Modern Treatment Coverage in Health Insurance

In today’s healthcare, ‘modern treatment’ refers to advanced medical treatments like robotics technologies. It’s crucial for comprehensive health insurance policies to cover these advanced treatments to ensure people get the best care when they need it. Some modern treatments might require a 24-hour hospital stay for coverage, while others (like daycare procedures) might not.

List of modern treatments in health insurance:

The list of modern treatments covered in a health insurance policy generally variesvary from insurer to insurer, available in their policy documents. However, IRDAI has provided an exhaustive list of all possible modern treatment methods that may be covered under a health insurance plan –

1. Uterine Artery Embolization and HIFU
2. Balloon Sinuplasty
3. Deep Brain stimulation
4. Oral chemotherapy
5. Immunotherapy-Monoclonal Antibody to be given as injection
6. Intra-vitreal injections
7. Robotic surgeries
8. Stereotactic radiosurgery
9. Bronchial Thermoplasty
10. Vaporisation of the prostate (Green laser treatment or holmium laser treatment)
11. IONM – (Intra Operative Neuro Monitoring)
12. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.

What are some of the diseases that can require modern treatments ?

These treatments address conditions that were previously difficult or impossible to cure. 

For example:

• Cancer
• Cardiovascular diseases (e.g., heart disease)
• Neurological disorders (e.g., Parkinson’s disease)
• Autoimmune diseases (e.g., rheumatoid arthritis)
• Genetic disorders (e.g., cystic fibrosis)
• Infectious diseases (e.g., HIV/AIDS)
• Chronic respiratory diseases (e.g., COPD)
• Diabetes
• Rare diseases (e.g., muscular dystrophy)
• Mental health disorders (e.g., schizophrenia)

Importance of Modern Treatment Coverage in Health Insurance Policies

Comprehensive health insurance should cover modern treatments for effective healthcare because:

• Modern treatments are often expensive due to sophisticated technologies and specialised expertise.  Without insurance coverage, these costs could be financially devastating.
• Modern treatments offer a chance for better healthcare outcomes, including cures for previously untreatable illnesses or minimally invasive procedures with faster recovery times.
• Knowing you have coverage for modern treatments provides peace of mind. It allows you to focus on getting better without worrying about the financial burden.

Including modern treatments in health insurance reflects the evolving healthcare landscape, with insurers demonstrating a commitment to providing access to the latest advancements.

When Should You Consider Modern Treatments More?

Prioritise modern treatment coverage if:

• You’re ageing: As we age, the chance of encountering health issues requiring advanced treatments increases.
• You have a risky lifestyle: Smoking, inactivity, and other unhealthy habits can raise your risk of needing advanced medical care.
• You have a family history of certain diseases: A family history of specific conditions (e.g. gene mutations, diabetes, stroke, cancer, etc.) can make you more likely to need modern treatments in health insurance.

Modern Treatment Cover Cost

Coverage for modern treatments in comprehensive health insurance policies can impact the overall cost of premiums. To find affordable health insurance policies with adequate coverage for modern treatments:

• Compare different health insurance plans to identify the most suitable option for your needs and budget.
• Evaluate each plan’s coverage, including modern treatments cover cost, and assess how it aligns with your desired sum insured. Higher-sum insured plans often provide broader coverage for modern treatments, but they also come with higher premiums.
• Understand the sub-limits on specific modern treatments. This means the insurance company will only cover a set amount for that particular treatment, even if it falls within your overall insured sum.

Other Critical Features or Limitations to Be Aware of While Buying Health Insurance

In addition to modern treatment cover cost, there are several other critical features and limitations you should be aware of when purchasing health insurance. These include:

• Co-payment

This is a cost-sharing arrangement between you and your insurer. You pay a fixed percentage of the covered medical bill, and the insurance company pays the remaining amount according to the policy limits.

• Room-rent limits

Some plans have limitations on the daily room rent covered in a hospital. This could leave you with a significant out-of-pocket expense if you require a higher-class room.

• Waiting periods

These are time frames after policy purchase during which certain benefits or treatments aren’t covered. Understanding these waiting periods associated with specific benefits can prevent claim denials.

• Pre-existing disease coverage

Some insurers may have waiting periods or exclusions for pre-existing medical conditions. Be sure to understand how your plan handles these situations.

• Specific exclusions

Every plan has limitations. Carefully review the policy wording to identify specific diseases or treatments excluded from coverage.

Key Takeaways

When choosing health insurance online, prioritising modern treatment coverage is crucial. Using platforms such as PhonePe can simplify the process of selecting and buying the right health insurance.

This ensures access to cutting-edge medical procedures that can significantly impact your health outcomes. Consider your age, lifestyle, and potential health risks to determine the level of modern treatment coverage you need.

Remember, factors like co-payments can affect your out-of-pocket costs. Carefully navigate these features to find an affordable and comprehensive health insurance plan. By prioritising modern treatment coverage, you can manage your health effectively and gain financial security in the face of unexpected medical situations.