Considering that organ donation and transplant involves 2 parties: the donor and the receiver, what comes under the purview of one’s policy?
Health insurance policy is valid for all diagnosed conditions, procedures, surgeries, treatments that require hospitalization, of course subject to terms and conditions. So, in case of the receiver in need of an organ, health insurance policies are fairly clear that they would cover the cost of surgery as well as tests and procedures involved with getting the organ transplanted up to the sum insured.
But the donor expenses (harvesting, storage, screening etc) will have to be borne by the person getting the organ. However, there are some insurance companies who cover the donor expenses as well.
So what kind of costs does one have to face in case one is willing to undergo organ donation?
There are mainly 6 types of medical expenses incurred as far as the organ donor is concerned:
1. Organ screening for compatibilities like blood group matching and overall well-being.
2. Pre-hospitalization costs – Once the donor is finalized, the donor may be required to go through certain medication, treatment, before he can be ready to be hospitalized.
3. Hospitalization Costs: Cost of the room, nursing with respect to the donor.
4. Organ transplantation surgery: The actual surgery, for harvesting the organ and transplanting into the recipient – Cost of surgery, Surgeon fees.
5. Post-surgery complications, recovery – Post-surgical complications, for instance, functioning with one kidney, are not uncommon with respect to organ transplantation. So, there is a high probability of increased cost of recovery, medications, stay in hospital etc
6. Post Hospitalization Costs for the Donor- Medication, Doctor follow-ups etc.
Of the above costs, pre and post-hospitalization costs of the donor and costs because of post-surgery complication are not covered by most insurance policy in India as on date. Some companies restrict the procedure to sublimit or restrict on the pre/post-hospitalization expenses.
However, the cost most expected to be included by all policies, i.e. of the actual surgery is unfortunately only covered by a few companies.
What are some conditions that should be kept in mind under organ transplant insurance?
- Any other medical treatment for the donor consequent on the harvesting is not covered
- There are strict guidelines when it comes to organ transplantation, therefore the organ donor whose organ has been made available should be in accordance and in compliance with the Transplantation of Human Organs Act 1994 (as amended) and the organ is donated for your personal only
- This cover has a waiting period that ranges from 2 to 4 years, or you must wait for a minimum of 2 years from the policy start date, to avail this benefit.
Now with organ Transplant Insurance, the gift of life and healthy living is not out of reach anymore.
