Does Your Health Insurance Cover Overseas Cost?

Many high-income individuals prefer to get treated overseas in case of critical illnesses, in order to take advantage of the technological advancement in medicine in the. Alternatively, in case of life-threatening diseases you may be compelled to look outside your country for a cure. A major impediment in both cases is the cost.

The average cost incurred in the US in case of a heart attack is $760,000 (over 5 crore rupees), compared to Rs.3.5 lakhs in India. Because of the high cost of healthcare overseas and the unfavorable exchange rate, Indians going abroad find it difficult to make the payment out of their own pockets.

SO, Can the Coverage of Your Health Insurance Extend to Overseas Expenses? Probably not!

LIC’s popular health insurance solution, Jeevan Arogya, makes the following statement in their brochure:

“The Hospital Cash Benefit shall be payable only if Hospitalization has occurred within India.”

HDFC Life’s Health Assure includes the following under the heading of Permanent Exclusions:

“Treatment outside India - Any medical expenses incurred for or arising out of treatment outside India.”

Indian health insurance providers do not, as a rule, include overseas treatment within their coverage; in fact, they explicitly exclude it. As a result, high net-worth individuals often purchase insurance from insurers in their country of preference in order to pay for treatment.

Recently, a number of Indian insurers-three to be exact-have also introduced health insurance plans which specifically target treatment in countries other than India. Considering the rapid economic development in India, this is a good move. Here is a look at your options.

1. Max Bupa Heartbeat:

• Comes in Silver, Gold and Platinum variety, and only the Platinum plan gives worldwide coverage.
• Individual and family floater plans, both available-for Platinum plans, coverage is from Rs.15 lakhs to 1 crore.
• The Family First policy offers coverage across the world, while Heartbeat Platinum offers coverage in all countries except Canada.
• Provides coverage to 9 critical illnesses, as well as emergency medical evacuation and hospitalization.
• Family floater coverage for up to 6 people-2 adults and 4 children (at most)

2. Religare Health Insurance – Care:

• Comes with a variety of options, like Floater plans, Co-payment, and No-claims bonus.
• Does not cover maternity or pregnancy related expenses, other than ectopic pregnancy
•  Minimum age of entry is 5 years.
• Discount for e-policy, family plan, loyalty, co-pay and long tenures.
• International costs will be reimbursed only in India, and in Indian currency.

3. Cigna TTK Prohealth:

• Provides international coverage only in case of emergencies.
• Coverage can be between 2.5 lakh and 1 crore rupees.
• Comes in 4 varieties- Protect, Plus, Preferred and Premier. The first two offers emergency worldwide coverage up to the value of full sum insured, while the last two provide maximum international coverage up to the sum of Rs.10 lakhs.
• Robotic surgery or surgery by remote techniques are not covered under this plan.
  Check all Plans of CignaTTK Health Insurance Here

The annual premium for these plans is much higher than a plan providing equivalent benefits but restricted to India. Here is an estimate of the premium rates for a 40 year-old male with a coverage of Rs.50 lakhs, and other basic features:

Benefit	Cigna TTK Prohealth	Max Bupa Heartbeat	Religare Health Insurance - Care
Policy coverage	2.5 lakhs to 1 crore	15 lakhs to 1 crore	50 to 60 lakhs
Number of diseases covered	International coverage only for emergencies	9	5
Rate of premium	Rs.44,343	Rs.70,474	Rs.40,646
Cashless payment	Not available	Available	Not available
Pre-existing illnesses	International coverage only for emergencies	After two years	After four years

So your typical health insurance plan does not cover international expenses, but you can go for one of these specialized policies which will cover the cost of treatment abroad. As these plans cost more than twice what a similar domestic plan would, the demand is limited as of now.

Here are a few things to keep in mind while purchasing health insurance with worldwide coverage:

• Cashless facility is available in select plans only. It is difficult for insurers to maintain a global network of associated hospitals, so claim is usually entertained with a reimbursement after the fact.
• Unless it is an emergency, make sure you give proper notice before travelling abroad for the purpose of treatment.
• To avail insurance in US and Canada you may have to pay more premium. Consult your insurer before you make specific plans.
• International travel insurance can also come with medical coverage, but in that case the primary purpose of travel cannot be treatment, and coverage is also limited.
• Unlike travel medical insurance, health insurance with international coverage also includes treatment in your home country.