Mpox in India: How can standard health insurance provide financial immunity?

The Indian government confirmed the First case of Mpox On Monday, alarm was raised over the transmission of the virus in the country. This coincides with the prevalence of other infectious and vector-borne diseases, such as malaria, dengue, chikungunya, etc., which increases concerns about rising medical costs.

He World Health Organization The United Nations (WHO) declared Mpox clade 1 variant, a viral disease caused by monkeypox virus, a Public Health Emergency of International Concern in August 2024. However, the Union Health Ministry confirmed that the Mpox patient in India was infected with clade 2 variant, which is not part of the current public health emergency. Mpox outbreak persists, let us understand how health insurance plans provide financial immunity against such diseases.

Is a standard health insurance plan enough for Mpox?

According to health experts, most basic health insurance plans cover medical expenses for monkeypox as it is classified as an infectious disease. “Since monkeypox is classified as an infectious disease, the costs associated with hospitalization, diagnostic tests and treatment are usually included in the standard provisions of comprehensive health insurance policies. However, it is always advisable to check the specific details of your policy or check with your insurer to confirm the extent of coverage,” said Rakesh Jain, CEO, Reliance General Insurance.

The rising costs of hospitalization for viral infections

From doctor’s visits to medical examinations, the usual treatment for viral infections has become expensive, especially in metropolises. The cost of treatment increases significantly if hospitalization is involved.

“The cost of treating severe viral infections can exceed ₹10- ₹15 lakh, especially in private hospitals in major cities,” said Siddharth Singhal, Director – Health Insurance, Policybazaar. He also recommended that people residing in metropolitan cities opt for health insurance with a sum insured of ₹1 crore.

Should I purchase specific infectious disease coverage?

Specific infectious disease coverages or vector-borne disease riders can enhance the benefits of a standard health insurance policy by providing additional benefits. A common infectious disease, such as dengue or malaria, can also result in longer hospital stays.

“Policyholders may face the additional challenge of losing their job due to prolonged illness. To help mitigate this financial burden, riders or add-on covers can prove very beneficial. These optional benefits can be added to an existing health insurance policy. For example, a hospital cash rider provides a daily cash allowance during hospitalization, helping to cover unexpected expenses,” said Rakesh Jain.

However, due to low popularity, the market offers fewer options for coverages or riders for specific infectious diseases. “In the past, companies had tried specialised insurance products to deal with mosquito-borne diseases (malaria/dengue), but they were unable to attract a good number of customers due to lack of interest in a policy that is needed for a few weeks in a year,” said SK Sethi, co-chairman, BFSI Committee.

Comprehensive coverage and telemedicine services

Experts also urge people to opt for a comprehensive health insurance policy that covers pre- and post-hospitalization expenses as well as other costs like outpatient care expenses, ambulance charges, ICU fees, etc.

Parthanil Ghosh, Director & Chief Commercial Officer, HDFC ERGO General Insurance, highlights the need for adequate sum insured cover and advises insurance buyers to check the ‘claim payout ratio of the insurance company’ for better reliability and efficient processing of claims. He also recommends opting for a policy that offers telemedicine services.

“Several insurers are also using telemedicine, another facet of medical technology, to ensure accessibility to healthcare, which becomes crucial in case of quarantine or when physically visiting a doctor is not possible,” added Parthanil Ghosh.

How are insurers adapting to frequent disease outbreaks?

Several insurance companies are updating their risk assessment approach and policies to better serve customers during outbreaks. “Now, insurers are also adapting to the increasing frequency of global disease outbreaks by leveraging data-driven underwriting for better risk assessment and integrating telemedicine and digital health services. Additionally, insurers are partnering with healthcare providers and aligning with international health guidelines to ensure better access to care during outbreaks,” noted Siddharth Singhal.