White fungus, also known as candidiasis, is a fungal infection caused by the candida yeast, a fungus type. It affects people with low immunity and pre-existing medical conditions such as HIV, cancer, diabetes, etc. People are more vulnerable to it as the moulds can be easily inhaled, spreading to vital organs such as lungs, kidneys, brain, etc.
“Policyholders can heave a sigh of relief to know that the treatment cost related to black fungus and white fungus is covered under all comprehensive health insurance policies by default as these diseases are in-built and thus, you need not hold any special health plan to be covered," said Agrawal.
However, policyholders have to fulfil the terms and conditions as specified in their health insurance policy like informing their insurer about pre-existing illnesses, planned or emergency hospitalization, submitting all the required documents, etc. At least 24 hours of hospitalization is required to make a claim.
Some states have geared up to incorporate black fungus cover in their state health insurance programmes.
Agrawal said: “The government of Maharashtra has announced that patients suffering from black fungus will get covered up to ₹1.5 lakh under health insurance schemes like the Pradhan Mantri Jan Arogya Yojana and Mahatma Jyotirao Phule Jan Arogya Yojana. The Rajasthan government has announced the Chiranjeevi Yojana Insurance Scheme to cap admission and treatment costs at private hospitals for those suffering from the disease."
Besides, if you are covered under the employer’s group insurance or have a super top-up plan, the policy will cover fungal diseases.
However, coronavirus-specific policies might not cover these diseases.
“Though mucormycosis is found to be caused by the heavy dosage of steroids to cure covid patients, unfortunately, covid-specific policies don’t cover the treatment of mucormycosis, as there is still a grey area whether the diseases will be covered. In such a case, settlement of the claim will depend on the insurer," said Naval Goel, founder and CEO, PolicyX.com.
So, if you have comprehensive health insurance, you can raise a claim for the treatment of black fungus and white fungus. You can avail of a health insurance claim by sending an intimation of hospitalization to your insurer, and then locating a cashless network hospital near you. Keep the requisite documents handy for a hassle-free and quick claim settlement process.