An allergic condition in India is a serious health issue as it is one of the top reasons why most of the population visit hospitals these days (Thakkar, 2016). Around 30% of the Indian population suffers from some kind of allergic condition and most reported cases include young adults between 25 and 30 years of age. These allergies are caused majorly due to the allergens in the environment like dust, smoke, pollens and pet dander. The increasing allergy prevalence and severity are also caused by increasing levels of pollution in India (Thakkar, 2016). The increasing prevalence of allergy in India has resulted in a big economic burden on the cost of treatment impacting allergic conditions treatment capability. Therefore, health insurance may improvise insurance-based aid to the management and improve allergic conditions treatment capability in India.
Classification of allergic condition treatment by medical insurance companies
Insurance companies in India classify allergic conditions as;
- Common allergic conditions: These are the common type of allergies caused by the allergens that are omnipresent in the environment like dust or pollen, for example- rashes on the skin, food allergies, sneezing, and breathing difficulties (IRDAI, 2017). These types of allergies do not lead to fatal conditions or death. They can be easily managed by taking medication or treatment that helps to fight against such an allergic reaction and can bring back the individual to normalcy.
- Severe allergic conditions: There are several conditions where the immune system of the individual causes an overreaction to some allergens, for example, asthma, rhinitis, eczema, etc. Such conditions can cause severe problems and even at some point can lead to loss of consciousness or major breathing issues. Therefore, severe allergies can lead to hospitalization or requirement of continuous major treatment plans of the affected individual (Samal, 2017).
Medical insurance coverage for allergic conditions treatment
The guidelines of IRDAI do not provide any provision for health insurance in cases of chronic allergic conditions. Health insurance coverage is only made in cases of severe allergic conditions such as asthma and allergic rhinitis (IRDAI, 2017). Severe allergic conditions that lead to hospitalization and require continuous treatments are considered eligible for medical insurance. IRDAI also lists insurance eligibility of immunotherapy which on the other hand helps in allergic conditions treatment (IRDAI, 2017). Therefore, it may be considered that immunotherapy-based treatment for allergy has insurance provisions. Most health insurance provides coverage for the expenses occurred for the treatment of allergic reactions triggered by sinus conditions (Policy Bazaar, 2017). So, only allergic asthma and allergic rhinitis are covered under insurance in cases of hospitalization. However, in recent years a few insurance companies have started to provide medical insurance to allergic cases undergoing AYUSH treatments (IRDAI, 2017).
Allergic conditions treatment capabilities in India
Studies report the prevalence of various forms of allergic conditions in India and are continuously rising. Allergic conditions treatment in India is majorly done via prescription medications in the form of oral medications, nasal sprays and/or eye drops. Another commonly used treatment for allergy available in India is Sub Cutaneous Immunotherapy (SCIT). Immunotherapy is also available for severe allergic conditions. Another most common allergy treatment is epinephrine. Costs of allergy based treatments are high with respect to immunotherapies.
It is estimated that per session of Rs. 1-1.5 lakhs which extend for over a period of 4-6 months. Similarly, SCIT which is a vaccination form of immunotherapy costs Rs. 1000 per shot. Annually, the Indian population spends almost 1000 crores on medications each year on an average (Ahmed, 2016). Increased research capabilities and medications expenditures indicate allergic conditions treatment capabilities in India. It also implicates that the insurance companies may start provision of coverage to the treatment of allergic conditions apart from asthma and allergic rhinitis.
Role of insurance in enabling allergic conditions treatment capabilities in India
Insurance plays a major role in managing severe allergic diseases by covering the major expenses of the treatment and therapies. This helps in mainly managing the allergic diseases in a better way because the economic burden caused by the allergic diseases will not hinder the process of the treatment (Ahmed, 2016). The insurance policies nowadays can also cover the patients suffering from a severe allergic disease of any age i.e. from children up to old age (Koul and Dhar, 2018). It also provides safety in the case of severe reaction to some allergens leading to hospitalization, while travelling.
Therefore, insurance policies can effectively increase the economic capacity of the country to deal with severe cases of allergies. This will lead to better treatment and a decrease in the prevalence of diseases (Koul and Dhar, 2018). The economic burden of allergic disease decreases with access to preventive care, early treatment, and the use of primary care health providers. This is, however, possible because of the usage of proper health insurance.
Health gain insurance in India
The health gain insurance is of two types; individual plan and family floater plan. The individual health gain plan covers the expenses of the disease of the individual insured, while the family floater plan covers several members of a single-family (Reliance General Insurance, 2018). This insurance covers the hospitalization, reimbursement, pre and posts hospitalization expenses and numerous other add-on features that will cover all the major expenses related to severe allergies.
Senior citizen medi-claim policy
This policy is for senior citizens who are in the age group of 65 years to 80 years. This policy also covers pre-existing medical conditions (Policy Bazaar, 2017). The senior citizen medi-claim policy is beneficial in case of allergies prevailing in old age.
Travel insurance along with the pre-existing medical coverage
This type of insurance protects the person suffering from an allergy in case of travel to a foreign land. This is due to the fact that while travelling to other places the allergies sometimes get triggered by some unknown allergens and becomes worse (ICICI Lombard, 2016). In that case, the travel insurance with the pre-existing medical condition waiver also covers the expenses of hospitalization. The only term that comes with this type of medical insurance is that the pre-existing medical condition must be stable from the past 3 months i.e. no changes in the severity of treatment.
- Ahmed, M.A., 2016. Comparative data review on prevalence, economic burden and epidemiology of Allergic rhinitis between the USA and India. Journal of Evolution of Medical and Dental Sciences, 5(45), pp.2940-2942.
- IRDAI, 2017. Insurance Regulatory and Development Authority
(Health Insurance) Regulations, 2013. [online] Available at: http://ayush.gov.in/sites/default/files/Gazette%20IRDA%202013.pdf
- ICICI Lombard. (2016) Pre-existing diseases and how they Affect Your Travel Insurance. Available at: https://www.icicilombard.com/insurance-information/travel-insurance-info/article/check-pre-existing-diseases-when-buying-travel-insurance (Accessed: 26 October 2018).
- Koul, P. A. and Dhar, R. (2018b) ‘Economic burden of asthma in India.’, Lung India : official organ of Indian Chest Society. Wolters Kluwer — Medknow Publications, 35(4), pp. 281–283. doi: 10.4103/lungindia.lungindia_220_18.
- Policy Bazaar (2017) Can I get a Health Insurance Policy if I have Allergies. Available at: https://www.policybazaar.com/health-insurance/general-info/articles/health-policy-for-allergies/ (Accessed: 26 October 2018).
- Policy Bazaar (2017) Senior Citizen Health Insurance: Mediclaim Policy for Senior Citizens. Available at: https://www.policybazaar.com/health-insurance/senior-citizen-health-insurance/?utm_source=organic&utm_medium=articles&utm_campaign=withintextlink (Accessed: 26 October 2018).
- Reliance General Insurance (2018) Health Insurance: HealthGain Medical Insurance. Available at: https://www.reliancegeneral.co.in/Insurance/Health-Insurance/Health-Gain-Insurance.aspx (Accessed: 26 October 2018).
- Samal, Chirag Mohanty. (2017) A guide to dealing with severe allergies. Available at: https://www.femina.in/wellness/health/a-guide-to-dealing-with-severe-allergies-61013.html (Accessed: 26 October 2018).
- Thakkar, Aniket. (2016) Can I get a Health Policy if I have allergies? Available at: https://www.coverfox.com/health-insurance/articles/can-i-get-a-health-policy-if-i-have-allergies/ (Accessed: 26 October 2018).