Does Health Insurance Cover Kidney Transplants?


Does Health Insurance Cover Kidney Transplants?

Medical science has come a long way to change lives and organ transplant is a miraculous procedure that was beyond imagination in earlier times. Organ transplants have become the saviour for all those patients who are suffering from single and/or multiple organ failure. A process where medical experts replace the patient’s weak organ with that of a stronger organ from a donor is the simplest way to understand organ transplant.

Kidney transplant is one of the most successful organ transplant procedures performed by surgeons at different medical institutions. However, it indeed is an elaborate procedure that requires advanced nursing and skills. Kidney transplant, the ultimate hope for patients, is a rather expensive process, making it a wise step for individuals to opt for insurance coverage.

One might be wondering, is kidney transplant covered by insurance? Well, the answer is yes. However, before opting for an insurance plan, you must educate yourself on the basics of organ transplant and its insurance coverage principles.

Who Needs a Kidney Transplant?

Two bean-shaped organs located below the rib cage of your body are kidneys. The sole purpose of the kidney is to filter out waste from your body periodically in the form of discharge. Now, imagine if your kidney fails to perform this function. All the waste and unwanted material will accumulate inside your body, giving rise to numerous life-threatening diseases.

Modern food habits and heretical problems might have paved the way for you to face kidney-related diseases that need intervention at the earliest stage. In any case, if your kidney faces complete failure, medical science can help you replace it with a stronger kidney from a donor.

A rather common procedure- kidney transplant is sadly an expensive one, leaving you wondering- does health insurance cover kidney transplant? Yes, it does and we are here to make you understand how.

Insurance Coverage for a Kidney Transplant

Now that you are well-versed in the basic concept of a kidney transplant let’s understand the principles of insurance coverage and why it is wise to opt for a policy.

Insurance coverage for kidney transplants is designed to offer financial assistance for patients to meet the expenses of the donor and hospital. There are different types of policies that cover expenses to a specified limit and help patients undergo a smooth and stress-less surgery. Additionally, with insurance coverage in hand, finding a donor becomes easier as insurers help establish contact.

Why is Coverage for Kidney Transplants Important?

Kidney transplant is an elaborate process, which starts from meeting the cost of finding a reliable donor. In addition, it is performed under advanced medical setup and assistance that pushes the overall expenses rather high. On average, getting a kidney removal surgery cost without insurance from a reputed institution can be between ₹5 lakh to ₹20 lakh.

An insurance cover is planned out carefully to offer financial assistance to policyholders who are undergoing life-threatening diseases that can lead to kidney failure, such as diabetes and high blood pressure. Choosing an insurance plan for a kidney transplant requires you to consider several aspects to ensure that you are opting for a plan that is best suited for your condition. Insurance coverage is planned to keep in mind the goodwill of patients and is, therefore, a reliable option to explore. Before you opt for the policy, it is recommended to carefully get your medical history and reports examined by a medical professional to understand your medical condition better.

Generally, the cost of surgery is covered up to the specified limit. Depending on the insurance coverage you choose, the coverage limit changes; therefore, it is advised to carefully evaluate all aspects of kidney transplants covered by insurance.

>> Also Read: Discover the Top Causes of Kidney Stones and How to Prevent Them

Benefits of Kidney Transplant Coverage

Kidney removal surgery cost with insurance acts as a saviour in an unfortunate event of kidney failure as it helps with

  • Medical expenses, including in-hospitalisation charges
  • Reimbursement of costs (up to a specified limit) incurred by patients to find donors.
  • Tax benefit under section 80D of the Income Tax Act, 1961.

Things to Keep in Mind while Buying Kidney Transplant Insurance

You may find multiple policies offering coverage under their organ donor benefit where the expenses incurred towards a transplant are covered. Health insurance plans such as Care Supreme or Care Advantage by Care Health Insurance can be an ideal choice if someone is looking for higher sum insured for insuring against the expenses of such organ transplant. These carefully designed plans are unique in the market that offer higher sum insured up to 6 cr. However, to ensure that you are not getting trapped into a plan that is not ideal for you, make sure to keep these practical tips in mind-

  • Read every word of the policy paper carefully, and if needed, seek a professional’s help to better understand the terms and conditions.
  • Visit your doctor to get yourself examined, and then choose a plan that covers probable threats in your condition.
  • Carefully evaluate the hospital chains your policy offers, as you would want to go for a trusted hospital in case of an organ transplant. 
  • Don’t get tricked or enticed by exceptionally low monthly instalments. Rather, keep your focus on the coverage the plan offers. 
  • Look for additional benefits and combo insurance plans to avoid any other type of health risks.
  • Family floater plans are affordable, and you can get great deals.
  • Check the claim for the coverage of donor costs. You can go for either of these methods-
  1. Cashless Method- If your plan offers a cashless method of claim settlement it means that your medical bills will be paid by the insurance company directly to the network hospital without your involvement in the transaction Every policyholder gets a medical card that can be used at a wide network of hospitals. 
  2. Reimbursement Method- At a non-network hospital, you have to bear the cost of medical expenses from your pocket initially and get the money reimbursed later on.

Summing Up

Keeping in mind the uncertainties of life and increased chances of life-threatening diseases, an insurance cover designed for your needs has become a must. You are free to explore over 50 types of plans and choose what best serves your financial and medical needs. Remember to check out kidney transplant insurance coverage that offers maximum coverage, as the cost of this surgery is usually high and can become a huge burden on your pocket if you don’t have a coverage plan in hand.

At Care Insurance, the complete process of selecting an insurance cover is transparent, and our experts are more than willing to guide you through each plan and help you customise, as well.

Disclaimer: 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.

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