Organ Donor Expenses Explained in Health Insurance

Organ donation, even though it has become a remarkable and incredible reality, is still a complex, risky, and extremely expensive process. Therefore, where a receiver needs an organ, health insurance plans are quite clear that they will cover the cost of surgery as well as testing and treatments involved in getting the organ transplanted up to the insured amount.
Despite organ donation being promoted by several insurers as part of health insurance plans, it is important to remember that Health insurance providers do not cover all of the expenses related to organ donor's hospitalisation or surgery.

Medical Expenses Incurred by the Organ Donor

Following are the expenses incurred by an Organ Donor:

1. Compatibility Test: Evaluation of the organ for compatibility with the donee’s anatomy.

2. Hospitalisation Expenses: Includes consultation charges, room rent, and other charges.

3. Post-Hospitalisation Expenses: Post-discharge expenses, and expenses related to mandatory health checkups.

4. Post-surgery Care & Recovery: Includes expenses for post-operative treatment for a full recovery.

5. Pre-Hospitalisation Expenses: Relates to rigorous medication and treatment expenses before hospitalisation.

6. Surgery: Surgeon’s fees and the cost of harvesting the organ are covered.

Insurance Coverage For Donor

Organ donor cover is a feature available in health insurance plans that offer coverage up to a specified limit. The following are some of the features of organ donor health insurance plans

1. Cap on Expenses: Although the expenses of donors are covered, they may come with limits. The same health coverage that covers the donee (organ recipient) will usually have a donor cover feature. However, policies like that may have caps (limits). Health policies that cover organ donation, for instance, will only provide cover for in-patient hospitalisation expenses. Compatibility organ screening which is necessary may not be covered by the cost.

2. Coverage: Health insurance policies are ideally intended to cover the financial expenses borne by a policyholder as a result of a health condition. Organ donation is not a health condition that needs treatment. Typically, a donor needs to be healthy when an organ is given. This makes the donor high-risk, in the eyes of medical science. If you want to buy a fresh policy and are an organ donor already, then it is the insurance company’s prerogative whether it wants to cover you or not. Some companies may decide to not sell you a policy because they may consider you a high-risk case.

3. Donee Health Insurance: Several donee health insurance policies covering donor expenses will restrict the expenses of the donor to a percentage of the insured amount (10 percent of the insured amount) or a fixed limit, say Rs. 50,000 to Rs 5 lacs.

4. Add-On Product: Insurance includes hospitalisation expenses for the donor as an add-on benefit but there is a cap on the cover and other restrictions. This implies that you are expected to pay more than the base premium.

Also Read

Health insurance–Why Do You Really Need One?

Ways in Which Covid-19 Has Changed Health Insurance in India

Conclusion

Good health insurance plans must cover all hospitalisation expenses, that is, medical, surgical as well as pre- and post-hospitalisation incurred by the insured (donee).First, though many health plans cover hospitalisation expenses for recipients of organs, only a few cover the donor because organ donation is a voluntary medical procedure. You must refer to your health insurance policy document to understand the scope of cover for organ donation procedure.

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.