Health Insurance for Surgery

Some illnesses and medical conditions can only be treated with surgery. But getting surgery done can be mentally and financially stressful. By buying a health insurance plan for surgery, a patient can get operated on without worrying about paying the surgery bills and concentrate only on recovery.

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      What is Surgery Insurance?

      Surgery insurance is a health insurance plan that provides coverage for medical expenses incurred on a surgery. Also known as operation insurance, it covers the cost of surgical procedures required for the treatment of an illness or medical condition. Health insurance plans for surgery covers the cost of surgeries that require in-patient hospitalization as well as day care surgical procedures.

      List of Surgeries Covered Under Operation Insurance Plans

      Take a look at the various surgeries covered under surgery insurance plans in India:

      List of Surgeries Estimated Cost of Surgery(Rs) Waiting Period Applicable Under Surgery Insurance Plans
      Cataract Surgery 50,000 to 1.2 lakh 2 years
      Heart Surgery 1.9 lakh to 7.9 lakh 90 days/2 years
      Knee Replacement Surgery 2.2. lakh to 9.2 lakh 2 to 4 years
      Kidney Stone Removal Surgery 1 lakh to 2.1 lakh 2 years
      Bypass Surgery 1.9 lakh to 6.03 lakh 90 days
      Appendix Surgery 76,000 to 1.7 lakh 90 days
      Liver Transplant Surgery 25.4 lakh to 35.5 lakh 90 days
      Brain Surgery 2.5 lakh to 7.5 lakh 90 days/ 2 years
      Kidney Transplant Surgery 3.1 lakh to 13.9 lakh 90 days
      Prostate  Cancer Surgery 3.4 lakh to 6.3 lakh 90 days
      Heart Transplant Surgery 14.6 lakh to 25.4 lakh 90 days/ 2 years
      Bariatric Surgery 2.8 lakh to 6.03 lakh 2 to 4 years
      Breast Cancer Surgery 1.9 lakh to 4.2 lakh 90 days/ 2 years
      Aorta Graft Surgery 4.1 lakh to 5.08 lakh 90 days/ 2 years
      Lung Transplant Surgery 13.9 lakh to 15.8 lakh 90 days
      Robotic Surgery 1.4 lakh to 11 lakh 30 days
      Hip Replacement Surgery 3.8 lakh to 6.3 lakh 2 years
      Deep Brain Stimulation Surgery 12.7 lakh to 14.6 lakh 30 days/ 90 days
      LASIK Eye Surgery 10,000 to 1.6 lakh 30 days

      Let’s understand about various surgical procedures in detail below:

      1. Cataract Surgery

        Cataract Surgery is carried out to treat a person suffering from a cataract. It is an eye disease that causes fogging of the eye lens and can lead to blindness. This surgery is carried out as a day care procedure

      2. Heart Surgery

        Heart Surgery is done to treat heart problems, including heart failure, blocked coronary artery, aortic aneurysm, faulty heart valves and abnormal heart rhythms. It can be performed either as open heart surgery or with advanced procedures that involve a small incision in the chest.

      3. Knee Replacement Surgery

        Knee Replacement Surgery is conducted to resurface a knee damaged due to arthritis or an injury. It resurfaces the damaged knee joint to relieve the patient from excruciating knee pain caused either due to osteoarthritis, rheumatoid or traumatic arthritis.

      4. Kidney Stone Removal Surgery

        Kidney Stone Removal Surgery is conducted to remove kidney stones with the help of a ureteroscope. It involves breaking large kidney stones into tiny pieces with a laser and removing tiny stone pieces from the body. This surgery is performed as a day care procedure and does not require hospitalization.

      5. Bypass Surgery

        Bypass Surgery or Coronary Artery Bypass Graft Surgery (CABG) is conducted to cure coronary artery disease. It involves connecting a healthy blood vessel to above and below the blocked arteries of the heart.

      6. Appendix Surgery

        Appendix Surgery is done to treat acute appendicitis, which is the inflammation of the appendix. Nowadays, appendix surgery is mostly performed via laparoscopy, which involves making small incisions in the patient’s body.

      7. Liver Transplant Surgery

        Liver Transplant Surgery is conducted to remove the patient’s dead liver and replace it with another person’s healthy liver. It is mostly required by people suffering from end-stage chronic liver disease complications.

      8. Brain Surgery

        Brain Surgery is conducted to correct any problem or anomaly in the brain, such as blood clots, tumours, Parkinson’s disease, aneurysms, etc. It involves repairing critical structural defects in the brain.

      9. Kidney Transplant Surgery

        Kidney Transplant Surgery is performed to replace a non-functional kidney with a healthy kidney of a donor. The surgery is usually required to treat end-stage renal disease where 90% of the kidney fails to function properly.

      10. Prostate Cancer Surgery

        Prostate Cancer Surgery is performed to cure prostate cancer at an early stage that has not spread to bones and lymph nodes. It involves the removal of the entire prostate gland along with some surrounding tissues.

      11. Heart Transplant Surgery

        Heart Transplant Surgery is performed to replace the patient’s dead or failing heart with the donor’s healthy heart. The surgery is usually required to treat heart conditions, such as heart failure, heart valve disease, congenital heart disease, etc.

