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Options for overseas medical treatment

LiveMint logoLiveMint 13-06-2017 Deepti Bhaskaran

When you travel abroad, it’s advisable to buy travel insurance. This insurance policy pays for medical emergencies other than insuring any flight inconveniences. It doesn’t of course cover planned hospitalization, but did you know there are health insurance plans that cover planned international hospitalization as well? Here we discuss some of these plans in the market and get views of experts.

A typical health insurance policy pays for your hospital bills but only if the hospitalization takes place in India. Now, some insurers have started offering health insurance that covers hospitalization abroad in addition to insurance in India. However, there are some caveats you need to be aware of. 

For instance, Apollo Munich Health Insurance Co. Ltd has a rider called Critical Advantage. A rider is like an add-on that you take with a base policy. So you can take Critical Advantage with any of Apollo Munich’s basic health insurance policies, provided the sum insured under the base policy is at least Rs10 lakh. However this rider specifically insures only against eight critical conditions like cancer, neurosurgery and coronary artery bypass surgery. The maximum sum insured under the rider is about Rs3 crore ($500,000). “Our plan also provides for travel expenses of the patient, one attendant and donor if applicable along with accommodation and complete hospitalization expenses up to the sum insured,” said Antony Jacob, chief executive officer, Apollo Munich. “The policy is cashless so the treatment takes place only in one of our network hospitals,” he added. Since this policy insures only planned hospitalization, you need to be diagnosed in India for treatment abroad. 

Max Bupa Health Insurance Co. Ltd covers international hospitalization under the platinum version of its plan called Heartbeat. This policy offers cashless treatment for nine critical illnesses as well as for emergency hospitalization abroad. The maximum sum insured under this plan is Rs1 crore. However, the policy doesn’t provide insurance covers in the US and Canada, and you need to pay extra to included these countries. You can also choose a co-pay up to 20% to lower the premium. 

Religare Health Insurance Co. Ltd offers two kinds of international health insurance covers: one that covers critical illness and the other that covers both planned and unplanned hospitalizations. “Our product care offers sum insured up to Rs 6 crore. For sum insured option from Rs50-75 lakh, international cover is available for 12 specified critical illnesses where we cover both planned and emergency hospitalization globally,” said Anuj Gulati, chief executive officer and managing director, Religare Health. “For sum insured option of Rs1 crore and above, our offering is unique where we offer global coverage of all conditions for both planned and emergency hospitalization,” he added. The maximum sum insured under this plan is Rs6 crore. For option of Rs1 crore and above, the policy doesn’t insure you for hospitalization in the US. You need to pay extra for it. It also has a co-pay clause of 10% for sum insured. Also, when you are abroad, the risk coverage period is 45 days per trip and 90 days cumulatively. So, if you are abroad and there is a medical emergency on the 47th day, the policy will not cover you. 

Then there is the Elite version of Royal Sundaram General Insurance Co. Ltd’s Lifeline plan, which is available for up to Rs1.5 crore of sum insured. This policy again offers two kinds of international covers: for emergencies of any kind and planned hospitalisations against 11 critical illnesses. For planned hospitalization it also offers to cover the return trip, to a maximum of Rs3 lakh. However, you need to pay extra to include coverage in the US and Canada. The planned hospitalization cover has a co-pay of 20% and in the first year it pays only 50% of the sum insured. 

Cigna TTK Health Insurance Co. Ltd offers international cover, but only for emergencies. “Our in-built benefit in ProHealth Insurance covers medical expenses incurred for emergency in-patient treatments for an illness or injury outside of India up to the sum insured chosen by the policyholder. The insurance claim is paid on a reimbursement basis only in India and in Indian rupees,” said Jyoti Punja, deputy chief executive officer, Cigna TTK. Also, you can claim worldwide emergency hospitalization only once in a policy year,” she added. The sum insured in this health insurance plan is Rs1 crore. 

While international covers are a solution if you wish to get treatment abroad, they are not a substitute for travel insurance policies. “Some international covers only pay for planned hospitalization whereas travel insurance covers flight inconveniences and emergency hospitalization,” said Nikhil Apte, chief product officer, Royal Sundaram. “However these products compliment a travel insurance plan as travel insurance will typically never insure a pre-exiting disease but international covers will after the waiting period is over,” added Apte. 

These plans can also be very expensive. For instance,  a 30-year-old buying a sum insured of Rs 50 lakh, would have to pay Rs50,000 to cover planned hospitalization and emergencies. Planned hospitalization that insures only critical illnesses, would cost about Rs25,000 and a pure domestic policy would cost around Rs18,300. “Buying a high sum insured health insurance with comprehensive international cover can be expensive and some insurers offer riders that are more cost-effective because the benefits are sharply defined and available at lower base sum insured as well,” said Kapil Mehta, co-founder, SecureNow.in. “Generally, the sum insured available is insufficient for overseas care, plus post-hospitalisation expenses are excluded. This means that you may still end up paying over 50% of the costs out of pocket,” he added. 

As per Mahavir Chopra, director, health, life and strategic initiatives, Coverfox.com, these plans may make sense for high net-worth individuals. “Mobility has improved considerably and more people are now keen to travel abroad for treatment. Some policyholders opt for very high covers and for them having some sort of international coverage helps,” he said. 

As per Nayan C. Shah, MD, Paramount Health Services (TPA) Pvt. Ltd, these are early days before insurers eventually start offering global policies. “It helps if the policy also takes care of ancillary expenses like travel and accommodation. Even employers that send employees abroad are interested in global covers but for that the policy needs to offer OPD as well as in-patient treatment without any caps. Such policies are available and plans in India need to develop to that level,” he said. So while health insurance plans that cover international hospitalization may excite you, keep in mind the costs and restrictions. 

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