Health Insurance for Genetic Disorders in India

Introduction

Ever seen a strand of DNA (Deoxyribonucleic Acid)?

Looks pretty incredible, right? As intriguing as it looks, it’s even more interesting when it comes to how important genes (collection of DNA), the biological units of heredity, are in building the characteristics of an individual. I mean genes get all the credit when it comes to appearances, nature, and talents.

However, unfortunately, genes also do often share the responsibility of bringing in some major ailments, otherwise called genetic disorders. Parents pass on some of their genetic mutations to their children, making them vulnerable to genetic ailments that suggest a high risk for critical ailments. Subsequently, health insurance plans become a necessity.

Now, the question is if health insurances are at all available for individuals with genetic disorders. And even if they are available, what kind of exclusions are you looking at? How can you choose a plan that caters to your genetic condition? Such questions have been answered across the blog. Nonetheless, we first need to acknowledge what exactly are genetic disorders, which are the most common ones in India, etc.

Read on to know all about these ailments and the details on health insurance for genetic disorders in India!

What is the recent condition of Genetic Disorders in India?

India hosts a population that is culturally heterogenic and has a rich genetic diversity. This, coupled with certain marriage practices across endogamous groups and the practice of consanguinity as a popular cultural tradition - makes India susceptible to certain rare genetic disorders.

Subsequently, rare genetic disorders have become a growing concern among the Indian population. While the Genomics for Understanding Rare Diseases: India Alliance Network (GUaRDIAN) has been aiming to offer genomic solutions to such rare conditions, the treatments are in no way inexpensive. But we will talk about the financial aspect later, first let’s understand what genetic disorders are.

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A. What are Genetic Disorders?

Remember how we talked about DNA being the formative bricks of an individual? Well, these DNAs also build proteins. When there is a mutation in a DNA, the instructions that they carry to build a protein also change. And since these proteins carry out a majority of the work across cells in an individual’s body, a mutation in its development means a missing, an extra, an absent, an overtly active, inactive, or abnormal gene. This becomes a genetic disorder.

Such genetic disorders can be inherited from a mutated gene from either a single or both parents. Also, such disorders in the genetic arrangement of an individual can happen later, across the lifespan of an individual.

Here is a look at examples of genetic disorders -

1. Albinism
2. Colon Cancer
3. Cystic Fibrosis
4. Down Syndrome
5. Breast Cancer
6. Crohn's Disease
7. Thalassemia
8. Sickle Cell Anaemia
9. Huntington's Disease
10. Parkinson's Disease
11. Autism
12. Prostate Cancer
13. Wilson Disease, and more.

B. What are the types of genetic disorders?

Genetic disorders can be categorised into 3 types -

1. Single-gene disorders - When the mutation affects a single gene.

For example - Sickle cell anaemia.

2. Chromosomal disorders - When parts of a chromosome or multiple chromosomes are affected, change, or go missing.

For example - Down Syndrome.

3. Complex disorders - When the mutation affects two or more genes. In this case, sometimes, one’s lifestyle and environmental conditions also lead to his/her genetic mutations.

For example - Colon cancer.

C. How are genetic diseases treated?

Genetic diseases call for an effective solution - gene therapy. In the process, the affected gene of an individual is replaced with another gene stem. The normal genome strives to cure the genetic disorder that the individual has been facing due to the infected or affected gene. Sometimes across this treatment process, the affected genome is also deactivated so that the genetic disorder is cured.

Why should you avail of health insurance plans for genetic disorders?

While gene therapy treatments are extremely effective, considering that they are at their root development phase, and require a lot of work and additional improvements, the charges for these treatments are extremely high.

As and how genetic disorders across the globe grow in numbers considering various contributing factors, the demand for these treatment processes boosts. Unfortunately, not all can afford such high-end treatment procedures. And hence, there is an increased demand for health insurance plans that offer coverage for genetic disorders.

Now, gene therapy is still going through growing pains as it is in its initial phases. Naturally, not all the best health insurance providers are quite acquainted with the procedure, and hence, not all policies offer coverage for the procedure. Among the best plans available, here is a look at the ones that are recommended considering the superior features and pristine perks.

What are the best health insurance plans for Genetic Disorders in India?

The offerings of health insurance plans that we have listed below are based on the specific ailments that are covered. Not all policies cover all genetic disorder treatments. Plus there are a multitude of things that you need to take into account when availing of a health insurance plan (you can take a look at these top tips in the next subheading).

"NOTE: However if the condition is diagnosed before the policy purchase (PED), there might be chances of rejection. The plan that can be offered for genetic disorders is Care Freedom with PE on that condition"

Things to know before availing of a health insurance plan for genetic ailments?

#1. Genetic diseases that are covered in the policy

Health insurance providers do not offer coverage for all genetic disorders. So, before availing of a health insurance plan, it’s best that you take into account any and all pre-existing conditions or any genetic predisposition to an ailment related to one’s genome. You can then choose a plan that best caters to the diagnosis and treatment of the condition.

#2. Waiting period for various genetic diseases

Genetic disorders coverage across health insurance plans often involves a waiting period - a span across which a policyholder is not financially covered for the specific genetic ailment. This is a financial security measure across the insurer’s front however, obviously, the lesser the waiting period in a health insurance plan, the better it is for a policyholder. So, look out for a plan with a minimal waiting period.

#3. The reputation of the health insurance provider

The last thing that you want as a policyholder is a policy from a health insurance provider that has a low Claim Settlement Ratio and/or Incurred Claim Ratio. These low ratios would indicate that the insurer isn’t efficient when it comes to hassle-free claim settlement process and/or that its financial standpoint doesn’t seem great for the future. It’s best to not approach such health insurers because that wouldn’t be a good financial or medical decision for your future purposes.

#4. A policy that comes with sub-limits and/or copayments on the genetic disorder treatment

In general, no health insurance policy that comes with a copayment clause or a sub-limit is not a great choice (unless of course, any medical conditions that you have make it impossible for you to get a health insurance plan).

However, with health insurance plans for genetic disorders -

1. Mandatory copayment clauses suggest that you are looking to pay substantially towards a high hospital bill across the long span of a treatment procedure.
2. A disease-wise sub-limit on your health insurance policy for gene therapies (that, may we remind you, are extremely expensive) means that you will be paying off substantially from your pocket. And this means you will be digging away from your savings. Really defeats the entire purpose of availing of a health insurance plan and paying the premiums in due time.

So, it’s best to avoid plans that mandate co-payments or disease-wise sub-limits.

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Conclusion

Genetic disorders are a medical backfoot for all individuals. The ailments take a toll on one’s finances and health. And treatments for the procedure are on the horizon. While such treatments might be bringing a lot of good news, financial stability might not be one of them. Under such circumstances, health insurance for genetic disorders is a Godsend. All that one needs to do is weigh out the pros and cons of such plans prior to availing of such policies.