      12. Bariatric Surgery

        Bariatric Surgery is done to reduce an obese patient’s weight through surgeries. It restricts the intake of food and reduces the body’s ability to absorb nutrients from the food. It is performed on people suffering from serious weight-related health problems who have been unable to lose weight through diet and exercise.

      13. Breast Cancer Surgery

        Breast Cancer Surgery is conducted to treat advanced-stage breast cancer. The procedure involved in breast cancer surgery varies from the removal of a portion of the breast tissue or lymph nodes to the entire breast.

      14. Aorta Graft Surgery

        Aorta Graft Surgery is carried out to prevent an enlarged section of the aorta from bursting or tearing. It involves replacing the enlarged aorta section (aneurysm) with an artificial tube or graft and the aortic valve with a biological or mechanical valve.

      15. Lung Transplant Surgery

        Lung Transplant Surgery is conducted to replace the patient’s dead or failing lung with another person’s healthy lung. The surgery is performed to replace one or both lungs damaged due to high blood pressure, chronic obstructive pulmonary disease and cystic fibrosis among others.

      16. Robotic Surgery

        Robotic Surgery allows surgeons to conduct complex surgeries with better precision, control and flexibility. It is performed with the help of the da Vinci surgical system that consists of specialized arms to hold a camera, surgical instruments, a magnified screen and a console.

      17. Hip Replacement Surgery

        Hip Replacement Surgery is carried out to remove a painful hip joint with a metal and plastic-based artificial joint. It is mostly required when the patient suffers from severe hip pain due to arthritis that makes walking and other daily activities difficult.

      18. Deep Brain Stimulation Surgery

        Deep Brain Stimulation Surgery is performed to treat people suffering from Parkinson’s disease, epilepsy, dystonia and OCD amongst others. It involves implanting electrodes in the brain to generate electrical impulses that result in the control of abnormal brain activity.

      19. LASIK Eye Surgery

        LASIK Eye Surgery is carried out to correct eyesight problems, such as hyperopia, myopia and astigmatism. It corrects the vision of a person, thus, eliminating the need for wearing glasses or lenses. The surgery is done as a day care procedure but is covered under health insurance only in case of accidental injury.

      Inclusions of Surgery Insurance Plans

      Health insurance for surgery plans provide coverage for the following:

      • In-patient hospitalization expenses
      • Day care procedures
      • Pre-hospitalization medical expenses
      • Ambulance charges
      • Post-hospitalization medical expenses
      • ICU Charges
      • Diagnostic benefit
      • Organ donor expenses
      • Second opinion

      Exclusions of Surgery Insurance Plans

      The following medical expenses are excluded under health insurance for surgery plans:

      • Treatment for self-inflicted injury
      • Pregnancy and related procedures
      • Cosmetic and plastic surgery
      • Treatment for alcohol or drug addiction
      • HIV AIDS
      • Treatment received outside India
      • Non-allopathic treatment
      • Unproven treatment

      Benefits of Buying Health Insurance for Surgery

      Here are some of the reasons why buying a surgery insurance plan is a good idea:

      • Coverage for Wide Range of Surgeries – It covers the insured against medical expenses incurred on more than 600 surgeries, regardless of them being day care procedures or critical operations.
      • Annual Health Check-up – A lot of operation insurance plans offer annual health check-up benefits on each renewal so that the insured can monitor his/her health regularly.
      • Cashless Claims – Cashless claim benefits are available under all health insurance plans in case the surgery was done at a network hospital of the insurance company.  
      • No Claim Bonus – The policyholder is granted a No Claim Bonus (NCB) on every claim-free year that can be used to avail up to 50% discount on the renewal premium.
      • Tax Benefits - The premiums paid for a surgery insurance plan can be claimed under Section 80D, Income Tax Act.

      Surgery Insurance Plan Eligibility Criteria

      Take a look at the eligibility criteria to buy a surgery insurance plan:

      Categories

      Eligibility Criteria

      Minimum Entry Age

      Adult – 18 years
      Children – 3 months

      Maximum Entry Age

      Adult – 65 years
      Children – 25 years

      Renewability

      Lifelong

      How to Buy Health Insurance for Surgery Online?

      In order to buy surgery insurance online, follow the steps given below:

      • Visit the website of Policybazaar Insurance Broker Private Limited
      • Go to the ‘Health Insurance for Surgery’ page and fill in the form
      • Enter your personal details like age along with your medical history
      • A list of health insurance for surgery plans will be displayed.
      • Choose the surgery insurance plan you want to buy
      • Review the coverage, IDV, premium and benefits of the plan
      • Pay the premium online
      • Your operation insurance plan will be issued as soon as the payment is processed.

      Things to Keep in Mind While Buying a Surgery Insurance Plan

      Here are a few things that you must remember while buying an operation insurance plan:

      • Check the list of surgeries covered under the surgery insurance plan
      • Analyze your health needs and buy an operation insurance plan with a sum insured that adequately covers your needs
      • Check if there are any network hospitals of the insurance company near your residence where cashless hospitalization can be availed
      • Check if the surgery insurance plan comes with lifetime renewability or not
      • Remember to check the waiting periods, co-payments and exclusions of the operation insurance plan before buying

      Health Insurance for Surgery FAQs

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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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