Does Health Insurance Cover Brain Tumour?

What is Brain Tumour?

A brain tumour refers to the abnormal growth of cells or lumps in the brain. This group of cells have an uncontrollable growth pattern and can compress brain tissues & other structures in the skull. As a result, a brain tumour can be life-threatening.

A brain tumour can be either malignant or benign. Malignant brain tumours are cancerous and can spread to other body parts. On the contrary, benign brain tumours are non-cancerous and do not spread to other parts of the body.

As per the International Association of Cancer Registers (IARC), about 28,000 brain tumour cases are registered in India every year. However, out of total registrations, 24,000 people lose their lives due to the disease or its complications.

If diagnosed at an early stage, brain tumours may be removed with surgery. However, surgery to remove a brain tumour is expensive. In India, a brain tumour surgery costs somewhere between Rs 2.5 lakh to Rs 7.5 lakh on average.

However, the prices may differ depending on the city and the hospital where the surgery is being conducted. For example, a brain tumour surgery in Delhi will be more expensive than the one done in Patna. Similarly, the cost of brain tumour surgery in a private hospital will be more than a government hospital.

Is Brain Tumour Covered by Health Insurance Plans in India?

Yes, brain tumours are covered under health insurance plans in India. They provide coverage for the medical expenses incurred on brain tumour surgery. It also covers the cost of hospitalization, ICU charges, ambulance charges, pre-hospitalization, post-hospitalization and other medical expenses incurred during the brain tumour surgery. The scope of coverage may vary from one policy to another.

In case you are suffering from a benign brain tumour, the surgery cost will be covered under a critical illness insurance policy. Under this type of policy, your insurance company will provide you with a lump sum amount equal to the sum insured on the diagnosis of the brain tumour. The amount can be used to pay the surgery cost, medical bills, medicine costs, etc.  

However, not all critical illness plans provide coverage for benign brain tumour costs. Therefore, you must read your policy documents carefully to know if it covers brain tumour or not.

Waiting Period for Brain Tumour Under Health Insurance

All health insurance plans will provide coverage for brain tumours once the waiting period is over. In case you raise a claim for brain tumour surgery, your insurance company will have the right to reject it. This is because you are allowed to raise a claim under the health policy only after your waiting period is over.

Usually, all regular health insurance plans come with an initial waiting period of 30 days. However, if you have a critical illness insurance policy, you can raise a claim for the medical expenses incurred on brain tumour surgery after a waiting period of 90 days.

Moreover, critical illness insurance plans also come with a survival period of 30 days. If the insured patient dies within 30 days of raising the claim, then the insurance company will not be liable to pay the claim amount.

Summing It Up

A brain tumour is a critical illness that can lead to severe brain damage and can be fatal. However, early diagnosis of the disease is essential for timely tumour removal surgery. However, the removal of a brain tumour is an expensive surgery and thus, having a critical illness insurance policy is advisable. Just make sure to go through the waiting period and policy details carefully before you raise any claim.