Does Your Health Insurance Cover Heart Transplant in India?

Heart transplant is performed to replace a damaged heart of a patient’s with a healthy one. This blog helps you to undersand how much a heart transplant can cost in India you and why health insurance is needed.

A few months ago, the news of Pakistani teen Ayesha Rashan’s journey to India for a new heart captured a lot of attention. After the right donor was found, Ayesha underwent the cardiac transplantation procedure on 31st January 2024, at MGM Healthcare, Chennai. With a price tag of ₹30 to ₹40 lakhs, Ayesha’s life-saving operation would have been out of reach without the support of a Chennai-based NGO and the contributions of other transplant patients.

Ayesha’s story is heart-warming, and her quest for a new heart has become a beacon of hope for many. However, it also highlights the daunting barriers many face in accessing life-saving treatment. The story behind the surgery is a stark reminder of the challenges heart patients face, especially when money is scarce.

Continue reading this article to know what are the heart transplant costs, factors affecting heart transplant costs in India and how does health insurance help in mitigating those expenses.

What is a Heart Transplant?

A heart transplant is a surgery that is performed to replace the heart of a patient from that of an organ donor. The surgery is usually performed as a last resort for the patient as it involves several complexities. A heart transplant helps a patient suffering from heart failure to leave a normal life.

The advancement in healthcare industry has made it possible to perform surgery as critical as transplant a heart. The first successful heart transplant in India was performed by Dr. Venugopal in 1994. The success rate of the surgery has gotten better over the years. However, heart transplant continues to be a rare surgery due to reasons like transplant complexity and lack of organ donors.

Heart Transplant Cost in India

Heart Transplant is a rather expensive surgery due to its complex process. Here’s a list of average surgery costs in Indian metropolitan cities.

Analysing the Cost of a Heart Transplant

The heart transplant cost in India varies from one hospital to another depending on the city of residence. However, one thing that is constant everywhere is the high transplant costs, which can hit one’s pocket severely. Having said that let’s evaluate the factors that affect the price of surgery in India:

1. The Hospital

Heart transplant is a complicated process that requires expert hands and a well-equipped surgical facility, drawing the majority of the population to look for the best heart transplant hospital in India. These facilities are established in metropolitan cities that while offering a comfortable experience, hence charge a hefty amount. Additionally, more people continue to opt for private hospitals to get heart transplants because of the better infrastructure and advanced technological setup.

2. Surgeon’s Fees

One of the main costs affecting the overall heart transplant bill is the surgeon’s fee. A limited number of surgeons perform the surgery in India, which translates into higher fees.

3. Surgery-related Expenses

Getting a heart transplant includes several other expenses incurred on pre and post-hospitalisation. Pre-hospitalisation includes the cost of health check-ups, tests and medications and post-hospitalisation demands special care that can be expensive.

4. Organ Donor

India faces major challenges when it comes to finding an organ donor. A study conducted in 2022 shows that with over 3 lakh people on the waiting list, the number of donors in the country has yet to show a pleasant movement. The number of organ donors grew from 6,916 in 2014 to only 16,041 in 2022.3 Given the waiting list and lack of organ donors, the surgery cost automatically shoots up, making burns in the pocket and, in many cases, seems impossible for patients.

>> Also Read: Health Insurance for Organ Transplant Surgeries

How does Health Insurance Help?

The rising costs of healthcare in India have posed serious threat to the public health sector in India. However, while we wait for some major transformations in the medical field, a health insurance plan creates a safety net for policyholders to meet the medical expenses of surgeries.

The journey of Pakistani teen Ayesha Rashan captivated hearts across borders. However, it also highlighted how a surgery like a heart transplant can be an insurmountable challenge. It can leave many patients and their families grappling with the impossible decision of choosing between life and financial collapse. The only way that most Indians can deal with the financial implications of such a procedure is through a suitable health insurance policy.

However, the coverage for a heart transplant depends entirely on the mediclaim policy that you have purchased. Various procedures take place, and the costs can vary from patient to patient. Thus, it is essential that you are well aware of the coverage of your policy. For example, with the Care heart Mediclaim policy, you can get coverage of up to SI or ₹15 lakh whichever is lower. Along with the organ donor cover, the policy covers you for in-patient, pre and post hospitalistaion expenses, day care treatment, global coverage, air ambulance and many more. Go through the policy brochure and understand the inclusions and exclusions of the policy to make a well-informed decision.

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.