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Does a Health Insurance Plan Cover Brain Tumours?

By Juhi Walia
26 August 2022, 5:40 PM

We are all aware of how crucial our brain is as an organ that keeps us moving. The brain gives us the essentials for survival, such as memory, senses, intelligence, and so forth. Therefore, it is alarming when there is even a minor problem with how the brain functions. And the anxieties multiply if you have a serious illness like a brain tumour. This is due to the fact that treating brain tumours is quite expensive because it is a serious sickness. Therefore, it is crucial to understand whether or not a brain tumour is covered by health insurance in India. We shall talk about the same topic in this blog.

What is a Brain Tumour?

The unusual development of cells or masses in the brain is referred to as a "brain tumour." These cells might squeeze the skull's structures and brain tissue due to their unregulated development style. A brain tumour may therefore pose a hazard to life.

A brain tumour may be benign or cancerous. Cancerous malignant brain tumours have the potential to spread to other organs. Benign brain tumours, on the other hand, are not malignant and do not spread to other body areas.

Approximately 28,000 cases of brain tumours are reported each year in India, according to the International Association of Cancer Registers (IARC). However, the disease or its complications claim the lives of 24,000 persons out of all registrants.

Brain tumours may be surgically removed when discovered early. However, having a brain tumour surgically removed is expensive. A brain tumour operation typically costs between INR 2.5 lakh and INR 7.5 lakh in India.

However, the costs may vary based on the location of the facility performing the surgery and the city. For instance, a brain tumour operation in Delhi will cost more than one in Patna. Similar to this, a private hospital will charge more for brain tumour surgery than a government facility.

So, Does Health Insurance in India Cover Brain Tumour?

Yes, health insurance plans in India do cover brain tumours. These offer coverage for the medical costs related to surgery for a brain tumour. Additionally, they pay for any hospital stays, ICU fees, ambulance costs, pre- and post-hospitalization costs, as well as other medical costs related to the brain tumour procedure. Between policies, there may be differences in the extent of coverage.

A critical illness insurance policy will pay for the procedure in the event that you have a benign brain tumour. When a brain tumour is diagnosed under this type of policy, your insurance provider will give you a lump sum payment equivalent to the sum insured. The money can be used to cover the cost of the operation, medical expenses, medication charges, etc.

However, not all critical illness insurance policies cover expenses related to benign brain tumours. To determine whether your policy covers brain tumours or not, you must carefully examine the policy paperwork.

Waiting Period 

Once the waiting period is finished, all health insurance policies will cover brain tumours. Your insurance provider has the right to deny any claims you make for brain tumour surgery. This is so that you can only submit a health insurance claim when your waiting period has ended.

Standard health insurance policies typically have a 30-day waiting period at the beginning of coverage. However, during a 90-day waiting period, anyone with a critical illness insurance policy may file a claim for the medical costs associated with a brain tumour operation.

Additionally, critical illness insurance plans have a 30-day survival term. The health insurance company is not responsible for paying the claim amount if the covered patient passes away within 30 days of filing the insurance claim.

The Review

It is worrisome to read the data on the number of patients who pass away from brain tumours each year in India. According to studies, hundreds of brain tumour cases are reported each year in various regions of the nation, and many of these individuals pass away as a result of the illness. These are primarily caused by complications or by not getting the right care. Additionally, if the illness is discovered in an advanced stage of a brain tumour, an early detection is crucial since it can save lives.

As has already been mentioned, a brain tumour is a serious condition that needs to be properly managed. Without such care, the patient's condition could worsen as a result of catastrophic brain damage. If caught early enough, the tumour can be surgically removed. However, since the procedure is costly, it's crucial to have critical illness insurance coverage.

But before filing a claim, it's crucial to carefully review the policy's waiting period provisions. Before purchasing such a plan, it is vital to make comparisons between health insurance plans after reviewing the various waiting periods and other coverage details. 

Conclusion

A brain tumour is a serious condition that can be deadly and cause significant brain damage. However, prompt tumour removal surgery depends on early disease identification. However, since removing a brain tumour requires a costly procedure, it is recommended to have a critical sickness insurance policy. Just be sure to properly review the policy specifics and waiting period before submitting any claims.

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FAQs

1. Is having a brain tumour fatal?

Some low-grade (slow-growing) brain tumours are incurable. The tumour may potentially result in death, depending on the age at diagnosis. Or one could live a full life and pass away for a different reason. It depends on the type of tumour one has, where in the brain it is located, and how it reacts to therapy.

2. How fast do brain tumours spread?

In particular, benign brain tumours grow slowly in number. Instead of being surgically removed right away, some benign tumours can be carefully examined by a team of doctors for months or even years. However, a lot of malignant tumours are more aggressive and grow quickly, so they probably require quick medical attention.

3. Can I become normal as I was, after having brain surgery?

Some patients make a full recovery after brain surgery, but it can take some time. Some other people experience short-term difficulties or challenges. Depending on the region of the brain where the tumour existed, you could experience issues.

4. Which type of health insurance plan covers brain tumours?

Critical illness insurance policy covers brain tumours. You get a fixed lump sum amount upon the diagnosis of brain tumour. You will need to survive for a month or two, as specified in your policy document, to get covered.

5. Can I get covered for brain tumours with a critical illness add-on?

Yes, you can buy the critical illness add-on with your health insurance policy. An additional premium will be charged for the same.

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