Mysterious Pneumonia Outbreak in China: Can Your Health Plan Protect Your Child? Here's What Experts Say

Health insurance plays an important role in covering the financial costs associated with respiratory illnesses.
Secure Your Life with Health and Term Plans Amidst Global Pandemic
Secure Your Life with Health and Term Plans Amidst Global Pandemic

As COVID-19 infections recede, China is witnessing a surge in new and mysterious respiratory illnesses, especially among children in the country's northern region. This illness has raised concerns among parents, government agencies and healthcare providers alike. The outbreak has flu-like symptoms and is characterized by lung inflammation and high fever. This has led to rise in hospitalizations in big Chinese cities, particularly in Beijing. Investigators are trying to find out the exact cause of this outbreak, but they suspect it may be due to a post-Covid phenomenon called 'immunity debt'. This debt stems from a reduction in exposure to common viruses and bacteria due to Covid-related lockdowns, which creates a surge in cases once these restrictions are lifted and people get exposed to these infections again. Since their immune system was not adequately challenged during lockdowns, it makes them more susceptible to these infections.

Also Read: Artificial Intelligence In Personal Finance: Its Pros, Cons And How To Make The Most Of It

While there is no specific vaccine or treatment for this mysterious pneumonia outbreak from China, parents must get their wards vaccinated as prescribed by health experts, especially for influenza, maintain hand and cough hygiene, avoid close contact with sick individuals and monitor symptoms.

Health Insurance Against Mystery Disease

Health insurance plays an important role in covering the financial costs associated with respiratory illnesses. This includes fees for doctor visits, diagnostic tests, and hospitalizations. You should review your health insurance policy carefully and understand the specific coverage for respiratory illnesses and any out-of-pocket costs. Here's what Insurance experts are saying about this issue:

Adhil Shetty, CEO, Most health insurance plans in India cover the treatment of respiratory illnesses, including pneumonia. However, there may be some limitations to the coverage, such as limits on the number of days that a child can be hospitalized or on the amount of money that will be reimbursed for treatment. It is important to read the terms and conditions of your health insurance plan carefully to understand what is covered. You can check your health insurance plan by contacting your insurance provider or by looking at your policy documents. You can also search for a plan on the website of the Insurance Regulatory and Development Authority of India (IRDAI). It is recommended to remember that insurance coverage can vary widely based on the type of plan, policy terms, and the insurance company. It's crucial to review the policy documents carefully or consult with the insurance provider directly to understand the extent of coverage for respiratory illnesses in children under your specific plan.

Syed Meraj Naqvi, CEO & Principal Officer, Riskbirbal Insurance Brokers Private Ltd.: The insurance policies of most insurance companies are meticulously designed to offer comprehensive coverage for a diverse range of medical conditions, including respiratory illnesses such as COVID-19 and SARS. As the nature of the current respiratory situation reported in China is mysterious, the insurance industry is in continuous communication with relevant health authorities and stands ready to adapt its offerings as needed to address the evolving landscape. In my opinion, the primary step is to assist clients in gauging the situation, help them understand various health insurance coverage plans, address queries, and explore options that best suit their health and well-being.

The health insurance industry is proactively reviewing its policies to ensure that customers maintain the necessary protection. We underscore the importance of robust health coverage in mitigating potential financial risks associated with unforeseen health challenges. As experienced during the COVID-19 pandemic, during these challenging times, it is primordial to educate and reassure customers that health insurance companies are always there to support them in their time of need.

Rakesh Goyal, Director of Probus Insurance Broker: Most health plans offer limited coverage for children, focusing only on hospitalization expenses. However, in the face of emerging global health threats like the mysterious respiratory illness affecting children in China, parents need to have comprehensive health insurance for their kids to ease the financial burden of treatment. Health insurers need to design supplemental policies that offer outpatient coverage for children to cover the costs of doctor consultations, tests and medications in case of infectious diseases. This will ensure children can access timely medical care without financial constraints. National-level schemes and state-run insurance programs also cover certain outpatient expenses for kids. However, their pan-India portability and benefits may vary. For superior protection against emerging global health threats, parents can consider top-up plans with international coverage in addition to basic health insurance. This will ensure children have financial security for both domestic and overseas medical emergencies.

S.K. Raghav, M.D. Lords Mark Insurance Broking Services Pvt. Ltd.: The health insurance sector is closely monitoring the developing scenario due to the respiratory outbreak in China. At the moment, as per the assessment of the Union Health Ministry, the risk is lower from the H9N2 avian influenza case and the clusters of respiratory illness in China. Insurance coverage for respiratory illnesses in children can vary depending on several factors, including the type of insurance plan, the specific illness, and the terms of the policy.

Most health insurance plans typically cover respiratory illnesses in children, including conditions such as asthma, bronchitis, pneumonia, and others. Here are some points to consider:

Health Insurance Coverage: Most health insurance plans cover doctor visits, medications, hospitalizations, and treatments related to respiratory illnesses. It's essential to review your insurance policy or contact your insurance provider to understand the specifics of your coverage.

Specialized Treatments: Some respiratory illnesses might require specialized treatments or medications. Check if these are covered by your insurance and if there are any limitations or requirements, such as pre-authorizations or referrals.

Out-of-Pocket Costs: Even with insurance coverage, there might be out-of-pocket costs like copayments, deductibles, or coinsurance. Understanding these expenses can help in planning for potential medical costs.

Preventive Care: Many insurance plans cover preventive measures such as vaccinations or regular check-ups, which can help in preventing respiratory illnesses or managing them effectively.

Network Providers: Insurance plans often have networks of preferred providers. Visiting in-network doctors or hospitals can reduce costs, so it's a good idea to confirm if your child's healthcare provider is within your insurance network.

Pre-Existing Conditions: Some insurance plans may have limitations or waiting periods for pre-existing conditions. If your child has a pre-existing respiratory condition, review how it is covered under your policy.

Always review your insurance policy documents, talk to your insurance provider, and ask specific questions about coverage related to respiratory illnesses in children to ensure you understand what is covered and what might incur additional costs. It is better to contact an Insurance Broker licensed by IRDAI, to provide the advisory services to the insured.

Related Stories

No stories found.
Outlook Business & Money