What are Coverage Limits for Rheumatoid Arthritis?

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Rheumatoid Arthritis refers to a chronic autoimmune condition which causes pain, stiffness and irritation in the joints. It occurs when the body's immune system attacks its own tissue by mistake and ends up affecting the lining of the joints.


There are health plans which cover inpatient hospitalisation, daycare procedures, etc. However, these plans also come with a fair share of coverage limits. Read on to know about them.


What are the General Limits of Rheumatoid Arthritis Coverage in a Health Insurance Policy?


Wondering what the coverage limits of Rheumatoid Arthritis are in a health insurance policy? Here is a list of the general limits you should know about:


● Waiting Period


Rheumatoid Arthritis is usually treated as a form of Pre-Existing Disease by the majority of insurers. This means a mandatory waiting period applies before coverage benefits extend for treatment of that condition. The waiting period duration at insurers mostly lasts between 24 and 48 months.


However, there are some policyholders who may offer an option to reduce the waiting period for pre-existing diseases by paying extra (Buy-Back for Pre-Existing Diseases).


● OPD Coverage


There are some plans, like a specialised Outpatient Care insurance policy, which offer particular coverage for outpatient expenses (consultations/expenses) with defined waiting periods.


What are the Benefits of buying health insurance for Rheumatoid Arthritis in India?


Rheumatoid Arthritis has a very high incidence in India. It affects mostly a rapidly ageing population suffering from degenerative joints, delayed diagnosis and poor pain management.


Furthermore, the costs of treatment for the same are also expensive, ranging from diagnostic tests to medications. However, with a proper health insurance policy to cover the same, the cost can be easily managed.


Who Should Ideally Purchase Health Insurance for Rheumatoid Arthritis?



  • People in the age group of 30 to 60 years

  • Women

  • Smokers

  • People with periodontal gum disease

  • Obese and overweight people


What are Some Things to Look for in a Health Insurance Policy for Rheumatoid Arthritis?



  • Make sure that the policy you choose has post-hospitalisation expenses coverage.

  • You also need to check that the health insurance policy you get covers health check-ups, OPD treatments, and modern treatments.

  • Check the room rent limits and choose a plan which does not have any room rent capping. This will help prevent any out-of-pocket expenses.


Which Type of Health Insurance Policies Cover for Rheumatoid Arthritis?


● Comprehensive Policies


Many insurers include treatment for Rheumatoid Arthritis in their comprehensive policies. These kinds of health insurance plans offer an extensive range of benefits for a variety of treatment concerns of Rheumatoid Arthritis and other ailments.


● Senior Citizen Policies


Specialised policies designed for senior citizens offer coverage benefits for Rheumatoid Arthritis. They also have extensive benefits catered to age-related ailments such as this condition and offer high sum-insured options.


Final Words


Rheumatoid Arthritis is a very challenging condition, but with suitable health insurance and a combination of treatments, management of the condition becomes easier. Before finalising your purchase of the policy, make sure to read the policy terms and conditions thoroughly.