Diseases Covered in Health Insurance

Check the list of diseases covered in health insurance, and know which diseases are excluded.
Check our health insurance plans
3 mins
04 January 2024

Health insurance provides financial support and peace of mind in the face of medical uncertainties. Understanding the diseases covered by health insurance is crucial for individuals seeking comprehensive protection for their well-being. While the coverage offered by every plan may be different, one must carefully analyse the inclusions and exclusions, to ensure that coverage for any specifically required disease is covered under the plan.

This article explores the core diseases covered by health insurance, including pre-existing conditions and critical illnesses. Also, how you can compare and buy a health insurance policy at the Bajaj Finance Insurance Mall, ensuring that the plan covers the specifications that you are looking for in an insurance policy.

List of common diseases covered in health insurance

Here is the list of common diseases covered under health insurance plans.

  • Respiratory infections:
    Health insurance typically covers treatments for respiratory infections, ranging from common colds to more severe respiratory conditions such as pneumonia and bronchitis.
  • Cardiovascular diseases:
    Heart-related conditions, including coronary artery disease, heart attacks, and congestive heart failure, are commonly covered by health insurance plans.
  • Gastrointestinal disorders:
    Health insurance provides coverage for gastrointestinal disorders such as gastritis, acid reflux, and other digestive system-related issues.
  • Infectious diseases:
    Coverage extends to various infectious diseases, including viral infections, bacterial infections, and other communicable diseases.

Orthopaedic conditions: Health insurance covers a wide array of orthopaedic conditions, from minor injuries to major surgeries, ensuring individuals have access to necessary treatments for bone and joint issues.

List of pre-existing diseases covered in health insurance

Over time, health insurance companies have adapted and begun addressing contemporary needs. In alignment with this trend, these companies now extend coverage to a variety of pre-existing conditions.

Here is the list of pre-existing diseases covered by health insurance:

  • Diabetes: Many health insurance plans cover diabetes, a prevalent chronic condition requiring ongoing medical attention, medication, and lifestyle management.
  • Hypertension: High blood pressure, or hypertension, is often considered a pre-existing condition and is covered by health insurance for necessary treatments and medications.
  • Asthma: Asthma, a chronic respiratory condition, is typically covered, ensuring individuals have access to medications, inhalers, and other necessary treatments.
  • Arthritis: Various forms of arthritis, including rheumatoid arthritis and osteoarthritis, are covered by health insurance for treatments such as medication, physiotherapy, and surgeries if required.
  • Thyroid disorders: Both hypo- and hyperthyroidism fall under pre-existing conditions covered by health insurance, ensuring individuals receive necessary thyroid-related treatments.

List of critical illnesses covered in health insurance

Health insurance for critical illnesses includes the following diseases:

  • Cancer: Health insurance often includes coverage for various types of cancer, encompassing treatments like chemotherapy, radiation therapy, and surgeries.
  • Stroke: Critical illnesses such as strokes are covered by most health insurance plans, ensuring individuals have access to immediate medical interventions and rehabilitation services.
  • Kidney failure: Health insurance provides coverage for kidney failure, including dialysis treatments and potential kidney transplants.
  • Organ transplants: The cost-intensive procedures associated with organ transplants, including heart, liver, and lung transplants, are covered by health insurance.
  • Neurological disorders: Conditions such as multiple sclerosis and Parkinson's disease are often covered, ensuring access to neurologists, medications, and necessary therapies.
  • HIV/AIDS: This critical illness compromises the immune system, leading to severe health challenges. It is primarily caused by the transmission of the human immunodeficiency virus (HIV). A health insurance policy can cover hospitalisation and treatment charges for HIV AIDS.

Diseases not covered under health insurance

Below are the diseases usually not covered under health insurance plans:

  • Pre-existing diseases with waiting period: Some health insurance policies may have waiting periods for coverage of pre-existing diseases. During this period, the expenses related to the pre-existing condition may not be covered.
  • Certain chronic conditions: While many chronic conditions are covered, there might be exceptions based on the severity or nature of the condition. It is essential to review policy terms and conditions for specific details.
  • Cosmetic and weight loss procedures: Cosmetic surgeries and weight loss procedures that are not deemed medically necessary may not be covered under health insurance.
  • Experimental or unproven treatments: Treatments that are experimental, unproven, or considered alternative therapies may not be covered by health insurance.
  • Non-medical treatments: Health insurance typically does not cover non-medical treatments, such as spa treatments, health club memberships, or other wellness services.

