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Does health insurance cover Multiple Sclerosis in India?

Team AckoJan 17, 2024

Health insurance offers financial protection against most medical emergencies. But, there are diseases and health hazards that regular health insurance may not cover. In this article, we will be discussing a critical autoimmune disease called Multiple Sclerosis.

Although this disease cannot be cured, it can be treated. However, the expenses may be a strain on your wallet. Read ahead to know if health insurance covers multiple sclerosis in India.




What is Multiple Sclerosis in India?

Multiple Sclerosis, aka encephalomyelitis disseminata, is an autoimmune disease in which the immune system of the body damages the protective layer of nerves called “Myelin”. This disrupts the flow of information from the brain to the rest of the body, causing coordination issues in the neural networks of the body.

Multiple Sclerosis, is a progressive disease, i.e., it worsens with time. Also, its severity can escalate rapidly without proper treatment. Some of the symptoms of Multiple Sclerosis include lack of balance, bladder control issues and vision problems. According to the Multiple Sclerosis Society of India (MSSI) two lakh Indians are currently affected by Multiple Sclerosis.

Is Multiple Sclerosis covered under health insurance?

Although regular health insurance covers many medical scenarios, it may not offer coverage for Multiple Sclerosis disease. That is why you should also consider buying a Critical Illness plan on top of your basic health insurance plan. Also, note that a regular health insurance plan only offers limited cover and the sum insured may not be sufficient for every medical condition.

What is a Critical Illness Health Insurance Plan?

In a Critical Illness plan, the insured is provided with a bulk amount if diagnosed with a disease mentioned under the plan. Also, the insured gets to decide how they spend that money. The sum insured is much higher than a regular insurance plan and usually spans between Rs. 5 to 50 lakhs.

Also, read: Buy 1 Crore Health Insurance Plan

Diseases covered under a Critical Illness plan

Below are some of the common diseases covered under a Critical Illness Plan. The exact list of diseases may vary from insurer to insurer.

  • Heart attack

  • Cancer

  • Stroke

  • Coronary artery bypass surgery

  • Paralysis

  • Multiple Sclerosis

  • Etc.

Why buy a Critical Illness plan?

With the rising cost of living, being ill and not being able to work could cause a lot of financial stress. Investing in a Critical Illness plan gives you a financial cushion in such situations. Your insurer will give you a lump sum amount that you can use for your medical treatments and other expenses. Also, if you have dependents, they can benefit from this monetary compensation.

What is the difference between a health insurance plan and a Critical Illness plan?

As mentioned earlier, Multiple Sclerosis disease may not be an inclusion under a regular health insurance plan. However, in the context of critical illnesses, a regular health insurance plan covers only hospitalisation expenses. A Critical Illness plan, on the other hand, offers a bulk amount when the insured gets diagnosed with an illness that is included under the plan. This amount can be used for medical treatments and other expenses.

Also, read; Difference between a health insurance plan vs critical illness plan

Benefits of a Critical Illness plan

Here are some of the key benefits of opting for a Critical Illness Plan.

  • In the unfortunate event of getting diagnosed with a critical illness, you can receive a guaranteed bulk sum. The exact sum depends upon the terms of the plan you choose.

  • If you get diagnosed with a critical disease, after your treatment expenses are met, your dependents can benefit from the residual financial compensation.

  • As per the Income Tax Act of 1961, you can enjoy a tax benefit if you buy a Critical Illness plan (this benefit is applicable as per the current Tax Regime).

  • In the event of accidental death, the nominee of the insurance plan will receive a sum assured as stated in the policy document.

  • If the insured suffers from permanent disability due to an accident, they can avail a waiver of premium for disability.

The claim process of a Critical Illness plan

Unlike a regular health insurance plan, you cannot make multiple claims in a Critical Illness plan. Once you share your diagnosis for a disease listed under the plan, your insurer will usually approve the claim and give you a one-time settlement of a lump sum amount. In most cases, after this, your plan will become void, and you will not be able to use it any longer.

Tips to choose the best Critical Illness plan

Below are some guidelines that will help you choose the best Critical Illness plan.

  • Select a plan that has a reasonably high sum assured amount. This will give you abundant leeway if you become critically ill and can't work.

  • If you buy a Critical Illness plan at a young age, you will be eligible for a high sum assured at a low premium.

  • Choose a plan that has a high exit age. This will maximise the duration you can enjoy the financial protection offered by the plan.

  • Review the policy document thoroughly and find out the inclusions of the plan. Choose a plan that includes all the common critical illnesses.

Wrapping up

The cases of Multiple Sclerosis are increasing in India. And so, it is important to be financially protected against it. Since regular health insurance may not cover Multiple Sclerosis it is better to buy a separate Critical Illness plan. A Critical Illness plan will also cover you for other diseases like Myocardial Infarction, Stroke, Cancer, etc.

Frequently asked questions

Below are some of the frequently asked questions regarding Multiple Sclerosis and Critical Illness plans.

Is there a waiting period for a Critical Illness Plan?


Yes, usually there is a waiting period for the plan to become active. The exact period depends upon the plan you choose. The waiting period starts from when the plan commences.

Is it possible to buy a Critical Illness plan after getting diagnosed with a disease?


If you have a pre-existing disease, you will not be eligible to buy a critical illness plan. This plan does not cover health conditions that you have received treatment or medical advice for during the 48 months before buying the policy. Please refer to the terms and conditions of your policy for details.

Is a medical examination necessary for purchasing a Critical Illness plan?


Before buying a Critical Insurance plan, you usually have to submit your medical history. Based on its review, your insurer will allot medical tests for you to undertake. If any relevant medical information is hidden, your insurer has the right to deny claims in the future.

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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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