With the rising levels of heart-related issues and medical conditions, all thanks to the lifestyle we have adopted, the fear of medical emergencies always looms over us. The health of our near and dear ones is also a constant source of concern. On top of this, if you happen to be a heart patient with a stent, the complications are an add-on to the pre-existing conditions. The insurance offered to these patients falls under a different category of insurance coverage. You need to first make an understanding that it is never just about a backup plan or a last resort when everything goes wrong. It has to be the most practical approach we need to be ready with to protect ourselves or our dear ones from the unprecedented future. 

Need for Health Insurance for Heart Patients

For heart patients with stents, the health insurance chosen needs to provide coverage that aligns well with the requirements they have. Under the broader spectrum, the main aim is to help them to cover the high treatment cost as part of the cardiac treatment they would opt for. In situations when there is no insurance, the total amount you end up spending can go up to several lakhs, which can quickly dry up your savings. 

So, here comes the biggest question? What is the exact need of securing yourself with a plan? There are certain pressing reasons why we need to buy the plan-

• Soaring Medical Costs: The swift incline in medical costs and inflation is sure to dry upyour pockets in the coming years. In the case of heart patients, prolonged treatment and multiple hospitalisations happen over the years. To pay up for all these expenses, the best possible way is to get secured with a health plan. 
• Pre-Existing Condition Coverage: Heart disease falls under the category of pre-existing conditions for insurance claims. The claim can only be made for your treatment once the waiting period cools off. It stands at around a maximum of 3 years. So, without a proper insurance plan, there is a high chance that the medical claim can get rejected if you fall ill during the waiting period.  Planning well ahead helps you to avoid these dire situations. 
• Lifelong Monitoring:  Heart patients need to be on regular medication and monitoring through their entire life, with the cost mounting up to more than 1,00,000 annually. Apart from that, under medical emergencies, the cost of treatment can go up to lakhs. The insurance can act as a safety net to help prevent financial constraints. 

What needs to be looked at in a Health Insurance Plan?

Just choose the first plan you see is not how it works with buying plans, especially health insurance for heart patients, as there are many factors to be taken into consideration. 

• Minimal waiting period: Make sure that before buying the plan, you check the pre-existing condition (PED) waiting period. Usually, there is a waiting time of 3 years, but some specialised health plans have it up to 90 days. Since any claim made during the waiting period can be rejected, it is always advisable to choose the plan that gets you the minimal waiting time. 
• Coverage terms: Ensure and double-check that the plan chosen covers stent placement/replacement and angioplasty, since many times health plans may not cover the cost of specific stent types you select, upgrades in the room selected, non-medical expenses, and the total time you need to wait. 
• Plan chosen: The plan you choose and the total coverage it provides is also quite critical under healthcare treatments you would opt for. With the rising medical inflation in India that stands at around 13%, a surgery/procedure that would usually cost around ₹3 lakh today can easily cost somewhere between ₹5.25- ₹6.75 lakh in the coming 5 years. So, it is best to look at plans that have a high replenishment limit, so that you get covered even if there are multiple procedures required. 

What are the Health Insurance Plans Available for Heart Patients?

Numerous health insurance plans are available for heart patients with stents. This is where Niva Bupa comes into the picture, where they offer the best services under their insurance claims. Their health insurance plans exclusively cover and give the best plans for people suffering from heart ailments and diseases. It gets categorised under family, rider or ailment specific health insurance plans. 

1. Family Health Insurance Policy-

   Under this plan, the coverage is provided for the entire family for all medical expenses for the insured family members. It broadly covers hospitalisation costs, pre- and post-hospitalisation expenses, and some in-hospital charges. As a person with a stent and heart ailment falls in the category of a pre-existing condition, even under this plan, they would need to pass the waiting period to get the benefit of the claim. 

2. Rider Plan to General Insurance Policy-

   It is also quite manageable to get a health insurance plan if you already have a pre-existing plan. In such a scenario, you can opt for the rider plan that acts as an add-on to the already existing one. Just give the insurer details of the heart issues you have, so that they can find the best rider plan. It is quite beneficial as the premium paid and the overall cost would be less than an individual medical insurance plan. 

3. Niva Bupa Criticare Insurance Policy -

   Under this plan, the patient gets coverage from around ₹3 lakhs to ₹2 crores. It also has a process of guaranteed renewal, along with offering a direct settlement option and a free review period of around 15 days. Under this plan, ailments like coronary bypass surgery, heart attack of certain intensity (first), open heart replacement, and stroke get covered. 

Mandatory Documents Required for Buying Health Insurance

Certain essential documents and reports need to be submitted while you are trying to buy a health insurance plan. These mainly include-

• Proof of Identity (Aadhaar/ Pan/ Driving Licence/Voter ID/Passport).
• Proof of Age (Birth Certificate/ 10th Marksheet/ Passport/Driving Licence).
• Address Proof (Aadhar/ Electricity Bill/ Voter ID).
• Passport-Size Photograph. 

As a heart patient with a stent, in addition to these basic mandatory documents, you will also need to submit medical reports-

• Documents for Surgery Done and Medical Reports 
• Test Reports- 
• ECG
• Echocardiogram
• Angiogram
• Stress
• Blood Sugar
• Liver Function
• Kidney Function
• Lipid Profile

Ensure that all the reports submitted are the latest. Your acceptance into a plan and subsequent claim highly depend on the clearance you receive after submission of all these primary and secondary documents and test reports, and verification.

Closing Up 

Buying a plan is one side of ensuring that your life is secured for a longer period of time. At Nuva Bupa, we ensure that we offer you the best of services and plans under health insurance for heart patients, so that your life ahead, even after a stent, is less of worry and more of merry. All the plans we provide as suggestions are the best out of the lot as per your specifications, that has much reduced premiums and the maximum coverage under the requirements made. While we ensure to take care of your health conditions with utmost priority, by providing the best insurance plan available, it is crucial that you, as an individual, make your lifestyle choices better, along with taking the right diet and exercising regularly.

Frequently Asked Questions

1. What is the most common reason for claim rejection for a heart patient?

   The main reason for the claim getting rejected is the patient not disclosing their pre-existing heart condition. This includes not sharing details of your surgery, stent replacement, if any, medications prescribed, or history of heart disease in the family. The insurer will be able to provide the best available medical plans if and only if you provide them with the severity of the health complication you have, so that they will be able to assess the risk accordingly. 

    

2. What factors affect the premium for heart patients with stents?

   The premium for heart patients with stents is calculated using medical underwriting. The company treats the stent as a pre-existing condition, which causes them to add a loading premium between 15% to 50%, which can vary, depending on the medical history of the individual patient. It is also influenced by the time duration since stent replacement, the present health status, age, medical history, and lifestyle factors. The policy you have applied for is also a key factor that affects the premium. 

    

3. Is it possible to get health insurance for a heart patient with multiple stents?

   The acceptance of the insurer towards their policy under conditions that you have multiple stents depends entirely on the plan you choose. Usually, once the full disclosure is made about the number of stents replaced, the company goes through the complete medical reports to assess the health risk and complications. An additional fitness certificate from your last cardiologist would also be needed as part of the verification process. Even though you would be able to get the health insurance, the premium loading can he higher, along with longer waiting periods.