Operation Insurance

Benefits of Buying Health Insurance for Surgery

Purchasing health insurance for surgery offers a crucial economic shield and peace of mind. It guarantees you receive necessary medical treatments without the hurdle of overwhelming costs. Here are the key benefits:

• Economic Protection: Health insurance for surgery covers all the medical expenses, reducing the need to pay out-of-pocket for expensive procedures.
• Access to Quality Care: Insurance plans usually give you access to their top network hospitals and skilled surgeons.
• Emergency Protection: In unpredictable emergencies, insurance helps you get instant surgery without stressing about finances.
• Pre- and Post-Surgery Care: Coverage usually includes diagnostic tests, follow-up treatments, and medications.
• Lower Overall Costs: Insurance significantly lowers the cost of surgery and related services, making healthcare more affordable.

Optional Benefits of Buying Health Insurance for Surgery

You can also choose optional benefits when buying surgery insurance coverage. Below listed are a few optional benefits that you can choose from

• Co-payment Option: By choosing this optional benefit, you will bear a co-payment of 20% per claim, and our liability shall be restricted to the balance amount payable, subject to terms and conditions.
• Unlimited Automatic Recharge: If you ever exhaust your health coverage, we reinstate the entire sum insured unlimited times in a policy year, provided you use the recharge amount only under hospitalisation expenses.
• Air Ambulance Cover: We will pay you up to the amount specified in the Policy for availing air ambulances in India for your transportation from the place of occurrence of a medical emergency to the nearest hospital.
• Room Rent Modification: Your Room Rent/Category and ICU Charges should not have any restrictions or limits. In this optional benefit, you will have no limit on room rent/room category during Hospital accommodation.

Why Do You Need Health Insurance for Surgery?

Surgery may become inevitable for a person suffering from an illness or having a specific medical condition. Surgeries are performed effectively and quickly owing to the technological advancements in healthcare, thus benefiting the patients. A surgical operation demands excellent care, so it becomes crucial to avail yourself of quality treatment at the best hospital. This policy will protect you against many medical costs besides hospital bills. It would offer cover for expenses such as:

• In-patient Hospitalisation- including room rent, operation theatre, and ICU charges
• Day-care treatment, including day-care surgeries
• Pre-hospitalisation Medical Expenses incurred for 30 days before admission
• Post-hospitalisation Medical Expenses incurred for a period up to 60 days after discharge

What is Covered Under Operation Health Insurance Plan?

An operation insurance plan offers financial protection against various surgical expenses incurred by the policyholder. Here is what is covered under Care Health operation insurance plan:

• Cover for Defined Surgical Procedures : Our plan makes it easy for you if you have to undergo a surgical procedure. With our best insurance for surgery, you will not have to pay anything out of your pocket.
• Pre-hospitalisation Expenses : We cover medically necessary expenses such as examinations, tests, and medication up to the Sum Insured for 30 days immediately before the date of your hospitalisation.
• Post-hospitalisation Expenses : We cover the medically necessary expenses up to the sum insured incurred for 60 days immediately after your discharge from the hospital and your return home for recovery.
• In-Patient Care : We will pay for medical expenses through a cashless or reimbursement facility up to the Sum Insured, including room charges, nursing expenses, ICU charges, surgeon’s fees, doctor’s fees, anaesthesia, blood, oxygen, OT charges, etc., subject to terms and conditions.
• Daycare Treatment : We will pay through a cashless or reimbursement facility for all listed daycare treatments that require hospitalisation for less than 24 hours, up to the Sum Insured.
• Organ Donor Cover : Organ donor coverage in an operation insurance policy covers the medical costs of organ donation. If the donor is a living person, it involves the donor’s surgery, hospitalisation, and recovery costs. However, the recipient’s costs are usually covered under the policy for transplant surgeries. Reviewing the policy terms is essential, as some policies might involve specific exclusions or requirements related to organ donation.
• Second Opinion : If you are diagnosed with or have undergone/are undergoing any of the covered conditions and feel uncertain about your diagnosis/treatment or wish to get a second opinion within India from a doctor on your medical reports for any other reason, we arrange one for you without any impact on the Sum Insured amount. This second opinion is available to every Insured person, once for each Illness / Surgery per policy year.
• Annual Health Check-up : We offer annual health check-ups on a cashless basis from the second policy year on continuous coverage at our network hospitals for all the insured persons covered under the policy. This Benefit shall be available only once per insured person's policy year.
• No claim bonus : If you filed no claim in the expiring policy year, we raise a cheer to your good health as a bonus for you. At the end of 1st claim-free policy year, we will enhance the Sum Insured by 50%, at the end of 2nd claim-free policy year by 25% and at the end of 3rd Claim free policy year by 25%.

What is Not Covered Under Operation Insurance?

When buying a health insurance policy, checking the list of exclusions is essential. It will give you an idea of the various scenarios where you will not be eligible for a claim. Here is the list of the permanent exclusions of the policy:-

• Act of self-inflicted injury, attempted suicide, or suicide
• Any illness related directly to the consumption of Alcohol/Tobacco/Cigarettes, etc.
• HIV/AIDS or any other sexually transmitted disease
• Cosmetic or plastic surgeries or related treatment
• Pregnancy, miscarriage, childbirth, maternity including C-section, abortion or complications of any of these
• All the hazardous activities
• Damage caused by a nuclear, chemical or biological attack or weapons
• Illness or injuries caused due to any breach of law by the insured with any criminal intent

List of Surgeries Covered Under Operation Insurance Plans

Care Health Insurance covers almost all surgical procedures, subject to terms and conditions. A list of some standard surgical procedures are:

Surgery Insurance Plan Eligibility Criteria

Here is the eligibility criteria of operation insurance policy in a tabular format:

Key Factors to Keep in Mind While Opting for an Operation Insurance Policy

Choosing the right health insurance cover is paramount so you can stay worry-free about possible out-of-pocket expenditures. Here are some essential factors you must remember when selecting health insurance for surgery:

• Make sure you check the list of surgical procedures which are covered under the policy
• Find out the network hospitals where you could avail of cashless hospitalisation facility
• Decide the coverage amount which would be suitable for your estimated medical expenses
• Remember to take into account the waiting period clause, sub-limits, and exclusions
• Make sure the policy you have selected has features like lifelong renewability
• Check if there is an option of equated installments for premium payment
• You need to decide if you want this health insurance plan as an individual cover or as a family health insurance plan.

How to Select Operation Health Insurance Online?

Buying operation health insurance online is a simple process that does not involve any paperwork. You can get the best health coverage for your medical expenses in a few clicks. Before proceeding, ensure you have assessed your medical needs and estimated costs. 

Now, visit the official website of Care Health Insurance, where you will find the best operation insurance policy. You can pick the sum insured based on your financial requirements. Moreover, you can calculate the premium and pay the amount online. 

How to Claim Health Insurance for Surgery?

Below is the process you can follow to file a cashless or reimbursement claim under your surgery insurance coverage:

Kindly refer to the prospectus for a complete list of procedures covered.

Difference Between Operation Insurance vs Health Insurance

Many people gradually realise the importance of buying a health insurance plan to safeguard themselves during medical emergencies. A health plan offers numerous benefits and covers medical expenses not restricted to hospitalisation.While this is true, having specific health coverage for surgery is also essential. It could be possible that your existing health policy becomes insufficient to cover all the expenses you incur due to an illness. Operation insurance coverage is wise as it will provide additional cushioning by covering the surgical procedures defined in the policy document.