Cardiac ailments, commonly known as heart diseases, are on the rise. Several research studies have confirmed that such ailments are on the higher side in India.
Heart disease being a lifestyle disease, not all health insurance companies offer Mediclaim policy for heart patients. So, it is always beneficial to get a health insurance policy when you are young and healthy.
Of late, some insurers have started offering medical insurance for heart patients. In this article, we will talk about policies that are solely meant for heart patients.
What is a health insurance policy for health diseases?
As is in other health insurance policies, medical insurance policy for heart patients is a simple contract between the policyholder and insurance company, wherein the insurers promise to cover the health medical expenses incurred of the policyholder if he/she pays premium on time. Health insurance policies for heart patients exclusively meant for those who have already been diagnosed with such an ailment. For health Insurance Policies for heart patients, the premium amount, waiting period and other terms and conditions are usually different from normal health policies. Not all health insurance policies offer such specific health insurance policies.
Such ailments are not rare among senior citizens and several senior citizens buy this policy. However, do not mistake it for senior citizen health insurance policies. The two policies are different from each other.
Note that if you are diagnosed with a heart ailment after buying a policy, then your health policy would be treated as a regular policy.
Income tax benefit: If you buy such specific policies, you are eligible for income-tax benefit under the Section 80D of the Income Tax Act.
Things to remember while buying a heart disease insurance: First thing first, if you have been diagnosed with a heart ailment and have been scouting for such a specific health plan, then first confirm with your insurer that they have such specific products. It is important to be clear with the insurance company regarding pre-existing illnesses. In cases of any miscommunications between the two parties, the health insurance company might deny coverage for such ailments.
Check the benefits offered by the insurance policy: While buying a health insurance policy, it is essential to understand the benefits offered by the company. This holds true for heart disease insurance policies too.
In-patient hospitalisation: When the policyholder is admitted to the hospital for more than 24 hours, then it is termed as in- patient hospitalisation. This is the basic criteria for claiming health insurance benefit, so all health insurance provide cover for in-patient hospitalization – mostly 100%. However, if you have a special policy, do not forget to check if there are any specific clauses or terms and conditions for it.
Pre- and post-hospitalisation : All health insurance policies cover pre- and post- hospitalisation expenses. This is usually one month for pre-hospitalisation and three months for post hospitalisation. Check for the time period specified by your health insurance company.
Domiciliary hospitalization : When a patient cannot be moved, often medical care needs to be given to him or her at their home. Such treatments are known as domiciliary hospitalisation. Heart diseases are critical illnesses and often patients might require such a line of treatment. Confirm with your health insurer whether such treatments are covered by the health plan.
Check the terms and conditions: The terms and conditions for such policies are widely different for policies meant for others. So read them carefully. For example, there might be a waiting period. Check with your insurer how long is that hibernation period. Lower the waiting period, the better as such treatments are quite expensive and do need constant monitoring.
Secondly, there might be a condition specifying when you can buy the policy. For example, some policies say that you can buy a policy only after 6 months to one year if you have gone through an angioplasty. For example, if you have gone through an angioplasty in January 2021, then you can buy a policy on July 1, 2021 or January 1, 2022, as per the terms and conditions mentioned in the fine print.
Then some companies also put a time limit on the maximum period for buying such a policy. For example, if there is a time limit of maximum five years, then you cannot buy such a policy if you have gone through an angioplasty in 2015.
Check the hospitals covered : It is extremely essential for all policyholders to check whether the hospitals preferred by you are covered by your health insurance company. And this is more so those who are undergoing treatment for critical illnesses like cancer, heart ailments.
For example, if you have been diagnosed with a critical ailment like heart disease, you must be consulting a specific doctor. Also, for such specialist treatment, only few hospitals in a particular city. It is extremely necessary to check with your health insurer whether it covers these hospitals and doctors.
Check if any riders are offered with your health policy: Rider is an additional benefit that you get for your insurance policy on paying a nominal amount. For example, you can buy an accidental benefit rider with your life insurance policy, third party accident benefits with your car insurance policy or child birth benefit with your health insurance policy.
Similarly, if you are buying a health plan specific to heart patients, check if the insurance company offers any rider with it.
Why is it essential to buy a critical health insurance rider with your health insurance policy?
All health insurance companies offer critical health insurance riders with the policy. The critical health insurance rider includes diseases like cancer, heart ailment, kidney diseases etc. If you have bought health insurance with such a rider, then on being diagnosed with one of the diseases listed in it, the health insurance company will pay you a lump sum amount. This is over and above the coverage amount for the treatment.
For example, let’s suppose you have a health insurance policy with a critical illness rider of Rs 1 lakh. Now, unfortunately, you have been diagnosed with heart ailment and the treatment cost during the hospitalisation is Rs 1 lakh. Then the insurance company will pay you Rs 2 lakh. That is, Rs 1 lakh for the insurance coverage for the hospital treatment, and another Rs 1 lakh for the critical insurance rider. Such riders are also available with life insurance policies as well.
Also, critical illness policies can be bought separately. These policies give cover as high as Rs 25 lakh to Rs 30 lakh, and the amount is paid in lump sum on being diagnosed with one of the critical illnesses mentioned in the policy.
You have a comprehensive understanding now about health insurance policies for heart patients. Keep the above factors in mind while choosing such a special policy.
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.