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Kidney Health Insurance

In India, kidney ailments are the 8th leading cause of death. One in ten people in India suffer from some form of kidney problem. Global kidney ailment studies show that the number of deaths related to kidney failure in India is greater in comparison to other countries with low-middle income economies, and the number of patients covered with insurance is lower in comparison. Why this dichotomy?

Kidney treatments are very expensive and the costs can range anywhere between Rs.15,000 and Rs.50,000 per month. The more serious the kidney problem, the more expensive is the treatment. Kidney failure is the final stage of kidney disease and normally there is not much scope for recovery from that stage. There are many signs of kidney diseases that patients might ignore as small ailments. Kidney insurance is one of the best ways to meet the rising medical expenses related to these ailments.

What is Kidney Health Insurance?

Kidney health insurance is specially designed to cover expenses related to the treatment of kidney related ailments. Kidney health plans are critical insurance plans and pay out the sum insured as lump-sum upon the diagnosis of a kidney ailment. Insurance for kidney covers ailments such as kidney failure; either partial or total.

What causes chronic kidney disease?

Chronic Kidney Disease (CKD) is a condition where the kidney loses its functions gradually. It essentially means long lasting damage to the kidneys, which can cause kidney failure, which is the last stage of kidney diseases. There are five stages of CKD from mild to severe. Some of the common causes of chronic kidney disease are:

  • Blood pressure – high blood pressure or hypertension can damage parts of the kidney leading to other serious kidney diseases.
  • Heart disease – at times the arteries get blocked obstructing blood flow to the kidneys. This can cause serious damage to kidneys.
  • Diabetic conditions – blood sugar level imbalance is linked to occurrence of diabetic conditions. When blood sugar is high or if not controlled well, it can damage kidneys.
  • Hereditary factors – certain kidney diseases are hereditary or genetic. Those who have a family history of kidney diseases must take special care of their kidney health.
  • Age – 60 years and above – age affects all organs including the kidneys. In fact, prolonged exposure to certain medicines can also result in kidney failure.

Symptoms of kidney failure

In many ways, the deterioration of the kidneys happens gradually. However, the symptoms are there in various forms. The symptoms of kidney failure might actually become apparent only a few weeks or months before the onset of kidney failure. The symptoms of kidney disease are quite general and so one might not associate them to kidney conditions until and unless diagnosed. Here are some of the most common symptoms:

  • Itching
  • Sleeplessness
  • Muscle cramps
  • Loss of hunger
  • Swelling of feet and ankles
  • Too much or too little urine

When kidneys stop working suddenly, one may notice the following symptoms:

  • Abdominal pain
  • Fever
  • Nosebleeds
  • Back pain
  • Vomiting

What happens if the kidney disease gets worse?

When kidney disease gets worse, it leads to kidney failure, which is the end stage of kidney diseases. Kidney failure is when kidney functions drop below 15% of the normal functioning of kidneys. In such a case, kidneys are not able to remove waste or create red blood cells, are not able to remove excess water from the body or control the blood pressure.

What is the treatment for chronic kidney disease?

Different kidney ailments have different treatments. The two key treatments are dialysis and kidney transplant.

Dialysis – it is a process that involves the removal of waste and excess water from the kidneys. It helps to remove waste and extra fluids present in the blood. However, damage to kidneys cannot be reversed. Even if the patient is undergoing dialysis treatment, the kidney problems will continue. The average cost of dialysis is around Rs.20,000 per month and the process is extremely painful and most patients are not able to withstand the pressure.

Kidney transplant – it is a process through which kidneys are transplanted with the help of kidney donors. The process involves one person donating a kidney to the other person. The kidney could be sourced from a live donor or from a deceased donor. This process involves the surgery of the kidney donor as well. The average cost of a kidney transplant can range from Rs.5 lakhs to Rs.20 lakhs and there is really no guarantee that even if you get the kidney that matches, you could actually live a normal life.

Does the kidney plan cover dialysis

Kidney insurance plans provide coverage for dialysis. Dialysis is one of the key treatments for kidney diseases and it is quite an expensive proposition. It is a process that involves the removal of waste and excess water from the kidneys. It helps to remove waste and extra fluids present in the blood. However, damage to kidneys cannot be reversed.

Even if the patient is undergoing dialysis treatment, the kidney problems will continue. The average cost of dialysis is around Rs.20,000 per month. With health insurance plans that cover dialysis, policyholders can meet the high expenses with ease. However, it must be remembered that it is a stage from which there is no reversal.

Kidney insurance plans

Insurance companies in India offer different kinds of plans that cover kidney diseases. While some companies offer health insurance plans that include the coverage of kidney ailments, other offer plans specially designed to cover kidney diseases. You can even opt for a Kidney coverage top-up, in case you run the specific risk. Here are some of the best kidney plans.

Plan

Features

Bajaj Finserv Kidney Stone Insurance

  • Pre-hospitalization and post-hospitalization
  • Hospitalization
  • Medication
  • Diagnostic tests
  • Doctor’s fee
  • Sum insured: Rs.50,000
  • Room rent
  • Premium starts at Rs.500 per annum

Bajaj Allianz Critical Illness Plan

  • Sum insured: Rs.1 lakh to Rs.50 lakhs
  • Entry age: 18 years to 65 years
  • Children: 6 years to 21 years
  • 100% payout
  • Available for individual and family
  • Portability feature
  • Lifetime renewability

Bharti AXA Smart Super Health Insurance Policy

  • Sum insured: Rs 5 lakh to Rs 1 Cr
  • No capping of room rent
  • Pre and post-hospitalization
  • 100% sum insured restoration
  • No-claim bonus up to 100% sum insured
  • Annual health check-up
  • AYUSH treatment#

# AYUSH – Ayurveda, Yoga, Unani, Siddhi, Homeopathy

HDFC Ergo Critical Illness Plan

  • Sum insured: Rs.1 lakh to Rs.50 lakh
  • Entry age: 18 years to 65 years
  • Pre and post hospitalization
  • No-claim bonus
  • Available for individual and family
  • Two variants of the plan available

Kidney insurance claim process

The claim process for kidney insurance is all about the methodology of making the request – from a policyholder to the insurance company – to receive the payment for the medical treatment costs incurred by the policyholder. There are two types of claims in this case.

