Am I Covered For Organ Donor Expenses In Health Insurance?

With the repeated advancements in technology in the health sector, today the doctors can transplant an organ of an individual in case of organ damage, or accident, etc. even though the facility is available in our country, the costs of organ transplant are severely high. It is difficult for middle-class individuals to incur the expenses of organ transplantation from their pocket. To help people get organ transplants in case of an emergency, there exist health insurance policies that cover the benefit of organ transplantation. 

According to the standard guidelines, a regular health insurance policy covers the organ transplantation benefit. The receiver of the organ enjoys all the benefits like hospitalization expenses, surgeries, treatments, etc but the expenses of the donor have to be incurred by the receiver of the organ. Some health insurance companies provide certain benefits to the donor but the extent and sum assured under the policy are not sufficient and therefore, the receiver has to provide the donor some monetary aid.

Expenses Incurred By An Organ Donor 

As stated above, the expenses of the organ donor are to be met by the receiver of the organ. However, in the case of certain insurance companies, the donor’s expenses are also met. Let us look at the list of expenses that a donor has to incur for donating an organ to a person in need of it: 

• Tests for compatibility of the organ of the donor with that of the receiver's anomaly have to be conducted which incur some expenses in the initial stage.
• Doctor’s consultation, treatment, surgery, room rent, and other medical expenses of the donor are also applicable. 
• Post-hospitalization expenses which include regular health checkups are to be incurred.
• Pre and post-surgery care and expenses during the recovery are also to be met for the donor of the organ. 
• A Surgeon's fee is also a part of the expenses of the donor of an organ during an organ transplant. 

The above-mentioned expenses are to be taken care of by the receiver of the organ, either from his/her pocket or with the help of a health insurance policy which includes the donor’s expenses. 

Features of Health Insurance Plan Covering The Organ Donor’s Expenses 

If your health insurance plan includes the organ donors expenses benefit, then the following is the list of features that will be included with this benefit for the donor:

• With certain limits as specified by the insurer, the expenses of the donor for hospitalization, surgery, treatment, etc. are covered under the plan. In some cases, the compatibility screen test, which is mandatory, might not be covered. Under organ donation cover, only the in-patient expenses are taken care of by the insurance company. 
• These plans only cover the financial expenses of the organ donor as it is not a pre-existing condition or disease. The organ has to be transplanted successfully from the donor’s body to the receiver’s body which makes it a high-risk case and therefore, some companies do not include it.  
• Some insurance companies have fixed the benefit for the donor to be the 10% of the receiver’s sum assured. It ranges from Rs. 50,000 to Rs. 5 Lakh. The amount and the benefits for the donor differ from one insurer to the other and are limited. 
• If your health insurance coverage does not include the donor’s expenses, and you do not want to pay the expenses from your pocket then you can purchase an add-on cover that specifically meets the requirements of the organ donor. 

Conclusion 

You must read all your policy-related documents carefully to make sure that the organ donor’s expenses are covered under your purchased policy or not. If not you must buy a policy or top-up cover, as the amount incurred can be really high which can result in the exhaustion of your financial savings. 

Also Read: Organ Transplants and Health Insurance-How Does It Work?

Critical Illness Insurance Plan For Organ Transplant

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.