Hepatitis B Insurance Coverage in India

Before insuring an individual, the insurance companies determine their probability of reimbursing the medical expenditures. Also, there are policies offered by companies that not only cover the treatment cost but also the burial expenses, i.e. burial insurance for hepatitis C or hepatitis B.

For this, the insurer asks for details of the applicants which is nothing but the factors that affect the insurance coverage. Read below to know them. 

Health history 

1. The applicant of hepatitis b insurance coverage in India is expected to provide the medical history to the insurer. Previous history or current infection of hepatitis B or C or any other disease is considered.
2. If an individual has no previous or present medical condition, then their application goes for processing. However, in case of a health issue, the application may be sent for closer review before being processed. 

Age 

1. Age is one of the most important factors that influence hepatitis b insurance coverage in India. This is because it decides the number of premiums an applicant can pay. If insurance is taken at a younger age, the premiums would be lower.
2. The reason is that people at an older age are likely to have low immunity and their chances of catching the infection increase. 

Gender 

1. Hepatitis b insurance coverage can also be affected by gender. Some insurers consider gender as one of the insurance criteria to check the range of medical expenses to be covered.
2. If a woman applies for insurance during the childbearing age, the premium can be slightly higher for her. The reason behind this is that she may catch an infection during maternity, and there can be added medical expenses too. 

Habits or Lifestyle 

1. An individual's lifestyle and habits are essential in shaping their health. Thus, it's obvious that it is considered an insurance criterion. Place of residence, workplace, consumption of alcohol or tobacco, smoking, overweight, etc., are some of the factors that can affect insurance.
2. Depending on the insurer's policy, an individual might be responsible for paying a higher premium due to unhealthy habits or lifestyle. This is because an unhealthy lifestyle can make a person prone to infection more readily. 

Family History 

1. The insurer will also assess if a medical condition runs in the applicant's family. A family member or member who has/had a liver disease or hepatitis infection can affect hepatitis b insurance coverage in India. A simple reason is an individual's increased vulnerability to this disease. 

Health insurance for hepatitis b in India have a list of entities that are included and excluded in the cover. It is vital for an applicant to read the policy documents before signing to know what all the insurance company is liable of paying. Given below are some of the inclusions and exclusion of hepatitis B insurance coverage. 

Inclusions

1. Hospital expenses: The moment a policyholder is admitted to the hospital till the time he gets discharged, the insurer is accountable of bearing all the expense of the patient. Room and ICU charges, doctor's fees and other treatment expenses such as IVs, injections or medicines are covered in the insurance plan. 
2. Pre and Post hospitalisation expenses: Expenses apart from hospitalisation such as doctor's appointments and medications or treatments prescribed for the cure. This also covers the doctor's follow ups post hospitalization including medicines and other medical services to assist in recovery. 
3. Annual health check up: Hepatitis B insurance coverage and most of the health insurance policies offer a health check up to the policyholder once in a year. The cover is inclusive of basic diagnostic tests that a policyholder can avail at the diagnostic center or hospital as per mentioned in the insurance documents. 

Exclusions

1. Pre-existing medical condition: Pre-existing medical conditions are those diseases or infections that an individual already has before applying for the policy. 
2. Pregnancy related expenses: For the pregnant women, the hepatitis B insurance coverage in India does not offer medical assistance besides hepatitis treatment. Hospital charges, medications or follow ups related to pregnancy, childbirth and other conditions such as miscarriage or abortion are not covered in the insurance plans. 
3. Self attempted injury and other conditions: If a policyholder attempts intentional acts of harming themselves such as commiting suicide or intoxicating drugs, alcohol, etc; the insurer is not accountable to bear medical expenses in such conditions. 
4. Other health issues: The insurance policy for hepatitis B covers expenses for its treatment and related medications only. Hence, an individual suffering from other health issues such as joint pain, heart disease, diabetes, etc, cannot expect reimbursement from the insurer as claims for such medical conditions are rejected. Also, the insurance cover does not offer any benefit in case a policyholder is met with an uncertainty such as a car accident. 

