Convalescence Benefit in
Health Insurance
  • Understand Convalescence Benefit
  • How Can You Claim?
  • Family Benefits
Convalescence Benefit in Health Insurance
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Convalescence: An Introduction

If you search for ‘Convalescence’ the definition says ‘Time spent recovering from an illness or medical treatment’. Recovering from an illness or a medical treatment is time-consuming and can affect your ability to go to work or resume your normal life.

All organizations offer a fixed amount of paid and casual leave which may lead to limited income during prolonged hospitalizations. The built-in convalescence benefit in your health plan is your friend in trying times.

Uncover the concept of convalescence benefit with PolicyX as we shed light on the importance and benefits of the same.

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What Does Convalescence Benefit Mean?

Convalescence benefit provided by health insurance companies supports you during prolonged hospitalization due to illness or simply recovering from treatment.

It is the maximum lump sum amount your insurer is liable to pay as per the policy schedule in addition to the treatment cost covered by the health insurer. Convalescence benefit is reimbursed at the time of claim settlement. Some health insurance plans also cover compassionate family visits under the convalescence benefit which is explained further in the article.

Health insurance plans usually have an in-built convalescence benefit. When browsing through a health insurance plan, look for these things in the policy schedule

  • The maximum number of days that will be covered as convalescence
  • The maximum amount to be reimbursed under the convalescence benefit

Understanding Convalescence Benefits With An Example

Let us understand how convalescence benefit works in real-time

Mr. Akash, a sales professional of a multinational company had to undergo surgery due to an unfortunate accident. Post-surgery, doctors suggested a 15-day convalescence period for efficient rest and recovery.

His inability to join work post-surgery led to a loss of income. He is, however, not worried as his health plan provides him a pre-decided lump-sum amount as a convalescence benefit.

When Can You Claim Convalescence Benefit?

Not all health insurance plans offer a convalescence benefit, it is also easy to mistake the post-hospitalization period for the convalescence period. It is important to read the terms and conditions carefully to determine the benefits available under the plan.

You can claim the convalescence benefit along with your overall health claim only if your days of hospitalization exceed the maximum number of days mentioned in the policy schedule.

For example, if your health policy states that you must be hospitalized for at least 10 days before the convalescence benefit kicks in. But, if you are discharged in 5 days you will not receive the convalescence benefit.

Maximum Amount Of Convalescence Benefit Available

How much amount will be reimbursed under the convalescence benefit in health insurance? A common question for many.

The answer lies in the health plan policy documents you plan to purchase. Convalescence benefit in health insurance varies from insurer to insurer. The minimum number of hospitalizations required to avail convalescence benefits may also vary.

Family Visit Coverage Under Convalescence Benefit

Some health insurance plans offer coverage for ‘compassionate visits’ by family members under convalescence benefit. This means if your family members live far away from the place of treatment their travel expenses will be covered by the health insurance provider.

How To Avail The Best Out Of Convalescence Benefit?

Here are some points you must remember before purchasing a health plan to avail the best out of your convalescence benefit:

  • Read the terms and conditions carefully as the convalescence benefit kicks in after you are hospitalized for a fixed number of days as per the policy schedule.
  • Convalescence benefits are available in both individual and group health insurance.
  • Check the maximum amount provided by your health insurance plan under the convalescence benefit.
  • Understand if compassionate visit for family members is covered under the convalescence benefit or not.

The Final Verdict: Should You Care About It?

While convalescence benefit is often overlooked by many, if included in your health plan, it can prove to be beneficial. To make the best out of the convalescence benefit, make sure you study the points to remember carefully before purchasing health insurance.

Having convalescence benefits in your health insurance is a bonus in difficult times. To understand more about convalescence benefits, give our insurance experts at PolicyX a call today!

Convalescence Benefit in Health Insurance: FAQ's

1. What is the convalescence benefit of health insurance?

Convalescence benefit provides policyholders with a lump-sum amount paid by the health insurance plan to support them during extended hospitalization. If your health plan covers convalescence benefits, you are entitled to take advantage of this benefit.

2. Is the convalescence benefit available in all health insurance plans?

Availability of convalescence benefits in a health insurance plan varies from insurer to insurer. When purchasing a health insurance plan, study the policy documents carefully to understand if convalescence benefit is a part of your health plan.

3. Are convalescence benefits and post-hospitalization benefits the same?

No, both features can often be confused but are entirely different. Post-hospitalization coverage will cover expenses related to recovery post-illness/treatments such as pharmacy bills, doctor consultations, etc. Whereas the convalescence benefit offers you the freedom to choose the way you spend the reimbursed amount. This lump-sum amount covers you for the extended period you take a leave of absence from your work and are unable to earn.

4. Is the convalescence benefit available as a rider?

No, the convalescence benefit is available as an in-built benefit usually mentioned in the health insurance policy documents.

5. What is the maximum limit for convalescence benefit?

Usually, health insurance plans offer a convalescence benefit for 10 to 30 days. However, with different health plans, the maximum amount and number of days vary.

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Simran Kaur Vij

Written By: Simran Kaur Vij

Simran is an insurance expert with more than 3 years of experience in the industry. She may have all the answers to your insurance queries. With a background in Banking, she proactively helps her readers to stay on par with all the latest Insurance industry developments.