Friday, November 13, 2009

Health Insurance woes

Since my son was born, I have been trying to get an health insurance policy for my son. I have still not been able to. I have spoken to so many of them. Some have refused because of down syndrome, some due to his heart surgery and I guess there was a company that refused because he had tracheostomy. Some of the insurance companies have it clearly listed 'genetic condition' under permanent exclusion. Isn't this the worst form of discrimination? Isn't it unethical that they would not sell the policy to someone because there are chances that he might need it the most? This whole system is frustrating and tiring!

Of course, there is a government scheme offering insurance to people with disabilities. The monetary cover provided by the policy isn't too much but then something is better than having nothing at all. So, I decided to apply for it. When I approached people for an application form, they informed me about the process. They wanted me to get a national id card where a doctor would examine my son and certify that he is mentally retarded and provide the percentage of retardation. Only after getting the card would I be able to avail government insurance. But, I have his karotype report stating that he has down syndrome. Shouldn't that be enough? Looks like it isn't. Only a national id card stating my son is mentally retarded would be accepted as a proof to provide him health insurance benefits.

What I don't understand is that why should this be required to get a simple health insurance policy? This policy isn't going to cover his therapy charges or anything special that a normal health insurance wouldn't cover. This is just like any other health insurance policy. They do not cover anything special. When I can get a health insurance policy without having to prove my mental capabilities, why should my son prove otherwise in order to get his? Also, how is a doctor going to examine a 15 month old, evaluate his mental condition and come up with the percentage of retardation? It all sounded so unfair and I immediately dropped the idea of availing the government health insurance for my son.

Ok, going back to the private insurance companies, the telemarketing calls that I receive are so pathetic. There is usually some insurance agent desperately trying to sell me a policy. I tell him about my son and he immediately asks me what is down syndrome. (this has happened in almost all the telemarketing calls). I tell him its a genetical condition and they don't usually understand. So, I try to explain in layman terms and by the end I hear the agent saying 'Ma'm we wouldn't provide cover for this disease but all other diseases would be covered. And, after four years or so, you can also get a cover for this disease'. Do they even listen when you take time and explain to them what things really are! So, I just ask them to note down the word 'down syndrome' consult their superiors and get back if they still think they could sell us their policy. Almost most of the times, I never get a call back. I'm not sure if its because they can't sell it to us or the agent found it unworthy of his time to find things. Just once a person called back and apologised because the company doesn't sell policy to people with genetical problems. I was angry but at least I was happy that I don't have to approach them again.

When my son was admitted in January this year, he was on prolonged hospitilazation. Within hardly a fortnight all our money was almost spent. We had no idea what we were going to do. That is when my aunt, people from the Down syndrome federation of India and my husband's collegues came to our rescue. We never asked anyone for help. The help just came and we were able to manage the situation. But the bigger question is what about other kids with down syndrome? What if no one comes to help them out? Why should they suffer to get medical assistance just because they are born with down syndrome or other similar condition? And, why should things be made more complicated for parents like us when we have a lot of other medical complications to worry about?

I wouldn't blame the government for not providing enough medical funds. India is still a growing economy and with a huge population, it is difficult for government to help beyond a certain point. On the other hand, they should be able to put a stop to the discriminatory policies adopted by the private insurance companies. Health care should be available to all and denying it to people who need it the most makes no sense at all.

I'm just hoping for a positive change would come over soon. In the meantime, my search still continues. Tomorrow, I'm planning to fill out a form and apply for my son's health insurance with another private insurance company. Will have to wait and see what happens. Until then, just wish us luck!


  1. Oh, Sumithra! It is pure discrimination and I don't think that insurance companies India are alone in their endeavors to choose who gets coverage.

    I think, too, that having a telemarketer call your home and then refuse Vignesh coverage, without even having an ounce of understanding about Down syndrome would be more of a slap in the face!

    I feel for you and I certainly understand your frustration. *hugs*

  2. How frustrating! I see that the US isn't the only place with health insurance issues.