What Coverage is Available for Waterborne Diseases?

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Monsoon season in India not only helps to ease the heat but also spikes an increase in waterborne diseases. Every year, lakhs of Indians suffer from cholera, typhoid, hepatitis A and acute diarrhoea, thus burdening the families with high financial costs. Having a good health insurance policy in place can help you protect yourself from sudden health costs.


What Are Waterborne Diseases?


Water-borne diseases are illnesses that are spread through contaminated or untreated water. The most common are cholera, typhoid fever, viral hepatitis A and E, and acute diarrhoeal diseases in India. These diseases can progress quickly and are potentially life-threatening, and are treated in a hospital setting.


Does Health Insurance Cover Waterborne Diseases in India?


Yes. In India, most of the usual health insurance policies cover waterborne diseases if they lead to hospitalisation. Some insurers offer coverage through their comprehensive health plans. However, coverage is triggered when:



  • The sickness results in a minimum of 24 hours of hospitalisation.

  • The diagnosis is certified by a registered medical practitioner.

  • Treatment is given at a network or empanelled hospital.

  • The first waiting period (usually 30 days) for the policy has passed.


What Does Health Insurance Cover for Waterborne Diseases?


In India, the following costs of waterborne diseases are usually covered under a comprehensive health plan:



  • Hospitalisation Charges: Room rental, nursing, ICU, and medicines charges during the period of stay at the hospital.



  • Pre-Hospitalisation Diagnostics: Tests (blood, stool and urine) and imaging necessary for the diagnosis of the illness; usually covered for 30 to 60 days prior to admission.



  • Doctor and Specialist Fees: Any fees associated with the treating physician, gastroenterologist, or infectious disease specialist's care while the patient is admitted to the hospital.



  • Medicines and IV Fluids: Oral rehydration therapy, antibiotics and IV fluids offered in hospitalisation are normally reimbursable.



  • Post-Hospitalisation Follow-Up: Consultation charges and medication costs for 60 to 90 days after discharge (as per policy).


Key Exclusions to Know


Knowing the exemptions helps to avoid denials. The majority of health insurance policies in India do not include coverage for:



  • OPD (outpatient) treatment without hospitalisation, unless the policy has an OPD rider.



  • Treatment within the first 30 days after the policy goes into effect.



  • Taking medicines without a registered doctor's prescription.



  • Investigational or unapproved medications are used to treat infections related to water.


Final Thought


India's monsoons are becoming more severe annually, and water-borne diseases are occurring more often, making a solid health insurance plan essential. Compare plans with cashless hospitalisation in network hospitals, minimum waiting period and extensive coverage. Buying early and reading the fine print makes sure you will not be left vulnerable when illness strikes.