What is Organ Donor Coverage in Health Insurance?

Organ donation is a gift of life that saves the lives of many people suffering from end-stage organ failure or life-threatening conditions. Organ transplantation offers a second chance to people in need of an organ transplant. Organ donation is possible from both a living as well as a deceased donor. However, the organ transplant procedure can be costly including many medical expenses such as organ screening, hospitalisation, surgery, etc. However, with a comprehensive health insurance plan, one can get coverage for the incurred expenses towards transplantation. 

Keep reading to understand coverage for organ donor expenses in health insurance. Let us learn everything about the various expenses involved in organ transplantation procedure and organ transplant coverage. Before that, let’s know about the various expenses involved in this procedure. 

What are the Expenses Involved in Organ Transplantation?

Organ transplantation not only involves the cost of transplantation surgery but it also includes a host of other medical expenses required before and after the surgery. So if you are looking for organ donor insurance, you need to be aware of these expenses to find suitable organ donor insurance coverage. Following are the expenses incurred during an organ transplant surgery.

Organ Donor’s Screening and Testing Expenses

Donor’s detailed medical examination is done to check suitability for organ transplant. It helps the doctors to assess the organ’s quality and anatomy through medical tests. Organs are matched based on physical features and blood type. Once a match is found, the presence of any type of infection in the organ or the donor’s blood is checked.

Pre-hospitalisation Expenses

Pre-hospitalisation expenses refer to the costs incurred in preparing the organ recipient as well as the donor for the surgery after a suitable donor has been identified. Such expenses may include the cost of diagnostic tests and medications required to ensure that the recipient's and donor’s vital markers are within the normal range necessary.

Hospitalisation Expenses

It involves the cost of a doctor’s consultation, room rent and nursing charges for the donor.

Transplantation Cost

It includes the actual cost of the transplantation surgery, the cost of harvesting the organ and the surgeon’s fees.

Recovery and Rehabilitation expenses

It includes the cost of monitoring, post-operative care for recovery and expenses for treatment of any post-surgery complications.

Does Insurance Cover Organ Donation?

If you are an organ donor, your health insurance may not cover the costs of organ donation as it is a risky procedure and donating an organ may expose you to many health risks. However, if you are an organ recipient and you have opted for organ donation insurance coverage, your health insurance will cover the cost of organ transplantation surgery for the donor also up to the limit specified in the policy. Hence, the organ donor will not have to pay anything out of his pocket. Please note that there may be certain expenses that are excluded from the organ donor coverage, so check the list of organ donor benefits before selecting a health insurance coverage.

Care Critical Mediclaim with Organ Donor Cover

Care Health Insurance offers a number of health insurance plans with inbuilt organ donor coverage. One such plan is Care Critical Illness Mediclaim plan that provides organ donor coverage up to ₹ 15 lakhs.

It is a plan that protects you financially against 32 listed critical illnesses. It provides coverage for international second opinion, global coverage, OPD expenses cover, alternative treatments cover along with the organ donor cover. Some important points to know about organ donor coverage under the plan are:

• Inclusions: The plan provides coverage for in-patient care for the donor and the cost of harvesting the organ.
• Exclusions: The plan does not cover screening expenses for the donor, pre and post-hospitalisation expenses for the organ donor and the cost of transportation of the organ.
• Waiting Period: A waiting period is applicable as per the terms and conditions of the policy before you can file a claim.
• Coverage Limit: There is a coverage limit specified in the policy. The organ donor coverage is available up to the sum insured subject to a maximum of ₹ 15 lakhs. 

Organ Donation: Some Facts

Here are some facts about organ donation you might not be aware of:

• Anyone healthy can become a donor irrespective of race, age or medical history.
• A donation from a deceased donor can save up to eight lives. This is because different organs can be transplanted into multiple patients. For instance, two kidneys can be donated to two patients, one liver can be split between two patients, two lungs can help two patients, and one pancreas and one heart can save two lives.
• There is a difference between a living organ donor vs non-living organ donor. A single deceased donor can potentially donate up to 37 organs and tissues if the donor has been declared brain dead. On the other hand, a living donor can donate only a specific organ.
• In addition to organs like the heart, liver, kidney, pancreas, cornea, and intestines, tissues like bone marrow, skin and blood vessels can also be donated. 
• An organ donation is covered by health insurance only if it complies with the Transplantation of Human Organs Act 1994.

Concluding Lines 

With comprehensive coverage for organ donor expenses in health insurance, any individual in need of an organ transplant can get treatment without the stress of medical expenses. It will also help in addressing the gap between the demand and supply for organ donation because organ donors will be covered for the process under the receiver’s health insurance. Check out different health insurance plans from Care Health Insurance to get the best organ donation insurance coverage.

>> Also Read: Health Insurance for Organ Transplant Surgeries

Disclaimers: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information.