Do you need insurance cover for dengue?

Pre-monsoon showers have brought the mercury down, but these may also lead to vector-borne diseases such as dengue and malaria, say doctors.

Dengue is quite a dreaded disease, and insurance companies are offering special insurance cover to take care of the medical expenses in case it is required. These plans provide independent risk cover to people to meet the expenses incurred for the treatment.

The average cost of hospitalisation for dengue treatment could vary between Rs 35,000 and Rs 70,000. Dengue insurance covers both inpatient and outpatient treatment. In fact, a single-disease plan offers wide coverage, and also acts as an add-on to the basic health insurance cover. Let us understand how good these plans are and whether you should opt for it.

What the policies offer

1. No pre-insurance health check-ups are needed to buy a dengue insurance policy. You only have to make a self-declaration in the application form that you are currently not suffering from dengue.
2. The premium for this policy remains the same, irrespective of your age.
3.  
4. If dengue is diagnosed, some policies such as the DHFL Pramerica Dengue Shield pay the full sum assured to the policyholder depending on your medical condition - be it dengue fever, dengue haemorrhagic fever or dengue shock syndrome. A doctor's certificate to this effect will be required, and you must have minimum 24-48 hours of inpatient care at a hospital for medical treatment of dengue.
5. A few insurance companies provide for inpatient and outpatient treatment separately and bear the costs that are not borne by health insurance policies. "The outpatient treatment and home-care pharmacy and diagnostic expenses for dengue are not covered by any health insurance policy. Also, most of the times, hospitalisation is not needed for dengue treatment," says Antony Jacob, Chief Executive, Apollo Munich Health Insurance.
6. Insurers cover all medical costs incurred 15 days before and after hospitalisation. Hospitalisation coverage is provided if a policyholder is hospitalised for more than 24 hours. Apollo Munich covers outpatient treatment under its dengue plan, providing a coverage of up to Rs 10,000 for outpatient doctor consultation, pharmacy, diagnostic tests and home nursing.
7. These plans can be claimed simultaneously with other existing health insurance policies.
8. There is no maturity benefit payable under dengue insurance policies.

Premiums for these single-disease-specific plans are quite low. For its dengue care plan, Apollo Munich charges a premium of Rs 511 per annum for Rs 50,000 sum insured. It covers up to Rs 50,000 for inpatient care expenses and up to Rs 10,000 incurred for outpatient treatment for a one-year policy. DHFL charges an annual premium of Rs 661 for Rs 50,000 sum assured for a 30-year-old individual. The policy term, in this case, is five years. The maximum cover available for dengue insurance is up to Rs 1 lakh, and the minimum is Rs 25,000.

Should you go for it?

As these are dengue-care-specific plans, they only cover dengue-related treatment. While buying illness-specific policies, one must ensure that the plan offers comprehensive coverage, including inpatient and outpatient treatment, home-care, diagnostics and so on for the illness that is being covered. "It is advisable to have a basic health insurance product as it will always serve as a base to the special benefit plans," says Jacob of Apollo Munich. "One of the benefits of these products is that when policyholders suffer from the disease, they can make an independent claim against the dengue policy, and not impact the no-claim benefits accrued in their core health insurance policy," says Mahavir Chopra, Director - Health, Life and Strategic Initiatives, Coverfox.

Exclusion

People who are suffering from dengue are not eligible for these policies. Also, no other medical conditions are covered other than dengue fever and dengue shock syndrome. If dengue treatment requires less than 24-48 hours of hospitalisation, hospitalisation costs will not be covered. Moreover, diagnosis and treatment outside India are not covered under dengue plans.