June 10, 2023

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Do Health Insurance Plans Cover Rare Diseases?

Do Health Insurance Plans Cover Rare Diseases?

What are rare diseases?

When we talk about rare diseases, we mean conditions that only affect a small portion of the population as a whole. The World Health Organization (WHO) defines a rare disease as one that affects 1 or fewer people per 1000 people. 

Typical forms of rare diseases 

Presently, there are more than 7000 uncommon diseases known to exist. Several of the most prevalent uncommon disorders include: 

  • Pompe 
  • Adzuna syrup Urinary Illness
  • Gaucher illness
  • Sickle Cell Disease 
  • Cirrhosis Fibrosis 
  • Tyrosinemia
  • Haemangioma 
  • Osteopetrosis 
  • Haemophilia
  • Fabry Syndrome 
  • Syndrome Hurler 
  • Wolman Syndrome

Cure for rare diseases 

The majority of uncommon diseases have no known treatments. Not simply the treatment but also the timely diagnosis of such disorders results in greater patient suffering. If there is a cure for a rare condition, it is extremely expensive. 

Also, the majority of rare disorders are chronic in nature. As a result, they will need treatment for a very long time, which will cost a lot of money. Moreover, patients might be put on long-term pharmaceutical regimens and need to undergo repeated diagnostic procedures. As there are so few pharmaceutical companies producing medications for the treatment of uncommon diseases worldwide, they are quite expensive. Due to this, medications used in their treatment are referred to as “orphan drugs”, and rare disorders are also known as “orphan diseases”. 

Are rare diseases included in Indian health insurance plans? 

Yes. Some health insurance programmes in India cover the treatment expense of a rare disease. You can file a claim for the treatment costs under your health insurance plan whether or not a rare condition is inherited. The insurance plan will cover the costs of daycare visits, surgeries, post-hospitalization consultations, diagnostic testing, and other medical procedures. *

You can choose health insurance for uncommon diseases with a coverage value of up to Rs 6 crore, depending on your budget. A health insurance premium calculator is a tool you may use online to determine the amount of coverage required based on your needs.

Unfortunately, not all rare diseases might be protected by Indian health insurance coverage. Furthermore, not all health plans offer the same level of coverage. So, it is advised that you research a health insurance policy’s list of rare diseases covered before purchasing it.

Waiting time for health insurance to cover rare diseases 

Health insurance does cover unusual disorders. However, the coverage is not immediately available after purchasing the plan. You must first wait throughout the waiting time before receiving the coverage. While there is a 30-day initial waiting period for all health insurance policies, coverage for the majority of uncommon diseases becomes available after a 2-year waiting period. This means that your insurance company will only pay for the expense of treating a rare condition when your health insurance coverage has been renewed twice in a row. *

The 2-year waiting period, however, will only be applicable if you receive your rare disease diagnosis after purchasing the health insurance coverage. If you have a diagnosis of a rare illness prior to acquiring the coverage, it will be regarded as a pre-existing condition. A waiting time for pre-existing diseases will be applied in this situation. Make sure you compare health insurance plans before buying one.

Guidelines for preventing the development of rare diseases 

Although the precise causes of many rare diseases are unknown, you can live a healthy life and avoid uncommon diseases by following the advice given below: 

  • Consume a diet full of fruits and vegetables, especially green ones. 
  • Don’t smoke 
  • Keep moving and work out frequently. 
  • Avoid drinking alcohol on a regular basis. 
  • Obtain the necessary vaccinations 
  • Avoid being exposed to dangerous chemicals.

* Standard T&C Apply

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.