Are Surgeries Covered In A Health Insurance Policy?

Are Surgeries Covered In A Health Insurance Policy?

We all are aware of the medical expenses in India. If you have to get hospitalized by any chance then you better need to be prepared with quite a good amount of money. As a matter of fact, if you want to get the right good medical treatment in the country, you must have a good bank balance. What if you do not have that kind of money but have no option other than getting the right medical treatment? Well, this also has a solution. You can buy a health insurance policy.

When you have a health insurance policy, you can stop worrying about the high hospital bills. All that you need to look for is a good network hospital where you can get your treatment. However, does a health insurance policy cover the expenses of surgeries? Well, the majority of health insurance plans provide coverage for surgeries. Nevertheless, those health insurance plans come with certain terms and conditions. The expenses that are covered have to be considered medically necessary. This means, the surgery must be health improving, life-saving, and can prevent an illness. On the other hand, if the surgery is being conducted for cosmetic reasons, then there will not be any coverage provided.

How much coverage does a health insurance policy provide for surgery?

The coverage of health insurance for surgery depends on several factors. To find out how much coverage your insurer will provide, you have to check the terms and conditions of your term insurance policy. You can also get in touch with your doctor to find out the expenses of the surgery so that you can plan accordingly. However, you need to know that the exact amount can only be done after the surgery is completed since additional costs can also be incurred.

What are the additional costs of surgery?

There are some aspects of surgery that go along to determine that general expenses. Let us take a look at them:

  • Pre-operative and Post-operative tests: X-rays, Bloodwork, etc. are needed to check the condition of the patient before as well as after the surgery.
  • The fee of surgeon and attendant:The fee of the attendant who is attending to the patient at the time of the surgery is applied on the bill separately. These may include doctors, surgeons, co-surgeons, or even nurses.
  • OT expenses:Operation Theater is the place where the surgery takes place. This will have separate costs on a procedure and on the basis of per hour.
  • Medical equipment:Cost of the crutches or a brace if needed by the patients after the surgery.
  • Medication:The medication costs include anesthesia, intravenous medication, etc. which are prescribed by the doctor.
  • Recovery room and in-patient care:It totally depends on the situation of the patients on the basis of which a stipulated recovery time is given after the surgery. This is added to the expenses of the surgery.

The coverage depends completely on your health insurance policy since all the plans come with different levels of coverage.

To conclude, we can say that surgeries now are covered under many health insurance policies; however, they come with some terms and conditions. As per the majority of the health insurance policy terms and conditions, they have to be medically necessary so that the insurance company approves them for filing a claim.  Nevertheless, the detail of the coverage varies from one policy to the other. This is why you must go through the documents of the policy. To find the health insurance policies that provide coverage for surgeries, you can visit the IIFL website. You can also come across various types of health insurance policies on the website that you may find interesting.

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