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Do health insurance policies cover Black Fungus treatment?

Team AckoMay 24, 2024

As we struggled with the effects of the COVID-19 pandemic, new concerns emerged, including the rise of a rare but serious fungal infection known as Black Fungus. Although this fungus is commonly found in the soil and air, its impact on people recovering from COVID-19 has become increasingly evident. This led individuals not only to focus on getting treatment for COVID-19 but also to question whether their health insurance covered Black Fungus treatment.

With the potential harm Black Fungus infections could cause, those recovering from COVID-19 sought clarification from their insurance providers regarding coverage for this particular condition. Insurance companies were tasked with addressing this evolving aspect of healthcare, ensuring that policyholders received the necessary support for dealing with post-COVID complications, including fungal infections like Black Fungus.

As our understanding of how COVID-19 interacted with other health issues grew, it became increasingly important for health insurance policies to provide comprehensive coverage, safeguarding people's health in the aftermath of the pandemic. Let us shed light on this possibility through the following article.

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Contents

Does health insurance cover Black Fungus or Mucormycosis treatment?
What is Black Fungus?
Origin And History
What Does Black Fungus Do?
How is Black Fungus related to COVID-19?
Black Fungus types
Causes of Black Fungus
Why Is It Developed By Covid-19-Recovered Patients?
Who is at a higher risk of getting Black Fungus infection?
- Things to Remember
Black Fungus diagnosis
How does health insurance help in medical emergencies?
Frequently asked questions

Does health insurance cover Black Fungus or Mucormycosis treatment?

Black Fungus treatment requires hospitalization, and in some severe cases, surgery also. Both these are covered under health insurance. A health policy that covers COVID-19 would also allow a claim for Black Fungus treatment. However, there might be a certain waiting period to raise a claim. It is thus necessary to confirm such details with the insurer.

Health insurance companies that cover Black Fungus are allowing related claims and paying the cost of treatment including hospitalization or surgery, as per the terms and conditions of the plan. Additionally, government schemes like Pradhan Mantri Jan Arogya Yojana and Mahatma Jyotiba Phule Jan Arogya Yojana offer health insurance coverage for Black Fungus.

What is Black Fungus?

Black Fungus (Mucormycosis) is caused by a type of mould known as Mucormycetes. It is commonly found in households and can be inhaled by anyone. It can also enter the body through an open wound or small cuts. A healthy person can easily fight this infection off. Those who can't, develop a serious infection that can affect the respiratory system, skin, gastrointestinal tract, eyes, or brain of the infected person.

Origin And History

Mucormycosis, caused by a group of moulds, lacks a clear origin due to its complex nature. Friedrich Kuchenmeister's 1855 description marked its earliest recognition, possibly as mucormycosis. The fungus Saksenaea Vasiformis, linked to the disease, was isolated from Indian soil in 1953.

Despite its historical presence, the disease has surged to epidemic levels post-Covid-19 recovery. This escalation underscores its newfound prominence. The connection between immunosuppression and environmental factors likely contributes to its resurgence. While not new, its current prevalence demands heightened attention and research efforts to understand its evolving epidemiology and mitigate its impact on public health.

What Does Black Fungus Do?

These fungi, known for their invasive nature, infiltrate blood vessels, triggering tissue necrosis with potentially fatal consequences. Present in the environment; their spores settle in sinuses and nasal passages, germinating and ravaging surrounding tissue, including bones of the orbital, hard palate, and skull base. This manifests in symptoms such as eye pain, protrusion, blindness, and restricted eye mobility.

Moreover, these fungi can induce brain strokes, pulmonary tissue degradation, respiratory distress, and systemic dissemination, posing a grave threat to life. Primarily targeting the brain and oral cavity, they also affect other vital organs like the gastrointestinal tract and skin, amplifying the severity of their impact on health.

Mucormycosis is a fungal infection and can infect any immuno-compromised person. Meaning, it may affect a person who has weak immunity. Since this is a common situation of a person recovering from COVID-19 infection, the patient is at a higher risk of getting infected by Black Fungus. People that were critically ill from COVID-19 are at a higher risk as the drugs and extreme life-saving treatment they received for treating COVID-19 had an adverse effect on their immunity.

Common reasons of Black Fungus infection also include poor sanitation, misuse of steroids, oxygen source, antibacterial medications, or contaminated food. Using dirty masks, staying in closed or less ventilated areas for a long time can cause this infection.

Black Fungus types

Identifying the specific type of black fungus is crucial for effective treatment, as different strains require tailored approaches. Pulmonary mucormycosis commonly affects cancer patients and transplant recipients, primarily targeting the lungs. Rhinocerebral mucormycosis, stemming from a sinus infection, can extend to the brain and is prevalent among individuals with untreated diabetes or kidney transplant recipients.

Cutaneous mucormycosis manifests as skin infection, often affecting healthy individuals via bloodstream invasion. Gastrointestinal mucormycosis predominantly afflicts young children, especially premature births or those undergoing surgery or immunosuppressive therapy. Disseminated mucormycosis, impacting various organs via circulation, poses a significant threat, particularly to the brain. Understanding these distinctions is vital for precise diagnosis and treatment planning.

Causes of Black Fungus

Black fungus, often termed opportunistic infections, exploits compromised immune systems, with mucor fungi proliferating in moist environments. Millions of spores are dispersed in the air, germinating into mycelia upon contact with moisture-rich substrates like plant debris or animal waste.

These mycelia feed on sugars, posing a risk upon human contact, either through skin lesions or inhalation. While most individuals encounter these spores daily without harm, immunocompromised individuals face heightened susceptibility, potentially leading to sinus, lung, or brain infections.

