List of Critical Illnesses in Health Insurance
India is facing an alarming risk of health ailments among its youth due to sedentary lifestyles, unhealthy eating habits, stress, and other factors. This leads to a long list of critical and chronic diseases. Health insurance offers coverage against a wide range of critical illnesses, with some plans covering up to 64 conditions in India.
In this article, we discuss prevalent critical illnesses in India and the best health plans that cover them. Let's dive into the inclusions, exclusions, and more.
Extraordinary Facts
As per a World Health Organization (WHO) report, chronic diseases/critical illnesses are a major reason for deaths in India, resulting in over 53% of overall mortality rates. Critical illnesses such as cancer cause over 10 lakh deaths in India, as stated by The Lancet Regional Health Southeast Asia journal via Live Mint.
What Are Critical Illnesses?
Firstly, what is a critical illness and how does critical illness insurance work?
In the insurance sector, a critical illness is defined as a preset dreadful disease listed in the insurance coverage section. The insurer contracts to pay the policyholder a lump sum amount upon diagnosis of any of these illnesses. A critical illness policy provides financial and medical protection against life-threatening diseases. To claim against a critical illness treatment, one must fulfill the initial waiting period.
This page provides a detailed list of critical illnesses covered by insurance, the best plans for critical illnesses, their inclusions, exclusions, and more.
Key Takeaways
- Critical illness insurance saves you from a financial crisis, as it offers a lump sum cash benefit when diagnosed with any of the listed illnesses.
- Before buying a critical illness coverage policy, check the initial and other waiting periods.
- Health insurers have predetermined critical illness lists for which they pay a lump sum (only after diagnosis).
- Niva Bupa CritiCare, ManipalCigna Lifestyle Protection, and other critical illness policies offer excellent coverage benefits.
- Individuals aged 18 to 65 years can typically buy and claim coverage for critical illness.
- Choose a critical illness policy that includes benefits like a second medical opinion, worldwide cover, and regular medical care.
What Are 64 Critical Illnesses?
It's important to understand that the list of critical illnesses covered can vary significantly between insurance providers. However, many comprehensive critical illness plans aim to cover a wide range of common critical illnesses, as mentioned below.
- Cancer
- Stroke
- Heart failure or heart attack
- Heart valve replacement
- Kidney failure
- Aorta surgery, thoracotomy, or laparotomy
- Organ transplants (e.g., liver, heart, bone marrow, lungs, kidney)
- Multiple sclerosis
- Primary pulmonary arterial hypertension
- Total or permanent deafness and blindness
- Fulminant viral hepatitis leading to liver failure
- Paralysis with permanent loss of limbs or paraplegia
- Parkinson's disease
- Coma
- Permanent loss of speech
- Third-degree burns
- Alzheimer's disease or other degenerative brain disorders
- Chronic lung disease
- Benign brain tumor
- Encephalitis
- Chronic liver disease
- Chronic persistent bone marrow failure leading to anemia
- Muscular dystrophy
- Poliomyelitis
- Bacterial meningitis (inflammation of the spinal cord or brain membrane)
- Craniotomy or brain surgery
- AIDS
- Necrosis of the brain cortex or apallic syndrome
- Coronary heart diseases (e.g., defects in Circumflex, RCA (Right Coronary Artery), and LAD (Left Anterior Descending Artery))
Note: This is not a full list of critical illnesses for which you can buy critical illness insurance. For a detailed list of coverage, check your policy documents thoroughly.
Factors to Consider Before Buying Critical Illness Insurance
Waiting Period
Most plans have an initial waiting period (e.g., 90 days) and a survival period (e.g., 30 days). You can only claim benefits if diagnosed after the initial waiting period and survive the survival period.Age Limit and Eligibility:
Typically, insurance is available from age 18 to 65, but some insurers may have different limits.Conditions Covered by the Insurer:
The list of critical illnesses will vary from insurer to insurer. Compare offerings from various insurers to ensure your policy covers the illnesses most relevant to your health risks.Lump Sum or Staggered Payout:
Some policies offer a lump sum payout upon diagnosis, while others provide staggered/installment payments. Choose the payout option that best fits your financial needs.Renewability and Lifetime Coverage:
Select a policy that offers lifetime renewability to ensure continuous coverage.Second Medical Opinion & Wellness Benefits:
Many policies include additional benefits such as free second opinions, health check-ups, telehealth consultations, and online wellness programs. These benefits add value to maintaining the policy long-term.
