India’s First Group Health Insurance for

People Living with HIV Stanley JosephNational Coordinator – InsuranceINP+

Stanley JosephNational Coordinator – InsuranceINP+

Types of Insurance Life Insurance

Gives protection and financial stability to family. There is no Life Insurance for PLHIV

Non Life or General Insurance

Property, Theft, vehicle Insurance and Personal Insurance - Accident and Health Insurance .

The HIV/CARE policy is a Health Insurance and it is the first in the country.

• There is no Insurance for known PLHIV

• Though ART is covered by Govt. expenses are high for PLHIV

• 80% of the health expenses in Indian Household are out of pocket and 20% are coming from government

• Out of Pocket expenses are 3-6 times more than the general population for PLHIV

• Cost are high for Life long treatment of HIV and AIDS

Need for insurance for PLHIV

• Covers only HIV infected individuals

• No age limit for the applicant

• The Period of Insurance is for one year like any other Mediclaim Policy

• Sum Insured is Rs 30,000/-

• Annual Premium Amount is Rs. 1511/-

• PSI will support 50% of the premium ie. Rs.756/-

• Member has to pay only Rs.755/- for one year cover

• 50%( Rs. 15000/-) of the SI is covered for Hospitalization and 50% (15000/-)on reaching AIDS Stage

Key features of the policy

• The HIV Care Policy is issued to a group of persons infected with HIV

• Policy taker must be a member/beneficiaries of the proposer

• Pre Insurance screening is mandatory for all applicants (CD4 cell count of 300 and above) to rule out AIDS stage

Eligibility

• Inpatient Services/Hospitalization

• Emergency Ambulance charges up to a sum of Rs 750/- per hospitalization and a limit of Rs 1500/-

• Pre Hospitalization expenses for 30 days

• Post hospitalization expenses for Rs 5000/-

• Waiting period of 30 days for hospitalization claim and 90 days waiting period for AIDS stage

Policy coverage details

• All diseases/injuries which are Pre-Existing. PED will be covered only after 4 fours of continuous renewals.

• ART and Tuberculosis treatment are not covered (BOTH provided by government)

• Any disease contracted by the Insured person during the first 30 days of the policy

Exclusions under the policy

Process of forming group PolicySupport groupmeetings

Orientation on Insurance

Consent forms distributed and collected from members

Premium collection from members who can form a group of 200

Eligible members CD4 >300 can be part of the policy

More than 1 district can come together to form a group of 200

Group of 200 members is formed and policy is issued

CD4 camp to be conducted

Thank You