There are many companies offering insurance for Hepatitis disease. Most of the insurance policies in India offer coverage for Hepatitis B treatment and related expenses. However, it totally depends on the type of plan or the policy rules prescribed by the company. Hence, reading and understanding the policy before applying is always better. 

Below are some of the insurance companies that provide hepatitis B coverage:

1. HDFC ERGO
2. HDFC group 
3. ICICI Lombard 
4. Reliance Group 
5. Religare Health 
6. Bajaj Allianz
7. Star Health Insurance

Ayushman Bharat Yojna is a scheme launched by the government of India to provide financial aid to Indians for combating Hepatitis B infection. 

Salient features of the scheme 

1. Ayushman Bharat Yojna is a national health policy that provides affordable and adequate insurance coverage to Indian citizens. Given below are some of its features. 
2. The scheme offers health insurance for hepatitis b in India, providing coverage of 5 lakhs INR per family each year. 
3. This insurance program covers about ten crore families, i.e. ensuring around 50 crore individuals annually. 
4. The scheme has set standard protocols for medical practitioners or hospitals for efficient diagnosis and treatment against Hepatitis B infection. 
5. The insurance covers the cost of pre and post-hospitalisation, medications and medical follow-ups until the full recovery from the condition.

Criteria of the scheme 

1. If asked which health insurance hepatitis B is suitable for the lower class groups in India, Ayushman Bharat Yojna is indeed promising. This is because the Indian government includes families of the lower income class to provide this insurance. 
2. The scheme includes not only the poor but also families from rural areas. Further, this insurance by the government benefits around ten crores of underprivileged families every year, irrespective of an individual's age or the family's size. 
3. The Ayushman Bharat Yojana is a paperless scheme that offers individuals cashless healthcare assistance. The scheme covers government hospitals with some network private hospitals. The medical centre allotted to the individual depends on his or her residence, i.e. the one which is nearby.  

A health insurance claim is a request an individual must send to the insurance company for compensation for the treatment expenses incurred. There are two ways by which one can settle medical expenses. This depends on the type of policy availed as well as the circumstances of the health severity. 

Cashless claim 

1. In a cashless claim, the policyholder does not pay anything to the hospital where they seek treatment. The insurer provides a cashless health card when taking insurance which the policyholder is expected to reproduce while taking admission to the hospital. 
2. The third-party administrators (TPA) accomplish the verification of the policy, and it is essential to commence the TPA formalities before 2-3 days of admission. 
3. The policyholder is expected to fill out the cashless request form at the hospital and submit it along with other related documents to the TPA. 
4. Once the claim is approved, the insurance company settles the hospital bills and other health expenses as mentioned in the policy norms (excluding the cost of entities not covered in the insurance). 

Reimbursement claim 

1. In the reimbursement claim, an individual is liable to pay the medical expenses initially, and then the insurance company pays back or reimburses the amount. 
2. While filing the reimbursement claim, the policyholder is expected to produce all the required insurance-related documents along with bills from the hospitals or the medical expenditure record. 
3. After the verification, the insurance company credits the amount to the policyholder's bank account. 
4. If the cashless claim is disapproved, an individual can apply for reimbursement. However, it is crucial to know that the claims can be settled only if the policyholder seeks treatment in the network hospitals of the insurance company (list of hospitals mentioned in the insurance documents). 

Hepatitis B viral infection targets the liver, causing severe damage, which can sometimes lead to death. Knowing hepatitis B insurance coverage in India is vital as this infection can also disturb other aspects of life besides being harmful to the body. Financial stability is one of those vital aspects that is stroked harder due to Hepatitis B. This affects not only the infection-bearers but their families, too, as most patients in India lack enough resources to pay off their medical expenses. 

Consider getting your and your family's health insured to protect or fight against uncertainty or dreadful illness. HexaHealth is always at your service to offer you valuable medical advice related to health insurance or sustaining a healthy lifestyle. Get in touch with us to have your health-related queries answered.