Which critical illnesses are covered under health insurance?

Comprehensive health insurance is one of the most vital steps that a person can take to help secure medical expenses of themselves and their family. Health insurance works in a very simple way. The insured person has to pay annual premiums to the insurance company for the duration of the health insurance plan. If the insured person is diagnosed with certain diseases covered in the policy or is hospitalised, then the insurance company is liable to pay the medical expenses for the same. But it is important to note that even a plan that is called a ‘comprehensive health insurance plan’ doesn’t cover each and every illness. Read on to find out what is usually covered in a health insurance plan and whether critical illnesses are covered or not.

What is usually covered under health insurance?

A normal health insurance policy usually covers basic hospitalisation expenses as well as treatment expenses in case of illness. Naturally, the treatment expenses claimed have to be covered by the specific health insurance policy that the insured has chosen. That is why it is necessary to go over all the minute terms of the policy to find out what is covered and what is not.

Is critical illness covered in a health insurance policy?

Now there’s a million-dollar question. Hospitalisation and basic illnesses may be covered by your policy, but what about critical illnesses? Ailments like cancer, coma, renal failure, organ transplant, limb paralysis and others can be termed as critical illnesses. And they are usually not covered in your basic health insurance policy.

However, insurance providers nowadays have lots of health insurance products with many different features. One such feature is an add-on benefit or ‘rider’ for critical illnesses as well. Their goal is to ensure that people can buy a single health insurance policy that covers all aspects rather than go for 2 separate plans to cover critical illnesses. So, for an additional premium, a critical illness cover can also be included in your existing policy so that you get the benefit of expanded coverage.

What critical illnesses are covered in such a policy?

The following critical illnesses are covered in a health insurance policy that has a critical illness cover:

– Cancer of specified severity.

– Coma of specified severity.

– Major Organ/Bone Marrow Transplant.

– Stroke Resulting in Permanent Symptoms.

– First Heart Attack – of specified severity.

– Motor neuron disease with permanent symptoms.

– Open Chest CABG.

– Permanent Paralysis of Limbs.

– Open Heart Replacement or Repair of Heart Valves.

– Kidney Failure Requiring Regular Dialysis.

– Multiple sclerosis with persisting symptoms.


Therefore, if you’re looking for protection against a critical illness like cancer, make sure you choose health insurance with cancer cover included or added on to it. This can be helpful for individuals with familial history of certain critical illnesses or high-pressure jobs. Another advantage of an added critical illness benefit is the low premium that you have to pay. A separate critical illness health insurance may require higher premiums, thus requiring you to pay two hefty premiums for health insurance. For a little extra amount, you can get medical coverage for all those illnesses listed above.

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