List of Critical Illnesses Covered in Health Insurance

Posted on: Jul 26, 2024 | 3 mins | Written by: HDFC ERGO Team

List of Critical Illnesses Covered in Health Insurance

Amid this medical inflation, we buy health insurance with the hope that we don’t come across any financial hiccups when opting for high-quality healthcare during medical emergencies. But what happens when we are diagnosed with an ailment that requires extensive treatment? This is when the sum insured starts to look relatively inadequate. That’s why it is recommended that you add critical illness coverage to your healthcare policy. However, many people are not aware of the benefits of this coverage and hardly know what illnesses are covered under critical illness insurance. So, let’s clarify all doubts about how it works.

What is a Critical Illness?

Critical illness is a medical condition that can damage the normal functioning of our body. It is a life-threatening ailment requiring immediate medical attention and long-term treatment. If left untreated or not promptly treated, a critical illness can cause complications, even leading to death.

List of Critical Illnesses/Diseases

Some critical illnesses which are covered under a critical illness health Insurance plan are:

• Cancer

• Heart attack

• Stroke

• Paralysis

• Kidney Failure

• Multiple Sclerosis

• Major organ transplantation, such as heart, lungs, kidney, or bone marrow

• Parkinson’s Disease

• Alzheimer’s Disease

• Coronary Artery Bypass Surgery

• Benign Brain Tumour

• Heart Valve Replacement

• Primary pulmonary Arterial Hypertension

• Chronic liver disease

• Muscle dystrophy

• Poliomyelitis

• Encephalitis

The critical illness list can vary from insurer to insurer. So, before buying a critical illness rider, check the critical illness list and opt for an insurance provider offering extensive coverage.

Need for Critical Illness Insurance

Being diagnosed with a critical illness can be traumatic not only for an individual but also for his/her family. And before you come to terms with it, you learn about the exorbitant cost of treating the illness. This is when a critical illness insurance plan comes to your rescue. So, here are the benefits offered by critical illness insurance plans —

• Lump sum compensation:

If you get diagnosed with a covered critical illness and complete the survival period, you will receive a lump sum amount up to the sum assured, irrespective of the treatment costs. Standard health plans are indemnity plans and reimburse the actual expenses incurred.

• Substitute for lost income:

As critical illnesses require long-term treatment, the insured may have to take a sabbatical from work, leading to loss of income. The compensation can be used to substitute lost income, such as paying off debts, children’s education, etc.

• Access to quality healthcare:

Having insurance will help you avail treatment from the best specialists and healthcare centres without having to think about the expenses.

• Tax benefits:

Under Section 80D of the Income Tax Act, you are eligible for a tax deduction on the premium paid for the policy and reduce your tax liability.

• Short waiting period:

Critical illness plans usually have a shorter waiting period compared to standard health insurance plans.

• Easy access to claims:

While claiming compensation, you don’t have to submit any bills, discharge summary from the hospital, and other documents. Only proof of diagnosis is enough to receive the claim amount.

How to Choose Critical Illness Cover?

While choosing a critical illness insurance policy, here are some important factors you must consider —

Survival period:

Critical illness plans come with a survival period, which means the insured has to survive this period after being diagnosed with the ailment to claim the policy benefits. The period can range from 14 to 30 days, depending on the plan. If the insured dies within this survival period, the insurer will not pay any compensation. So, you must opt for a policy with a shorter survival period.

Sum assured:

As critical illnesses are expensive to treat, you must choose a high sum assured to cover your expenses in tough times. After the survival period, you will get a lump sum compensation up to the sum assured for your medical and miscellaneous expenses.

Age:

Buying a critical illness insurance plan at a young age will cost you less and offer a high sum assured compared to buying at a later age when the risks are high.

Inclusions and Exclusions:

It is important to understand what is covered and what is not in a critical illness insurance plan; this will help you buy a plan with more inclusions and fewer exclusions.

Wider coverage:

The more illnesses covered, the better. So, look for insurance companies offering extensive coverage.

Sub-limits:

There may be sub-limits for surgeries or medical tests. Being aware of these will help you to know how much coverage you have and stay prepared for out-of-pocket expenses.

Conclusion

Critical illnesses can be genetic or due to unhealthy lifestyle choices. If there’s a family history of critical illnesses or you have a sedentary lifestyle, you should consider adding critical illness insurance to your standard healthcare plan. This will provide extensive protection against critical illnesses. While buying a critical illness rider or a standalone policy, check what illnesses are covered under critical illness insurance, sub-limits of the plan, inclusions and exclusions, and the cost.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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