This post has been self-published on Youth Ki Awaaz by Just like them, anyone can publish on Youth Ki Awaaz.

Here’s Why Hospitals Aren’t Accepting Your Insurance For Covid-19 Treatment

More from

This post is a part of YKA’s dedicated coverage of the novel coronavirus outbreak and aims to present factual, reliable information. Read more.

*Trigger Warning: Covid*

On a Wednesday morning, I was having my coffee and reading the newspaper when my dad walked out of his room. His face looked tired and dull. I checked on him only to find that he had a mild fever. We ignored it since he had taken the first jab of Covaxin. Fever and body pains were some of the common side-effects of the vaccine. 

We ensured he was isolated for a couple of days just to be sure that he didn’t have Covid. Two days later, when the fever didn’t come down, we decided to get an RT-PCR test to be sure. 

Covid test
Representative Image.

Now came the challenging part — the wait of 24 hours for the result. The following 24 hours were spent anxiously waiting for the result. We heard the devastating effects of the second wave, which led to a shortage of oxygen cylinders, lack of beds and limited availability of Remdesivir, which did not help. 

The result came back positive. We started our routine of online consultations and medications prescribed by the doctor and brought ourselves an oximeter and thermometer to regularly check his vitals. The doctor recommended a mandatory CT scan which would show the severity of the infection. The scan showed a moderate infection that required hospitalisation. This was worrying.

At 10:30 p.m., we managed to reach a hospital and arrange for a bed. And we were in for a surprise. The person at the reception said, “We do not accept cashless insurance for Covid. If you want cashless treatment, then you need to try other hospitals.” 

The unavailability of cashless hospitalisation was a blow to us. The much-hoped insurance that I felt would come in handy in these circumstances was of no help. And yes, we could claim a reimbursement, but that process is long, and often the full amount is not reimbursed. 

I kept my options open and came back home with my dad. I started making calls, and it took me less than 30 minutes to understand that hospitals weren’t accepting cashless treatments for Covid care across Bangalore.

The next day we got him admitted to the hospital by making cash payments. Hospitals and insurance are usually tricky, but this time the case was different. The room rent cost us Rs. 18,000, 6 times the price of the room on a regular day. We knew the claims would be under settled as the insurance company had a cap of only 4,500 per day for room rent. 

Banquet Halls Converted Into Covid Care Centre In Delhi
Representative Image. (Photo by Mohd Zakir/Hindustan Times via Getty Images)

Now let me break all this down. As per the Insurance Regulatory and Development Authority of India (IRDAI), hospitalisation due to Covid is duly covered and is eligible for cashless treatment. But why aren’t hospitals accepting this? 

As per the service level agreement (SLA), consumables are not paid by the insurance company. Consumables are the PPE kits, gloves, masks and sanitation material used by the staff. These consumables are essential while treating Covid patients. 

When billed separately, the insurance company does not pay these consumables, leading to conflict with the hospital and insurance company. The hospital combines the cost of consumables along with the room rent and nursing charges. 

When such a bill is raised, the per-day room rent charges go high, usually more than what is agreed in the SLA. This again leads to a reduction in claim amount being settled for cashless treatment. The tug of war continues between the hospital and the insurance company.

So what is the convenient option? Hospitals are refusing to accept cashless treatment for Covid cases. The rise in Covid cases and the shortage of beds would mean the general public has no option but to get a bed by paying cash even though they are eligible for cashless treatment. 

The more you try to reason with the authorities or the hospital, the chances are you will lose your bed. The emergency drives people to get the treatment first and then worry about insurance reimbursement later. The insurance company has promised reimbursement for Covid hospitalisation. But the claims are under-settled. 

As I said, the consumables won’t be reimbursed as it is not agreed upon in the SLA. The claim settlement is often at 50–55% in most cases. In the end, the insured party who pays the premium is often at a loss. 

Representative Image by Kelly Kirk from Pixabay.

Let’s see what happens when we don’t get a bed. Due to the lack of beds, most people are turned away by the hospitals. This forces the patients to get treatment at home with whatever private help they can get. And this comes at mostly inflated prices. 

Most existing mediclaim/indemnity type health insurance policies do not cover standalone domiciliary hospitalisation, i.e. medical treatment at home. Although most policies cover pre and post hospitalisation care, mandatory hospitalisation would be required to claim a reimbursement. 

The condition of 24 hours of hospitalisation presumes that hospital beds would be available on-demand, which is not the case in the current pandemic. The loss again is at the insured person’s end, who would have to part money from their savings. 

IRDAI has come up with Corona Kavach, but that comes with its pros and cons. It’s an additional policy that you would have to purchase apart from the existing one to cater to Covid illness. 

The Corona Kavach Policy can be bought for an individual or as a family floater plan, but it can only be availed by persons between the ages of 18 and 65. However, the policy will not cover any other treatment that is unrelated to the present pandemic. The plus point, though, is that the policy covers home treatment without the mandatory hospitalisation criteria. 

The Corona Kavach also covers the cost of sanitisation materials like PPE kits, gloves, masks, etc.

Currently, health care in our country is in crisis. When people struggle to get medication for their friends and family while keeping themselves safe, do they have time and patience to go through the different policies and terms and conditions? 

Insurance companies must develop a plan to address the claims due to the ongoing pandemic that’s ravaging our country. The focus should be to ease the burden on the insured person during these challenging times rather than make them run from pillar to post with insurance paperwork. Here is what they can do:

  1. Ensure cashless treatments for Covid care by the hospitals. 
  2. Take action against hospitals not providing cashless facilities. 
  3. Pay for consumables for Covid treatment with the existing policies (masks, Gloves, sanitiser, PPE kits, etc.) 
  4. Come up with a plan to honour the cashless claims and draft a new SLA with the hospitals for existing medical policies.
  5. Reimburse Covid hospitalisation entirely. 

What has your experience been like? Tell us in the comments. And sign the petition to demand insurance for Covid treatment. 

You must be to comment.

More from

Similar Posts

By Accountability Initiative

By India Development Review (IDR)

By Nupur Pattanaik

Wondering what to write about?

Here are some topics to get you started

Share your details to download the report.

We promise not to spam or send irrelevant information.

Share your details to download the report.

We promise not to spam or send irrelevant information.

An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

Share your details to download the report.

We promise not to spam or send irrelevant information.

A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

Sign up for the Youth Ki Awaaz Prime Ministerial Brief below