Are cardiac procedures for Coronary Artery Disease covered easily?

Yes, most health insurance plans in India cover cardiac procedures for Coronary Artery Disease. However, you need to review your policy terms and conditions. One can get the coverage easily depending on a few important factors.

The first and most important factor is whether the treatment is medically necessary. In situations when a doctor recommends procedures like angioplasty, stent placement, or bypass surgery, the health insurance companies may approve the claim. These procedures are commonly covered under hospitalisation benefits in standard health insurance policies.

The next thing you should check is the waiting period. If you have already been diagnosed with coronary artery disease before buying the policy, it may be treated as a pre-existing condition. In that case, you may get the coverage only after you complete the waiting period. This waiting period can range from 2 to 4 years.

Sum insured and policy limits are also important things to look for. This is because these types of procedures can be expensive, so the insurer will only pay up to your policy limit. Moreover, some plans also come with caps on specific treatments or room rent.

Many people think that they can choose any type of hospital, but they forget that if they opt for a network hospital, they can avail themselves of a cashless treatment facility.

Not keeping the policy documents properly can put you in trouble. Make sure you have all the hospital documents, such as medical reports, prescriptions, and discharge summaries. Failing to submit the documentation can delay claim approval.