Health insurance cannot be denied to HIV infected
1 min read 06 Aug 2021, 01:42 AM ISTArogya Sanjeevani policy offers coverage for treatment received in hospitals in India. It does not cover for expenses that you may incur on healthcare in the US
PremiumI am going to the US along with my family (parents, wife and two children) for four years as my employer is sending me to their US office as part of work. Given this situation, should I purchase an Arogya Sanjeevani policy to insure my family and myself for health expenses, or will the insurance provided by my employer also offer me global coverage for the same? My status will change to non-resident Indian (NRI). In such a scenario, will the policy settle any claims once I am back, and will the status not affect the claims made in future? What should I do?
—Ramesh Kumar
Arogya Sanjeevani policy offers coverage for treatment received in hospitals in India. It does not cover for expenses that you may incur on healthcare in the US.
However, when you are back in India, and if you would like to make claims for treatment expenses incurred in India, it will be admissible under the policy.
Your resident status, that is, of being an NRI, will have no impact on the admissibility of the claim. If you buy a policy now, your waiting period towards specific diseases and pre-existing cover will start getting utilized now. By the time you are back, it is likely that all waiting periods will be over.
Most employers provide health insurance coverage to their expatriate employees. So, you would likely be covered under a corporate plan. Expatriate plans can be customized to cover specific geographies or offer global coverage. You must specifically check the geographical coverage from your employer.
Is it mandatory for an HIV positive person who is in good health, has zero viral load and CD4 count of less than 700, and has been on antiretroviral medication for more than 10 years, to declare his/her HIV+ status while applying for medical insurance? If yes, can the insurer deny health cover to a person on the grounds that he/she is HIV+? What are the IRDA guidelines regarding this?
—Name withheld on request
If you have a health condition, including well-controlled HIV, you must declare this to the insurer. As per regulatory guidelines, insurers cannot deny coverage only on the grounds that a person is HIV positive. But, they can put in sub-limits and restrictions. You may also want to consider exclusive HIV plans offered by some insurers.
Abhishek Bondia is principal officer and managing director, SecureNow.in.
