Heart diseases are among the most prevalent and expensive medical conditions globally, and India is no exception. If you’re suffering from heart ailments, the cost of treatments,  such as angioplasty, bypass surgery, etc, can pose a significant financial burden. 

This is where specialised health insurance plans for heart patients play a critical role. These plans are designed to address these ailments, ensuring they receive the necessary medical attention without compromising your financial stability.

So, let’s take a detailed look at how these plans help you and how you can avail yourself of coverage for the same.

Top Health Insurance Plans for Heart Patients

Top Health Insurance Pan Waiting Periods Other features Insurer Metrics
Aditya Birla Activ One Max (With Chronic Care add-on) PED WP: 3 years (add-ons can reduce it)
SI WP: 2 years		 Pre & post hospitalisation cover: 90 & 180 days
Restoration: 100% of base SI, unlimited times
Loyalty Bonus: 100% pa, up to 500%		 Network Hospitals: 11k+
CSR: 95%
ICR: 61%
Care Heart PED WP: 3 years
SI WP: 2 years		 Pre & post hospitalisation cover: 30 & 60 days (Up to 5% of the base cover amount)
Restoration: 100% of base SI, once a year (for a different illness)
Beware: Care Heart has disease-wise sub-limits for certain treatments such as knee replacement, hernia, hysterectomy, etc. It also has a mandatory co-payment of 20% if you’re less than 70 years, and 30% if you’re older than 70.		 Network Hospitals: 16k+
CSR: 90%
ICR: 58%
Star Cardiac Care Platinum PED WP: 3 years (Pre-existing cardiac ailments covered after 30 days)
SI WP: 2 years		 Pre & post hospitalisation cover: 30 & 60 days
Restoration: 100% of base SI, once a year (for a different illness)		 Network Hospitals: 14k +
CSR: 83%
ICR: 82%
Star Comprehensive PED WP: 3 Years
SI WP: 2 years		 Pre & post hospitalisation cover: 60 & 90 days
Restoration: 100% of base SI, once a year (for a different illness) only when you completely exhaust your base cover.
Special feature: Some coverage for Maternity, Out Patient Dental/Ophthal treatment, & Medical consultation.
Beware: Star Comprehensive has disease-wise sub-limits for AYUSH, modern treatments, and a few other diseases.		 Network Hospitals: 14k +
CSR: 83%
ICR: 82%
Pro tip: The health insurance market can be a labyrinth. Instead of spending hours navigating through the hundreds of policies out there, why not book a 30-minute call with our expert IRDAI-certified advisors? We don’t spam or pressure you to buy. Just honest insurance advice.

Features to Look For Heart Patients Getting Health Insurance

Heart conditions often involve ongoing treatments, hospitalisations, and surgical interventions, which can be financially draining. Thus, while comprehensive health insurance plans might be a solid choice when you don’t have any pre-existing medical conditions, in the case of individuals with cardiac issues, you need a niche plan. 

We are talking about a health insurance policy that will specifically cater to the medical and financial requirements of a cardiac patient. So, here is a quick look at some of the features that your health insurance for heart patients must have - 

