What are the Diseases Covered Under Health Insurance?
Common Diseases and Conditions Covered by Health Insurance Policies
Health insurance plans cover many medical conditions, from serious illnesses to chronic ones. While the details may differ depending on the specific health plan and healthcare insurance provider, these policies cover most common diseases and conditions that require hospitalization, surgery, and long-term treatment.
Here is a general breakdown of all diseases covered by most health insurance policies.
1.Chronic Conditions
Chronic conditions require long-term management, and health insurance schemes cover treatment, hospitalization, outpatient services, and diagnostic tests. Common chronic conditions covered are:
●Diabetes Mellitus: Inpatient care and consultations, tests for blood sugar management.
●Hypertension (High Blood Pressure): Covers treatment with visits to the doctor, tests, and even hospitalization if complications arise.
●Asthma and Chronic Respiratory Diseases: Coverage usually includes medication, inhalation drugs, and hospitalization for respiratory diseases.
2.Cardiovascular Diseases
Heart conditions are common and frequent emergencies, which is why most health insurance plans provide coverage for them. Conditions that are usually covered include:
●Heart Attack: Services include in-hospital stay, emergency room service, surgical cost, and treatment after surgery.
●Coronary Artery Bypass Surgery: Covers include treatment, recovery, and rehabilitation for the post-operative period of CABG surgery.
●Congenital Heart Disease: Services normally include any corrective surgical procedure and medication for congenital malformations of the heart.
3.Cancer
Chemotherapy, radiation, surgery, as well as treatment over an extended period is necessary in such cases. Hence, health care insurance coverage includes:
●Cancer Surgery: Includes breast cancer, lung, and colon, among others.
●Chemotherapy and Radiotherapy: The treatment also covers inpatient and outpatient procedures, ensuring everyone gets the medical attention to cure cancer.
●Bone Marrow Transplant: In some forms of insurance for cancer like leukemia, transplantation procedures, and their allied treatments are available.
4.Infectious Diseases
Health insurance always covers diseases requiring hospitalization and intensive treatment, including:
●Tuberculosis (TB): Most health insurance policies pay for hospitalization expenses, laboratory tests, and medication to treat tuberculosis.
●HIV/AIDS: Insurance policies typically cover the treatment, specifically Antiretroviral therapy (ART), inpatient care, and other procedures for managing HIV/AIDS.
5.Neurological Disorders
Neurological diseases usually require expensive and complicated treatments such as surgeries and rehabilitation. The most common insurable neurological disorders are:
●Stroke: It is usually covered, as are the costs of emergency medical treatment, surgery, and therapy.
●Parkinson's Disease: Most policies cover long-term treatment, including drugs and doctor consultations.
●Epilepsy: Treatment of recurrent seizures in most cases is covered by hospitalization, surgery, and medication.
6.Renal Diseases
Kidney conditions, particularly chronic kidney disease, are prone to frequent treatments, including dialysis and even organ transplants. Health insurance policies usually cover:
●Dialysis: Routine dialysis sessions for end-stage renal failure are generally included in the coverage.
●Kidney Transplant: Coverage for kidney transplants, including surgery, hospitalization, and post-surgical medications.
7.Mental Health Disorders
Mental health coverage is becoming increasingly important in health insurance. Some mental health conditions that are often covered include:
●Depression: Coverage for inpatient care, therapy, and long-term medication.
●Schizophrenia: Treatment costs for hospitalization, therapy, and medication may be included.
●Bipolar Disorder: Many plans cover inpatient and outpatient treatments, including medication and therapy sessions.
8.Pregnancy and Childbirth-Related Diseases
Health insurance plans usually cover maternity care, including:
●Complicated Pregnancies: Pregnancy complications that require hospitalization or special care are typically covered.
●Cesarean Section (C-Section): The surgery and complications during delivery are usually covered.
9.Accidental Injuries
Accidents, such as fractures or burns, are usually covered under most health insurance plans. Coverage generally includes:
●Accidental Injuries: Fractures, burns, surgeries, and hospital stays.
●Emergency Treatment: Expenses incurred during the visit to the emergency room and the treatment given immediately after the accident.
The medical plans offered by Star Health cover a wide range of diseases, from chronic to serious. To remain well-protected and get coverage during medical emergencies, it is essential that you go through the policy’s inclusion, exclusions, and other terms. Also, you can opt for add-ons to increase the coverage of your base plan and gain added protection against multiple conditions.
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This FAQ page contains information for general purpose only and has no medical or legal advice. For any personalized advice, do refer company's policy documents or consult a licensed health insurance agent. T & C apply.