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Which Illnesses Are Covered In Health Insurance?

By The Assam Tribune
Which Illnesses Are Covered In Health Insurance?
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Health insurance is a valuable resource that helps people to be financially shielded from medical costs, and thus receive the required medical treatment without facing high costs. But what is health insurance and what does it include, how can one find out what health insurance plan is suitable for them? In this article, you will learn about the types of diseases that are included in the health insurance policy so that you can know what to expect from it.

Understanding Health Insurance Coverage

Health insurance policies are meant to cater for all forms of illnesses, ranging from normal check-ups to critical and long-term illnesses. However, the coverage depends on the type of health insurance plan that one opts for in the market. Generally, most health insurance plans cover the following categories of illnesses:

Hospitalisation and Surgical Expenses

The basic component of most health insurance policies is hospitalisation for sickness or accident. This comprises the room charges, the doctor’s fees, the nursing care and the surgery fees. From a sudden appendicitis surgery to a heart bypass surgery or even treatment of a severe infection, hospitalisation costs are generally included in the basic health insurance plans.

Chronic Diseases and Pre-existing Conditions

Conditions such as diabetes, hypertension and asthma are illnesses that need constant doctor visits and constant management. Although there are some health insurance plans that do not cover pre-existing conditions, most of them provide coverage after a certain period of time. The best health insurance plans guarantee that people with chronic diseases get the required treatment without suffering financially.

Critical Illnesses

Critical illness coverage is available as part of a standard health insurance plan. This type of coverage is essential for those diseases that are chronic and need a lot of medical attention and time to heal, for example, cancer, heart attack, stroke, kidney failure and major organ transplants. The most favourable health insurance plans often include a one-time payment in case of the diagnosis of a severe disease, which is helpful in a difficult period.

Maternity and Newborn Care

Maternity related costs, such as prenatal and postnatal care, delivery and newborn care, are usually included in most health insurance policies. Some policies also include coverage for pregnancy related complications and childbirth. However, it is crucial to understand that maternity benefits are usually offered with a waiting period, so it is better to think about it beforehand. The best health insurance plans provide adequate coverage for maternity services so that both the mother and the baby are well taken care of.

Mental Health Disorders

Mental health is now considered an important part of a person’s health and most insurance policies provide for mental health. This can include treatment for depression, anxiety, bipolar disorder and schizophrenia, among others. It may include treatment sessions, counselling, psychiatric consultation and hospitalisation, if necessary. The addition of mental health benefits in the best health insurance plans is an indication of the changing perception towards mental health.

Infectious Diseases

Infectious diseases are usually treated under health insurance policies and this may include malaria, dengue, tuberculosis and the recent COVID-19. An infectious disease can occur at any time; this means that you will be forced to incur some costs, and this is why it is important to have a health insurance policy that covers such conditions. The best health insurance plans may also include vaccines and preventive measures against some infectious diseases.

Lifestyle-related Illnesses

Lifestyle diseases, including obesity, cardiovascular diseases and some types of cancer, have become common due to increased cases of people leading sedentary lifestyles. Most health insurance plans have included these conditions in their coverages since people need a complete treatment plan. This may comprise lifestyle change programs, nutritional counselling and treatment of other conditions associated with obesity.

Genetic and Congenital Conditions

Although in the past, many genetic and congenital conditions were not covered by most health insurance policies, some of the best health insurance policies are now covering them. These are diseases that are present at birth and may need to be treated throughout the lifetime. Some of them are cystic fibrosis, congenital heart diseases and haemophilia. Having coverage for these conditions may be important for families who have to deal with the expenses of long-term care.

Respiratory Diseases

Other illnesses that are often included in the health insurance plans are respiratory illnesses, including chronic obstructive pulmonary disease (COPD), asthma and bronchitis. These may warrant hospitalisation, frequent check-ups with the doctor and prescription drugs which can be costly if the insurance is inadequate. The best health insurance plans offer adequate coverage for respiratory diseases so that patients can adequately manage their diseases.

Bone and Joint Disorders

Many health insurance policies provide benefits for various bone and joint diseases, such as arthritis and osteoporosis, and various orthopaedic procedures, like knee or hip replacement surgeries. These conditions can affect the quality of life, and the management includes surgery, physiotherapy and lifelong medications. It is, therefore, important to make sure that your health insurance policy includes these conditions to enable you to maintain mobility and good health.

Selecting the Right Health Insurance Policy

While choosing the right health insurance plan, ensure that you go through the policy terms and conditions to determine which illnesses are catered for. Here are some tips to help you choose the right plan:

  • Assess Your Health Needs: Think about your current health, your family’s health history and your possible future health problems. If you have a chronic disease or any other disease history, then make sure that it is included in your plan.
  • Compare Plans: Do not just stick to the first plan that you come across. When selecting a health insurance plan, compare the various plans to identify one that will provide the best coverage for the diseases that are most likely to affect you.
  • Check the Waiting Period: Most health insurance policies come with waiting periods for pre-existing diseases, pregnancy and some other diseases. Make sure you know these waiting periods before you sign up for any of the plans.
  • Look for Add-ons: There are also optional benefits or extras in some health insurance policies, such as critical illness, mental health and other specific conditions. These can complement your coverage and give you much-needed relief.
  • Read the Fine Print: The first thing that one should always do is to read the policy document very carefully. There are always some conditions that may limit the insurance coverage or some co-payments that may be required.

Conclusion

Health insurance is one of the most important things that you should consider taking since it covers all illnesses and medical conditions. The best health insurance plans are those that offer adequate coverage to meet your and your family’s requirements. Knowing what diseases are included in your health insurance policy helps you make the right choices and choose the right plan, which will give you confidence in the face of a disease.

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