  1. Nominal to 0 waiting period: A shorter waiting period for pre-existing cardiac issues ensured quicker access to coverage, which is critical for heart patients requiring immediate care.
  2. No disease-wise sub-limit, specifically for cardiac conditions: Look for policies that do not have disease-wise sub-limits for cardiac treatments. Despite a high cover amount, these sub-limits can significantly restrict your coverage. This can leave you with out-of-pocket expenses, which is not ideal.
  3. No room rent limit: Heart surgeries may require prolonged treatments & recovery in hospital rooms. Ideally, you should get a policy without room rent restrictions, because if you exceed the room rent limit, you will have to pay the amount proportionately across the entire bill, and not just the extra room rent.
  4. Extensive pre and post-hospitalisation coverage: Heart treatments often involve frequent follow-ups, tests & medications. Similarly, there can be several procedures before the treatment. So, policies with extensive pre-and-post hospitalisation coverage can help manage these expenses.
  5. Reasonable premiums: Health insurance policies designed for individuals with pre-existing diseases (such as cardiac issues) often have a fee other than the standard premium. This is called the “loading charge”, and is applied based on your age, health history, the severity of your existing conditions, etc. It’s important to compare plans and evaluate your premium-to-coverage ratio to ensure that the policy is worth it. But remember, having some coverage is better than having no coverage at all.
  6. Cardiac condition-based add-ons: To provide specialised care for heart patients, many health insurance policies include add-ons tailored to cardiac conditions. These add-ons can enhance the base policy, ensuring coverage for specific treatments, advanced procedures, or extended recovery periods. Such add-ons may also include features like rehabilitation support and annual health check-ups to ensure regular monitoring of cardiac health.
  7. Minimum exclusions for heart conditions/treatments/procedures: Many general health insurance plans exclude coverage for pre-existing conditions or impose stringent waiting periods. Specialised plans, however, aim to minimise exclusions by providing coverage for treatments like angioplasty, valve replacement, or heart transplants after fulfilling the initial waiting period. Policies with fewer exclusions ensure you receive timely and comprehensive care without the stress of claims being rejected.
  8. Consumable coverage: Consumables, such as gloves, syringes, oxygen masks, and surgical equipment, often contribute significantly to your hospital bill, but are usually not covered under standard health insurance policies. This can lead to substantial out-of-pocket expenses, especially for heart patients who require extended ICU stays or complex surgical procedures. Health insurance plans that include consumable coverage ensure that even these often-overlooked costs are taken care of.
  9. Bonus: A no-claim/loyalty bonus will allow your cover amount to grow year-on-year, even after claims are made. This ensures that policyholders do not exhaust coverage after a single treatment, making it particularly beneficial for individuals managing chronic heart conditions, which may require frequent hospitalisation.
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What are the Best Health Insurance Plans for Heart Patients in India? 

  1. Aditya Birla Activ One Max (With Chronic Care Add-on): Aditya Birla Activ One is a comprehensive health insurance plan that caters well to individuals with pre-existing conditions like heart ailments. It offers significant benefits such as a pre- and post-hospitalisation cover of 90 and 180 days, ensuring coverage for follow-up treatments and recovery periods after major surgeries like bypass or angioplasty.
  2. Care Heart: Care Heart is a plan dedicated to people with pre-existing cardiac issues. A major highlight of this plan is its affordability, making it a feasible option for those on a budget. However, it is important to note that Care Heart comes with numerous disease-wise sub-limits on specific treatments such as knee replacement, hernia, and hysterectomy. These sub-limits can restrict payouts, especially for complex cardiac procedures.
  3. Star Cardiac Care Platinum: Star Health’s Cardiac Care plan is another dedicated option if you have pre-existing heart ailments. This plan offers pre- and post-hospitalisation coverage of 30 and 60 days. While this coverage duration is shorter compared to other plans, it still covers essential follow-up care after procedures such as angioplasty or bypass surgery. The plan also includes 100% restoration of the base sum insured once a year, but only for claims related to different illnesses.
  4. Star Comprehensive: Star Comprehensive is one of Star Health’s flagship plans, offering broader coverage for heart patients alongside other medical needs. It includes pre- and post-hospitalisation coverage for 60 and 90 days, ensuring extended care for surgeries or critical procedures. A significant benefit of this plan is its restoration feature, which reinstates 100% of the base sum insured once a year for unrelated illnesses only after complete exhaustion of the base amount. However, this policy also comes with disease-wise sub-limits on certain treatments.

(Note: Issuance of the plan solely depends on the underwriting team of the insurer and the severity and complications involved in the ailment.)

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Conclusion

If you have a heart condition, choosing the right health insurance plan is critical to securing financial stability and access to quality healthcare. Specialised plans such as Star Cardiac Care, Care Heart, and Aditya Birla Activ One provide coverage for heart patients, ensuring expensive treatments and surgeries are also included.