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Health Insurance for Organ Transplant Surgeries | 3161


Health Insurance for Organ Transplant Surgeries

WhatsApp Image 2023 06 13 at 8.46.58 AM

Medical science today has made a long journey to nowhere medical sciences are at such a developed stage that malfunctioning organs are being replaced with fully functional ones, saving and increasing the life expectancy of thousands of people. While organ transplants are genuinely a boon for an ailing individual, the cost of the same creates a huge gorge in their pockets as a transplant depending upon the organ can range anywhere from 50,000 to 35 lakh making health insurance, a priority for people to have for such trying times.

Health Insurance For Organ Transplant Surgeries

Insurance for organ donation is a three-way street, consisting of the donor who will be providing the organ, the recipient who is the individual with the health insurance and will be the receiver of the organ, and the insurance company that will cover the expenses of the procedure. While this is the premise of most health insurances for organ transplants, in some cases, the donor expenses (harvesting, storage, screening, etc.) will have to be borne by the recipient.

Coverage of the Health Insurance for Organ Transplant Surgeries

The coverage for policyholders, regardless of the company one is insured with, remains the same and they are:

1. Organ screening that checks for compatibilities of the organ between the donor and recipient and overall well-being.

2. Pre-hospitalization costs for the donor before they are ready to be hospitalized.

3. Hospitalization costs- expenses of staying in the hospital room, nursing with respect to the donor.

4. Organ transplantation surgery- the process where the malfunctioning organ is removed, and the functioning one is transplanted into the recipient, which contains the cost of surgery and surgeon fees.

5. Post-surgery complications and recovery- for instance, the donor of a kidney may have certain complications as they are not uncommon, which creates a likelihood for the increased cost of recovery, hospital stay, medication, etc.

6. Post hospitalization costs for the donor- medication, follow-up steps, and others.

Things to Keep in Mind While Purchasing

When buying a critical illness insurance plan with organ donor cover, one should carefully read the policy documents and understand what is covered and what is not in the plan. For instance, organ donor cover will not include the pre-hospitalization and post-hospitalization medical expenses for the donor. Moreover, the amount of sum insured must be selected, keeping in mind one’s estimated treatment costs. It is also important to check the presence of network hospitals near one’s location to ensure easy access to quality medical care.

Two Modes of Coverage

Once the insurance is availed, the policyholder can be covered in one of two ways: a cashless facility in which there is no need to pay for medical bills as the policyholder can simply use the health care provided by the company to avail treatment from a network hospital and the insurer will settle the expenses directly with the hospital which makes the facility the most beneficial one for people whose financials are not at their best to support a costly transplant. The other method is a reimbursement facility which comes into use when a policyholder avails treatment from a non-network hospital in which case, the individual pays all the medical bills firsthand and is paid back at a later date.


In today’s changing environment and lifestyle, critical illnesses are on the rise and sometimes leave the patient and their family penniless due to the heavy costs borne by them. In such cases, health insurance assures that one avails the best treatment possible, while also keeping their financials safe.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.


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