The Insurance Regulatory and Development Authority of India (IRDAI) states that medical conditions like mental illness and genetic disorders cannot be ignored in the efforts to promote healthcare and health insurance in India.
As per a draft on the standardization of what is excluded out of a policy, the IRDAI states that any disease transmitted after taking the plan should be covered. It should be noted that by law it is mandatory for health insurance companies to provide coverage for people suffering from these illnesses.
However, insurance companies have been very selective in providing such cover. But now, the treatment prescribed by IRDAI has to be followed. In addition, the use of prescription drugs or antidepressants is part of health insurance coverage. Also, failure to follow medical advice or treatment should not be used as a condition for denial of insurance. The insurance regulatory body of the country has a similar approach to treatment and coverage of genetic disorders.
What is a genetic disorder?
A genetic disorder is a disease caused by an abnormality in a person’s gene. These genes are passed into a person from their parents. Hence, if your parents have developed a certain disease and then you develop it as well, the cause of it could be the genetic material you received from your parents. People suffering from genetic diseases in the past have had difficulty getting health insurance. However, according to guidelines from the Insurance Regulatory and Development Authority of India (IRDAI), genetic diseases or disorders are no longer out of health insurance’s scope of coverage.
Health insurance companies now cover genetic disorders under a standard health insurance policy. This is an important step, as people wouldn’t have to go through troubles with their coverage just due to inherited diseases. Such individuals will be able to get quality medical care without having to worry about costs. Hence, they can buy Mediclaim online without the worry of claim rejection for genetic disorders.
According to the guidelines issued in September 2019 under the certification of exclusions in health insurance contracts, IRDAI has standardized the terms of the exclusions. This means that there will be a standard set of exclusions for health insurance across the country. Treatment of congenital diseases, genetic diseases or disorders, mental illness, stress or mental disorders and neurodegenerative disorders is now covered in health insurance policies.
Why is health insurance necessary for genetic disorders?
Prior to the standardization of exclusions of a health insurance policy, policyholders were concerned about the rejection of health care claims related to genetic disorders. Also, diseases such as diabetes and heart disease can be genetic and are generally covered by health insurance plans. This ambiguity has now been resolved as coverage for genetic diseases is now included in health insurance policies.
Health issues are inevitable these days. The threat of diseases is increasing, at the same time, medical costs are skyrocketing. All of these factors indicate that an individual needs financial assistance to cope with this burden. Health insurance plans are not limited to the hospital for this purpose but also provide coverage for a wide variety of medical expenses. That is, medical insurance also covers one’s other expenses during medical treatment, including medical expenses before and after hospitalization, ambulance cover, daycare treatment, etc. Furthermore, the provision of cashless medical treatment has gained importance due to its wide range of benefits such as claiming through a health insurance app.
When choosing a health policy, there are a number of factors to consider, such as current medical condition, age, premium price and amount of insurance to suit one’s needs. Also, reading the policy documents will give you a better idea of what the policy has to offer. Moreover, you should know that there is a 24-month waiting period for some diseases, some of which can be categorized as genetic disorders. Choosing the best health insurance is the first step to ensuring a healthy life.
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