Is Brain Surgery Covered by Health Insurance?

The brain is the most complex organ in our body, which is responsible for our memories, speech, emotions, hand-eye coordination, breathing, blood circulation, etc. In short, your brain is responsible for the functioning of your body and any anomaly or injury in the brain can be fatal. Sometimes, surgery of the brain is required to treat these anomalies or injuries. Are you are wondering if health insurance is covered by brain surgery? Let’s find out.

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    What is Brain Surgery?

    Brain surgery refers to a surgery that corrects any physical anomaly in the brain. It involves repairing any structural problems in the brain. These problems may be present from birth or may arise due to a disease or injury. Moreover, brain surgeries are also done to treat medical conditions that may pose a risk of critical health problems.

    Brain surgery is a critical and complicated procedure. It involves the risk of bleeding, swelling, coma, memory loss, etc. Therefore, it is carried out by neurosurgeons with extra caution in the presence of an anesthesiologist. However, medical advancement today allows surgeons to operate on a part of the brain without making an incision in or near the patient’s head.

    When is a Brain Surgery Required?

    Brain surgery may be required to treat the following disease or medical conditions within or around the brain:

    • Brain tumours
    • Aneurysm
    • Bleeding
    • Blood clots
    • Nerve damage or irritation
    • Skull fracture
    • Stroke
    • Parkinson’s disease
    • Epilepsy
    • Pressure post head injury
    • Fluid building in the brain
    • Abnormal blood vessels
    • Damages to Dura tissue
    • Abscesses

    Types of Brain Surgery

    Several types of brain surgeries are done to treat different medical conditions. The type of brain surgery used depends on the medical condition and the area of the brain. Take a look at the various types of brain surgery below:

    • Craniotomy
    • Neuroendoscopy
    • Deep Brain Stimulation
    • Biopsy
    • Posterior Fossa Decompression
    • Thrombectomy and Cerebral Aneurysm Repair
    • Endonasal Endoscopic Surgery

    Cost of a Brain Surgery

    Brain surgery is major surgery and naturally, is an expensive procedure. Usually, brain surgery in India may cost more than Rs 2-3 lakh depending on the medical condition and the type of surgery. For instance, a brain surgery done to remove a tumour may cost Rs 2.5 lakh to Rs 7.5 lakh approximately. Moreover, the surgery cost may vary with the hospital and the city. For example, a brain surgery done at a hospital in Mumbai may cost more than a surgery done in Pune.

    Moreover, several diagnostic tests and scans may be required before and after the surgery, such as CT scans, MRI scans, etc. Needless to say, they can result in a lot of medical expenses. Moreover, the cost of hospitalization as well as post-surgery consultations can cost you immensely.

    Do Health Insurance Plans Cover Brain Surgery?

    Yes. Most health insurance plans in India provide coverage for the cost of brain surgery. They cover the medical expenses incurred on hospitalization, ICU charges, pre-hospitalization, ambulance services as well as post-hospitalization resulting from brain surgery. You can opt for a health insurance plan with a coverage amount of up to Rs 6 crore. However, the coverage and the sum insured can vary from one health insurance plan to another.

    Besides, brain surgery is mostly done to treat critical illnesses and hence, they are also covered under critical illness insurance plans. Under these plans, a lump sum amount will be paid to you as soon as you are diagnosed with a critical illness that requires brain surgery. In India, critical illness insurance plans are available with a sum insured of up to Rs 25 crore.

    However, you are advised to check with your insurance company if the critical illness you are diagnosed with is covered by your insurance plan.

    Waiting Period to Cover Brain Surgery Under Health Insurance

    All health insurance plans come with a waiting period irrespective of whether you buy a regular health insurance policy or a critical illness insurance policy. This means you will have to wait for a specified period before brain surgery will be covered by your health insurance plan.

    To begin with, all health insurance plans come with an initial waiting period of 30 days. However, medical conditions or diseases requiring brain surgery may only be covered after a waiting period of 2 years. Moreover, if you require brain surgery to treat a critical illness, then it will be covered after a waiting period of 90 days.   

    In case you have been diagnosed with a medical condition or critical illness requiring brain surgery before buying health insurance, your insurance company will consider it a pre-existing disease. In that case, the waiting period for pre-existing diseases will be applicable. In India, most health plans cover pre-existing diseases after a waiting period of 2 to 4 years. Hence, you are advised to buy a health insurance policy as early in your life as possible.

    Summing It Up

    Brain surgery is a critical as well as an expensive surgery. Instead of exhausting all your savings in case of brain surgery, it is better to buy a suitable health insurance plan that will cover its cost. You can choose the best health plan for yourself by comparing different plans at websites like Moreover, make sure to prepare yourself mentally and emotionally before going for brain surgery.

    Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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