Health Insurance Policy for Bariatric Surgery in India

Bariatric Surgery or Weight-Loss Surgery Health Insurance Policy in India

Obesity is one common problem faced by a majority of the world’s population. People try various diets and exercise regimes to shed those extra kilos. But what if the excess weight is not ready to go away and is leading to other medical and health issues? Then, comes the option to undergo a weight loss surgery called bariatric surgery. If the thought of high bariatric surgery cost is your reason to say no to this surgery, go for a health insurance that covers weight loss surgery. All the top-notch health insurers offer health insurance plans to help you in this regard.

In this post, we aim to enlighten you about bariatric surgery cost in India. We will also throw light on the main question that is bariatric surgery covered by medical insurance?

What is Bariatric Surgery?

Do you think that Bariatric surgery in India is a new concept to get rid of obesity? Yes, you are right. Bariatric surgery is nowadays recommended by doctors in India for those suffering from obesity-related medical issues. The best bariatric surgeon in Indiaperforms this weight loss surgery on people with a BMI or Body Mass Index of 40 and above. Before undergoing bariatric surgery, a person is supposed to go on a special diet, and once the surgery is done, he/ she needs to indulge in regular exercise to avoid weight gain post-surgery.

Who needs Bariatric Surgery?

A majority of the population would love to lose weight, but let us try and understand who needs it actually? Bariatric surgery may be opted for as a cosmetic treatment by many. However, this weight loss surgery should be opted only if obesity is leading to other serious health disorders like:

  • Hypertension
  • Diabetes
  • Non-alcoholic Steatohepatitis
  • Insomnia or Sleep Disorders
  • Cardiovascular Diseases or Strokes

Is bariatric surgery covered by insurance?

Now, the question that comes to mind is does health insurance cover bariatric surgery cost? Yes, as we mentioned earlier, all the reputed health insurance companies in India happily cover claims for weight loss surgeries like bariatric surgery. It was not the same way until 2019 when such surgical costs were not included in any health plan. However, later as per the new IRDA guidelines, the cost of bariatric surgery is also offered as a benefit in health insurance plans only if it is advised as a medical necessity.

What are the Prerequisites for Health Insurance Plans to cover Bariatric Surgery Cost?

To ensure your health insurance plan covers bariatric surgery, we suggest you go through the terms and conditions that most insurers consider before accepting your claims for such surgeries. Have a look:

  • Surgery must be advised by a reputed and licensed doctor.
  • The surgery should not be for cosmetic reasons but as a medical necessity.
  • Bariatric surgery to be conducted should be done after thorough medical testing and diagnosis.
  • The patient must have a BMI of 40 or more.
  • A person undergoing bariatric surgery must be over the age of 18 years.

How much does a Bariatric Surgery Cost in India?

Talking about the bariatric weight loss surgery cost in India, let us tell you that no surgery in India is cheap. A standard bariatric surgery procedure in India would cost between Rs. 2.5 lakh – Rs. 5 lakh depending on certain factors like gastroenterology surgeon’s fee, fatty liver disease of the patient, surgical instruments used, high blood pressure, and other similar health issues of the patient during the surgery.

Benefits of a Health Insurance Plan with a Bariatric Surgery Cover

If you are still not sure as to why to buy a bariatric surgery covered by your health insurance plan, worry not. Reading the following benefits of a health plan with bariatric surgery cover will convince you for sure:

  1. Cashless Hospitalization
  2. Wide Array of Network Hospitals
  3. Pre- and Post-Hospitalization Coverage
  4. No Claim Bonus
  5. Daily Allowance
  6. Ambulance Cover

What is the Waiting Period for a Bariatric Surgery Cover?

Generally, the waiting period for a bariatric surgery covered under any health insurance plan is between 2 to 4 years. Your surgical cost for bariatric surgery will be compensated only if you undergo the surgery after this waiting period.

How to Claim a Bariatric Surgery Cost?

To get the bariatric surgery claim from your health insurance company, you need to ensure the following things:

  1. Record of medical prescriptions, diagnostic testing, and surgical prescriptions.
  2. A copy of the health insurance policy.
  3. A proof of medical report that shows the patient had a BMI of 40 or more.

What is Excluded from the Coverage for Bariatric Surgery Treatment?

Many health insurers indeed offer coverage for bariatric surgery, but they do so with some limitations. The coverage for such treatments is subjected to the terms and conditions of the plan bought by the policyholder. No coverage is provided for any pre-existing condition that is not part of this surgery. Moreover, if the surgery is being performed for cosmetic reasons, chances are that your claim will be rejected. Similarly, the health insurance companies don’t entertain claims for bariatric surgery if it is done to treat obesity due to untreated hormonal imbalance, psychiatric reasons, wrong eating habits, or drug intake.

Best Health Insurance that covers Weight Loss Surgery in India

To make things simpler for you, we are now sharing a list of health insurance plans that cover bariatric surgery costs in India:

  1. ACKO Health Insurance Plan
  2. Bajaj Allianz Health Insurance Plan
  3. Care Health Insurance Plan
  4. Godigit Health Insurance Plan
  5. HDFC ERGO Health Insurance Plan
  6. Star Health Insurance Plan
  7. Tata AIG Health Insurance Plan

Conclusion

Over to You

Care Health Supreme and HDFC ERGO Optima Restore are among the best health insurance policies in India today. It is a matter of your priority, coverage depth over cost effectiveness. Here’s a quick recap for you to make an informed decision.

Both offer coverage of up to ₹1 crore; Optima Restore starts at ₹3L, Care Supreme at ₹7L. Supreme offers unlimited recharge; Optima Restore offers 100% once a year, after a claim is made. Care includes OPD + unlimited e-consults; Optima lacks OPD, allows one consultation/year. Care gives a 30% discount + 500% bonus; Optima offers 8% discount + 50% bonus. Care Supreme is costlier but has more features. Optima suits budget buyers; Care fits those needing wider, long-term coverage.

Whichever health insurance plan you choose, ensure to read the policy wordings and seek advice from an expert before you make the purchase. The best health insurance is the one that covers you the way you want to be covered.
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Author Bio

Paybima Team

Paybima is an Indian insurance aggregator on a mission to make insurance simple for people. Paybima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. Paybima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

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