Does Health Insurance cover kidney transplant?

Wondering About Kidney Transplant Insurance Coverage Plans? | CignaTTK

Meta Description: A transplant could prove to be a huge financial burden on your family. Find out if your health insurance covers organ transplant or not.

The kidneys are some of the most crucial organs in the human body. When either one or both of these small, bean-shaped organs fail to perform their regular functions, it can cause life threatening situation for a person. In such situations, it becomes imperative for the patient to undergo an organ transplant or take regular dialysis. Both these circumstances may prove to be heavy financial burden. For some, it may wash away the hard-earned savings and also cause an emotional turmoil on the family.

As per the data shared by Indian Renal Foundation, the average cost that a transplant patient has to bear comes to around INR 4 lacs, excluding the cost for post-treatment medications. The cost may vary on the hospital chosen. Hence, it is advisable to be covered under a health insurance policy that does not affect your financial condition in case of a transplant. 

Earlier, many organ transplants were not covered under comprehensive health insurance policies because of the risks involved. Organ transplant affects two people – the donor and the receiver. 

  • In case of the donor, even though he/she may be covered under a health insurance policy, some companies may not reimburse the expenses as it is not a health condition for the donor. Hence in certain circumstances, only the hospital expenses for the donor are covered. Certain insurance companies provide products which may not cover the donor expenses as the main cover but they may offer it as add-on services. Expenses towards organ harvesting and the surgery of the donor are generally covered.

For an insured recipient, the policy will cover all expenses including surgical, medication, and the post-hospitalization treatment expenses. 

  • Before choosing a health insurance policy, it is advisable to have a thorough knowledge about the products offered and what will be the reimbursement for the donor as well as the recipient. One must choose a plan depending on their medical condition and not hide any information while purchasing the plan. A recommended policy is the ‘Critical Illness Insurance’ policy which can help in withstanding the high cost of transplants, and is also beneficial as a lump sum amount can be received post diagnosis from most insurance companies providing such a comprehensive policy. Nowadays, the option of cashless health insurance is also available where the expenses are directly settled between the insurance company and the chosen hospital. 

As a small chunk of advice, if you are planning to undergo a kidney transplant, you should ask the hospital for a detailed cost breakup for the donor as well as recipient. This helps in  understanding the financial impact and narrows the scope of repudiation on the part of the insurance companies.