Choosing Health Insurance That Covers Organ Transplant: A Brief Guide


Medical science is advanced enough to save human lives but at a price. An organ transplant can give a new life to human beings facing health issues because of impaired or missing organs in the body. But, there may be dilemmas in one’s mind regarding the cost and expenses included in the organ transplant surgery.

Organ transplantation is a surgical process where an organ is separated from the donor’s body and stored well to be placed into the recipient’s body later. It involves enormous costs depending on which organ is to be transplanted. Health insurance can be a relief from such considerable expenses in the entire practice of transplantation. Here is the post that would guide how to choose health insurance covering organ transplants. Let us start with the significant expenses involved in organ transplantation surgeries.

Major Expenses Incurred in Organ Transplantation

1.   Organ screening expenses

The requirement for a suitable organ for the patient is fulfilled after considering several factors. The whole process involves huge expenses.

2.   Expenses before hospitalization

Once the right organ is found, the patient needs to undergo a few medical processes and medication to come in the necessary medical state. It is the pre-hospitalization cost.

3.   Expenses during hospitalization

These are hospitalization charges that include the fees of doctors, nurses, and room charges in the hospital.

4.   The surgical cost

This is the cost to be paid for the procedure of the surgery. It includes the surgeon’s fees also, which is usually very high.

5.   Monitoring and post-surgery hospitalization expenses

It is necessary to monitor both the recipient and donor after the surgery. It incurs post-surgery expenses.

6.   Expenses for Post-surgery complications, if any.

Post-surgery complications may require further surgeries that can be lengthy procedures and expensive also.

To get an idea of organ transplant cost in India –

  • Liver transplant can be between Rs.20-25 lakhs.
  • Kidney transplant costs can be between Rs.5-15 lakhs.
  • A heart transplant can be a financial burden at the cost of Rs.20-35 lakhs.

If you are going through an organ transplant surgery, you must know the detailed break-up of costs involved. It is necessary to ask hospitals about the break-up of costs for the donor and the recipient. Such break-ups will help you to plan your organ transplantation financially. You will be able to estimate the cost you have to bear after considering your policy’s inclusions and exclusions. For this, you need to know first what a health insurance policy covers.

Coverage for the Insured and the Donor

Two people involved in organ transplants are the insured recipient (the donee) and the organ donor. A health insurance plan covers the medical expenses and surgical expenses for both as of now.

In India, health insurance policies had covered the recipient’s treatment cost involved in organ transplantation in earlier times. But, it did not cover the donor’s medical costs. With the increasing requirements of organ transplants, many insurance companies have introduced health insurance policies covering the treatment costs of both the donor and the recipient.

Inclusions and Exclusions

The insured person’s covered expenses include pre-hospitalization expenses, post-hospitalization expenses, medical expenses, and surgical costs. The health insurance policy will cover these overall treatment costs up to the sum insured.

The donor’s covered expenses include the storage of the organ and surgical costs. Generally, it does not cover the donor’s pre and post-hospitalization cost, screening cost, and post-surgery medical expenses in case of any complication. The insured recipient is liable to bear such costs. The cover for donor’s expenses may vary from insurer to insurer.

You can choose a policy from some of the best health insurance providers at the Bajaj Finserv website.

Factors To Be Considered

The total cost incurred could be much higher. Such huge charges can drain all savings and even make a person borrow funds. Following are the considerable factors while buying health insurance for organ transplantation:

1.   Waiting Period

When you buy a new health insurance plan, there would be an initial waiting period. Keep in mind that you may not make claims before this period. Check this waiting period with your insurance provider. Compare it with different insurers.

2.   Survival Period

There would be a survival period after the first diagnosis of the disease. It is a considerable period to receive the lump sum amount. It may vary from 15 days to 30 days.

3.   Reimbursement and cashless facility

Many insurance companies offer both options – a cashless facility and a reimbursement facility. It would be best to select an insurance provider offering you the liberty of using any of these facilities. Cashless health insurance is convenient and preferred by most insurers.

4.   The inclusion of organ transplantation

As per the Insurance Regulatory and Development Authority of India (IRDAI) guidelines, comprehensive health insurance policies must cover at least 12 critical diseases. And organ transplantation should be included in the list. It would be best to ensure that organ transplantation is included in a policy as an acute illness or not before buying a policy. Basically, it should be a critical illness insurance plan.

5.   Check Sub-limits

Organ transplant cover is generally subject to sub-limits, and after a limit, the insured has to bear the cost of the donor’s expenses on its own. Different insurance companies have different sub-limits. Get the details about the sub-limits while you choose the policy.

Shield yourself against the high costs of organ transplantation with a comprehensive health insurance policy. It would be a financial back for your family. Therefore, a decent health insurance plan is a must. You can check out various organ transplant covers at Bajaj Finserv website.

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