Will COVID-19 policy cover all your hospital bills?

Posted on May, 2021

When the Coronavirus pandemic started in March 2020, policyholders with health insurance policies were uncertain about the coverage of covid related treatment costs. Analysing the insurance needs of the citizens, IRDAI directed every insurance broker and insurance company to cover COVID-19 treatment costs through their insurance policies. Although the introduction of COVID-19 specific insurance policies such as Corona Kavach and Corona Rakshak has significantly increased the coverage, there are some bills that the policies do not cover.

Look out for these uncovered expenses

Although a COVID-19 policy covers all the major costs, here are some expenses that you must incur from your own pockets:


In the treatment of COVID-19, consumables such as PPE kits are recurring expenses because of their single usage. For a COVID positive patient, wearing PPE Kits is mandatory for the visiting family members, doctors and attendants, constituting over 10% of the total treatment cost. Since the treatment can stretch over weeks, the insurance companies have defined a maximum limit for the expenses on consumables that a COVID-19 policy will cover. In most cases, the insurance company only pays for one PPE kit per day or provides Rs 1,200-2,000 per day for the expenses on consumables. Look for plans which do not have such limitations.

Exclusion in Room Charges

The COVID-19 pandemic saw the shift of attention to measures ensuring utmost hygiene and sanitisation in the hospital room. Although these measures are an inevitable necessity, they increase the cost of the overall treatment. In various cases, the hospitals bills have been above the directives shared by governments or above the limits of the policy features & definitions. In such scenarios complete bill may be settled on proportionate basis or extra charges could be deducted as per policy T&C

Medical Equipment

During the COVID-19 treatment, the COVID positive patient requires medical equipment such as thermometers, nebuliser kits, steam inhalers etc., to progress the treatment. However, these types of equipment are unique to a particular patient as the doctors can’t use them on other patients. Although these types of equipment are fundamental to the treatment, the insurer does not cover seperate cost incurred on their purchase. Furthermore, the policy also excludes the cost of hiring a private attendant and nurses at home or at the hospital.

Over and Above Costs

It is the provision of every health insurance policy to cover the medical expenses equal to the sum insured. For example, if your current health insurance policy has a sum insured of 5 lakhs, the insurance company will reimburse your COVID, or any other treatment costs up to 5 lakhs. If your treatment cost goes above the sum insured amount (Including bonus amount) , you will have to pay the remaining amount to the hospital.

What should policyholders do?

First of all, in this current situation, policyholders must consult their Insures / Intermediaries and do a thorough review of the health insurance policy, its features and how well it can protect the policyholders and their family in case of hospitalisation due to COVID.

Health Insurance policies have always been critical in ensuring a burden-free financial future. Now, more than ever, when health insurance policies are capable of covering Coronavirus treatment costs, their importance has risen tremendously. With the current second coronavirus wave negatively affecting the health of citizens, buying a comprehensive health insurance policy will be the best decision you can take.

While you take care of yourself, we will take care of you. Do not let unprecedented incidents affect your mental health and create an imbalance in your financial stability. Explore yourself while we have got you covered. Being composite brokers in India, we at PINC Insurance provide a range of insurance and risk advisory services. We help you buy, renew, and compare insurance that suits your needs and budget. We ensure hassle free and seamless insurance purchase and insurance claims process. So, leave all your insurance related worries to us and start exploring yourself.

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