Web Exclusive
These health policies are specifically designed for treatment abroad

We are all quite familiar with the term 'medical tourism', where people travel from their own country to another for cheaper medical treatment. According to the Medical Tourism Market Report 2015, India was considered to be among the low-cost medical tourism destinations offering highest-quality treatment. But what about Indians wanting to go to abroad, say, to the US, to get superior treatment for cancer or some other life-threatening disease, for which the cost is much higher than anything you can get in India? Then, of course, there are other expenses, such as travel, accommodation and food, which need to be considered, apart from the dollar-rupee exchange rate.

Health insurance policies in India don't normally cover medical treatment abroad and one can make a only claim for treatment availed in India. However, there are few insurers, such as Religare, Max Bupa, and Cigna TTK, that offer policies for overseas health care and will pay the claims for treatment taken abroad. Some others, like Apollo, have add-ons and riders covering treatment overseas. 

Insurers mostly target high net-worth individuals (HNIs) who opt for large covers. Earlier, HNIs used to buy insurance policies from foreign insurers for treatment abroad. Now, similar policies are available with Indian companies. But most of these policies have restricted their cover to only a few specified illnesses for overseas treatment. Also, along with the sum insured, the premiums for such policies also run into a few hundred thousand rupees. "Since the cost of treatment abroad is much higher than in India, these policies are available commonly with high sum insured options," says Anuj Gulati, MD & CEO, Religare Health Insurance.

For instance, Religare's Global Care offer comes with sum insured ranging between Rs 5 million and Rs 60 million. Royal Sundaram's Lifeline Elite plan offers sum insured starting from Rs 2.5 million and going up to Rs 15 million. Max Bupa's Heartbeat provides sum insured starting with Rs 1.5 million and up to 10 million. However, these policies do not pay for each and every treatment or treatment-related cost incurred abroad. Broadly there are three types of plans that are differentiated depending upon the coverage of the treatment they provide. 

1. The comprehensive plan provides complete international treatment for all illnesses that are usually covered in a domestic health insurance plan. For instance, the Religare Care Global Cover provides international coverage (excluding the US) up to the sum insured for hospitalisation expenses and a sets a limit on the cover for maternity treatment (10 per cent co-payment per claim). Also, the facility of return airfare is not covered under this plan.

2. The Critical illness cover provides extensive international treatment but is limited to critical illnesses only. For example, Royal Sundaram's Lifeline Elite plan provides international coverage (excluding the US and Canada) with 11 specified critical illnesses. All claims are subjected to a co-payment of 20 per cent. It also comes with one-time return airfare for the insured person.

3. Some health plans also double up as travel plans, and provide international medical treatment cover up to the point that insured person is rendered stable and fit to be brought back home for further treatment upon falling sick during an international journey. The Cigna ProHealth Insurance Protect plan is one such that covers emergency treatment for illness sustained outside India which cannot be postponed. The cover extends to the point that the insured person has returned to India and is available up to specific limits. The medical expenses are limited to in-patient hospitalisation.

Health insurance plans providing comprehensive treatment provides cover all illnesses that are included in a domestic health insurance plan. For health insurance plans providing treatment for only critical illness, there is a specified list of illnesses which differs from plan to plan. (See Table: Specific illnesses covered) For instance, the Max Bupa Heartbeat provides international coverage for both individual and family under its platinum plan. You should also find out which countries are covered under the policy. Most companies do not cover treatment in the US and Canada, but you can get them included in some policies by paying an extra premium.

The claim settlement in most cases is by way of reimbursements only. "Wherever insurance companies have been able to build up a network globally, the cashless facility is provided, but sometimes it becomes difficult for a domestic insurance company to maintain a global network of hospitals. So usually the claim is settled with reimbursement only," says Vaidyanathan Ramani, Head Product and Innovation, Policybazaar.com. Cashless is available only in selected plans. "Critical illnesses are covered on a cashless basis if detected in India by a certified medical practitioner within the policy period," says Ashish Mehrotra, MD & CEO, Max Bupa Health Insurance.

Things to keep in mind while buying these policies 

These plans have specified sum insured and specified illness listed for international coverage plans. They are typically available in higher sum assured values and a higher premium is charged. "It is also important to give proper notice to the insurer before traveling abroad, unless there is an emergency," says Jyoti Punja, Chief Operating and Customer Officer, Cigna TTK Health Insurance. For treatment in the US and Canada, which is generally excluded from all health insurance plans, you might have to pay a higher premium than for treatment in other countries. 

"Given the high cost of treatment, one must choose a coverage amount that is adequate. It is recommended to opt for sum insured upwards of Rs 5 million," adds Gulati. Health insurance with international coverage also includes treatment in your home country. However, a travel insurance coverage for emergency medical treatment is absolutely different from international health insurance cover. If you are traveling abroad for the purpose of planned medical treatment, then the standard travel insurance will not cover you. To get insurance coverage, you need to get a proper health insurance policy for such treatment.

 


Outbrain