Does Your Health Insurance Policy Cover Surgical Expenses?

• Written by Care Health Insurance

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Surgery is an important medical procedure for the treatment of certain illnesses. For a patient and the family members, it is natural to feel a bit nervous. In the event of a surgical operation, a lot of care is required. It hints at the need for getting quality treatment at the best hospital.

Medical procedures, including surgeries, are getting advanced. However, their costs are quite high, especially in private hospitals. Having a health cover or a mediclaim policy becomes absolutely essential to prevent one’s financial savings from draining out. 

Operation Insurance by Care Health Insurance is a health cover for surgical expenses. 

Features and Benefits of Health Insurance with Surgery cover

Health insurance products offer comprehensive cover for various medical expenses, including surgical expenses. Based on the policy, a number of surgeries may be covered, for instance, bypass surgery, knee replacement, and cataract operation. The best thing is health insurance for surgery comes at quite an affordable premium. There is a wide range of features and benefits, and the policyholder can avail coverage from Rs 10 Lakh to a coverage amount up to Rs 2 crore. 

Let us discuss the prominent features of this plan: 

• Hospitalisation Cover: Hospitalisation costs, including room rent, ICU and operation theatre charges, get covered in a health insurance policy. 
• Pre and post hospitalisation: Health insurance plans allow the insured person to get coverage for pre and post hospitalisation medical costs, for 30 days and 60 days, respectively.
• Ambulance Cover: A health policy also covers the incurred emergency ambulance costs up to a specified amount per hospitalisation. 
• Day Care Treatment: Operation mediclaim and health insurance plans with surgery cover prove beneficial when the patient has to avail day care surgical procedures. Such plans cover several day care treatments listed in the plan.  
• Organ Donor Cover: Many ailments that lead to complications may need organ transplant surgery. Health insurance with surgery cover will provide coverage for such expenses. 
• Lifelong Renewability: Health plans come with lifelong renewability option. Thus, one gets continued coverage for a long time and need not think of buying another policy. 
• No Claim Bonus: If the insured spends a claim-free year, he/she can avail of the no-claim bonus that provides an increase in the sum insured by a specified percentage per policy year. 
• Cashless Hospitalisation: The best insurance for surgery offers the cashless treatment facility at network hospitals, enabling a policyholder to get immediate medical care without needing to bear the hospital bills upfront.

Many indemnity-based health insurance plans cover the actual expenses incurred due to the surgery. Thus, they prove to be a vital safety net for one’s hard-earned savings and help a family sail through any emergency or planned surgery that often leads to hefty medical bills. Before any surgery, a patient may have to go through numerous diagnostic tests such as an electrocardiogram (ECG) test, ultrasound, blood tests, etc. Besides, post-operative care is also essential for a patient, which include follow-up visits to the doctor. These medical expenses borne by an individual are reimbursed under the policy, thus giving financial protection.

Further, the cashless treatment feature eases the stress that one may have to go through during emergency hospitalisation. It is advisable to look at the network hospitals list, when buying a health policy, to identify a hospital in the vicinity. Care Health Insurance promises hassle-free hospitalization with a network of 24800+ cashless healthcare providers. One can approach any network hospital empanelled with us and get admission using a health card. This feature eliminates the task of arranging funds to pay the medical bills. We will expenses directly with the hospital, and you can stay worry-free!

Know the Exclusions

While you ensure you get the best insurance for surgery, do not forget to look at the exclusions mentioned in the policy documents. These are cases where the insured will not be eligible to obtain a claim for certain expenses. Cosmetic surgeries, plastic surgeries, and infertility treatment are some types of surgeries that are generally not included in the policy cover.

Important Tips to Avail Coverage for Surgery

• Whether it is a planned hospitalisation or emergency hospitalisation, the policyholder should remember to inform the insurer as per the specified time. It is vital so that there are no hassles in getting the claim.
• The insured should be aware of the waiting period for specific diseases. In case an illness is diagnosed, or a medical emergency occurs during that period, they should make prior preparation to avoid any major financial implications. 
• While choosing the sum insured, one’s medical condition is an essential factor to keep in mind. 

In the case of certain non-communicable diseases, an individual may not show symptoms initially. The chances of medical emergencies may suddenly rise as the disease progresses. Any treatment involving medication and surgeries may cost up to lakhs of rupees. So, opting for comprehensive health insurance with various features and insurance cover for surgery is the best way to ensuring the welfare of the entire family.

>> Also Read: Guide to Buying Short Term Health Insurance Plan

*Please read the policy T & C, brochure, and prospectus to know more about our health insurance plan.