Will your health insurance policy cover the cost of the COVID 19 vaccine?

The coronavirus has become a vaccine for the disease almost a year after battling the epidemic. Although the vaccine rollout program is still in its nascent stages, the road ahead is positive. Institutions and companies such as Bharat Biotech, Pfizer and Serum Institute of India have already applied for authorization to market their vaccines, while the vaccine being developed by Zydus will be available by the end of 2021. Frontier warriors have already begun to meet. Vaccine shot and senior citizens are registered for the same. What about the cost of such vaccination? Will it be covered under your health insurance policy?

If you are looking for a simple answer, the answer is ‘no’. Vaccination costs are a part of OPD’s expenses that are not covered by most health insurance policies, even COVID-specific health insurance plans. However, this is not the universal answer. In some cases the cost of vaccination may be covered under a health insurance policy. Let’s know how –

Case 1 – If vaccination is a part of hospitalization

If you are hospitalized for COVID and you receive the vaccine pill as part of the treatment of the disease, then the vaccination will be considered a part of your inpatient hospitalization treatment. In such cases, all health insurance plans will cover the cost of the vaccine.

Case 2 – If your policy has OPD cover or you have opted for one

Another situation in which your health insurance policy will cover the cost of the vaccine is if you have OPD coverage in your health insurance plan. Although most health insurance plans do not allow coverage for OPD expenses, many policies have inbuilt OPD coverage benefits. In addition, many plans offer OPD coverage as an optional additional benefit. Therefore, if your plan has OPD coverage as inbuilt benefit or you have paid additional premium to avail OPD coverage under the plan, then the cost of immunization will be covered.

However, under OPD coverage, here are some points you should remember –

  • Plans with inbuilt OPD coverage may have higher premiums.
  • If you opt for OPD cover as an add-on, the premium will be increased
  • OPD coverage is allowed to a certain extent. If the cost of the vaccine exceeds the allowed coverage limit, you will eliminate out of pocket expenses

What should you do?

Check your health insurance plan coverage. If you are opting for elective vaccination and your plan does not have OPD coverage, then you will have to bear the cost of the vaccine. Even if the plan has OPD coverage, check the extent of coverage because you can spend extra on the vaccine. If, on the other hand, you are hospitalized for COVID and you are vaccinated, then your health insurance plan will cover the cost of the vaccine.

So, coverage for the cost of the vaccine depends on your health insurance plan and when the vaccine is given. Even if the cost is not covered in your health insurance policy, it will not be enough to be affordable. Getting vaccination against the epidemic is important, even if you have to pay out of your own pocket, isn’t it?