Health insurance is vital for managing healthcare costs and ensuring access to necessary medical treatments. Understanding which diseases are covered in health insurance can help policyholders make informed decisions about their coverage.
Let’s explore the list of diseases covered under health insurance, which includes common diseases, pre-existing conditions, and critical illnesses. It also addresses diseases that are not included in your health insurance cover.
Which diseases are covered in health insurance cover?
Health insurance plans cover a wide range of common diseases. These include:
1. Respiratory Infections
Common respiratory infections, such as bronchitis and pneumonia, are covered under health insurance. This includes consultations, medications, and hospitalisation if required.
2. Cardiovascular Diseases
Health insurance policies commonly cover conditions like high blood pressure (hypertension) and heart disease. Coverage includes the cost of medications, diagnostic tests, and consultations with healthcare providers.
3. Gastrointestinal Disorders
Conditions such as gastritis, acid reflux, and peptic ulcers are included in the list of diseases covered under health insurance. The coverage consists of diagnostic tests, medication, and doctor consultations.
4. Infectious Diseases
A health insurance policy covers infectious diseases like dengue, malaria, and tuberculosis. Treatment costs, including hospitalisation, medications, and consultations, are generally included.
5. Orthopaedic Conditions
Health insurance plans also cover orthopaedic conditions such as fractures, arthritis, and joint replacements. It includes the cost of surgery, physiotherapy, and other related treatments.
6. Urinary Tract Infections (UTIs)
UTIs are common, particularly affecting women, and can cause considerable discomfort. Health insurance policies usually cover the diagnosis and treatment of UTIs.
List of Pre-existing Diseases Covered In Health Insurance
Pre-existing conditions refer to health issues a person has before enrolling in a health insurance plan. Coverage for these conditions can vary, but many policies now have pre-existing diseases covered from day 1. Some common pre-existing diseases that may be covered include:
1. High Blood Pressure (Hypertension)
Hypertension is a prevalent condition that, if left untreated, can lead to serious health issues such as heart disease and stroke. Health insurance plans often cover hypertension diagnosis, treatment, and management.
2. Diabetes
Diabetes is a chronic condition that requires ongoing management, including medication, insulin therapy, and regular monitoring. A health insurance policy covers the costs associated with diabetes care.
3. Asthma
Asthma is a chronic respiratory condition that also requires ongoing management. Many health insurance plans cover asthma treatments from the first day of the policy.
3. Heart Disease
Certain health insurance plans may cover conditions such as coronary artery disease and heart failure. Coverage often includes diagnostic tests, medications, and surgical procedures if necessary.
4. Thyroid Disorders
Hypothyroidism and hyperthyroidism are common thyroid disorders that require lifelong management.
5. Arthritis
Arthritis, including osteoarthritis and rheumatoid arthritis, is a chronic condition that can cause pain and disability. Many health insurance plans cover arthritis treatments.
List of Critical Diseases Covered In Health Insurance
Critical illnesses are severe conditions that can significantly impact a person’s health and finances. Health insurance cover for these illnesses is crucial, as their treatment costs can be extremely high. Some of the critical illnesses commonly included in the list of diseases covered under health insurance are:
1. Cancer
Cancer treatments are expensive and involve various stages, such as surgery, chemotherapy, and radiation therapy. Health insurance policies often provide comprehensive coverage for cancer treatment.
2. Heart Attack
A heart attack requires immediate and extensive medical care. Health insurance plans typically cover the costs associated with hospitalisation, surgery, and post-operative care.
3. Stroke
Many health insurance policies cover stroke treatment and rehabilitation, including emergency response, hospitalisation, and long-term recovery.
4. Kidney Failure
Kidney failure often requires dialysis or a kidney transplant, both of which are expensive procedures. Health insurance plans generally cover these treatments.
5. Organ Transplants
Many health insurance policies cover organ transplants, including those involving the liver, heart, and lungs. Health insurance coverage for such conditions generally covers both the surgical procedure and postoperative care.
List of Diseases Not Covered Under Health Insurance
Certain conditions are explicitly excluded from standard health insurance policies. The list of diseases not covered under health insurance includes:
1. Cosmetic Surgery
Health insurance plans do not cover procedures performed purely for aesthetic reasons rather than medical necessity.
2. Alcohol-Related Illnesses
Health issues arising from alcohol abuse, including diseases like cirrhosis, are often excluded from coverage.
3. Infertility Treatments
Treatments for infertility, including in-vitro fertilisation (IVF), are usually not covered under standard health insurance policies.
4. Self-Inflicted Injuries
Injuries or illnesses resulting from self-harm or suicide attempts are generally excluded from coverage.
Knowing which diseases are covered in health insurance helps you make informed decisions about healthcare coverage. However, you must read the terms and conditions of your health insurance plans and pre-existing diseases covered from day 1 to understand the coverage. Factors such as policy terms, waiting periods, sum insured, network hospitals, and renewal criteria influence the scope of your coverage.
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