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Does health insurance cover Crohn’s disease?

Team AckoNov 3, 2023

Inflammation in the digestive tract can be annoying and frustrating due to the discomfort caused by Crohn’s disease. Another thing for those with Crohn’s disease is the need to manage the cost of treating the condition. The cost of tests and treatments can be expensive. The below sections dwells into everything about the disease and if there are health insurance plans that cover Crohn’s disease.

Does Health Insurance Cover Crohn’s Disease in India?

Contents

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What is Crohn’s disease?

Crohn’s disease, is a condition that deals with inflammation in your digestive tract. Characterised under Inflammatory Bowel Disease (IBD) causes painful swelling and irritation in the digestive tract. You might experience symptoms such as diarrhoea, belly pain, rectal bleeding and weight loss. Medical practitioners usually diagnose Crohn’s disease through a physical examination. You may also have to undergo X-rays and diagnostic tests and, in some cases, biopsy tests to look inside the colon to check if it is cancerous.

The disease is usually treated through medicine. However, the treatment depends on your symptoms and how bad they are. This brings us to whether Crohn’s disease is covered by health insurance. Read on to learn about it in the following section.

Does your health insurance policy cover Crohn’s disease?

Yes, health insurance plans in India cover the treatment for Crohn’s disease. There are several Critical Illness Insurance Plans that might cover the cost of the treatment of the illness. Typically, these plans offer a lump sum payment based on the sum insured you have opted for.

That said, not all health insurance plans cover the disease. Read the terms and conditions of the plans thoroughly before you buy.

Depending on the type of coverage, you might be covered for hospitlisation expenses, daycare procedures, outpatient consultations costs, diagnostic tests, ambulance services, etc. It is better to compare the different health plans online to make the right choice.

Types of Crohn’s disease

Since the inflammation is in the digestive tract, it can affect different parts of the tract. Here are the types of Crohn’s disease.

  • Ileitis: Inflammation and swelling in the small intestine.

  • Ileocolitis: Inflammation in the small intestine and part of the large intestine, or colon.

  • Jejunoileitis: Small patches of inflammation in the upper part of the small intestine.

  • Gastroduodenal: Irritation and inflammation in the stomach and the upper part of the small intestine.

Symptoms and causes of Crohn’s disease

Following are the symptoms and what causes Crohn’s disease.

Symptoms

Causes

  • Autoimmunity

  • Genes

  • Smoking

  • Environmental factors

  • Excessive intake of oily and spicy food

Treatment of Crohn’s disease

The treatment for Crohn’s disease differs depending on the symptoms and the severity of the disease. Your medical practitioner might recommend one or more of the following treatments for Crohn’s disease.

  • Antibiotics

  • Antidiarrheal medication

  • Bowel rest

  • Steroids

  • Immunomodulators

  • Surgery

Coverage for Chronic Illnesses in Health Insurance Plans

In India, many health insurance plans cover chronic illnesses, but there's usually a waiting period, typically around 2 years. If you're already diagnosed with a chronic condition before getting the policy, it's considered a pre-existing condition, and you won't be able to make claims during the waiting period.

The specific waiting period and other terms vary depending on the insurance policy you select, so it's essential to carefully review the policy details before choosing one.

Crohn's Disease and Health Insurance Coverage

In India, health insurance plans usually cover Crohn's disease, but it's essential to check the specific policy details. Many insurers include Crohn's disease in their coverage for hospitalisation, treatment, and medication expenses.

However, pre-existing conditions might have a waiting period (typically around 2-4 years) before they're covered. If you're diagnosed before buying the policy, the waiting period for Crohn's disease might apply. Some plans might have specific terms or higher premiums due to the chronic nature of Crohn's.

Before choosing a health insurance plan, carefully read the policy documents, check for inclusions related to Crohn's disease, waiting periods, and any limitations or additional costs that may apply. It's always best to clarify with the insurance provider to understand the coverage details for Crohn's disease.

Steps to Maximise Health Insurance Coverage for Crohn's Disease

  1. Assess your needs: Consider what Crohn's management involves to find a plan covering those needs.

  2. Get comprehensive coverage: Review plans covering all Crohn's expenses, like treatments and medications.

  3. Choose the right provider: Opt for plans including specialists experienced in treating Crohn's disease.

  4. Check the cost: Understand cost-sharing to ensure the plan is affordable for your budget.

For claim-related support:

  1. Keep records: Save all medical bills and records for insurance claims.

  2. Follow guidelines: Understand the insurer's requirements for claim documentation.

  3. Maintain timeline: Work with healthcare providers for accurate and timely document submission.

  4. Follow-up: Keep track of claims and promptly resolve any issues or delays.

Additional support:

  1. Seek guidance: Get help from insurance brokers or healthcare advocates for plan selection.

  2. Join support groups: Connect with others in patient support groups for insights on insurance coverage.

  3. Research advocacy groups: Find organizations offering guidance and resources for Crohn's patients.

  4. Know your rights: Understand your rights concerning health insurance coverage for pre-existing conditions like Crohn's.

Waiting period for Crohn’s disease in health insurance

The waiting period for Crohn’s disease in health insurance depends on the insurer. From no waiting period to a certain number of days can be the waiting period for the coverage of Crohn’s disease in health insurance.

At ACKO, there is a Zero Waiting period for treatment of Crohn’s disease with the 1 crore health insurance plan. You need to make sure that you disclose pre-existing diseases at the time of buying ACKO’s health insurance plan to avoid rejection of claims.

It is better to refer to the terms and conditions of the policy to understand the required waiting period before you can raise a claim against the medical cost involved in treating the disease.

How Can You Protect Yourself Against Crohn’s Disease?

Here are some ways you can try to prevent Crohn’s disease.

  • Follow a few dietary rules by avoiding troublesome, oily or spicy food and drinking lots of water.

  • Learn to manage stress by exercising regularly, Yoga and meditation.

  • If your current lifestyle is causing the disease, make the required changes to suit your digestive system.

In a nutshell

Inflammation in your digestive system can be a hassle, and if you don’t treat it during the early stages, you may end up dealing with Crohn’s disease lifelong. It is prudent to make lifestyle changes and ensure you eat nutritional food. Besides changes to your lifestyle, it is better to buy a health insurance plan or Critical Illness Cover that provides financial protection against the medical expenses in treating Crohn’s disease. Remember to compare the plans and read the terms and conditions to choose the best health insurance plan.

Frequently asked questions

Here are common queries about health insurance cover for Crohn’s disease.

Is Crohn’s disease considered a pre-existing condition in health insurance?

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Yes, the insurance company could consider the disease a pre-existing condition.

Which is the most suitable health insurance plan for Crohn’s disease coverage?

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Not all regular health insurance plans cover the medical cost to treat Crohn’s disease. However, you can buy the Critical Illness Cover, which may offer coverage for the treatment of Crohn’s disease.

Are there any natural remedies for treating Crohn’s disease?

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You must alter your lifestyle and eating habits to ensure you are not affected by the disease. There are natural remedies to reduce inflammation, such as increasing the intake of probiotic drinks and diets that enable the digestion of food.

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Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet; and is subject to changes. Please go through the applicable policy wordings for updated ACKO-centric content and before making any insurance-related decisions.

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