News Analysis

Covid vaccine: Only a few health insurance policies provide cover

Bavadharini KS BL Research Bureau | Updated on August 27, 2020 Published on August 27, 2020

As Covid-19 vaccine is for those who are not infected with the virus, health insurance with OPD could cover for vaccine expenses.   -  Reuters

Policies that cover OPD expenses could reimburse vaccine expenses

Since the outbreak of Covid-19 pandemic, the insurance regulator and industry have helped ease the financial burden of policyholders by extending the grace period for premium payment, the introduction of standard health policies and Covid-19 health policies and some insurers even offered to continue cumulative bonus benefits. However, in the case of Covid-19 vaccination expenses, only specific health policies could cover for vaccine expenses.


OPD may cover

As Covid-19 vaccine is for those who are not infected with the virus, health insurance with OPD could cover for vaccine expenses. OPD refers to procedures that do not require a stay in the hospital and are done in the outpatient department. It covers costs including doctor’s consultation fees, pharmacy bills, dental treatment expenses and non-allopathic treatment.

Preventive care such as vaccination too may get covered, provided it doesn’t form part of exclusions. Many OPD plans usually exclude coverages of expenses on inoculation or vaccination (except for post-bite treatment and medical treatment for therapeutic reasons).

According to Sanjay Datta, Chief underwriting, claims and Reinsurance, ICICI Lombard General Insurance “If health policy covers OPD expenses and that include vaccinations, both for children and adults, then it will cover vaccine expenses.”


Therefore, those policies which specifically offer to include vaccinations as part of their system would cover for Covid-19 vaccine as well. For instance, in ICICI Lombard’s iHealth Plus plan, for an additional premium (under wellness and preventive care clause), the policy covers for routine physical and preventive examination, vaccinations, education, consultation and training programs such as nutrition tips, and exercise guidelines and pandemic preparedness in terms of providing necessary drugs and equipment to protect the insured. Similarly, Bajaj Allianz’s Health Care Supreme plan too covers for Covid-19 as part of OPD.

Rashmi Nandargi, Head, Health Retail, Underwriting, Bajaj Allianz General Insurance says “Vaccination will be covered under OPD plans, as hospital admission is not required for vaccination purpose. We would cover for Covid vaccine under our OPD policies provided it is prescribed by the (medical) consultant”

Further, since the outbreak of the virus, insurers have not only launched products to offer cover against Covid-19 but also provide cover for Covid-19 home treatments and protection equipment and kits. Vaccination expenses too could be included as part of basic cover later on.

According to Bhabatosh Mishra, Director Underwriting, Products & Claims at Max Bupa Health Insurance “Currently, Covid vaccination is not covered under indemnity plans available in the industry. However, in the foreseeable future, it being a critical need, we will evaluate covering it under our plans, once the Covid vaccine availability and pricing comes in”.

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Published on August 27, 2020
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