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All You Need to Know About Health Insurance for Autoimmune Diseases in India

We all are aware of the benefits of health insurance plans. A health insurance plan can be your protective shield against sudden financial strains. Keeping in mind the current scenario, it is necessary to opt for health insurance plans for family and senior citizens.

However, there are certain diseases that many people believe won’t be covered under a health insurance policy. For instance, autoimmune diseases. Every human being comes with an immune system that helps fight against viruses and bacteria. But the same immune system may give rise to certain physical conditions that are often hard to treat, like autoimmune ailments.

So, are such autoimmune diseases covered under a health insurance policy? Let’s find out below.

But first, let’s dig a little deeper inside the definition of autoimmune diseases.

What are Autoimmune Diseases?

Simply put, autoimmune diseases are the ones where the immune system of our body mistakenly attacks its own cells. This is because the immune system perceives some parts of the body as foreign cells. Due to this, the body releases autoantibodies that end up attacking these healthy cells in the body.

Someone with a history of autoimmune diseases in their family is more at risk of developing similar conditions in their lifetime. Besides, people who are more exposed to situations where bacterial or viral infections are regular, are the ones who are at risk of developing autoimmune diseases.

Some Examples of Autoimmune Diseases

Here is a list of the most common autoimmune diseases in India:

  • Type 1 Diabetes
  • Systemic Lupus Erythematosus (SLE)
  • Rheumatoid Arthritis (RA)
  • Multiple Sclerosis
  • Addison’s Disease
  • Psoriasis-Arthritis
  • Inflammatory Bowel Disorder
  • Pernicious Anemia
  • Autoimmune Vasculitis
  • Sarcoidosis
  • Hashimoto’s Thyroiditis
  • Crohn’s Disease
  • Scleroderma

While most autoimmune diseases attack just one organ in the entire body, many of them may also affect the whole body. For instance, SLE can damage the functioning of the entire body.

How to Treat Autoimmune Diseases?

Some of the early symptoms for autoimmune diseases are generally similar. For example, skin rashes, hair loss, fatigue, numbness of the feet and hands, etc., are the common symptoms of such diseases. Therefore, testing and diagnosis at the right time may help start medications on time.

However, most autoimmune diseases are not curable fully. The medications and treatments can only regulate the responses of the disease and provide a kind of relief from the extreme symptoms. The doctors prescribe medicines that can be taken to relieve the pain and irritation from numbness, rashes, pain, and swelling in most cases.

Will Your Health Insurance Policy Cover Autoimmune Diseases?

Most of the health insurance plans in India, including family medical insurance plans, provide coverage against autoimmune diseases. Depending upon the plan you choose, the insured amount may range from ₹1 lakh to ₹1 crore.

Also, some autoimmune disease covers might come under customised plans. However, some could be covered under critical illness health insurance plans. For example, Addison’s disease and SLE’s are mostly covered under critical illness plans, and type 1 diabetes is often covered under standard health insurance policies.

A health insurance plan covering autoimmune diseases covers expenses related to hospitalisation, treatment, daycare procedures, ambulance charges, diagnosis charges, and so on.

However, it’s important to talk to the insurer about the kind of autoimmune diseases that they cover under their health plans to be sure of what you can expect when you go for health insurance claims in the future.

What is the Waiting Period for Health Plans Providing Coverage Against Autoimmune Diseases?

Generally, the initial waiting period for normal health insurance claims is 30 days. For critical illness claims, the waiting period maybe 90 days with a 30 days survival period. However, the health insurance waiting period could be anything between 2 to 4 years for pre-existing autoimmune diseases.

Hence, when opting for health insurance plans with coverage for autoimmune diseases, you must discuss the waiting period well with your insurance provider. Also, you should always read and evaluate the terms and conditions of the health insurance plan to be aware of the waiting period of the same.


Although, as we have already mentioned above, autoimmune diseases aren’t curable, one can delay or reverse the same effects by following a good diet and lifestyle. For instance, consuming omega-3 fatty acids and vitamin A regularly can reduce the risk of several diseases. Also, including probiotics and prebiotics in the diet of infants can prevent certain autoimmune diseases as well. If you are looking for health insurance plans covering autoimmune diseases, you must always check with your insurance provider to know more about the kind of coverage options that you can expect.

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