Autoimmune diseases occur in a body when the immune system of the body starts to kill its own healthy cells. The immune system’s primary job is to protect the body from unhealthy foreign substances like viruses and bacteria.
However, due to some reasons, the body considers its own cells as harmful and destroys them mistakenly.
Some common autoimmune diseases are Type 1 diabetes, multiple sclerosis, Graves’ disease, Addison’s disease, etc. The exact cause behind it remains clinically unproven. However, people with family history and women are more susceptible to diseases. One silver lining here is that people can have health insurance cover for autoimmune diseases as well. Let’s explore them in detail:
Are Autoimmune Diseases Covered Under Life Insurance?
In September 2019, the Insurance Regulator and Development Authority of India brought some changes in the terms and conditions related to ‘pre-existing diseases’ under health insurance. In India now there is the availability of health insurance for autoimmune diseases. There are several insurance companies that offer health insurance cover for autoimmune diseases, however, the sum insured, the features and coverage may differ from plan to plan and company to company. The waiting period for autoimmune diseases can generally range from 30 days to 90 days depending on the type of coverage.
Broadly there are two ways in which a company can offer health insurance cover for autoimmune diseases. Several companies offer disease-specific health insurance for autoimmune diseases and some covers it under critical illness benefits-
1. Disease-Specific Plans:
Disease-specific health insurance plans or tailored plans are the ones that are dedicated to a particular disease. For instance, there are plans for Type 1 diabetes. So, in this case, Type 1 diabetes being an autoimmune disease is covered under its specific plan.
2. Critical Illness Cover:
Some health insurance plans offer critical illness benefits and under this, several autoimmune diseases are covered. For instance, if you have medical insurance for disease, it majorly provides you health insurance benefits like hospital charges, ambulance, etc. One of its benefits may be critical illness cover.
List of Autoimmune Diseases
A list of autoimmune diseases is given below. It depends on a company how many of these diseases they offer coverage for:
- Rheumatoid Arthritis (RA)
- Type 1 Diabetes
- Multiple Sclerosis
- Systemic Lupus Erythematosus (SLE)
- Pernicious Anemia
- Addison’s Disease
- Autoimmune Vasculitis
- Inflammatory Bowel Disease
- Celiac Disease
- Sjogren’s Syndrome
Health Insurance Benefits for Autoimmune Diseases
A health plan for autoimmune diseases may provide coverage ranging from INR 1 lakh to 1 crore or even higher. The benefits and key features may differ with changes in the company and the plan. However, a health insurance plan meant for autoimmune diseases is most likely to offer the following benefits:
- Hospitalization expenses cover
- Outpatient treatment expenses cover
- Test expenses cover
- Day-care expenses cover
- Ambulance expenses cover, etc
Waiting Period for Raising Claim
Health insurance for autoimmune diseases also includes a waiting period like several other diseases and conditions. It can extend from 30 days (from the date of effectiveness of the policy) to 90 days (in case of critical illness cover). The waiting period is the time period under which you cannot raise a claim. Only after the end of the waiting period, an insured can make the claims.
Before you purchase a health insurance plan, make sure it offers critical illness cover for autoimmune diseases, especially if you have a family history of the same. Assessing the benefits is essential to understand if it is worthy to invest in a particular plan. Last but not the least, do not forget to go through the terms and conditions of the plan to understand them better.