World Heart Day 2023 | Health insurance checklist for cardiac patients

"Heart disease often requires long-term treatment and includes pre- and post-hospitalisation expenses and ambulance costs. Treatment for heart-related ailments such as coronary bypass surgery and angioplasty can cost up to Rs 3 lakh on average, and with medical inflation, it may go further up," said Peuli Das, Chief Insurance Officer at Future Generali India Life Insurance Company while talking to CNBC-TV18.com.

Sharad Mathur, Managing Director and Chief Executive Officer of Universal Sompo General Insurance Company Limited, said, "In today's fast-paced world, heart diseases have become a leading cause of mortality worldwide. Modern life places greater demands on individuals, and unhealthy lifestyle choices contribute significantly. Health insurance plans that cover heart-related care play a crucial role in alleviating the substantial medical costs associated with heart diseases like heart attacks and strokes."

These heart-specific insurance policies are tailored to cover a range of heart-related services, including tests, surgeries, and post-operative care. They are designed to address heart conditions and extend coverage to severe heart illnesses, providing financial support in the event of a critical diagnosis.

Vivek Chaturvedi, CMO and Head of Direct Sales at Go Digit General Insurance, pointed out, "The costs related to critical illnesses, especially for heart-related surgeries, are very high. A comprehensive health insurance plan with a high sum insured becomes essential. This ensures one can complete any requisite waiting periods related to pre-existing diseases and specific illnesses and get complete protection."

Cardiac health insurance plans come with several key features and benefits like compensation for cardiac treatment costs and other related expenses, including hospitalisation expenses. In case of cardiovascular illness diagnosis, a lump sum is paid by the insurer.

Depending on the policy, overseas treatment may be covered. It may also also cover compensation for the loss of income due to illness. These benefits, however, are subject to certain terms and conditions, according to PolicyBazaar, an insurance aggregator.

According to Rupinderjit Singh, VP, Retail Health at ACKO, health insurance typically covers the expenses related to hospital stays, including room and ICU, surgical procedures, anesthesia, and nursing care. Many health insurance plans cover outpatient services, such as consultations with specialists, diagnostic tests, and minor surgical procedures performed outside of a hospital prior to a hospitalisation and post hospitalisation related to the hospitalisation undergone by the consumer.

"On the other hand, insurance plans may not cover experimental or investigational treatments that have not yet been proven effective. In some cases, pre-existing conditions may not be covered immediately or may have waiting periods before coverage starts," he siad.

Vivek Chaturvedi, CMO and Head of Direct Sales at Go Digit General Insurance said, "Taking into account the rising medical inflation, one should consider getting a coverage of at least Rs 10 lakh for a single person and a cover of Rs 20-30 lakh for a family. Multiple hospitalisations within the year are sometimes seen during heart-related ailments. To ensure one does not exhaust the sum insured opted, check whether the insurance plan you are opting for offers restoration benefits."

The restoration benefit helps the sum insured of the health insurance policy to be restored up to the maximum limit as soon as it gets exhausted after a claim. This benefit is offered under health insurance plans available for individuals as well as families.

Additionally, those with existing heart diseases wanting to avail insurance cover would find it difficult to get a policy. Some insurers might still give them coverage, but it could be based on special terms, or they might have to pay high premiums.

"So, it's important for people with heart issues to investigate their choices and find the right insurance plan that fits their requirements," Chaturvedi told CNBC-TV18.com.