Corona Rakshak Policy - Know About the COVID-19 Health Insurance Plan

Insurance companies in India introduced the Corona Rakshak Health Insurance in response to the unprecedented challenges posed by the COVID-19 pandemic. The Insurance Regulatory and Development Authority of India (IRDAI) viewed the Corona Rakshak policy as a way to address specific needs arising from COVID-19.The Corona Rakshak policy is an individual plan that provides financial support in the form of a lump sum benefit to cover all expenses incurred if you test positive for COVID-19 and require hospitalisation.It is an ideal option if your current Health Insurance policy does not offer adequate coverage, as the Corona Rakshak Policy can cover the additional expenses.

Under the terms and conditions of the plan, the Corona Rakshak Policy is a short-term, fixed-benefit Health Insurance plan that provides you a lump sum payment upon a COVID-19 diagnosis. Individuals aged between 18 and 65 years can buy the Corona Rakshak Health Insurance policy.

In most cases, your standard Health Insurance policy will cover hospital expenses related to COVID-19. This coverage applies even if you get diagnosed with COVID-19 after purchasing your policy (provided you are not diagnosed with COVID-19 during the waiting period). However, note that your current Health Insurance policy does not cover COVID-19-related outpatient expenses, such as doctor consultations, lab tests and pharmacy bills. Furthermore, you may not be covered if you do not already have a Health Insurance policy and choose to purchase one after testing positive for COVID-19.

• You can choose a minimum coverage amount or sum insured of ₹50,000 and in multiples of ₹50,000 after that up to ₹2.5 lakhs.
• You can pay the entire premium as a one-time payment.
• You receive 100% of the sum insured in one lump sum on the positive diagnosis of COVID-19 from any government-authorised centre.
• You do not require any pre-medical examination before purchasing this policy.
• The maximum waiting period before your policy kicks in is 15 days.
• The policy is typically valid for 105 days, 195 days, or 285 days up to 31 March 2021.
• The insurance is offered on an individual basis.
• You can claim tax exemption on your premium payments under Section 80D.
• You can avail of the Corona Rakshak health plan benefits without any deductibles.

Also Read: Difference between Corona Kavach-and Corona Rakshak Health Insurance

The following are inclusions you can find in a Corona Rakshak policy.

Sum Insured:

You can get a sum insured or coverage amount of ₹50,000, ₹1 lakh, ₹1.5 lakhs, ₹2 lakhs, and ₹2.5 lakhs.

Hospitalisation expenses:

It covers charges for nursing care, room rent, medical equipment such as masks, PPE kits, gloves, ventilators, and specified diagnostic tests.

ICU/ICCU cover:

The policy also covers charges you may incur if you need treatment in the ICU/ICCU

Ambulance cover:

You can claim compensation for road ambulance charges up to a limit of ₹2,000.

Home treatment cover:

The Corona Rakshak policy also covers any home care or treatment you may need for up to 14 days.

AYUSH cover:

The plan also covers AYUSH treatment prescribed for COVID-19

Pre and post-hospitalisation cover

The insurance plan also pays for medical costs, such as diagnostic fees, incurred before 15 days of hospitalisation and after 30 days of discharge. Additionally, the Corona Rakshak Policy offers an optional cover benefit where you receive 0.5% of the insured amount each day for a maximum of 15 days of hospitalisation.

Certain exclusions apply to Corona Rakshak claims. Insurers may not settle claims in cases of:

• Reports from unauthorised testing centres.
• Overseas tests or treatment.
• Policy renewals and migration.
• Travel to restricted countries.
• Non-COVID-19 diagnoses.

Lump sum payout:

If you test positive for COVID-19, the policy offers a lump sum payment. You can claim the entire sum assured after at least three days or 72 hours of hospitalisation. So, if you bought a policy with a sum insured of ₹50,000, you can only claim this amount on hospitalisation. Any medical expenses over the ₹50,000 sum insured will be borne by you. The policy document specifies the payout amount, providing you with financial support during recovery.

Coverage for hospitalisation expenses:

The Corona Rakshak Policy covers certain other costs you incur if you require hospitalisation during the treatment of COVID-19. This coverage helps you manage medical expenses associated with the following:

• Hospital stays
• Consultations
• Medicines
• Diagnostic tests

Flexibility in policy tenure:

The policy term usually ranges from 3.5 months to 9.5 months, and you can select a term that best suits your needs. This flexibility ensures the policy matches your perceived risk and coverage requirements.

Affordable premiums:

The Corona Rakshak Policy comes at reasonable premiums. The premiums vary depending on the policy term, age, and the sum insured.

No pre-medical check-ups:

The Corona Rakshak Policy usually foregoes the need for pre-medical examinations, marking one of its main advantages. This aspect also streamlines the application process and ensures quick coverage.

Tax benefits:

The premium for your Corona Rakshak Policy may qualify for tax benefits under the Income Tax Act of 1961 (Section 80D). This clause gives you additional financial relief, making it a desirable option for many. Also Read: List Of Diseases Covered Under Health Insurance

Like other Health Insurance policies, you can make cashless or reimbursement claims for COVID-19.

Cashless claims:

• Choose a network hospital: Seek treatment at a network hospital authorised by your health insurance provider for a cashless facility for COVID-19.
• Submit a pre-authorisation request: Inform the insurance desk at the hospital about your health insurance policy. Submit the required documents, including ID proof and policy details, to initiate the pre-authorisation process.
• Medical verification: The insurance company's representative or TPA (Third-Party Administrator) will verify your details and medical reports to approve the cashless claim request.
• Approval and treatment: Once approved, you can receive treatment for COVID-19 without paying upfront. The insurer settles the medical bills directly with the hospital, subject to policy terms and coverage.

Reimbursement claims:

• Inform your insurer : Inform your Health Insurance provider about your COVID-19 diagnosis and hospitalisation within the stipulated time frame (usually 24 hours).
• Keep records : Maintain all original medical bills, discharge summary, test reports, prescriptions, and other necessary documents for claim processing.
• Submit claim form : Obtain and fill out the claim form from the insurer's website or office. Attach the relevant documents and submit them to the insurance company.
• Claim processing : The insurer evaluates your claim based on the policy terms, coverage, and documents submitted.
• Reimbursement : If your claim is approved, you will receive reimbursement for the eligible medical expenses as per your policy coverage.

Also Read: Need To File a Health Insurance Claim For Coronavirus? Here Is a Step-By-Step Guide

• Corona Rakshak Insurance coverage ranges from ₹50,000 to ₹2.5 lakhs. You can receive the amount as a lump sum on a positive COVID-19 diagnosis.
• The waiting period is 15 days, and you do not need a pre-medical examination.
• The policy provides coverage on an individual basis and allows tax exemption under Section 80D.
• It covers hospitalisation expenses, including nursing charges, room rent, PPE kits, diagnostic tests, ICU/ICCU costs, and ambulance charges.
• It also covers home treatment and AYUSH treatment for COVID-19.
• The Corona Rakshak policy covers pre- and post-hospitalisation expenses, and an optional cover benefit provides daily allowances during hospitalisation.
• The insurer can reject your claim if the report is from an unauthorised testing centre, involves overseas treatment, etc.