Health Insurance With Organ Transplant Cover

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Organ Transplant Policy

When any organ of your body stops functioning, and no surgery can revive its functions, and that it is considered as organ failure. When one suffers from organ failure, it needs to be replaced, and an organ from another person needs to be transplanted. Therefore, an organ transplant involves two people, the donor and the one suffering from organ failure. Organ transplantation can be done for vital organs, like the heart, kidney, liver, etc.

Key benefits of health insurance with organ transplant cover:

  • In-patient treatment
  • Doctor/hospital for a second opinion covered
  • 96.43% Claim Settlement Ratio FY 19-20
  • Cashless hospitalization at 7200+ hospitals
  • No room rent restrictions on MediCare Premier/MediCare

Please refer policy wordings for inclusion/Exclusions/Waiting period

Critical Illness policy wordings

Organ Transplant Overview

As these organs are crucial for one's body, the cost involved in transplantation is huge, ranging from Rs 5 Lakh-35 Lakh, depending on the organ that needs to be transplanted. Apart from this, you also need to bear the donor's cost, i.e. his/her organ harvesting and the surgery. An organ transplant can have a significant impact on your family's finances. Therefore, it is advisable to sign up for critical illness insurance covering organ transplant insurance, such that you are financially protected if anything unfortunate happens to you.

Tips to Choose the Organ Transplant Policy

As it would be a critical surgery, it is imperative to check the inclusions and exclusions of organ transplant policy. It should include:

  • Donor's expenses (Organ harvesting and surgery)

  • Consumable expenses like pre and post-hospitalization expenses, etc.

  • Cost of continuous monitoring, treatment post-surgery, investigations, etc., which might also involve considerable cost.

  • Choose the sum insured while keeping in mind the treatment cost of organ transplantation.

  • Check the network hospitals' list to know about the network hospitals in your area to get immediate and quality medical care.

  • Choose one with a hassle-free and straightforward claim settlement procedure. Usually, the claim is settled in two ways:

Cashless Facility

If you get the treatment done from one of our network hospitals, you need not pay any amount from your pocket. You can simply use the health card, and we will settle the amount directly with the hospital.

Reimbursement Facility

If you get the treatment done from any hospital other than the network hospital, you will have to pay the amount initially, and we will reimburse the same later. It is better if you apply for the claim at the earliest, such that you can receive the amount within a reasonable period of time.

Benefits of TATA AIG's Critical illness Insurance (Organ Transplant)

Kidney Failure Requiring Regular Dialysis

The diagnosis under this case needs to be carried out by an expert medical practitioner. If anyone experiences chronic irreversible kidney failure, the treatment includes a kidney transplant or regular dialysis. Depending on the condition, either hemodialysis or peritonial dialysis is carried out.

Hemodialysis takes place regularly, i.e. 3 to 5 times a week Peritoneal dialysis takes place daily

Major Organ/Bone Marrow Transplant

It includes the actual transplant of the heart, lung, liver, kidney or pancreas. Our critical illness insurance covers the transplantation cost in the case of irreversible end-stage failure of any one of these organs.

It also includes human bone marrow using haematopoietic stem cells. An expert medical practitioner should confirm the transplant.

There are a few exclusions of the organ transplant policy:

Stem-cell transplants other than bone-marrow surgery Where only Langerhans's islets need to be transplanted

Organ Donor Benefits Covered Under TATA AIG'S Medicare Policy

Organ donor's medical and surgical expenses are covered if the insured is the recipient, provided:

An organ donor is an individual whose organ is made available in compliance and accordance with The Transplantation of Human Organs (Amendment) Bill, 2011, and it is being used for the insured.

We also provide the benefit of in-patient hospitalization of the insured under the insurance plan. But, the expenses directly related to the hospital are payable.

Second Opinion

If you are unsatisfied with one doctor's opinion, you can avail of a second opinion in case of kidney failure or organ failure requiring a transplant. The overall cost will be covered under the insurance plan. The insured can avail of this benefit once during the policy year.

We at TATA AIG provide customized plans as per the clients' specifications, such that they can have broader coverage. We have various insurance plans for organ transplantation, such as critical illness, Medicare Protect, Medicare Premier and Medicare Plus, which have different specifications, terms and conditions. You can choose any one of them as per your financial capacity and specifications.

We also have dedicated Medicare approved transplant centers, such that the transplant surgery can be carried out by expert medical practitioners. You can easily apply for any insurance plan online by visiting our website. In case you need any assistance or guidance throughout the process, you can contact our customer care executives via call/SMS/email.