Apollo Munich’s ‘Dengue Care’ Health Insurance Plan : Features & Details

Hospitals across India have started reporting dengue infection as mosquito menace increased with the rains. A total of 135 dengue cases have been reported from Karnataka state alone in the last 25 days.

The World Health Organization (WHO) estimates that currently there are about 50-100 million dengue infections worldwide every year.  Nearly half of the population of the whole world is now at risk which resides mainly in tropical and subtropical regions of the globe.

As per provisional data available from National Vector Borne Disease Control Program (NVBDCP) India has witnessed a 14-fold increase in the number of dengue cases reported between 2007 and 2013  with severe symptoms that requires hospitalization. This in turn has resulted in an increase in health insurance claims for dengue treatment.

A 32% rise has been reported in dengue-related insurance claims between 2012 and 2013, according to an in-house health insurance policy analysis by ICICI Lombard. According to data from Apollo Munich, the share of dengue-related claims grew from 3.8% in 2011 to 9.8% in 2013.

Recently, Apollo Munich has launched an exclusive ‘Dengue Care’ Health Insurance plan. The company claims that this is India’s first health insurance plan against Dengue.

What is Dengue?

Dengue is a mosquito-borne infectious disease caused by the dengue virus, which is mainly found in the tropical countries like India. It is also known as ‘break-bone fever’.

There is no vaccination to prevent this disease. Also, there is no specific drug for treating dengue. The key in treatment is to recognize it early. Mild cases require adequate fluid intake, fever control and monitoring of blood count. If the case is severe, it may also require an ICU admission.

It is been estimated that the mortality rate of a dengue patient without hospitalization increases about 50 percent. Most of the dengue infected patients may have to undergo two weeks of treatment in a hospital. The patient has to undergo lot of diagnostic tests (especially repeated blood tests) which can be very costly. Also, non-medical related expenses can be very high.

(Platelet transfusion is an important aspect of dengue treatment as dengue patients who suffer from thrombocytopenia may need platelet transfusion. This procedure is very costly in private hospitals. Private labs may charge 7000-10,000 INR for every unit of platelet.)

Apollo Munich Dengue Care Health Insurance Plan 

Dengue Care is an exclusive plan that covers the insured for in-patient and out-patient treatment for Dengue. The main features of this medical insurance plan are;

• This plan charges uniform premium for all the age groups. Same Premium irrespective of age.
  • This policy covers persons in the age group 91 days to 65 years. The maximum entry age is restricted up to 65 years. The Minimum entry age for Adult is 18 years and maximum is 65 years. The minimum entry age for child is 91 days and the maximum is 25 years.
  • Premium for Sum Assured of Rs 50,000 is Rs 506 for the age group of 91days (new born baby) to 65 years.
  • Premium for Sum Assured of Rs 1,00,000 is Rs 659 (inclusive of service tax) for the age group of 18 to 65 years.
• No medical tests are required (irrespective of age).
• No-Sublimits and no co-payment clause for in-patient hospitalization. (Sub-limit is a monetary cap / restriction that an insurer places on your insurance claim. For example – room rent restrictions, sub limits on specific medical procedures etc.,)
• This plan also covers Out-patient treatment expenses (OPD expenses). On diagnosis of Dengue, Cover for OPD expenses of up to Rs. 10,000 is available. (OPD expenses can be Coverage for consultations, diagnostic tests, pharmacy and home nursing for dengue treatment taken at home)
• Hospital Room rent without any sub-limit is covered.
• If patient opts for a ‘shared accommodation’ (hospital room) then non-medical expenses incurred during hospitalization are also covered.
• A waiting period of 15 days from the date of inception of policy is applicable in the first policy year. This condition is not applicable for subsequent renewals.
• The policy can be renewed for life-long.
• Coverage for medical costs incurred 15 days before and after the hospitalization.
• A maximum of 6 members can be added in a single policy. A maximum of 4 adults and a maximum of 5 children can be included in a single policy. But, this plan does not work like a Family Floater. The coverage is offered on ‘individual sum insured’ basis only, which means each insured will have separate sum assured and has to pay the applicable premium.
• The insurance cover is for the treatment of Dengue fever only. Any treatment other than Dengue is excluded.
• The premium amount paid under this policy qualifies for tax deduction under Section 80D of the Income Tax Act.
• A 10% discount on Premium is provided if customer buys ‘Dengue Care’ plan through Direct channels (online).

My Opinion

Typically, these kind of disease-specific health insurance plans are required only if the comprehensive or regular plans you have do not cover that particular disease.

Applicability of Sub-limits or co-payment clause is also an important aspect in a health insurance plan. Suppose you may have a regular mediclaim policy with Rs 3 Lakh cover, with a sub-limit of say Rs 20,000 for treating a specific disease. There can be restrictions on room-rent expenses. In such cases, you may have to bear the expenses from your pocket.

The main advantage of stand-alone plans like ‘Dengue care’ plan is there are no sub-limits and no co-payment clause. Also, the OPD expenses are covered to certain extent.

So, the decision to buy this kind of exclusive plans depends on your existing health insurance cover and its features. If you do not have any health insurance cover, it’s a high time that you bought a regular or a comprehensive medical insurance plan (it is advisable to have an independent health insurance cover even if you have a group mediclaim offered by your employer).

In case, if you have a regular plan but have sub-limits or any claim restrictions then you can consider buying ‘dengue care’ health insurance plan from Apollo Munich.

For more details, download Dengue Care plan Prospectus & Customer Information Sheet.

(Relakhs.com is not associated with Apollo Munich. This post is for information purpose only) (Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net)