World AIDS Day, celebrated every year on December 1, provides a platform for governments, organisations, and individuals to raise awareness about the human immunodeficiency virus (HIV). In a nation grappling with the third-largest population affected by Acquired Immune Deficiency Syndrome (AIDS), the conversation around health insurance for these patients has gradually evolved, albeit with its share of challenges and limitations.
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Unlike for most medical conditions, HIV/AIDS remains a 'pre-existing condition,' often excluded from conventional health insurance policies due to the substantial expenses it incurs. However, recent advancements in treatment have prompted some insurance firms to devise tailored policies.
Understanding HIV health insurance
Individuals infected with HIV (with a CD4 count over 350), but which has not progressed to the AIDS stage, are eligible to acquire this specialised policy. Notably, age is not a restriction for these health insurance plans, according to ACKO General Insurance.
Coverage details
This policy comes into play when HIV progresses to AIDS, providing financial support to manage associated medical expenses. Similar to critical illness plans, policyholders receive a predetermined lump sum amount or reimbursement based on medical costs. Coverage includes inpatient hospitalisation, pre-hospitalisation, post-hospitalisation, non-allopathic treatments and day-care procedures.
There are specific exceptions, such as expenses directly related to treating the disease, that are not covered. Also, if AIDS is confirmed within a pre-specified period from the policy purchase date, it remains excluded, ACKO General Insurance mentioned.
Claim process
Timely communication with the insurance company upon reaching the AIDS stage is crucial for claim initiation. Failure to adhere to the timeline might result in claim rejection. Raising a claim involves contacting the insurer and following their stipulated process.
Available policies
| Insurance Provider | Plan Name | Key Features | Sum insured |
|---|---|---|---|
| Star Health Insurance | Star Health Net Plus Plan | - Coverage for HIV/AIDS patients-Confidentiality assured- Financial support at AIDS stage- No age limit for applicants | --- |
| Manipal Cigna | Global Health Group Plan | - Coverage for HIV/AIDS and related illnesses- Extensive coverage for COVID-19 treatment | Up to ₹3 crore |
| Niva Bupa | Health Premia Individual Health Insurance Plan | - HIV/AIDS treatment after a waiting period of 48 months- Available in Silver, Gold, and Platinum variants | ₹5 lakh - ₹3 crore |
(Note: Information sourced from Policybazaar)
The way forward
With advancements in chemotherapy, individuals living with HIV/AIDS can lead prolonged, healthier lives. However, sustained chemotherapy necessitates financial support, underscoring the need for accessible health insurance. The evolving landscape beckons more medical insurance companies to step up and extend their financial support to HIV-affected individuals.
(Edited by : Shoma Bhattacharjee)
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