Does Health Insurance Cover Heart Related Diseases?

Read everything there is to know about the various insurance plans for heart ailments available in the market.

Does Health Insurance Cover Heart Related Diseases?

Heart diseases have claimed almost 28.1%  of deaths in the country, according to a report released by the Indian Council of Medical Research, the Public Health Foundation of India, and the Institute for Health Metrics and Evaluation in 2017. This decade will only see this figure go higher up.

Only 10 years back, heart related conditions were something that troubled people who were 50 years and above. The numbers are now fast changing with so many people living less than healthy lifestyles. The University of Florida reports that despite nearly 20% of Indians being pure vegetarians, the country witnessed the highest number of people being diagnosed with CAD or coronary artery conditions. 

With 25% of heart attacks being recorded under the below 40 age group, it is time for Indians to ensure that they have adequate health insurance with heart-related diseases coverage. 

Taking Up Cardiac Care

A number of key insurance companies offer exclusive health insurance plans for heart patients in India. The new Cardiac Care Plan has been designed as a health solution for anyone who has a family history of cardiac diseases or has personally undergone cardiac procedures, for example, an angioplasty or a bypass surgery in the past. 

With such a policy in place, you are ensured the finest treatment and access to the best medical care that your sum assured under the policy can provide. This prevents any additional financial burdens on your family in case of a medical emergency since such treatment costs for heart diseases can be quite exorbitant. 

Related: Your guide to health insurance

Standard Critical Care Vs. Cardiac Plan

Standard Critical Care Health Insurance Plans mostly do not provide a cover against pre-existing conditions. This has driven insurance companies to come up with a dedicated health policy for heart diseases which does not have such an exclusion.

For example, let's say, you have a yearly income of Rs. 7,00,000 and are able to save 10% of that over a period of two decades. Estimating salary inflation of 10% annually, if you have to undergo a cardiac surgery 5 years into your work life, you will undoubtedly use up a chunk of your savings. In such a scenario, your Standard Critical Care cover may not insure you against every aspect of a medical situation. However, if you have a Cardiac Insurance Plan, your savings will not suffer a dent and can contribute towards reaching your future life goals.

Waiting Out the Waiting Period 

Anyone between the ages of 10 and 65 can apply for a health policy specific to heart diseases. 

Most insurance companies adhere to a six month to a three year application period for individuals who have had heart-related surgery in the past. Policy applications will not be entertained before six months or after the three year period. This is because of the potential high-risk that insurance companies may have to handle during critical conditions. 

Most policies do have a short waiting period which typically lasts for 91 days from the date that the policy has become valid. Generally, this clause applies to individuals who have had cardiac procedures such as angioplasty or bypass surgery in the past two or three years.  

The plan also covers other pre-existing diseases apart from heart conditions from the fifth year of the policy. Other conditions, for example, knee replacement surgery, hernia, piles, cataracts, sinus etc. are generally covered after a period of two years. 

Related: Unique features offered by different health insurers

Cardiac Care Coverage

You will have to undergo a battery of test before your policy gets approved. Besides the obvious advantages, a typical Cardiac Care Plan offers the following:

  • It acts as a regular health care plan and offers insurance against critical conditions. It also covers all types of heart-related diseases.
  • Premiums can be affordable if you research and buy the plan after comparing it with its competitors.
  • The option of a fixed lump sum payout as opposed to actual expenditures incurred in case of diagnostic screening or related medical procedures.
  • Specific policies offer hospitalisation benefit in terms of a lump sum payout.
  • Tax benefits under Section 80D of the Income Tax Act 1961.

Your Takeaway

The future is unpredictable. But you have the power to plan for unforeseen eventualities. A Cardiac Care Plan has been envisioned to serve this purpose, especially when you come face to face with heart-related emergencies. If you have a family history of cardiac conditions or if you are already living with a heart-related condition, investing in a heart insurance plan is definitely worth it. 

Here are some popular plans and their offerings

HDFC Life Cardiac Care

The Cardiac Care Plan offered by HDFC Life covers more than 18 heart ailments for individuals between the age of 18 and 65. It also offers additional benefits such as hospitalisation, indexation and income benefits. You can choose a cover between Rs 2 lakh ad Rs 50 lakh. Policy term varies from 5 years to 40 years.

Related: Why Insuring your Health is a Smart Decision?

ICICI Pru Heart and Cancer Plan 

The claim settlement ratio presented by ICICI Prudential is an impressive 98.6% as per IRDAI’s FY18-19 report. This plan protects against both cancer and heart ailments. Special benefits are offered to existing customers and couples. This plan also offers additional benefits such as hospitalisation, indexation and income benefits. One can get covered up to 40 years.

Aviva India Cardiac Health Insurance Plan

Aviva Heart Care covers 19 different heart conditions. It covers both your spouse and you. It also caters for loss of income. Irrespective of the cost of treatment, it offers a fixed payout. 

Star Cardiac Health Plan

There are three types of covers offered by this plan:

Cardiac Cover – It is for those with existing cardiac diseases.

Flexible Cover - Hospitalisation expenses for both cardiac and non-cardiac treatments.

Out-Patient Cover – This provides outpatient benefits.

There are two types of plans – Gold and Silver. 

The Silver plan covers surgical and interventional procedures. 

The Gold Plan covers all benefits along with medical management for cardiac treatments.

All these plans offer tax benefits under Section D, Income Tax Act 1961.

Take a look at 5 lesser known facts about the tax benefits of health insurance.


Disclaimer: This article is intended for general information purposes only and should not be construed as investment or insurance or legal advice. You should separately obtain independent advice when making decisions in these areas.


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