Dual Benefits of Health Insurance in Organ Transplant Surgeries


Being an organ donor, you can make a big difference in someone’s life. But there are ethical dilemmas and controversies in one’s mind that have threatened to undermine the entire practice of transplanting organs.

Safety issues and exorbitant costs of organ transplant surgeries are some of the main reasons why most people, especially organ donors slip back from this noble cause.

For instance, approximate package costs for heart transplant in India is Rs. 6-10 lakhs, and for liver the figure can go up to Rs. 24-28 lakhs.

Taking such alarming costs into consideration, some insurers in India have taken the initiative of providing policyholders an inbuilt cover on organ donor’s expenses. Let’s understand the coverage and exclusions of these policies in detail.

Coverage for both donor and recipient

Organ transplant necessitates two people – insured recipient and organ donor. Let’s say, you are an insured recipient, hospitalized for kidney transplantation and your friend is the kidney donor. The policy will cover all your expenses including medical, surgical as well as pre- and post-hospitalization.

Expenses incurred on your friend’s surgery and storage of organ will also be covered under the policy. Treatment expenses of yours will be fully paid for up to the sum insured, but cover for your friend’s expenses varies from insurer to insurer.

Below is the table showing donor expenses coverage limit vis-à-vis different insurance policies.

Donor Expenses Product Name Organ Donor Limit
ICICI Lombard Complete Health Insurance Up to Rs. 50,000
HDFC Ergo Health Suraksha Up to Sum Insured
Apollo Munich Optima Restore Up to Sum Insured
Religare Care Rs. 50,000 – 3 lakhs on the basis of Sum Insured
Star Health Family Health Optima 10% of Sum Insured or 1 lakh, whichever is less
Max Bupa Health Companion Up to Sum Insured

Exclusions in donor’s section  

As stated earlier, the donors cannot get their hospitalization costs covered under their individual health insurance policy. Therefore, the insured recipient may have to bear such expenses, making it critical to understand admissible and excluded expenses, as well as sub-limits.

The cost of treatment for the organ donor is covered only for surgery and for storage of the organ. Other costs associated with the donor’s hospitalization are generally not covered. Typical exclusions include cost of screening the donor, donor’s pre- and post-hospitalization costs and, post-surgical complications.

A piece of advice

If you are undergoing through an organ transplant surgery then you must ask hospitals for a detailed break-up of costs into donor and recipient expenses.

It is also important to demand a further break-up of donor costs into screening, medical and surgical expenses to understand the financial impact of the exclusions. This will help you plan your organ transplant surgeries financially.

Curated from Dual Benefits of Health Insurance in Organ Transplant Surgeries

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