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Does Health Insurance Cover Brain Surgery?

Many brain-related medical conditions can be treated with medicines. However, there are also some diseases or illnesses that require brain surgery. Brain surgeries are very complex medical procedures that can cost lakhs of rupees in India and put a dent in your savings. If the operation is being conducted in metropolitan cities like Mumbai or Bangalore, the cost can go even higher. There are also additional costs associated with surgery like tests, scans, hospitalisation, medicine, and more. If you wish to keep  yourself financially covered against these expenses, you should consider getting a health insurance plan that covers brain surgery. 

How Brain Surgery Coverage Works in Health Insurance 

  • Most health insurance plans offered by reputed insurers in India cover the cost of brain surgery. 

  • Health insurance plans cover the cost of medical expenses like ICU costs, hospitalisation, treatment expenses, pre and post-hospitalisation expenses, room rent, etc. 

  • The coverage for the brain surgery and related expenses will only be provided till the maximum sum insured in your health plan. 

Let’s Understand with an Example

If the total cost of your surgery is ₹12 Lakhs and your health insurance provides a maximum sum insured of ₹10 lakh, you will have to pay for the remaining ₹2 Lakhs out of pocket. So, when you are buying your health plan, make sure that you buy a policy with a high enough sum insured to take care of all your potential medical expenses in the future. You can also try to get a critical illness cover on top of your health insurance that will provide you with a large amount of money if you are diagnosed with a critical illness like cancer, lung disease, heart attack, etc. 

Waiting Period to Cover Brain Surgery under Health Insurance 

If you have any pre-existing conditions at the time of buying your health insurance plan, a mandatory waiting period of around 2-4 years will be applicable. While this waiting period is active, you will not be eligible for any coverage for your pre-existing medical conditions including your brain-related issues.

 

However, once the waiting period for your pre-existing disease is over, the coverage will continue and you can seek treatment for your brain-related conditions including brain surgery. In case you are suffering from a pre-existing condition, try to look for a policy that offers the lowest waiting period among all available options. On the other hand, if you do not have any pre-existing conditions, a basic 30-day waiting period will apply to your policy. 

Conclusion

Brain related medical conditions must be taken extremely seriously. If you end up needing brain surgery in the future and do not have health insurance, it can drain all of your savings and disrupt your financial planning. In case of brain surgeries that require prolonged hospitalisation, you may even have to go into serious debt to pay off your medical bills. You can protect yourself against the immense medical costs of brain surgery and other treatments by getting a good health insurance policy. If you do not yet have a plan, you can check out the various health insurance policies available at Bajaj MARKETS and buy the one that best fits your requirements.

Best Health Insurance Plans Available at Bajaj MARKETS

FAQs Related to Brain Surgery Covered by Health Insurance

  • ✔️Does health insurance cover brain surgery in India?

    Yes, most health insurance plans in India offered by reputed companies provide coverage for brain surgery in India.

  • ✔️ Will I get coverage for brain surgery if I have brain-related issues as a pre-existing disease?

     If you have any brain-related pre-existing conditions that require surgery, coverage will only be provided once the waiting period for your pre-existing condition is over.

  • ✔️What can I do if my insurance company rejects my health insurance claim for brain surgery?

     If your health claim has been rejected without any valid reason, you can try applying for it again. If it gets rejected again, you can try approaching the insurance ombudsman. 

  • ✔️ What happens if the cost of my brain surgery is more than the sum insured in my health plan?

     If the maximum sum insured on your health insurance plan gets exhausted, you will need to pay for the remaining medical expenses out of pocket.

  • ✔️Can I buy health insurance online that covers brain surgery?

    Yes, you can buy health plans that cover brain surgery online on Bajaj MARKETS and other insurance websites.