In India, Alzheimer’s and dementia are covered by insurance through various policies and schemes. Here’s an overview:

Health Insurance: Many health insurance policies in India cover Alzheimer’s and dementia, including:

  1. Individual Health Insurance Policies: Some insurance companies offer coverage for Alzheimer’s and dementia as part of their individual health insurance policies.
  2. Senior Citizen Health Insurance: Specialized senior citizen health insurance policies often cover age-related diseases, including Alzheimer’s and dementia.
  3. Critical Illness Insurance: Critical illness insurance policies may cover Alzheimer’s and dementia, providing a lump sum payment to help with treatment and care.

Government-Sponsored Schemes: The Indian government offers several schemes to support individuals with Alzheimer’s and dementia, including:

  1. Rashtriya Swasthya Bima Yojana (RSBY): A health insurance scheme for below-poverty-line families, which covers hospitalization expenses, including those related to Alzheimer’s and dementia.
  2. Ayushman Bharat: A national health protection scheme that provides coverage for secondary and tertiary care hospitalization, including treatment for Alzheimer’s and dementia.
  3. National Programme for the Healthcare of the Elderly (NPHCE): A program that provides health care services, including diagnosis, treatment, and care, for elderly individuals with Alzheimer’s and dementia.

Private Insurance Companies: Several private insurance companies in India offer policies that cover Alzheimer’s and dementia, including:

  1. ICICI Lombard: Offers a comprehensive health insurance policy that covers Alzheimer’s and dementia.
  2. Bajaj Allianz: Provides coverage for Alzheimer’s and dementia through its health insurance policies.
  3. Max Bupa: Offers a senior citizen health insurance policy that covers age-related diseases, including Alzheimer’s and dementia.
  4. Apollo Munich: Provides coverage for Alzheimer’s and dementia through its health insurance policies.
  5. Star Health: Offers a senior citizen health insurance policy that covers age-related diseases, including Alzheimer’s and dementia.

Limits and Exclusions: While many insurance policies cover Alzheimer’s and dementia, there may be limits and exclusions, such as:

  1. Waiting Period: A waiting period may apply before coverage kicks in.
  2. Sub-Limits: Sub-limits may apply for specific treatments or expenses.
  3. Exclusions: Certain expenses, such as long-term care or home care, may be excluded from coverage.
  4. Pre-Existing Conditions: Pre-existing conditions, including Alzheimer’s and dementia, may be excluded from coverage or subject to a waiting period.

It’s essential to review policy terms and conditions carefully and consult with an insurance expert to understand the coverage and limitations.

by | Sep 22, 2025 | Bajaj Allianz Life Insurance, Care, ICICI Lombard, Insurance, Star Health and Allied Insurance

Families of patients with Alzheimer’s disease or other forms of dementia often face uncertainty and financial burdens due to medical expenses and long-term care. While health and critical illness insurance policies can cover some hospitalization and severe-stage treatment costs, they usually exclude long-term care and routine support. Understanding what is included and excluded in these policies is crucial for effective financial planning.

Health insurance policies generally cover hospitalization costs for Alzheimer’s or related complications, including infections, injuries, or behavioral complications during hospital stays. However, long-term care, such as assisted living, home caregiving, or routine outpatient visits, is usually excluded unless an OPD add-on is purchased. Critical illness policies may list Alzheimer’s as a covered condition, but benefits often only apply at advanced, irreversible stages, and a mandatory survival period of 15-30 days is required before a lump-sum payout is made.

The definition of Alzheimer’s for insurance purposes is important. For critical illness policies, Alzheimer’s is defined as a progressive brain disorder causing severe memory loss and inability to perform daily activities, with early or mild cognitive impairment usually not qualifying. Health policies, on the other hand, do not differentiate by stage for hospitalization claims.

Common exclusions in health and critical illness policies include long-term care, rehabilitation, or assisted living, routine outpatient consultations and therapy, pre-existing neurological conditions, and experimental or unproven treatments. Insurers distinguish between medical treatment and supportive care, with long-term custodial care considered supportive, not hospitalization, which is why it is outside standard policies.

Health insurance premiums rise with age and health history, while critical illness premiums depend on age and coverage amount. Coverage for individuals already diagnosed with Alzheimer’s is generally unavailable, and critical illness claim settlements are contingent on verification of severe disease and survival-period compliance. Currently, there are no insurance products dedicated to Alzheimer’s or dementia, but insurers are expanding inclusivity in policies, covering mental health and other previously excluded conditions. Discussions are ongoing around long-term care solutions tailored for cognitive disorders, which may provide more comprehensive support for families affected by Alzheimer’s and dementia in the future.