Travel insurance policies taken in India can provide medical cover when abroad. But there is a sea of difference between plain travel insurance and global medical cover. Travel insurance delivers emergency care only, which enables a trip back home for the policyholder to resume treatment here, if needed. But on the other hand, a few health insurance policies allow for planned global medical coverage, which enables inpatient hospitalisation in other countries. For policyholders considering overseas travel or treatment, it is necessary to keep abreast of the insurance policies available and the conditions that come attached with the same.
Medical cover in travel insurance
Medical covers in travel insurance range from $100,000 to $1 million and travellers are recommended to purchase insurance above $500,000 when travelling to developed countries. Travel insurance policies covering medical, trip-related and baggage-related covers would cost the policyholder less than ₹2,000 for a week’s trip to the US. But the medical cover converted to domestic currency should not inspire false confidence.
Only injury or sickness occurring during the trip are covered by this medical cover up to the sum insured. Any pre-existing disease or even complications arising from PED are not covered. If the attending physician or doctor judges that the current episode is a part of a pre-existing disease, coverage would be waived for the policyholder and expenses to be borne by them. This would add a large financial burden, especially if occurring in high-income countries.
A life-threatening medical emergency on account of PED is covered, but only to relieve acute stress or pain and facilitate travel back home. This PED emergency sub-limit ranges from $2,000 to $5,000.
The main prerequisite for medical care to be availed from travel insurance is that it should be vetted by a medical assistance company. As the travel policyholder anticipates the need for medical care, an ‘assistance company’ should be notified. This company, which is mostly managed by the TPA (Third party administrator), is notified beforehand to the policyholder at the time of travel. When the assistance company is notified of a medical emergency resulting from an accident or sickness, they will contact the medical facility relevant to the policyholder’s location. In consultation with a physician, a best course of action will be determined, and necessary arrangements will be made by the insurer through the medical assistance company. Depending on the severity of the sickness or injury, the medical care will be again limited to fit-to-travel status of the policyholder. The policyholder can get appropriate treatment under the same travel insurance in India till a period of 90 days after the trip ends, based on the policy features.
Global medical covers
While medical cover under travel insurance is more ad hoc in nature, there are regular health policies offering global medical coverage. There are at least three insurers who are offering covers for planned medical care outside of India. Tata AIG’s Global Combo – ₹1.1-crore cover costs ₹16,440 per year for a 30-year-old compared with ₹12,619 for regular policy. Similarly, Reliance’s Health Infinity (More Global) cover of ₹1 crore that includes global coverage has a premium of ₹20,500 and Care Health’s Global Coverage costs ₹72,190 for the same cover at the upper end of premiums.
These policies will cover for planned medical expenses of the insured person incurred outside India, up to the sum insured, provided the diagnosis was made in India and the insured travels abroad for treatment. This obviously indicates that such treatment cannot be provided in the country.
But the policies may not be entirely on a cashless basis. It may also be on reimbursement basis, which is dependent on the geography of the medical care. Also, PED exclusion of three years does apply as in regular medical insurance.
The sum insured along with cumulative bonus accrued over the years may be used. Care Health may also allow restoration of cover for global coverage. With new-age policies allowing for 50-200 per cent increase in sum insured in four-six years, a significant cover amount which is appropriate for treatments outside of India may be accumulated on a No claim basis. Treatments like gene therapy and advanced cancer care are now available for policyholders with these policies. Tata AIG’s Global policy also includes compassionate travel allowance within the cover, giving room for a companion to join the policyholder for the overseas treatment.