Updated on 23 Dec 2025
urine, the bigger ones Kidney stones are a common health issue that occurs when salts and minerals form hard deposits inside the kidneys. Although the small stones might pass naturally through can stay in the organ and lead to severe pain. Surgery may be required to remove the hard stones.
The cost for the kidney stone treatment is high, particularly at private hospitals. Due to this reason, many individuals wonder if a health insurance policy would cover the kidney stone surgery. Let’s understand this in detail.
Overview of kidney stone treatment options
The kidney stone treatment relies heavily on the location, type and size of the stone. Some of the common options are:
- Open surgery: This is rarely needed these days, but it's used in many complex cases.
- Life changes and medication: This is perfect for small stones, which can pass naturally through urine.
- PCNL (Percutaneous Nephrolithotomy): This is a minimally invasive procedure for removing larger kidney stones.
- Ureteroscopy: In this procedure, a thin tube is passed via the urinary tract to remove the stone.
- ESWL (Extracorporeal Shock Wave Lithotripsy): Here, shock waves are used for breaking down the stones into small pieces. These crystals will be later excreted through urine.
Are kidney stone surgeries covered under health insurance?
Most health insurance plans cover surgical procedures for kidney stones, provided the policy terms are met. Coverage usually includes hospitalisation expenses, surgery costs, pre- and post-hospitalisation care, diagnostic tests, OPD consultations and ambulance charges. Insurers offer cashless treatment at network hospitals or reimbursement options. However, always review a policy’s waiting periods and exclusions to ensure adequate coverage.
What does health insurance typically cover in kidney stone surgeries?
In a medical or senior citizen health insurance policy, the following things get covered for kidney stone surgeries:
- Post and pre-hospitalisation expenses (follow-up care, diagnostic tests)
- Charges for operating theatre
- Fees of surgeons
- Price of consumables and medicines used during the surgery
- Hospitalisation costs (medical staff charges, nursing, room rent, etc.)
What is the claim process of health insurance for a kidney stone surgery
The claim process for kidney stone surgery is as follows:
- Notify the insurance company
It’s important to inform the insurance firm before the surgery or immediately if an emergency takes place.
- Cashless treatment
When visiting the network hospital, the insurance company will settle the cost directly.
- Reimbursement
For all the non-network clinics or hospitals, policyholders have to pay first and then submit the medical bills for reimbursement.
- Submit the documents
Physicians’ prescriptions, discharge summaries, bills and reports are needed during the claim process.
- Verification and processing
Once the insurance company verifies everything, it will process the claim.
Conclusion
Kidney stone surgery is typically covered under many health insurance plans. This allows policyholders to manage the high treatment expenses without worrying about their finances. However, it is essential to read the policy wording before purchasing insurance to ensure you get the required coverage during a medical emergency.
Trying to find the ideal health insurance plan?, Then, fill out the form on this page. We will provide personalised insurance solutions and help you choose a policy that fits your requirements.
FAQ
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Is there a waiting period for the kidney stone treatment under the health policy?
Yes. Many plans come with a waiting period of 2 to 4 years for all pre-existing issues, such as kidney stones.
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Does a health insurance plan cover all sorts of kidney stone treatments?
Most health insurance plans cover kidney stone treatments, including surgery and hospitalisation, but coverage varies by policy terms. Check waiting periods, sub-limits, and exclusions to know the exact benefits.
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Is it possible to receive cashless treatment for kidney stone surgery?
Yes. If the hospital is part of the insurance firm’s network, it will provide cashless treatment.
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What documents are required for the reimbursement?
Policyholders have to submit ID proof, hospital bills, prescriptions, diagnostic reports and discharge summary for the reimbursement claim.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.