Is Brain Surgery Covered Under Your Health Insurance?


Is Brain Surgery Covered Under Your Health Insurance?

The brain is a miraculous three-pound organ responsible for all bodily processes, interprets data from the external world, and embodies the mind and soul. The brain controls a wide range of functions, including memory, creativity, emotion, and intelligence. Memory, feeling, and even personality can all be affected by any brain damage. Any deformity or damage to the brain can be fatal, and the only way to address these abnormalities or damage is sometimes through brain surgery. 

Do you want to know if brain surgery is covered by health insurance? Let's check, but before that, know what brain surgery is.

What is Brain Surgery?

Any process that addresses irregularities in your brain is regarded as brain surgery. The brain is a component of the central nervous system. It controls your ability to communicate, move, think, and remember. Brain surgery aims to treat conditions without interfering with these vital functions. 

It is a complex procedure performed in a specialised setting by qualified neurosurgeons. The types of brain surgery that are performed are recommended by the doctor based on area of structural aberration, the patient's health, and the seriousness of the problem. Recent advancements in brain surgery have allowed many doctors to recommend it under some circumstances.


What is the Purpose of Brain Surgery?

Some of the following conditions could necessitate brain surgery:

  • Prevent cerebral haemorrhage caused by an aneurysm.
  • Conduct surgery to remove a tumour.
  • Release a brain region's pinned-down nerve.
  • Drain an infection's abscess or blood, and release any pressure on the brain.

When is Brain Surgery Needed?

The following cognitive impairments may necessitate brain surgery:

  • Tumours
  • Stroke
  • Bleeding
  • Nerve damage
  • Nerve irritation
  • Aneurysm
  • Blood clots
  • Skull fracture
  • Parkinson disease
  • Epilepsy
  • Abnormal blood vessels
  • Pressure post-head injury
  • Fluid building in the brain
  • Damages to Dura tissues
  • Abscesses

How Much Does Brain Surgery Cost?

An important organ like the brain requires costly surgery, which might deplete your resources. Depending on the severity of the ailment, the cost of brain surgery in India can be somewhere from Rs. 2 lakh to Rs. 10 lakh. In addition, prices can vary between hospitals and cities. 

The costs and surgery must also include the cost of scans, diagnostic testing, and post-hospitalisation care. Since brain surgery is costly, you should have health insurance that covers it to protect you from a heavy financial burden.

Is Brain Surgery Covered by Health Insurance?

Yes, there are health plans available from the top health insurance providers in India that provide coverage for brain surgery. As a result, an insured person may be reimbursed for the costs associated with surgery. Care Health Insurance offers Critical Illness Insurance that covers benign brain tumour treatment for the insured. The following expenses associated with brain surgical treatment are covered:

  • Pre-hospitalisation
  • Post-hospitalisation
  • Ambulance cover
  • ICU Charges
  • In-patient care

Critical illness plans from some insurers may cover brain surgery. Upon receiving a diagnosis of a serious illness requiring brain surgery, you will get a lump sum payment under the plan. For comprehensive insurance coverage, it is best to verify the types of critical illnesses that are covered in your health insurance policy. 

Find out more about the health insurance waiting period.

Is There a Waiting Period for Brain Surgery Covered by Health Insurance?

Yes, most healthcare plans have waiting periods before the insured can request coverage for a specific illness, including brain surgery. Therefore, the insurer will deny the insured's brain surgery claim if it is submitted before the waiting period has passed.

A 30-day initial waiting period is standard for most health insurance plans. Additionally, there may be a 90-day waiting period before the insured may file a claim under a critical illness policy for the costs associated with brain surgery.

The insurer may also impose a 30-day survival period under critical illness insurance. If the insured person is unable to survive this period, the insurance provider will not pay the claim.

Before purchasing a health insurance policy, it is essential to evaluate policy terms and conditions because there are many clauses pertaining to waiting periods, survival periods, etc.

What Are The Various Types of Brain Surgery?

Biopsy: A surgeon will make incisions in the skull to extract brain cells or tissue for testing.

Craniotomy: A certain type of brain surgery used to treat medical conditions like brain tumours. In this procedure, the doctor removes a portion of a person's skull.

Neuroendoscopy: To access the damaged areas of the brain and remove tumours, the surgeon makes minute incisions in the skull.

Deep Brain Stimulation: A tiny electrode is inserted into the brain through incisions made in the skull by the surgeon. Neural signals are sent to the brain by the electrode via a battery connection.

Endonasal Endoscopic Surgery: No brain incisions are necessary for this treatment. The surgeon inserts an endoscope via the nose and sinuses to remove tumours.

Posterior Fossa Decompression: A small cut is made behind the head during a posterior fossa decompression treatment to remove a little piece of the bone near the base of the skull. It relieves pressure on the spinal cord and gives the cerebellum more room to move.

Thrombectomy and Cerebral Aneurysm repair: The method does not require making any incisions in the brain or skull. Instead, to access the brain vessels and locate the troublesome blood flow, the surgeon threads a catheter through a major blood vessel in the groyne.

What Are the Potential Risks of Brain Surgery?

Surgery on the brain is frequently a difficult and sometimes dangerous treatment. A few of the risks linked to it include those listed below:

  • Speech issues, memory issues, muscle weakness, balance issues, vision problems, coordination issues, and other issues. These issues might disappear quickly, or they might persist.
  • Haemorrhage or blood clot in the brain
  • Seizures
  • Stroke
  • Coma
  • Infection of the skull, brain, or wound
  • Brain enlargement
  • A demand for additional operations

Summing It Up

Many significant medical ailments, such as brain tumours, aneurysms, and epilepsy, can be treated with brain surgery, and they can be expensive. Some brain surgeries may require an incision, and the sum may not depend upon the complexity of your ailment. As your health is most important, having a health insurance plan will get you quality healthcare irrespective of the cost. You can select the best health plan for yourself by comparing plans on various parameters such as waiting period, in-patient care, daycare treatment, etc. if you are undergoing brain surgery, make sure to mentally and emotionally prepare yourself.

Disclaimer - The above information is for reference purposes only: Policy Assurance and Claims at the underwriter's discretion. 


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