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Polycystic Ovary Syndrome and Health Insurance

PCOS is a condition in which the ovaries develop several cysts. Ovaries are the female internal reproductive organs. And they are responsible for the production of eggs. Cysts are sac shaped, fluid-filled structures that develop on organs.

3 min read

May 30, 2024

OneAssure

Triggers

A sedentary lifestyle, changes in the environment, metabolic disorders or regular stress are known triggers of PCOS.

Causes

PCOS is caused due to hormonal imbalance. In people suffering from PCOS, testosterone, the male reproductive hormone, is higher than usual.

It may be a genetic, inherited disorder having a close correlation with diabetes. It is said that there is a high chance of suffering from PCOS if the family has a history of PCOS or diabetes.

Symptoms

Symptoms of PCOS develop gradually. Therefore, everyone suffering from PCOS may not exhibit all the symptoms. 

Here are a few common symptoms:

  • Irregular periods

  • Painful periods

  • Excessive facial hair

  • Acne

  • Oily skin

  • Thinning of scalp hair

  • Depression

  • Problems getting pregnant

  • Unusual weight gain

  • Headaches

  • Heavy menstrual bleeding

Detection

If you identify as a woman and have started menstruating, you should visit a gynecologist if you exhibit any of the symptoms mentioned above. A specialist might recommend a combination of the following test. 

  • Blood test

  • Pelvic examination

  • Hormone test

  • Ultrasound

Can PCOS Go Undetected?

Those who menstruate may be silent sufferers of PCOS without knowing it. This is because they are reluctant to report the symptoms. As a result, some symptoms may be ignored as normal.

Treatment and Management

Unfortunately, there is no permanent cure for PCOS. However, it can be managed and kept under control using these techniques:

  • Healthy and Well balanced diet

  • Weight control

  • Yoga

  • Meditation

  • Regular physical exercise

In some cases, the physician may prescribe medication to suppress symptoms temporarily. These may be:

  • Birth control pills

  • Fertility medicines

Health Insurance

Lifestyle-related diseases like PCOS are becoming increasingly common among Indian women. Other lifestyle-related diseases are diabetes, cardiac conditions, hypertension etc.

Given the high incidence of these diseases, health insurance can safeguard your finances from medical expenses.

Benefits of Health Insurance

Health insurance comes with a host of benefits. Some of the more popular ones are:

Pre-Hospitalisation Expenses Cover

You probably have consulted doctors, specialists and undergone medical tests before deciding upon hospitalisation. You also probably consumed medicines before hospitalisation. All these expenses incurred with the hospitalisation before the actual hospitalisation are pre-hospitalisation expenses. Your health insurance policy covers these.

Hospitalisation Expenses Cover

Expenses that you incur during your hospitalisation are called hospitalisation expenses. Rooms rent, nursing, procedures, treatments, medicines etc., are some examples of hospitalisation expenses. The health insurance policy covers these.

Post Hospitalisation Expenses Cover

After you are discharged from the hospital, you may be asked to visit for follow up consultations. You may be advised to perform certain medical tests. You may be advised medicines for recovery. All of these are examples of post-hospitalisation expenses if related to the hospitalisation. All of these are covered by the health insurance policy.

Cashless Hospitalisation

Most insurers offer cashless hospitalisation as a part of the Mediclaim policy. As you are admitted to the hospital, a cashless pre-authorisation claim request is sent to the insurer. Normally, within one day, the cashless claim is approved. You need not worry about paying cash at the hospital now, as the claim is covered under cashless hospitalisation.

Pre-Existing Conditions

Any condition that the insured suffers from before purchasing the policy is a pre-existing condition. Common pre-existing conditions are diabetes, hypertension, cardiac conditions etc.

Pre-Medical Tests and Declaration

Some insurers conduct a pre-medical test to detect pre-existing conditions. At the same time, some insurers rely on a declaration by the insured about pre-existing conditions.

You should always declare pre-existing conditions truthfully in the declaration. Not declaring any pre-existing condition may result in the rejection of the claim later.

Waiting Periods

Some health insurance policies cover pre-existing conditions in the market. And then some policies don’t. 

Some insurers cover pre-existing conditions subject to the terms, conditions and limits specified in the policy. In addition, most insurers have waiting periods associated with pre-existing conditions. This means that the pre-existing conditions will be covered in the policy after a certain waiting period of a few years.

Woman’s Health Insurance Coverage: Check if PCOS is a Pre-Existing Condition

Mediclaim policies for women cover a host of standard ailments, diseases and conditions. However, not all policies may cover all ailments. Some insurers may treat PCOS as a pre-existing condition, while some may not. Check the policy document for coverage of PCOS before purchasing health insurance. Go for a women’s health insurance policy that is most appropriate for your condition.

Read Why should women opt for health insurance?

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