Quick Summary
- Kidney diseases are a significant health concern in India, and treatments, including transplants, can be expensive.
- Health insurance plans for kidney transplant patients cover surgery, hospital stays, and post-operative medicines.
- Choosing the right health insurance plan ensures comprehensive coverage for both the recipient and the donor.
Why You Need Health Insurance for Kidney Transplants
Have you ever been advised to get health insurance for kidney conditions? Kidney diseases, including kidney stones and chronic kidney failure, require costly treatment. In India, over 2 lakh patients await transplants, but only 15,000 donors are available. Additionally, 6,000 kidney transplants occur annually, far below the required number.
Without insurance, the high costs of kidney transplants—ranging from ₹4 to ₹10 lakhs—can become a significant burden. This article discusses the best health insurance plans for kidney transplant patients and what they cover. You’ll also learn about inclusions, exclusions, and tips to select the ideal plan.
What is Kidney Transplantation?
A kidney transplant involves replacing a failing kidney with a healthy one from a donor. The new kidney takes over the functions of the failed organs, reducing or eliminating the need for dialysis. If medications or other treatments are ineffective, transplantation becomes essential for the patient’s survival.
Does Insurance Cover Kidney Transplants?
Yes, health insurance policies cover kidney transplants, either through general health plans or specialized critical illness policies. If your existing policy doesn’t cover organ failure, you may need to invest in critical illness insurance, which also covers life-threatening diseases like cancer or heart failure. Upon diagnosis, insurers provide a lump sum amount to help with medical expenses.
Cost of Kidney Transplantation Without Insurance
- Dialysis treatment: ₹12,000 – ₹20,000 per month (up to 12 sessions per month)
- Kidney transplant surgery: ₹4 – ₹10 lakhs in private hospitals
- Post-treatment medicines: ₹10,000 per month
- Post-surgery care: ₹15,000 per month
These costs vary based on the hospital and city.
Top Health Insurance Plans for Kidney Transplants
When selecting insurance, ensure that both donor and recipient costs are covered, including pre- and post-hospitalization expenses. Below are some of the best health insurance plans for kidney transplants in India:
1. Aditya Birla Activ Secure – Critical Illness
- Coverage: 20 to 64 critical illnesses, including kidney failure and transplants.
- Sum Insured: ₹1 lakh to ₹1 crore.
- Key Feature: 100% of the sum insured is paid upon diagnosis of kidney failure.
2. Star Critical Illness Multi-Pay Insurance
- Coverage: Four groups of critical illnesses with multiple payout options.
- Age Eligibility: 18 to 65 years (no medical screening required up to 50 years).
- Waiting Period: First diagnosis after 90 days from policy start.
3. HDFC ERGO Critical Illness Plan
- Variants: Silver and Platinum.
- Coverage: ₹5 lakhs to ₹20 lakhs.
- Eligibility: 5 to 65 years (children covered if parents are insured).
- Payout: Lump sum on first diagnosis after a 30-day survival period.
4. Care Critical Illness Plan
- Coverage: Up to ₹2 crores for major transplants.
- Eligibility: 5 to 50 years.
- Waiting Period: 90 days from policy start.
5. Bajaj Allianz Critical Illness Plan
- Coverage: Includes donor screening, pre- and post-hospitalization, and transplant costs.
- Eligibility: 91 days to 80 years.
- Sum Insured: ₹1 lakh to ₹50 lakhs (for 6 to 60 years) and ₹1 lakh to ₹5 lakhs (for 61 to 65 years).
6. TATA AIG Critical Illness Insurance
- Coverage: Inpatient care, second opinion, and cashless hospital services at 7,200+ hospitals.
- Sum Insured: ₹1 lakh to ₹15 lakhs.
- Eligibility: 18 to 35 years.
- Condition: The insured must survive 30 days after diagnosis to receive the payout.
Ayushman Bharat Scheme for Kidney Transplants
The Ayushman Bharat scheme, the world’s largest healthcare initiative, covers the financially weaker sections of Indian society. Initially, kidney transplants were not included in the scheme. However, as of April 6, 2022, the revised Health Benefits Package 2.2 includes coverage for kidney transplants.
The scheme provides:
- Increased dialysis reimbursement: ₹1,800 per session
- Kidney transplant coverage: Full coverage of surgery and hospital expenses
The first transplant under Ayushman Bharat was performed at SKIMS in Jammu and Kashmir.
Tips to Choose the Best Kidney Transplant Insurance
When choosing an insurance plan for a kidney transplant, consider the following:
- Donor expenses: Ensure coverage includes harvesting, surgery, and screening.
- Pre- and post-hospitalization costs: Select policies that cover investigations, surgery, and aftercare.
- Medical check-ups: Choose plans that offer regular check-ups to monitor potential health risks.
- Consumables: Ensure coverage of essential consumables like medicines and medical equipment.
Other Key Factors
- Choose a sum insured that matches the expected treatment cost.
- Verify the network hospitals near you for quality care and cashless claims.
- Opt for policies with hassle-free claim settlement processes.
- Ensure 24/7 customer support from the insurer.
Claim Process for Kidney Transplant Insurance
Claiming health insurance for a kidney transplant typically involves the following steps:
- Inform the insurer: Notify them of the diagnosis as soon as possible.
- Submit documents: Provide medical reports, bills, and other necessary documents within 90 days of diagnosis.
- Receive lump sum payment: Upon verification, the insurer releases the sum insured.
Takeaway
Kidney transplants can save lives, but the associated costs are high. Health insurance can alleviate financial stress by covering surgery, donor expenses, hospitalization, and post-surgery care.
Since several insurers offer critical illness coverage, selecting the right plan may feel overwhelming. For expert advice, consult Aapka Care today! We’ll guide you in choosing the best insurance plan, connect you with experienced surgeons, and ensure you receive quality care at the right hospital.