Risk factors for black fungus include uncontrolled diabetes, cancer, organ transplants, low white blood cell count, HIV/AIDS, excessive iron levels, Covid-19, steroid use, drug abuse, unhealthy lifestyles, premature birth, and open skin wounds. While anyone may encounter the fungus, those with weakened immune systems are at greater risk. Understanding these risk factors is crucial for preventive measures and prompt treatment, particularly for vulnerable populations.

Why Is It Developed By Covid-19-Recovered Patients?

The diminished immunity caused by Covid-19 exacerbates the vulnerability to infections like black fungus. Patients with high diabetes experience compromised immune responses, further weakening their ability to fend off pathogens. This impaired immune function hampers the body's defence mechanisms, rendering the antibodies ineffective against the onslaught of black fungus.

Consequently, the fungus grows unchecked, inflicting severe damage to the body's tissues and organs. This symbiotic relationship between COVID-19-induced immune suppression and diabetes-related immunodeficiency underscores the heightened susceptibility to opportunistic infections, accentuating the severity of the health crisis faced by affected individuals.

Who is at a higher risk of getting Black Fungus infection?

Black Fungus thrives in conditions where the body does not have sufficient white blood cells (WBCs) to fight off the infection. This is what makes a common fungal infection deadly. WBCs or soldier cells can reduce from a recent or an ongoing disease and this leads to low immunity. So the Black Fungus infection can trigger in the following kind of patients.

Patients recovering from COVID-19 infection
People with HIV or AIDS
Someone that has recently undergone stem cell transplant
A patient fighting cancer
Diabetic people
A person suffering from heart ailment
Others with low immunity

Things to Remember

If you are recovering from COVID-19 infection or have a disease that has caused low immunity, it is important to note the following points.

Remember that Black Fungus is commonly found around the house.
Throw out any stale or decaying fruits and other food items.
Avoid gardening as there are high chances of Black Fungus being present in house plants, soil, manure, etc.
Build immunity by strictly following the post-hospitalisation treatment and other remedies.
Periodically monitor blood sugar levels.
Humidity in a closed space (house or office) should not be above the range of 30-40%, as high moisture environments promote fungus growth.

Black Fungus diagnosis

Diagnosing black fungus requires a systematic approach. Clinical assessment often starts with identifying common symptoms like headaches and tissue necrosis, alongside signs such as black scabs in oral or nasal cavities, eye inflammation, and vision loss. Imaging techniques like CT scans aid in detecting associated conditions in the brain, sinuses, and lungs.

Histopathological and microbiological examinations confirm the presence of the fungus through tissue analysis. Molecular testing, though less common, provides detailed genetic insights into Mucorales prevalence. While various methods are available, microscopic analysis usually proves sufficient for diagnosis, ensuring timely and accurate treatment initiation.

How does health insurance help in medical emergencies?

Through an active health insurance policy, your insurer has made a promise to bear the cost of covered medical treatments. Thus, you have a strong financial backup whenever you need money for medical treatment (provided it is covered under your health insurance plan). Your health insurance policy helps you get timely treatment that allows you better results as compared to having no financial backup and thus delaying treatment. Usually, you get the following coverages under a health insurance policy.

Hospitalisation

This includes the cost of treatment, room rent, doctor visits, surgery costs, nurse charges, etc. Additionally pre- and post-hospitalisation expenses are also covered.

Daycare treatment

Small medical procedures that don't require prolonged hospitalisation come under daycare treatments. Some examples of daycare treatment are cataracts, tonsillectomy, etc.

Ambulance charges

Usually the cost of one ambulance journey to or from the hospital is borne by the health insurance company under this coverage. This benefit may come with a sub-limit clause. Hence it is important to understand your policy terms.

Maternity expenses (Add-on)

The policyholder can choose to get coverage for maternity and newborn-related expenses by opting for the maternity expenses add-on coverage. Some health insurance plans also offer this coverage as a built-in benefit.

Frequently asked questions

Following are a few questions related to Black Fungus and health insurance. Consider contacting ACKO by sending an email to [email protected] in case of more queries.

Which symptoms suggest the presence of Black Fungus infection?

Since there are multiple types of Black Fungus infections, depending upon the site of infection, the symptoms can differ in each case. Following are common symptoms of Black Fungus infection.

Sinus or nasal pain and congestion
Fungus patch inside the mouth
Blurry vision
Swelling in the eyelids
Cough
Blackened skin tissue
Diarrhea
Nausea and vomiting
Ulcers on the skin

Can the Black Fungus infection spread from one person to another?

No, the Black Fungus infection does not spread from one person to another, i.e it is not contagious.

Do I need to buy special health insurance coverage for Black Fungus?

No, the health insurance plan that covers COVID-19 will also cover Black Fungus infection. Buying a new health insurance policy is not required if you already have sufficient coverage.

Does Black Fungus infection cause loss of vision?

Yes, advanced cases of Black Fungus have resulted in blurry or loss of vision. Thus, it is advised by doctors that any patient recovering from COVID-19 who is experiencing the symptoms of Black Fungus must immediately seek medical help. In case of delay, the infection can reach the brain and cause permanent damage.

How does health insurance help if a person has Black Fungus infection?

The treatment cost for Black Fungus amounts to lakhs of rupees, and it can burn a hole in the finances. In this situation, your health insurance policy can provide a financial back-up, and you can rest assured that you have a helping hand during the time of crisis. Thus, health insurance provides financial help if a person has Black Fungus infection, provided your health policy covers it.

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Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet; and is subject to changes. Please go through the applicable policy wordings for updated ACKO-centric content and before making any insurance-related decisions.