of 12 to 48 months, after which you can file a claim. Health insurance also covers various inpatient and outpatient procedures.

Buy health insurance online

Medical costs are higher than ever. However, you can easily manage these expenses with a health insurance policy. Health insurance helps you deal with the treatment costs of numerous diseases. Contact your health insurance company to choose policies per your preferences or purchase them online on the insurer’s website.

Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.

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