Best Critical Illness Insurance Plans in India
Here are some of the best health insurance plans with critical illness coverage that provide comprehensive support when you need it most:
| Critical Illness Plans | Entry Age | Sum Insured | Initial Waiting Periods |
|---|---|---|---|
| Niva Bupa CritiCare | 18 - 65 years | 3 L - 2 Cr | 90 days |
| ManipalCigna Lifestyle Protection | 18 - 65 years | 1 L - 25 Cr | 90 days |
| Care Critical Mediclaim | 18 - 65 years | 10 L -2 Cr | 90 days |
| Star Critical Illness Multipay | 18 - 65 years | 5 - 25 L | 12 months |
| HDFC ERGO Critical Illness Platinum | 5 - 65 years | 1 L - 50 L | 90 days |
Specifications of Critical Illness Coverage in India
Niva Bupa CritiCare
- Covers up to 20 life-threatening critical illnesses.
- HospiCash provides a daily cash allowance.
- Accident care is available.
- Assured renewal benefit for lifelong coverage.
ManipalCigna Lifestyle Protection
- Second medical opinion.
- Lump sum payout benefit.
- Access to online wellness programs.
- Provides coverage for siblings, in-laws, and other dependents on a family floater basis.
Care Critical Mediclaim
- Covers 32 major critical illnesses.
- Indemnity benefit with high sum insured options.
- Covers expensive treatments like chemotherapy and radiotherapy.
- Psychiatric counseling cover.
- Health services options include quick recovery counseling, global coverage, doctor-on-call, OPD cover, air ambulance, and second international opinion.
Star Critical Illness Multipay
- Covers 37 critical illnesses.
- Provides a lump sum payout upon diagnosis of listed illnesses.
- No pre-policy medical examination is required for individuals up to 50 years.
- Star Wellness Program benefits.
- Installment options for monthly premium payments.
HDFC ERGO Critical Illness Platinum
- Covers over 15 critical illnesses.
- Lump sum payout benefit in a single transaction.
- No medical check-ups for pre-acceptance up to 45 years.
- Advanced and quality medical treatment for critical illnesses.
- Lifelong renewability option is available.
What Does a Critical Illness Policy Cover?
- Critical illness coverage
- Tax benefit
- Waiting period
- Lump sum or staggered payout options
- Pre and post-hospitalization expenses
- Cashless hospitalization
- Chemotherapy and radiotherapy
- Congenital defects
- Dialysis coverage
- Financial support
- Expensive treatments
- HIV/AIDS infection
What Are the Exclusions of Critical Illness Insurance?
- Diseases caused by alcohol consumption or drug abuse.
- Disability from birth (congenital conditions).
- Health challenges related to childbirth, such as C-sections.
- STDs (Sexually Transmitted Diseases), including HIV/AIDS.
- War, riots, rebellion, terrorist attacks, etc.
- Dental treatment or surgery.
- Infertility treatments, reproductive assistance, hormone replacement treatments, etc.
- Death within the first month of diagnosis.
- Treatment taken outside the country (unless specifically covered).
Summary
Critical illnesses are not just about expensive treatments and financial burdens; they can shatter a patient's world and their family's future. What if you could be covered for critical illness treatment while keeping your emergency funds intact and supporting your family?
Yes, this is true. A critical illness health insurance policy can cover your treatment expenses, hospitalization charges, and provide a lump sum payout, offering financial support while you're unable to provide for your loved ones.
To know more about individual, family, senior citizen, and group health insurance, schedule your appointment with PolicyX advisors today!
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