Opt for high-value policies to cover treatment abroad
Most policies do not cover treatment in the US or Canada, but you can get these countries included by paying an extra amount
Many high net worth individuals (HNIs) nowadays want the option of going abroad for superior treatment, say, to the US, in case they contract a life-threatening ailment. Health insurance policies in India don’t normally cover treatment abroad. However, a few insurers, such as Religare, Max Bupa, and Cigna TTK now offer policies that will reimburse you for treatment in foreign countries. Some others, like Apollo, have add- ons and riders that cover overseas treatment.
High sum insured, high premium: The sum insured of these policies is generally much higher than what people opt for in domestic mediclaim policies. The premiums also run into a few hundred thousand rupees. “Since the cost of treatment abroad is much higher than in India, these policies are available 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 ~5 million and ~60 million. Royal Sundaram's Lifeline Elite plan offers sum insured starting from ~2.5 million and going up to ~15 million. Max Bupa's Heartbeat provides sum insured ranging from ~1.5 million to ~10 million. Three types of policies: Broadly, three types of international plans are available. They vary from each other depending on the coverage they provide.
The comprehensive plan provides international treatment for all the illnesses usually covered by a domestic health insurance plan. For instance, Religare Care Global Cover provides international coverage (excluding in the US) up to the sum insured for hospitalisation expenses and sets a limit on the cover for maternity treatment. It requires 10 per cent co-payment for each claim. This plan does not cover return airfare of the patient.
Critical illness policies cover a specific list of critical illnesses only (See Table: Specific illnesses covered). For example, Royal Sundaram's Lifeline Elite plan provides international coverage (excluding the US and Canada) for 11 specified critical illnesses. All claims are subject to a co-payment of 20 per cent. It offers a one-time return airfare for the insured.
Max Bupa Heartbeat provides international coverage for both individual and family under its platinum plan.
Some health plans double up as travel plans. If an insured falls sick during an international journey, they provide cover for international treatment up to the point that the insured is rendered fit to be brought back home for further treatment. The Cigna ProHealth Insurance Protect plan is one such cover. Only in-patient hospitalisation expenses are covered.
Claim settlement via reimbursement: Claim settlement in most of these policies is by way of reimbursement 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 insurer to maintain a global network of hospitals. So usually the claim is settled as reimbursement only,” says Vaidyanathan Ramani, headproduct and innovation, Policybazaar.com. Cashless facility is available only in select 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.
Find out which countries are covered: Most companies do not cover treatment in the US and Canada, but you can get them included in some by paying an extra premium.
The premium for treatment in the US and Canada is higher than for treatment in other countries. Make sure that you buy adequate coverage. “Given the high cost of treatment, choose a coverage amount that is adequate. Opt for a sum insured upwards of ~5 million,” adds Gulati.
“It is also important to give proper notice to the insurer before travelling abroad, unless there is an emergency,” says Jyoti Punja, chief operating and customer officer, Cigna TTK Health Insurance.
A travel insurance coverage for emergency medical treatment is different from international health insurance cover. If you are travelling abroad for the purpose of planned medical treatment, then the standard travel insurance will not cover you. You will need to buy a proper health insurance policy for such treatment.