Health Insurance for HIV Patients | Cover360

Posted by raghavendra on March 16th, 2021

WHO has long reigned Human Immunodeficiency Virus or HIV as a "global epidemic." As of 2018, 37.9 million people were living with HIV all over the world. Out of this, there were 2.1 million HIV patients in India. Yet, despite its increasing prevalence, insurance companies did not provide health insurance for HIV patients in India.

This was not helped by the mounting monthly cost of HIV medication in India. HIV medication continued being very expensive, therefore limiting the possibility of treatment.

This changed this month when the IRDAI issued a notice to all the insurance companies. They said, "...all Insurers are instructed to publish on their respective websites the underwriting philosophy and approach with regards to offering insurance coverage to... the following category of the population: ...Persons affected with HIV/AIDS."

This meant that insurance coverage for people with HIV might become a reality by October 1, 2020.

Let us take a more in-depth look into it.

HIV Treatment Options

There is still widespread unawareness about HIV. Its treatment being so expensive, has prevented insurance companies from offering it. Additionally, there is no cure for HIV.

Technological advancements have made it possible for doctors to increase the life span of HIV patients. However, there was no insurance for HIV patients in India that covered this.

This meant that a lot of people who needed treatment could not avail it under their insurance. By removing this level of financial support, HIV patients often could not pay for their treatment on their own.

This is why it is such a big step in the right direction.

That said, while things are meant to change come October; currently, only one insurance provider offers HIV coverage: Star Health Insurance. With their plan, Star Health Netplus, they are presently the sole providers of health insurance for HIV patients in India.

Their extensive network of hospitals also ensures that, under this policy, a patient can get access to some of the best HIV treatment in India. It is also not far-fetched to think that other insurance companies will follow Star’s example.

Star Health Netplus – the Only Insurance for HIV Patients in India

Under Star Health Netplus, there are no age barriers to eligibility. This individual-type plan has a list of features that make it desirable. The only two conditions are:

  •          Any patient who has contracted HIV but not AIDS is eligible to apply for Star Health Netplus.
  •          The CD4 count needs to be recorded above 350.

Other than this, its features include:

  •          Age Eligibility: Any age
  •          Coverage Type: Individual
  •          Sum Insured: Rs. 30,000 – Rs. 50,000
  •          Pre-medical Test: Compulsory to check CD4 count and ensure eligibility. Star Health covers the cost of pre-medical tests.
  •          Waiting Period: 90 days
  •          Annual Premiums: Rs. 2500 (Rs. 30,000 sum insured); Rs. 4000 (Rs. 50,000 sum insured)

Having such a policy, especially when the monthly cost of HIV treatment in India is so high, is necessary. Insurance is a way to maintain financial stability during difficult times. This is what makes this so noteworthy.

Key Features

Some key elements of Star Health Netplus include:

  •          It can be issued/purchased by people who have already been diagnosed with HIV. This means it does not exclude people for whom HIV is a pre-existing condition.
  •          Star Health covers pre-medical tests costs.
  •          There is no age limit.
  •          This truly offers financial support in financially trying times.
  •          The insured is offered complete confidentiality – this is very important considering the stigma surrounding HIV.
  •          A lump sum amount is offered rather than covering individual treatments.

Such bold examples are necessary and indicate towards, not only greater health insurance coverage but also a sensitisation. Health insurance for HIV patients in India will only increase compassion for people suffering from the illness.

Therefore, having examples of such policies being put into effect is important.

Inclusions and Exclusions

While there is no guarantee that Star Health will set the ultimate example, understanding their inclusions and exclusions can give us an idea of what to expect.

After all, change needs to begin somewhere. Maybe some companies will have more restrictions while others have fewer. But they will also make these decisions based on Star Health Netplus. So let us discuss this policy’s inclusions and exclusions.


  •          Pre-hospitalisation costs
  •          Post-hospitalisation costs
  •          Inpatient hospitalisation costs
  •          Non-allopathic treatment costs
  •          Daycare procedure costs


  •          Pre-existing medical conditions apart from HIV
  •          AIDS confirmed during the first 90 days from the commencement date of the policy
  •          Any expenses whatsoever incurred by the insured in connection with or in respect of costs towards the treatment of HIV

While the final point may seem odd, it is simply a reference to the lump sum idea. When a claim is filed, it avails the entire amount which the insured can then spend as deemed fit.

The Impact

The need for such an HIV-centric insurance policy is genuine. People all over the country greatly suffer because they cannot afford the best HIV treatment in India. Instead, they are either forced to live with their disease or get lower-quality treatment.

AIDS is the critical stage of HIV. While Star Health Netplus covers this crucial stage if contracted during the policy term, other insurers are yet to indicate their extent of coverage. Star's Netplus is the first step in humanity’s long battle against HIV – it lessens the financial burden during an incurable illness.

Come October; we should see the stances other insurance companies take. With Star Health setting the examples, providers of the same calibre are sure to step up and do their bit to combat the HIV crisis in the world today!

At Cover 360, we understand how stressful and financially draining illnesses can be. This is why, based on your needs, our experts choose the ideal insurance plan for you. This way, you get the most expansive coverage with minimum limitations quickly and easily!

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Joined: February 22nd, 2021
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