Does Health Insurance Cover COPD Treatment?

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Yes, most health insurance providers in India cover chronic illnesses like Chronic Obstructive Pulmonary Disease (COPD), especially when hospitalisation or advanced treatment is required. This condition is mainly covered under a comprehensive healthcare plan with respiratory coverage.


In fact, according to the Indian Times, India has registered nearly 55 million cases of this condition, showing the necessity of having this disease covered under your healthcare plan.


What are COPD Disorders?


COPD is generally an umbrella term for progressive, long-term lung diseases that restrict airflow and make breathing difficult. This condition primarily results from smoking or air pollution.


Moreover, there are two main conditions under COPD, which are emphysema and chronic bronchitis.


While emphysema causes damage to the walls of the alveoli in the lungs, chronic bronchitis involves long-term inflammation of the airways.


What Does Health Insurance Cover COPD Disorders?



  1. Hospitalisation and Emergency Care: If COPD leads to severe complications requiring hospital admission, your health care plan will cover inpatient expenses, such as room rent, ICU charges, doctor’s fees, and nursing care.



  1. Day Care Treatments: Certain treatments of the COPD condition, such as endobronchial ultrasound, thoracoscopy, and lung biopsy, do not require 24-hour hospitalisation. This is when the day-care feature helps to cover these treatments.



  1. Domiciliary Treatment: Policyholders with a severe COPD condition can use this coverage to receive quality treatment in the comfort of their home.



  1. Modern Treatment Cover: Under the comprehensive plan, policyholders can get modern treatments for COPD conditions, such as bronchial thermoplasty.


What Factors Must You Consider in COPD Coverage?



  1. Waiting Period Duration: The policyholder has to serve a waiting period of 12–36 months if theCOPD disorders develop before purchasing a policy.



  1. Adequate Sum Insured: The cost ofCOPD disorder treatments in India generally starts from ₹1,83,000. Therefore, you must have enough sum insured in your policy to cover these treatments.



  1. Check Buy-Back P.E.D. Option: Many reputable health insurance companies offer a buy-back pre-existing disease add-on to avoid long waiting times. Therefore, policyholders who need instant medical assistance for their COPD condition must get this coverage by paying an additional premium.



  1. No Claim Bonus (NCB): Considering the rising medical inflation in India, ensure having this benefit to increase your sum insured by a fixed percentage for every claim-free year.



  1. Coverage for Ongoing Treatment: For policyholders with a pre-existing COPD condition, the policy must verify if it covers essential ongoing treatments. These treatments mainly include oxygen therapy and nebulization, under the Day care or OPD coverage.



  1. Network Hospitals List: Ensure your provider has at least 10,000 network hospitals and specialised centres. This way, you can easily access cashless treatments for COPD-related conditions.


Final Words


Due to the rise in respiratory conditions like COPD, having a health insurance plan will help you to get quality treatment without any financial burden in future.


Therefore, to ensure having this coverage in your healthcare plan, always review your policy details carefully.