Does my health insurance cover home oxygen therapy for post-COVID issues?

Most standard plans only cover oxygen used during hospitalisation. For home therapy, you need a policy that specifically includes domiciliary hospitalisation or OPD benefits.

Will my premium increase if I disclose a past COVID-19 infection?

It might. Insurers may apply a 'loading' of 10-15% if your COVID case was severe, but this ensures your future claims are safe.

Can I claim for lung rehabilitation programs under my base plan?

Usually, base plans exclude rehab. Check for 'Modern Treatment' or 'Rehabilitation' riders that cover post-hospitalisation care to improve lung function.

Is there a waiting period for lung issues if I buy a new policy now?

Yes, if documented as a pre-existing condition, you typically face a 3-year waiting period before you can claim for respiratory treatments.

What happens if the insurer takes more than one hour for cashless approval?

IRDAI guidelines mandate 1-hour pre-authorisation for emergencies. You can file a grievance via the Bima Bharosa portal if they consistently delay.

Are robotic lung surgeries covered by all Indian insurers?

Yes, IRDAI mandates coverage for robotic surgeries under 'Modern Treatments,' but many insurers place sub-limits or caps on the payout amount.

Insurance for Post-COVID Lung Complications: Claims Guide

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Insurance for Post-COVID Lung Complications: How to Avoid Claim Rejections

Lung health issues after COVID can be expensive. Learn how to handle disclosures, modern treatments, and the new IRDAI cashless rules.

4 min read

OneAssure Team

March 30, 2026

Need advice tailored to you?

Looking for the right plan? You don't have to guess. Let us compare the fine print for you and give you an unbiased recommendation.

Need advice tailored to you?

Looking for the right plan? You don't have to guess. Let us compare the fine print for you and give you an unbiased recommendation.

The Lingering Shadow of the Pandemic

You survived the wave. But your lungs did not fully sign the peace treaty. Maybe it is a dry cough that just will not quit. Or perhaps you feel winded after climbing just two flights of stairs at your office in Gurugram. If you are 28 and feeling 60, your health insurance needs a serious reality check. Post-COVID lung complications like fibrosis or chronic inflammation are common now. They are also expensive to treat. If you do not play your cards right with your insurer, you might end up paying lakhs out of your own pocket.

The Golden Rule: Disclose Everything

Do not hide your medical history. It is tempting to keep quiet about that 2021 hospital stay to save a few hundred rupees on your premium. Do not do it. If you apply for a new policy today and hide your COVID history, you are setting yourself up for a disaster. Insurers use an investigation team for large respiratory claims. If they find a hidden discharge summary from three years ago, they will reject your claim instantly. They might even cancel your policy for fraud. It is better to pay a small extra amount, known as loading, than to have a zero-rupee payout when you actually need surgery.

Waiting Periods and the Three-Year Rule

Most insurers treat post-COVID lung issues as a Pre-Existing Disease (PED). This usually comes with a waiting period of three years. This means you cannot claim for lung-related hospitalisation during this window. However, some newer plans offer a waiver or a shorter 1-year waiting period for an extra fee. If you already have recurring respiratory issues, porting your policy early to a more flexible insurer is a smart move. Check if your current plan has a massive room rent cap. A ₹5,000 cap is useless when a private room in a top-tier city hospital costs ₹12,000 per night.

Modern Treatments and Robotic Surgeries

Medical tech has moved fast. Doctors now use robotic-assisted surgeries for lung nodules or advanced respiratory care. The good news? IRDAI mandates that insurers must cover 12 modern treatments, including robotic surgery. The bad news? Many old policies have hidden sub-limits on these. You might have a ₹10 lakh cover, but your policy might only pay ₹1 lakh for robotic procedures. Always check your Customer Information Sheet (CIS) for these caps. Platforms like OneAssure can help you identify which insurers offer the best coverage for these advanced treatments without unfair sub-limits.

The New IRDAI Speed Rules

Emergency breathing trouble does not wait for paperwork. IRDAI recently issued strict guidelines to speed up the process. Insurers must now provide pre-authorisation for cashless claims within one hour. The final discharge approval must happen within three hours. This is a game-changer for respiratory distress cases where every minute counts. If your hospital is delaying the process, remind them of these specific IRDAI timelines. It is your right as a policyholder.

OPD and Long-Term Care

Lung recovery is rarely a one-day affair. You might need regular Lung Function Tests (PFT), expensive inhalers, or home oxygen therapy. Most basic health plans only cover you if you are admitted for 24 hours. This is why you need a policy with strong OPD (Out-Patient Department) coverage. Also, check if your insurer covers pulmonary rehabilitation. These are exercise programs designed to restore your lung capacity. Many insurers still view this as 'lifestyle' or 'physiotherapy' and reject it. Look for plans that specifically include rehabilitation in their fine print.

The Cost Benefit: 0% GST Impact

Here is some breathing room for your wallet. The GST Council has moved to remove the 18% GST on health insurance premiums starting from late 2025. This makes high-quality comprehensive plans much more affordable. If you were holding back on buying a higher sum insured because of the cost, this tax break is your cue. A ₹25 lakh or ₹50 lakh cover is no longer a luxury for a 30-year-old; it is a necessity when dealing with long-term organ complications.Check your policy today. Ensure your COVID history is documented. If your current plan feels outdated, do not wait for the next breathing crisis to find out. Porting is easier when you are still relatively healthy.