Health Insurance for Beta Thalassemia Major

Beta thalassemia is a congenital blood disorder in which the patient’s body produces less haemoglobin. Haemoglobin is a type of protein that contains iron in RBC (red blood cells), which is responsible for circulating oxygen to cells across the body.

Types of Beta Thalassemia

Beta Thalassemia is further classified into two types based on the severity of its symptoms:

• Thalassemia Major
• Thalassemia Intermedia

Treatment of Beta Thalassemia Major

The patients experience severe symptoms, due to which they require frequent blood transfusions. Moreover, to treat Beta Thalassemia Major permanently, the patient must undergo a Stem Cell Transplant, also known as a Bone Marrow Transplant.

Health Insurance Coverage for Beta Thalassemia Major

This blood disorder is categorised under health insurance for congenital disease, which varies depending on the insurance provider and its specific plan. You can either obtain a policy that includes this disease as part of its standard health insurance coverage or request an add-on or rider.

Things to Consider When Buying Health Insurance for Beta Thalassemia Major

Here is a list of points that you must consider while buying an insurance policy that covers Beta Thalassemia Major:

• Waiting period: Insurance providers may have waiting periods ranging from 1 to 4 years to cover pre-existing conditions. 
• Limitations and Exclusions: You must go through the fine print to identify the exclusions, sincerely or if there are any limitations about congenital conditions. 
• Sum Insured: Ensure that you opt for a policy that provides a higher sum insured to cover lifelong beta thalassemia major treatment expenses. 
• Coverage under Congenital Diseases: Before making a purchase, ask the insurance provider if the policy explicitly recognises beta thalassemia major as a congenital disease.

Benefits of Buying Congenital Health Insurance

According to the 2019 guidance of IRDAI, health insurance policies must cover congenital diseases. Here is a list of benefits that you can expect from buying a policy:

1. Expense Covered: It includes expenses made during diagnosis or treatment for beta-thalassemia major. This expense includes inpatient hospitalisation, day-care procedures, surgeries, pre-hospitalisation, post-hospitalisation, and other related costs. 
2. Amount Coverage: The amount of coverage offered under insurance policies can range from Rs. 50,000 to Rs. 6 Crore. However, the insurer provides coverage and an amount based on the policy you own.
3. Financial Advantage: Beta thalassemia major is a lifetime blood disorder that requires frequent consultation and medication. The patient incurs high expenses in this process. This burden is eventually assumed by the insurer, making the process seamless.

Also, For Beta Thalassemia Major patients, the ABHA card ensures seamless access to transfusion records and medical history across hospitals. It helps doctors provide timely, informed treatment by digitally storing all essential health data.

Limitation in Coverage

There are challenges that one might face while claiming certain expenses. Therefore, it is wise to be aware of such challenges as follows so that you prepare for them:

• Lack of awareness about how the policy will treat beta-thalassemia major.
• There might be limits to the extent of expenses that you can claim under the specific health insurance.
• This disorder requires a treatment that includes ongoing therapies and surgeries. Therefore, buy comprehensive health insurance coverage.
• Multiple insurance providers cover congenital diseases such as beta-thalassemia major. However, the extent of coverage and type of treatment under the disorder vary from policy to policy.    

Preventive Measures Against Beta Thalassemia Major

• Having a proper, balanced diet that maintains the patient’s BMI (use BMI Calculator).
• Maintaining sugar levels is extremely crucial, as well as managing the risk of diabetes. 
• Incorporate vitamins and minerals in your food. 
• Avoid alcohol and tobacco usage regularly.
• Refrain from travelling to areas that are prone to infection.
• Avoid buying medication over the counter without consulting a medical expert first. 

Most policy insurers in India covers genetic disorders. However, consult with insurance companies to understand their scope and coverage. Also, policy providers should be looked for that have a robust hospital network working in collaboration with them, providing cashless treatment facilities for congenital diseases.