Does Health Insurance Cover Alzheimer's Disease Treatment?

Health insurance plans in India may cover the cost of treating Alzheimer’s Disease. However, the coverage will depend on the policy type, age of the insured person, and whether the condition is considered pre-existing.

Critical illness riders are part of some plans, which specifically address neurodegenerative disorders such as Alzheimer's, by providing financial assistance during hospitalisation, diagnostic tests, treatments and prescribed medications.

Having health insurance can ease the financial strain associated with long-term care, allowing families to prioritise support and caregiving. Read on to know more.

What are the Exclusions of Health Insurance for Alzheimer's Patients?

Health insurance policies do not cover certain expenses related to Alzheimer’s disease and associated conditions. Common exclusions include:

• Mental health conditions such as neurosis, psychiatric disorders, and other non-organic illnesses.


• Brain damage caused by alcohol consumption.


• Dementia or irreversible organic disorders are not covered by the policy.


• Treatments that lack medical evidence or are not widely recognised.


• Nutritional or dietary supplements.


• Injuries caused by high-risk or adventure sports.

What are the Diagnostic Tests of Alzheimer's Disease Covered by Health Insurance?

To determine whether someone has Alzheimer's disease, doctors perform diagnostic tests. These investigations might be covered by health insurance plans, depending on policy terms. What these tests usually do is:

• Neurological assessment evaluates memory, attention, language, reasoning, behaviour and mental stability to understand cognitive function and track progression.


• Blood tests and urine tests are performed to determine vitamin levels, thyroid function, liver and kidney condition, and mineral balance so that the doctors can exclude other potential causes of the symptoms.


• Medical history assessment involves examining current and previous diseases, medications, and family history of memory-related disorders. They also check for signs like blood pressure, pulse and temperature.


• Mental status tests are used to assess memory, concentration, ability to solve problems, numerical skills, and language proficiency to determine how cognitive functions decline with time.


• Lumbar puncture, or spinal tap, involves the examination of cerebrospinal fluid to identify tau and amyloid proteins associated with Alzheimer’s disease.


• MRI (magnetic resonance imaging) scans assist in determining brain shrinkage and detecting structural problems like tumours, strokes, or fluid buildup, which could have similar symptoms.


• The CT (computed tomography) scans show structural changes in the brain, particularly in the later stages, such as reduced brain size and enlarged fluid-filled areas.


• Amyloid PET (positron emission tomography) scans detect amyloid protein deposits in the brain, which are a key marker used in diagnosing Alzheimer’s disease.

In India, health insurance can help cover parts of Alzheimer’s treatment, especially hospitalisation and diagnostics, but coverage varies widely based on the policy and exclusions. While it may not support every aspect of long-term care, having a plan can still reduce the financial burden and help families focus more on care and support.