A health insurance policy is your life jacket in a stormy sea that protects you against medical and hospitalisation expenses. Some policies extend the coverage by paying for the cost of ground or road ambulance services as well.
Did you know that some health insurance policies cover air ambulance services as well? Sounds great! Right?
Imagine your friend needs immediate medical care for an emergency that isn't available at a local hospital. Since the recommended hospital is located quite far away and the treatment needs to happen ASAP, a ground ambulance is not a wise idea. An air ambulance may be a lifesaver in such instances.
Air transport is possible through a helicopter or an aeroplane. Its goal is to ensure that you receive the best possible care during transportation to the most appropriate medical facility.
Air ambulance coverage in health insurance is undoubtedly an excellent feature, especially when dealing with serious injuries or life-threatening diseases that might not be able to be treated locally. Some policies offer this as an additional benefit.
Are air ambulance charges covered under all health insurance policies? Are there any conditions?
Let’s have a look!
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Do All Health Insurance Policies Cover Air Ambulance Charges?
Some health insurance policies in India cover ambulance transportation by aeroplane or helicopter. Your policy will cover the air ambulance cost if it is stipulated in your document. Nevertheless, certain conditions must be met in order to qualify for the coverage.
Conditions For Air Ambulance Coverage Under Health insurance
As discussed above, air ambulance coverage varies across insurers. Here are a few things that you should keep in mind -
Covered Only If Evacuation Is Medically Necessary
Some policies cover air ambulance expenses only if the medical evacuation has been advised by a medical professional and is deemed essential.
The underlying conditions may vary across insurers -
Max Bupa and ICICI cover ambulance costs only in the event of a life-threatening health condition that requires immediate transportation to a hospital or a medical centre.
ICICI also does not cover air ambulance charges if you are already in a hospital where medically necessary treatment can be provided, but still wish to transfer to another hospital.
Some insurers like Care Insurance cover expenses if a doctor asks you to transfer to another hospital for better medical treatment.
Treatment Within The Same City Is Not Covered
Health insurance policies may require you to be in India for the treatment. However, air ambulance costs are not covered if the transfer happens within the same city. They are covered only when you need to be transferred from one city to another.
For example, Manisha, 30-year-old, residing in Kerala has a health insurance cover of Rs 10 lakhs and the air ambulance limit mentioned in her policy is Rs 50,000. She suffers from cystic fibrosis and the recommended medical treatment is available in Tamil Nadu. She needs to be transferred from Kerala to Tamil Nadu immediately through an air ambulance. Her air ambulance charges come around Rs 40,000 - which shall be covered under her policy.
There Is A Limit On The Claim Amount
Health insurance policies provide coverage up to a certain limit for air ambulance expenses. If the air ambulance expenses go beyond this limit, you need to pay for the same.
For example, Raghu has a health insurance cover of INR 8 Lakhs and the air ambulance coverage limit specified under his policy is INR 45,000. He met with an accident that resulted in severe injuries. Since the treatment wasn't available in a local hospital, the doctor prescribed Raghu to be transferred to a hospital located in another city. In this case, he can claim a maximum INR 45,000 for air ambulance expenses. Any additional costs will have to be borne by him.
Some Insurers Cover Return Transportation Charges
Some health insurance policies cover the cost of return transportation too, i.e., transportation from the hospital to your home.
For example, HDFC Ergo’s Optima Restore policy covers return transportation.
Mode Of Transport Must Be Approved
Depending on the insurance policy, only certain modes of transport are permitted for air ambulance services. For instance, some insurance companies will cover air ambulance costs only if the aircraft or helicopter used for transportation is certified as an ambulance.
Some Insurers May Allow Only Reimbursement Claims
Many insurers allow both cashless and reimbursement claims for air ambulance expenses. Some insurers, however, may accept only reimbursement claims. This means you will have to pay for the ambulance expenses out of your own pocket first before claiming reimbursement from the insurance company.
The Distance Matters Too!
Some health insurance policies state that air ambulance services can be used only if the hospital is at least 70 kilometres away from your residence.
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Expenses for ambulance transportation in an aeroplane or helicopter are covered under some health insurance policies in India. Air ambulance costs shall be covered only when the transfer is medically necessary and prescribed by a doctor. The limits and conditions may vary among insurers. Therefore, it is imperative that you read the policy document thoroughly before you opt for this benefit.