29 Jul, 2022 | Health Insurance

Air Ambulance Charges In Health Insurance: Covered Or Not?

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Besides offering protection against medical and hospitalisation expenses, a few health insurance policies in India also cover the cost you incur while getting to the hospital in an ambulance. And we're not just talking about ground or road ambulances here - air ambulance charges are covered too. It is available as an add-on benefit with some policies. 

An air ambulance might come to the rescue in situations where one requires immediate ambulance transportation which a ground ambulance cannot provide. These include situations where one meets with an accident and gets severely injured or is diagnosed with a life-threatening disease and requires immediate medical treatment that might not be available at a nearby hospital. 

But do all health insurance policies cover air ambulance charges? And up to what extent? Are there any conditions you must be aware of?

Let’s find out. 

Are Charges Of Air Ambulance Covered Under All Health Insurance Policies?

Expenses for ambulance transportation in an airplane or helicopter are covered under some health insurance policies in India. If it is mentioned in your policy document, your plan will cover the air ambulance cost in India. However, the cover will be applicable only if certain conditions are met.

General Conditions For Coverage Of Air Ambulance Charges In Health Insurance

The conditions for air ambulance coverage may vary across insurance companies. Here’s a quick rundown of some common conditions - 

1️⃣ Medically necessary 

A few policies cover air ambulance expenses only if the transportation through an air ambulance has been prescribed by a medical practitioner and is medically necessary. For instance, insurers like Max Bupa and ICICI will cover the ambulance costs only if the insured has a life threatening health condition that requires immediate and rapid ambulance transportation to the hospital or the medical centre.

Further, some insurers, like Care Insurance, cover the expenses if the doctor has asked to transfer the insured from one hospital to another for better treatment. Other insurers, like ICICI, do not cover air ambulance charges if the insured is already at a hospital where the medically necessary treatment can be provided, but is still transferred to another hospital through an air ambulance. 

2️⃣ Place of treatment

Some health insurance policies come with a condition that the charges of air services will be covered only if the insured person is in India and the treatment, too, is carried out in India - and not overseas. 

The cost of an air ambulance will not be covered if the insured is transferred within the same city of the first occurrence. Meaning, the cost won’t be covered if the insured stays in a small town of Delhi and is transferred to a hospital in Delhi itself. However, if the insured is transferred from Delhi to another city i.e., Mumbai or Jaipur, the charges of the air ambulance will be covered.

3️⃣ Maximum amount you can claim

The air ambulance expenses will be covered up to a limit specified under your health insurance policy. 

So, if you have a health insurance cover of INR 10 Lakhs and the air ambulance coverage limit specified under your policy is INR 50,000 - in this case, if you need to use the air ambulance benefit, the maximum amount you can claim under your policy will be INR 50,000. Any expenses you incur above this limit will have to be paid out of your pocket, even though you’ve taken a sum insured of INR 10 Lakh. 

4️⃣ Return transportation charges

Some health insurance policies like HDFC Ergo’s Optima Restore policy also cover the cost of return transportation i.e., transportation from the hospital to the insured’s home by air ambulance. 

5️⃣ Certified mode of transport

Insurance companies like ICICI and Bharti AXA have a condition under their policies that they will cover the air ambulance charges in India only if the airplane or helicopter used for transportation is certified for use as an ambulance.

6️⃣ Reimbursement claim allowed

While most insurers allow you to claim for the air ambulance expenses on both a cashless and reimbursement basis, a few insurers like Star Health allow you to claim on a reimbursement basis only. Meaning, you’ll have to pay for the ambulance expenses out of your pocket first and then claim the expenses from the insurance company through reimbursement later.

7️⃣ Distance between the residence and hospital

A few health insurance policies have a condition that the air ambulance services can be availed in case of an emergency only if the insured is at least 70 kilometers away from the residence. 

Please note: The above limits and conditions may vary across insurers. So, ensure you go through your policy document before you opt for this benefit.

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Key takeaways
  1. Expenses for ambulance transportation in an airplane or helicopter are covered under some health insurance policies in India.
  2. Air ambulance costs in India will be covered by some health insurance plans only if the evacuation is medically necessary and prescribed by a medical practitioner.
  3. Some policies cover the cost if the insured person is in India and gets treated in India only and not overseas. 
  4. The maximum amount you can claim will be up to the limit specified in your policy. 
  5. Some policies also cover the cost of return transportation to the insured’s home by air ambulance.
  6. In some policies, there is a condition that air ambulance charges in India will be covered only if the airplane or helicopter is certified for use as an ambulance.
  7. While you can claim through both cashless and reimbursement in some policies, in others, you can only claim on a reimbursement basis.
Team Beshak
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