Ulcer Coverage Under Health Insurance: What You Should Know

Digestive ailments such as ulcers are increasingly being diagnosed among urban Indians, often triggered by stress, erratic meals, or long-term medication. Treatment can involve hospitalisation, diagnostic tests, and follow-up consultations — all of which can strain household budgets. A well-chosen health insurance plan, however, can ease much of that burden.

What Health Plans Typically Cover

Most comprehensive health insurance policies in India cover ulcer-related treatments when hospitalisation or surgery is required. Expenses linked to admission, diagnostic tests, and medicines prescribed before or after the hospital stay — usually within a window of 60 to 90 days — can be reimbursed under standard policies.

“Surgical and hospitalisation expenses are covered under regular health insurance plans,” says Bhaskar Nerurkar, head- health administration team, Bajaj General Insurance. “Policyholders should also ensure that tests such as endoscopy, imaging, and blood work are included in their plan. Opting for day-care coverage is equally important, as several minor ulcer-related procedures don’t require 24-hour hospitalisation.”

While in-patient care is typically covered, outpatient visits, lifestyle counselling, or over-the-counter medication are not — unless clearly stated in the policy. Coverage limits and inclusions can also differ depending on whether the plan is individual, family floater, or critical illness–based.

Waiting Periods And Pre-Existing Clauses

Health insurance plans typically include a waiting period before claims can be submitted. “Every new policy carries an initial 30-day waiting period where only accident-related claims are accepted,” explains Nerurkar. “For pre-existing digestive conditions such as ulcers, the waiting period is longer — anywhere between one and three years, depending on the insurer.”

Once the waiting period is over, ulcer-related hospitalisation and treatment costs are covered, provided policy terms are met. Keeping a proper record of all medical reports, prescriptions, and diagnostic papers can make the claim process far smoother when the time comes.

For Those At Higher Risk

People who are more prone to ulcers — whether because of long working hours, chronic stress, diabetes, or the side effects of regular medication — need to be more careful while choosing their health cover. It’s wiser to go for policies that come with shorter exclusion periods and include outpatient department (OPD) or day-care procedures, since digestive problems often require frequent consultations rather than long hospital stays.

Some insurers also offer annual health check-ups, consultations with dietitians, and wellness add-ons, which can help in keeping such conditions under control. Ultimately, understanding what the policy leaves out is just as important as knowing what it covers. Picking a plan that fits one’s medical history and lifestyle can spare families both financial and emotional strain later on.