Are Dengue and Pneumonia Covered Under Health Insurance?

In India, health insurance is a significant category of insurance. The healthcare industry has continuously been revolutionizing with a wide range of services and products. Today, consumers are becoming extremely health conscious.

Factors such as fast-paced lifestyles, excessive workload and growing alteration in the environment have drastically affected the health and wellness of people. In this reference, health insurance is offered not only for critical illnesses but for common diseases also.

Some of the diseases that are prevalent in India, including dengue, tuberculosis, fever, cardiovascular diseases, dengue, etc. Few diseases that witness a lot of claims include respiratory diseases, tuberculosis, cardiovascular diseases, fever and infections, unintentional injuries, malignant tumours, diarrhoea, dengue, and chikungunya. Fever is one of the most common ill health that a sufferer suffers with.

Dengue and pneumonia are spread majorly due to incessant rains, stagnant water, and floods. Both diseases require proper rest and medication for recovery. In most cases, the treatment can be done at home with an adequate diet, medication and rest, but severe cases might require hospitalisation.

Dengue is a viral disease caused by the bite of the Aedes Aegypti mosquito. Some of the common symptoms during the initial phase of dengue are fever, joint and muscle pains, nausea, headache, rashes, and eye pain. While, more severe symptoms such as internal bleeding, disorientation, weak pulse, and constant vomiting indicate that the disease has progressed, and the patient should be hospitalised. The presence of dengue is ascertained with the low count of white blood cells, platelets and metabolic acidosis. Meanwhile, pneumonia is an infection (viral, fungal or bacterial) that leads to inflamed lungs. People of all ages can get down with pneumonia, particularly kids and older adults. The symptoms include fever, coughing, green or rusty sputum, headache, chills, shortness of breath, chest pain, increased heart rate, nausea and vomiting. Usually, one can treat pneumonia with hydration and over the counter medicines. Still, if the condition is critical with a weak immune system, then the individual will have to be hospitalised.

Are dengue and pneumonia covered under health insurance?

Under the comprehensive health coverage, all the hospitalisation charges (including room rent, pre and post hospitalisation) are included. It is applicable for dengue and pneumonia as well. However, as discussed earlier, most cases of dengue and pneumonia does not require hospitalisation. Recovering at home can still accrue a high medical bill. Some of the expenses that an individual incur for treatment at home includes diagnostic tests, medicines, home nurse (if required), etc. These are generally not covered in the health insurance policy. However, a dengue or pneumonia specific insurance or an add-on to the existing plan will cover these expenses and more.

What is dengue or pneumonia insurance?

Many insurance companies in India offer dengue specific insurance policies. Individuals can choose them either as an add-on to the existing health insurance or as a standalone policy. Some of the features of these policies are that they have low premiums. The premium for these kinds of policy remains the same, irrespective of the age, they cover the expenses incurred during both inpatient and outpatient treatment, and any claim for this policy by an individual will not affect the standard health insurance. All the medical costs suffered 15 days before and after hospitalisation are covered by the policy. Insurance coverage includes hospitalisation if the policyholder is hospitalised for more than 24 hours. There is no maturity benefit payable under the dengue insurance policies.

Further, there is no requirement for a pre-insurance health check-up to purchase a dengue insurance policy. An individual only needs to make a self-declaration in the application form that he/she is currently not suffering from dengue. However, if you are suffering from the disease, you are not eligible to purchase the same. If dengue treatment requires less than 24-48 hours of hospitalisation, hospitalisation costs will not be covered. Moreover, diagnosis and treatment outside India is not covered under dengue plans.

It is advisable that an individual purchase a basic health insurance product as it will always serve as a base to the add-on benefit plans. Also, if you are living in an area prone to these diseases, you should get an add-on coverage for these conditions in your regular health insurance plan. The advantage of these type of policies is that the policyholder can make an independent claim against the dengue policy (when suffering from the disease), and this will not impact the no-claim benefits accrued in their core health insurance policy.