Health Insurance Plan For HIV-Positive Patients in India

Health Insurance for patients suffering from the Human Immuno-Deficiency Virus - that is, patients who have tested HIV-Positive - is hard to get. Traditionally, insurance companies have considered HIV as part of permanent exclusions. Hence, a person who already tested positive had no available option for healthcare. However, in India, STAR Health Insurance company offers a health insurance plan for people with HIV whose condition has not progressed to Acquired Immuno-Deficiency Syndrome (AIDS).

One of the healthcare plans from Star Health Insurance India, is known as the Star Net Plus. This is currently the only plan that offers coverage for HIV+ patients. Here are some of the policy features:

Eligibility For HIV Health Insurance Plans 

This policy is specifically for people who are already HIV positive but not reached the stage of AIDS. An HIV positive person whose CD4 count is above 500, according to test reports that are not older than 45 days, and whose case for insurance is proposed by Government, NGOs, or Agencies working in the field of serving people with HIV/AIDS. 

[According to the policy prospectus, the cost of the test is covered by the insurance company]

HIV Health Insurance Plans Features

This policy is unique because it offers 2 types of coverage. The first one acts like a critical care policy specific to AIDS, and the second type of coverage is similar to a standard Mediclaim policy. 

Thus, under the first section, if an HIV+ person is diagnosed with AIDS, the sum insured (SI) amount is paid out as a lump sum, without any bill submission requirements, reimbursements, etc.  

1. Sum Insured in the Policy

The Sum Insured (SI) is accordingly split into 2 parts as per the policy provisions, the first section is for lump sum amount, and the second is for regular healthcare expenses. 

There are four available options starting with a min. SI of Rs. 15,000 going all the way up to an SI of Rs. 1 lakh where Rs. 50,000 is the maximum payable lump sum amount in case of AIDS diagnosis, and the other Rs. 50,000 is for regular coverage.

Also read here: Health Insurance Plans for HIV Infected Patients in India

2. Other Benefits of the Policy

As it is part Mediclaim in nature, this policy offers standard coverage and benefits like:

• Emergency Ambulance
• Cost of treatment and supplies for qualifying daycare and in-patient hospitalization
• Surgeon and specialist fees
• Room charges
• Pre/Post-hospitalization
• Pre-defined Modern treatments
• AYUSH treatments

3. Pre-Existing Diseases

For the Mediclaim part of this policy, pre-existing disease clauses and other exclusions and waiting periods are applicable.

4. Sub-limits of the Policy

Like most Mediclaim plans, this plan also has applicable sub-limits for medical expenses, and the total cost is capped at SI for the Mediclaim part of the policy.

Conclusion

HIV+ used to be a scary word until a few years ago, and in addition to social stigma, healthcare benefits were non-existent. Things have improved, and under IRDAI’s guidelines, insurance companies are now offering healthcare benefits to this unrepresented section. Over the years, scientific research has now made it possible to manage HIV and delay the progression to AIDS. Thus, obtaining healthcare coverage proves beneficial to meet medical expenses, and in case the condition gets severe, there is some financial cover to fall back upon.

You may also like to read: Top 10 Health Insurance Plans in India

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.