What is Corona Treatment Fee under Health Insurance

Mrs. Veena Sahay (58-years) lived in Pune with her son Arjun. On 4th April 2021, Mrs. Sahay developed some throat infections followed by cough and cold. On testing for Covid after two days, she was found positive. Initially, they started corona treatment at home. But after 5 days, her oxygen level started to dip. So, her son shifted her to a private hospital on 9th April after a frantic search. The hospital demanded Rs 1 lakh upfront and subsequently 3-4 installments upwards of Rs 35,000. Mrs. Sahay required Remdesivir injections (as corona treatment medicines) that Arjun purchased for Rs 40,000 because the hospital didn’t have the stock. Despite best efforts, Mrs. Sahay passed away within a week. Arjun spent nearly Rs. 3 lakh on her corona treatment process.

This scenario was common across the country in April and May when the second wave of corona hit the country with a vengeance. At this time, home quarantine was not adequate for many because of their dipping oxygen levels. These patients required hospitalization. Due to the ever-increasing demand and shortage of hospital beds, oxygen cylinders, and medications, the prices were sky-high. Apart from medicines and healthcare costs, many hospitals also took unwarranted advantage of the situation.

Many hospitals breached the government’s order regarding the costs of per day treatment for the COVID-19 patients. Though the government has capped everything (Rs. 8000-Rs. 15000 per day for covid treatment), still, private hospitals charge between Rs 50,000-60,000 per day. On the other hand, earlier ambulance services cost Rs 1,500-2,000 and were now available for Rs 10,000-12,000. Many people purchased Remdesivir injection by paying Rs 1 lakh, but their original cost was Rs 2,800-5,400. Similarly, an oxygen cylinder that would have cost Rs 1,500-2,000 was sold for Rs 30,000-50,000.

Besides these scenarios, in many cases, an entire family needs to be hospitalized at the same time because of the COVID-19 infection. New complications like black fungus or other infections sometimes lead to longer hospital stays. During this second peak, many people didn’t find hospital beds as most of the beds were occupied by other patients. Hence, they opted for home care treatment under complete medical supervision. Though hospitals had separate sections for corona treatment for kids, most of the hospitals were still filled up to the capacity. At that time, many hospitals started providing home treatment packages to take care of the deluge of sick patients. Considering all these parameters, many people had to pay as much as Rs 25-50 lakh for corona treatment.

The hospitals charged a hefty amount for Covid patients’ treatment because they arranged a dedicated Covid ward, ensured social distancing norms during treatment, and sanitized everything frequently. So, they were forced to add all these costs to the bills of patients, resulting in high bills.

People who have purchased adequate health insurance coverage may not feel the pain like others. But people with smaller plans or whose plans were exhausted paid the shortfall from their pockets. If more than one family member suffered from Covid and was shifted to a hospital, the sum insured will not be adequate.

In Delhi and Tamil Nadu, the average claim sizes were Rs 1.89 lakh and Rs 1.41 lakh, respectively. The claim amount was increased during the second wave because of severe infections; other complications like mucormycosis, etc., are responsible for enhancing the claim amount. Though insurance companies are bearing a good percentage of Covid treatment costs, 60-65% of healthcare expenses (for Covid) in India are out of pocket. Because a large population remains uninsured thus, it has become important for everyone to purchase health insurance policies that will help them stay protected against pandemics like the COVID-19.

Health Insurance

Everyone should purchase adequate health insurance to strengthen their financial status. Always buy a health policy based on your requirements, residence, and affordability. The hospitalization expenses in metros and tier 1 cities indeed cost 30-40% more than in tier 2/3 cities. The costs of moderate Covid treatment for 15 days in a hospital in Delhi range from Rs 1.8-2.5 lakh. If the patient has some comorbid conditions, it may go up to Rs 6-8 lakh. In extreme cases, it can go up to Rs 25 lakh.

If you have no Health Insurance

• Purchase a health insurance policy of Rs. 20-25 lakh for a family of 4, if you are staying in a metro/tier 1 city
• In a tier 2/3 city, you may purchase a health policy of Rs. 15 lakh
• If you are single, then go for coverage of Rs. 10 lakh
• If you can’t afford a big plan, then go for a Corona Kavach policy. Later, purchase a comprehensive health policy.

If you have an existing policy of lower cover Rs. 5-7 lakh, then purchase a top-up or super top-up plan of Rs 15-20 lakh. If you have only an employer policy, purchase an independent policy with an appropriate sum insured.

The standard Corona Kavach policy may be cost-effective and could be an ideal short-term option if you are at high risk and can’t afford a bigger cover present. But Rs 5 lakh cover in a place like Delhi may not be sufficient, so you should opt for at least a Rs 20-25 lakh cover if you have a family of 3-4 members. Moreover, if you have an existing insurance policy (Pre-Covid), you may need to pay a hefty amount from your pocket because of various limitations. But the newer post-Covid plans don’t come with any restrictions.

Whether new or old, always check if your policy includes home treatment coverage or not. During the COVID-19, many patients prefer to stay at home for their mild symptoms. The standard Corona Kavach policy offers homecare treatment. Regular health insurance plans also cover domiciliary treatment under regular hospitalization. These plans also offer coverage for drugs, diagnostics, doctor’s fees, even ICU care.

Purchase a health insurance policy that will offer you adequate coverage against the COVID-19 and will also protect your hard-earned savings. If you still don’t have a health policy, purchase it immediately so that you can stay protected from future pandemics and other illnesses.