Convalescence Benefit in Health Insurance

Convalescence refers to the period of time needed for a patient to recover from their disease or illness. For people who are admitted to the hospital for a prolonged period of time, health insurance companies provide the convalescence benefit. The convalescence benefit allowspolicyholders to get a lump-sum amount of money to cover their extended stay in the hospital.Some insurers may also provide coverage for a few other features under the convalescence benefit such as family visits.

The medical costs in India are rising by the day. During such times, a health insurance plan ensures that your medical expenses are well taken care of. And that’s not it! There are a few benefits of health insurance plans that people are still unaware of, one such example being the convalescence benefit.

Depending on your health condition, you might be required to get hospitalised for a prolonged period. The convalescence benefit meaning in health insurance is that it covers the expenses for long term hospitalisation and post-discharge recovery. This useful feature helps cover the loss of income experienced in case of prolonged hospitalisation by providing a lump sum amount for the recovery. This recovery period is termed as convalescence and is usually for 7-10 days but it may vary depending on the insurer.

For instance, if an individual needs bed rest for a period of 15 days and their insurance offers convalescence benefit, then they may receive a certain amount of money (depending on the max convalescence limit) for recovery post-discharge. Here, this amount acts as a backup for situations like loss of income during that period.

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024. The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918

Policyholders who buy health insurance plans are mostly unaware of the convalescence benefits available under it. With this feature, the insurer compensates you for the loss of income while you are hospitalised. It ensures that you have enough funds to last through your recovery period so that you or your family members do not have to dip into hard-earned savings.

The convalescence benefit kicks in only after a few days of hospitalisation have passed, and the amount of days differs based on different plans offered by different insurers. You should claim the convalescence benefit during hospitalisation when the minimum period of hospitalisation for convalescence eligibility in your health insurance plan has passed. You can use the extra cash from this benefit to cover any lost income due to hospitalisation and take care of your expenses.

Many a time, the convalescence benefit also covers compassionate visits under it. That means if any of your family members live away from you and want to visit you in the hospital, their conveyance expenses will be taken care of by the insurer. However, this may differ from one insurance provider to another and thus, it is recommended to read the fine print beforehand.

Here are the simple steps you can follow to buy health insurance with convalescence benefits:

• Step 1: Visit the ‘Health Insurance Calculator’ on the Bajaj Markets website.

• Step 2: Enter your personal details on the form that appears on the page.

• Step 3: Look for insurance policies that have the ‘Convalescence Benefit’ as part of the plan.

• Step 4: Select a plan that suits your specific requirements with the convalescence benefit.

• Step 5: Pay the online premiums for your chosen health insurance and it will soon be sent to you.

Health Insurance Plans at Bajaj Markets Offering Convalescence Benefit

Disclaimer: You must read all the policy details for each plan to make sure the convalescence benefit is available for the plan you wish to buy. You can also buy the convalescence benefit as an add-on cover.

Premium rates mentioned above for the above health insurance plans are not constant and subject to change over time.

Here are some important points related to the convalescence benefit in health insurance that you should be aware of:

• The convalescence benefit is available for both individual as well as group health insurance plans.

• The patient must be admitted to the hospital for a period of at least 7-10 days for the convalescence benefit to kick in. However, this period may vary among different insurance providers.

• This benefit under some plans may also cover the cost of travel expenses for your visitors.

• The convalescence benefit is completely separate from the cover that is provided for medical expenses.