Does Your Health Insurance Cover Open Heart Surgery Cost?

• Written by Care Health Insurance

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Matters of the heart need undivided attention. Whether a minor procedure or a major cardiac surgery, treating heart-related illnesses can become financially burdensome. One way to cope with the unbearable medical bills is to get adequate health insurance coverage. Yet, most people aren’t sure if their standard health plan covers critical surgeries like open-heart surgery costs and treatment.

Read on to learn everything about open-heart surgeries in India, their types, treatment, and insurance policies that cover cardiac surgery costs.

What is an Open Heart Surgery?

Any surgery during which the patient’s chest is cut wide open and the surgery is done on the heart’s muscle, valve, or arteries— is referred to as open heart surgery. Open heart surgery aims to repair or replace a heart’s damaged part or implant a device for the heart’s proper functioning.

As the name suggests, an open-heart operation is performed by stretching and opening the rib cage to repair, replace, or implant the blocked arteries or veins. The more blockage one’s heart has, the longer the surgery’s duration– up to 6 hours. 

6 Most Common Types of Open Heart Surgery in India

Given the rising lifestyle conditions and diseases in India, surgeons are executing over 60,000 open heart surgeries across the nation annually. Below are the commonly performed open heart surgery types:

1. Coronary Artery Bypass Graft (CABG)

One of the most common heart surgery, CABG, is done to replace a damaged heart artery or vein. It involves placing an artery or vein from another body part and using it to create a new blood flow passage around the blocked artery. 

2. Heart Valve Replacement or Repair

Under this surgery, the heart valve is repaired or replaced by an artificial valve. This procedure can be done either via open-heart or insertion of catheter method. 

3. Implantation of Pacemaker or Cardioverter Defibrillator (ICD)

To improve the heart’s irregular rhythm or arrhythmia, doctors either use medications or implant a pacemaker under the chest. Both the pacemakers and ICDs use electric sensors and shocks to retain the heart’s normal rhythm.

4. Heart Transplant

Medications may not work in case of severe heart failure due to coronary artery diseases. This requires the surgeons to replace the damaged heart with a healthy heart donated by a deceased person.

5. Pericardiectomy

A critical open-heart surgery– pericardiectomy involves the removal of the pericardium or the membrane around the heart. The surgery improves the stiffness, helping the heart chambers to fill the blood properly. 

6. Surgery to Place Ventricular Assist Devices or Total Artificial Hearts

It is a long-term solution to treat ill-functioning heart ventricles. The surgery is recommended for people who cannot undergo a heart transplant.

Open Heart Surgeries: Procedure and Risks Involved

As a critical operation, open heart surgery procedure involves the following steps:

• Firstly, the chest is slit open – with an almost 8-inch cut through the breastbone  – until the heart is exposed.
• The next step is to stop the heart from functioning and pumping blood. For this, the heart is connected to a heart-lung bypass machine to help the surgeon operate.
• The surgeon replaces the damaged vein or artery with a healthy or artificial vein to create a new path for the heart’s functioning. 

As far as the risk factors are concerned, the success rate of open heart surgery is more than 50% for most types of procedures unless there are life-threatening conditions. While the survival rate is high among most people, complications can arise in the form of excessive bleeding, uncontrollable vitals, allergic reaction to anaesthesia, infectious incision, etc. Together with pre-existing diseases like diabetes, hypertension, or kidney failure— open-heart surgeries can turn life-threatening.

>> Read More: Why should you invest in Heart Insurance?

What is the Cost of Open Heart Surgery in India?

The cost of open heart surgeries may differ from region to region. The average cost of heart surgery is between 1.5 lakhs to 5 lakhs in India. The cost of CABG is around 2.75 lakhs, whereas the cost of implanting devices goes up to 3 lakhs. Basic health insurance may not cover the expenses for open-heart surgeries. You would need specialised heart insurance policies to secure yourself against hefty medical treatment expenses for heart surgeries. 

The good news is that you can lower the financial burden of open heart surgeries in India by opting for Care Health Insurance Plans for heart ailments, namely— ‘Care Heart’ and ‘Care Heart Mediclaim’. Read on to learn what coverage we offer.

Get Coverage for Open Heart Surgeries with Care Health Insurance

At Care Health Insurance, we ensure that matters of the heart are well-supported by finances and quality medical care. Our medical insurance policies of ‘Care Heart’ and ‘Heart Mediclaim’ offer coverage for several open heart surgeries, including Coronary Artery Bypass Graft, Heart Valve Replacement or Repair, Implantation of Pacemaker, Implantation of Cardioverter Defibrillator, and other major day care surgeries. Our policies offer the following benefits against heart insurance:

1. Wide-ranging sum insured options, starting from 5 lakhs to 6 Crores. 
2. Cashless Hospitalisation at our network of 24800+ hospitals
3. In-patient Hospitalisation expenses up to the sum insured
4. 30 days pre and 60 days post-hospitalisation medical expenses
5. Day Care Treatment expenses up to the sum insured
6. Ambulance and Organ donor cover
7. Annual Health Check-up packages, including CBC, KFT, LFT, ECG, Treadmill test, etc. 

With specialised heart insurance policies for heart and non-heart patients, Care Health Insurance ensure a speedy open heart surgery recovery rate. Our high claim settlement ratio reflects our reliable customer service— promising a stress-free hospitalisation journey for people across India. 

Disclaimer: Please verify the policy coverage with the official brochure and prospectus. Claim settlement is subject to policy terms and as per the underwriter’s discretion.