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Does health insurance cover congenital heart diseases?

Q: My 2 months old daughter has been diagnosed with VSD (Ventricular Septal Defect) and might require surgery from 6 months - 2 years from now on as per the paediatric cardiologist. Do medical insurance companies in India cover VSD surgery and hospitalisation expenses for infants? My office medical insurance from oriental insurance covers 2 children, but I am not sure if the cover congenital heart diseases?

A:A congenital defect, VSD in your case, is normally not covered under the mediclaim policy. A congenital defect can be internal or external. In your case it is internal. In those policies where pre existing diseases are covered, treatment of this defect then is only excluded in the first year. Therefore you need to verify from your company if you have PED cover. In such a case, if the procedure is carried out after the first year, till be paid for by the insurer.


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