Why is having health insurance important?

Here are the benefits of health insurance policy:

  • Financial security: Health insurance provides financial security by covering the costs of medical treatments, surgeries, and hospitalisations, preventing individuals from facing significant financial burdens.
  • Timely access to healthcare: With health insurance, individuals can access timely medical care, including consultations, diagnostic tests, and necessary treatments, ensuring early detection and intervention for various health conditions.
  • Preventive care: Health insurance often includes coverage for preventive care, encouraging individuals to undergo regular check-ups and screenings to detect potential health issues before they become severe.
  • Peace of mind: Knowing that health insurance is in place offers peace of mind, reducing stress and anxiety associated with potential health emergencies and uncertainties.

Why buy health insurance plans offered through Bajaj Finance?

If you choose to buy a health insurance policy from the Bajaj Finance Insurance Mall, you can enjoy the following benefits:

  • Compare and buy: You can explore through the various policies available online, and choose the one that best suits your needs. If there are specific diseases that you want to be covered under the policy, you can check with the insurance provider and customise your plans, if the option is available.
  • Completely digital journey: You can buy the plan through a 100% digital journey. You may not have to visit the insurance provider for any updates.
  • Easy access: You can check your policy details at any time online.
  • Minimum documentation: You may not have to upload additional documents to complete the application process.

Health insurance serves as a robust safety net, covering a broad spectrum of diseases, including pre-existing conditions and critical illnesses. It offers financial security, timely access to healthcare, and peace of mind for individuals and their families. While health insurance is a powerful tool in managing medical expenses, understanding the specific diseases covered and exceptions is crucial. Health insurance stands as a reliable companion, promoting a proactive approach to well-being and ensuring a healthier and more secure future.

Frequently asked questions

Can I buy more than one health insurance plan?

Yes, it's possible to buy multiple health insurance plans to enhance coverage. However, coordination between plans is essential, and insurers must be informed. Dual coverage can help cover gaps and provide additional financial protection.

Does health insurance cover maternity expenses?

Many health insurance plans offer maternity coverage, covering prenatal care, childbirth, and postnatal expenses. However, coverage details for maternity health insurance vary, so it's crucial to review policy terms and inquire about specific maternity benefits before purchasing.

Can I add additional coverage for specific diseases or conditions to my health insurance plan?

Some health insurance plans allow you to add additional coverage for specific diseases or conditions. This may include coverage for ailments like cancer or heart disease.

Disclaimer

Insurance is the subject matter of solicitation. *T&C Apply - Bajaj Finance Limited (‘BFL’) is a registered corporate agent of third party insurance products of Bajaj Allianz Life Insurance Company Limited, HDFC Life Insurance Company Limited, Future Generali Life Insurance Company Limited, Bajaj Allianz General Insurance Company Limited, SBI General Insurance Company Limited, ACKO General Insurance Limited, ICICI Lombard General Insurance Company Limited, HDFC ERGO General Insurance Company Limited, Tata AIG General Insurance Company Limited, Niva Bupa Health Insurance Company Limited , Aditya Birla Health Insurance Company Limited, Manipal Cigna Health Insurance Company Limited and Care Health Insurance Company Limited under the IRDAI composite CA registration number CA0101. Please note that, BFL does not underwrite the risk or act as an insurer. Your purchase of an insurance product is purely on a voluntary basis after your exercise of an independent due diligence on the suitability, viability of any insurance product. Any decision to purchase insurance product is solely at your own risk and responsibility and BFL shall not be liable for any loss or damage that any person may suffer, whether directly or indirectly. Please refer insurer's website for Policy Wordings. For more details on risk factors, terms and conditions and exclusions please read the product sales brochure carefully before concluding a sale. Tax benefits applicable if any, will be as per the prevailing tax laws. Tax laws are subject to change. BFL does NOT provide Tax/Investment advisory services. Please consult your advisors before proceeding to purchase an insurance product. Visitors are hereby informed that their information submitted on the website may also be shared with insurers. BFL is also a distributor of other third party products from Assistance Services providers such as CPP Assistance Services Pvt. Ltd., Bajaj Finserv Health Ltd. etc. All product information such as premium, benefits, exclusions, sum insured, value added services, etc. are authentic and solely based on the information received from the respective insurance company or the respective Assistance service provider company.

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