Organ Transplant Surgeries- Procedure and Insurance

Organ transplantation for organs liver, heart, lungs, kidney, bone marrow, and pancreas involves a huge hospitalization cost. Organ transplantation can easily cost around Rs 5 lakh to 20 lakh.

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    Unforeseen medical expenses can either drain your savings and for this, you might need to borrow funds or take a loan. To prepare yourself for such unforeseen health risks, it is suggested to opt for health insurance with organ transplantation cover.  

    Organ transplantation can lead to complications during the operation and also post-surgery. Continuous investigations, monitoring, and treatment prevail post-surgery and all this ultimately adds to the total hospitalization cost. Most general insurance companies in India today offer organ transplantation surgeries as part of their regular health plan.

    Some health plans cover organ transplantation expenses and provide reimbursement of the complete cost of the treatment.  Some insurers put a capping on these expenses or provide it as an add-on or optional cover.

    How does Health Insurance treat Organ Donation and Transplantation in India?  

    Taking into consideration that organ transplantation involves two parties, first that covers donation expenses and transplantation expenses. So, what does health insurance cover?

    A health insurance policy would cover all the hospitalization expenses for a diagnosed medical condition. Medical Insurance covers all the hospitalization expenses including surgeries, medical treatments, etc. And all this is subjected to policy terms and conditions.

    When the receiver needs an organ, medical insurance policies would cover the cost of the tests, procedures, and surgeries. It will also cover the cost of the medical tests and procedures related to organ transplantation up to the policy coverage amount.

    But the organ donor expenses such as storage, screening, and harvesting shall be borne by the person getting the organ. Nevertheless, there are some insurers who pay for organ donor expenses as well.

    Types of Organ Transplantation in India

    1. Heart Transplant-A heart transplant is done to replace a patient’s damaged or diseased heart from a donor who has suffered brain death.

    2. Lung Transplant-It is also called pulmonary transplantation, in which the patient’s lungs are surgically removed with a donor’s lungs. The lungs can be retrieved from a living donor’s lungs or a deceased donor’s lungs. However, only lung lobes are taken from a living donor.

    3. Liver Transplant-It is also called as hepatic transplantation, in which the infected liver is replaced with the donor’s healthy liver. Patients with end-stage liver disease and liver failure may require liver transplantation.

    4. Cornea Treatment- This is a laser treatment that treats corneal dystrophies. The doctor’s use the procedure to reshape cornea and the procedure is called a phototherapeutic keratectomy. It is used to remove scar tissue, and make the vision clear.

    5. Kidney Transplant- It is called as renal transplantation, and is used for patients with end-stage kidney disease. It is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ.

    What are the costs involved n case one has to undergo organ donation procedure?

    Mainly there are six types of medical expenses incurred as far as the organ donor procedure is concerned:

    1. Organ Screening- This is to find out overall well-being and blood group compatibilities.
    2. Pre-hospitalization Costs- Once the donor is finalized, he/she needs to go through certain treatment, and medication, before the hospitalization procedure begins.
    3. Hospitalization Costs- Cost of the nursing, room rent, and donor expenses.
    4. Post-hospitalization Costs for the Donor- Medications, doctor, follow-ups etc.
    5. Organ Transplantation Surgery- This surgery is required to harvest the organ and transplant it into the recipient. This involves the cost of the surgery, and the surgeon fees.
    6. Post-surgery Complications & Recovery- Any post-surgical complications, like functioning with one kidney, are common in organ transplantation patients. And this can increase the cost of overall treatment, hospitalization cost, and increased cost of recovery.

    From the above-mentioned costs, the cost of pre and post-hospitalization of the donor and post-surgery complication costs are not covered by most of the insurance providers in India to date. However, the actual cost of the organ transplantation surgery is mostly not covered, only a few insurers cover the cost of the actual surgery.

    Things to remember for organ transplantation insurance

    Certain conditions that you should keep in mind regarding organ transplantation insurance are given below:

    • Medical treatment expenses incurred by the donor for harvesting the organ are not covered
    • Medical facilities follow strict guidelines related to organ transplantation. For this reason, the organ donor whose is donating the organ should be in compliance with the Transplantation of Human Organs Act 1994, provided the organ is being donated for personal use only
    • Usually, there is a waiting period that can range from 2 to 4 years, before you can avail the coverage benefits.

    Bottom-line

    With organ transplant Insurance, it is now possible to avail best treatment without any financial stress. You can checkout different health insurance plans that offer organ transplant cover from some of the top insurers in India. You can easily compare them on our site and select the one as per your medical requirements.

    Written By: PolicyBazaar - Updated: 29 July 2021

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