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Operation Insurance

Health insurance provides coverage for a range of medical expenses, including hospitalisation, OPD treatment, ambulance charges, etc. It also covers medical procedures, including operations and surgeries. Health insurance that covers operations and surgeries is also known as operation insurance and surgery insurance. Note that some operations and surgeries are covered by your health policy while you need to buy an add-on to cover certain surgeries.

  • Health coverage starting at ₹11/dayA

  • Access to 14,000+ Network hospitalsC

  • 24×7 assistance via IL TakeCare App

Benefits of buying health insurance for surgery

When you buy medical insurance for surgery, you get a host of benefits. These include:

Access to top hospitals

With health insurance, you can visit network hospitals and receive quality care. You can focus on getting better instead of worrying about high costs.

Protect your savings

Without operation insurance, surgery costs can empty your savings. Health insurance for surgery helps you save money for other needs and keeps your family financially secure.

Offers peace of mind

When you have health insurance that covers surgeries, you feel more secure. You know that if a sudden surgery is needed, your insurance will help. This removes a lot of stress during tough times.

Advantages of buying health insurance for surgery

Apart from the benefits mentioned above, there are several other advantages of having operation insurance. These include:

1

Cashless treatment

With health insurance for surgery, you don’t have to worry about paying hospital bills during surgery. You can get cashless treatment at network hospitals.

2

Pre and post hospitalisation expenses

Depending on the policy’s terms and conditions, you get coverage for pre- and post-hospitalisation expenses. This further reduces the strains on your finances.

3

Ambulance charges

Many medical insurance policies for surgery also cover ambulance expenses. You don’t have to pay separately for ambulance charges during an emergency. This gives quick and worry-free access to care.

List of surgeries covered under operation insurance plans

The various surgeries covered under health insurance for surgeries are through the plan and via add-ons are as follows:

List of surgery Estimated cost
Bariatric surgery Upwards of ₹1 lakh
Surgery to aorta Upwards of ₹2.5 lakh
Open Chest CABG (Coronary Artery By-pass Graft) surgery Upwards of ₹1.5 lakh

Note: These are just indicative figures. The actual cost may vary depending on your line of treatment. Also, go through the policy wordings to know the surgeries covered by your policy.

What is covered under health insurance?

  • Inclusions
  • Exclusions

A health insurance plan usually covers:

  • In-patient treatment
  • Technological advancements and treatment
  • Pre and post-hospitalisation expenses
  • In-patient AYUSH hospitalisation
  • Donor expenses
  • Bariatric surgery

Medical insurance for surgery has specific exclusions. It's essential to be aware of them to avoid unexpected costs. It doesn’t cover:

  • Expenses related to a pre-existing disease and its complications
  • Change of gender treatment
  • Cosmetic or plastic surgery
  • Expenses related to unproven treatments
  • Expenses related to infertility and sterility

Surgery insurance plan eligibility criteria

While the specifics of the eligibility criteria for health insurance for surgery may differ across insurers, generally, it revolves around these:

1

Age

You need to be within a specific age bracket to be eligible for the policy. Make sure you meet the minimum and maximum age criteria.

2

Medical history

Insurers may review your medical history before issuing a policy. You might need to undergo a medical check-up if necessary.

3

Policy type

Eligibility criteria may also depend on the type of policy you wish to purchase. It may differ for an individual policy and a family floater plan.

Things to keep in mind while buying an operation insurance plan

The important things that you should be mindful while buying health insurance for surgery are as follows:

Know what it covers

Before buying, check what the operation insurance actually covers. Some policies cover only specific surgeries, while others cover a wide range of procedures. Ensure the plan aligns with your medical needs.

Check the waiting period

Your surgery insurance policy may have a waiting period before you can make a claim. Read this section carefully to understand when the benefits will begin. It helps you avoid surprises later.

Understand the claims process

Learn how to file a claim in case you need surgery. Ensure to follow all the vital steps for a smooth claim process.

Look at exclusions

Read about what the policy does not cover. Some plans may not cover cosmetic or pre-existing conditions. Knowing this helps you make a smarter choice.

How to buy health insurance for operation insurance online?

Buying health insurance for surgery online is simple and straightforward. To purchase online:

  • Visit our official website here.
  • Click on ‘Health Insurance’ under ‘Health Insurance’
  • Enter the required details
  • Click on ‘Get Quote’
  • Follow the instructions to buy the policy after paying the required premium

How to claim health insurance for surgery?

There are two ways to make a claim - cashless and reimbursement. The process for both is given below:

Cashless claim procedure

1

Submit a copy of your health card and photo ID proof at the hospital TPA during admission

2

The hospital sends us a cashless approval request along with the necessary documents

3

We will process your claim as per the policy terms and conditions and will settle your claim payment directly with the hospital

Reimbursement claim procedure

1

Inform the insurer about your claim along with a claims form

2

Submit your claim request through our IL Take Care app or Whatsapp us at 7738282666

3

Retain all original documents and provide them to us

4

We’ll process the claims as per the policy’s terms and conditions and upon approval, reimburse the claim amount to you

Differences between operation insurance vs health insurance

The table captures the differences between operation insurance and health insurance on various aspects:

Aspect Operation Insurance Health Insurance
Coverage focus Covers expenses related specifically to surgeries Covers a wide range of hospitalisation expenses including surgeries, pre and post hospitalisation expense, etc
Scope Limited Vast
Premium Varies High
Ideal for Those who want specific protection against surgical costs For anyone looking for a wider protection

FAQs on operation insurance

Does health insurance for surgery offer tax benefits?

Yes. The premium you pay towards health insurance that covers surgery or operation qualifies for tax benefits under Section 80D of the Income Tax Act. However, this benefit is available under the old tax regime and not the new one.

Is it necessary to get a medical check-up before buying an operation insurance policy?

It depends on policy underwriting. Based on the information you provide in the proposal form, including your age, pre-existing medical conditions, etc., the insurer may ask you to undergo a medical check-up.

How should one decide on insurance for surgery insurance coverage?

Consider your age, health risks, present medical conditions and the estimated cost of surgery. Also factor in medical inflation while determining the coverage amount.

Can operation insurance policy be renewed?

Yes. You can renew your operation insurance policy just like a regular health insurance policy. You can renew online by paying the renewal premium.

Why is it necessary for me to disclose my current health status correctly and accurately while I buy a health insurance policy?

It’s essential for policy underwriting, and doing so helps ensure a smooth application process. Also, it helps avoid claim rejection during claims settlement.

Is there any discount on buying multiple tenure policy?

It varies across insurers. Insurers may offer discounts if you buy a multiple tenure policy. Once you buy such a policy, the premium remains locked throughout the policy tenure.

Do I get any discount while buying a health insurance plan for surgery?

You can receive a discount by purchasing a multi-tenure policy. However, the discount is subject to the insurer’s discretion and may change over time.

How do I know if my surgery is covered under my operation insurance plan?

Go through the policy wording to know if your surgery is covered under the plan or not. Alternatively, you can also call your insurer to know if a specific procedure is covered.

Disclaimer:

The information provided in this page is for educational and informational purposes only. It is advised to verify the currency and relevance of the data and information before taking any major steps. Please read the sales brochure / policy wordings carefully for detailed information about on risk factors, terms, conditions and exclusions. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.

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