  1. Cashless
  2. Reimbursement

For both types of claims, health insurers follow a set of processes, which has to be completed within a few days to a few weeks of the hospitalization. Typically, the process involves informing the insurance company about the medical procedure/emergency within a specified time frame, submitting a claims form and the required documents. The insurance company then investigates the documents before releasing the payment.

Cashless claim

Cashless claim is an agreement between the insurer and the network hospitals to allow policyholders treatments without any payments from the policyholder. In this type of claim, the insurer pays directly to the hospital. The policyholder does not have to make the payment and then receive it back as reimbursement from the insurance company. This ensures that the insured person does not have to worry about arranging short term liquidity.

This process, typically, follows these steps:

  1. Get treatment at a hospital that is part of the network of the insurance policy
  2. Submit a health insurance policy claim form at the hospital with relevant details
  3. The insurance company sends an approval to the hospital or raises a query in case of missing information

Reimbursement claim

In this type of claim, the policyholder has to make the payment to the hospital, which is then reimbursed by the insurer upon following the reimbursement process, as follows:

  1. The policyholder is required to fill a claims form and submit to the insurer along with the medical and hospital bills in original.
  2. The insurer then investigates the documents and ensures that the claims are in tune with the insurance contract between the patient and the insurance company.
  3. If the claim is approved, the insurance company sends an approval letter. In case of rejection, a rejection letter along with the reasons is shared with the policyholder.

How to choose health insurance for kidney disease?

There are some key factors to consider when you buy a dedicated kidney cover policy.

Dialysis treatment cost

Understanding the nitty-gritty of dialysis treatment cost is essential. Dialysis treatment includes various expenses such as the cost of dialysis machine, medicines, monthly lab tests, hospitalization cost, erythropoietin, and more. It is important to understand what all expenses are covered in a kidney insurance plan and what is explicitly excluded from the ambit of the insurance coverage before making the decision to buy it. For kidney patients, dialysis is an important cost and you must not miss that out.

Network hospitals

Kidney diseases are serious and if the patient doesn’t take enough precaution, it may lead to frequent hospitalization. It is important to check the network hospitals included in the insurance policy and whether or not they have the required facilities for treatment. Along with this, it is also important to check the costs of treatments as different hospitals charge different amounts. Ensure that the hospital you are going to is a reputed one.

Additional benefits

When buying a health insurance plan that covers kidney diseases, it is important to check the additional benefits that the plans offer. Some benefits that are additionally available in kidney insurance plans are organ donor charges, ambulance, room rent and free annual health check-ups.

Importance of health insurance plan with kidney illness coverage in India

Kidney illnesses are on the rise in India. Unhealthy lifestyles, rapid urbanisation, lack of exercises and unhealthy food habits are among the biggest causes of the rise of kidney diseases. Kidney ailments are the eighth leading cause of death in the country.

One in ten people in India suffer from some kind of kidney problem but are not aware of it until the ailments show severe signs. Studies show that the number of deaths related to kidney failure in India is greater in comparison to other countries with low-middle income economies, and the number of patients covered with insurance is lower in comparison.

Kidney treatments are expensive and can range anywhere between Rs.15,000 to Rs.50,000 per month. The more serious the kidney problem; the more expensive its treatment and we are not even talking about the steep costs of a kidney transplant. The average cost of dialysis is around Rs.20,000 per month. The average cost of a kidney transplant varies between Rs.5 lakhs and Rs.25 lakhs, assuming there are no additional complications.

It is important to buy a health insurance plan that offers coverage for kidney diseases to safeguard oneself from the expenses of kidney ailments in India. Such kidney ailments have become too common these days and it is normally an outcome of other problems like hypertension, diabetes, excess medicine intake, obesity etc.

Kidney diseases treatment without health insurance

Without kidney insurance, the patient would have to bear huge treatment expenses from their own pocket. Kidney disease treatments are expensive and can range anywhere between Rs 15,000 to Rs 50,000 per month. The more serious the kidney problem the more expensive its treatment. The average cost of dialysis is around Rs 20,000 per month. The average cost of a kidney transplant is Rs 10 to 30 lakh. Without having a kidney health plan, the patient will have to spend the entire amount from their own pocket.

Kidney diseases treatment with health insurance

Having a kidney insurance plan can help meet the high expenses of kidney disease treatment. Kidney policies offer coverage for a wide range of expenses such as pre- hospitalization and post-hospitalization, hospitalization, medication, diagnostic tests, doctor’s fee, annual health check-up, AYUSH treatment, among other expenses. Health insurance companies offer kidney insurance with sum insurance starting from Rs.50,000 and go all the way up to Rs.1 crore to Rs.2 crore. Having an insurance plan can help policyholders cover huge expenses that are associated with kidney ailments, particularly kidney transplant and dialysis.

Faqs

How does kidney health insurance work?

Kidney health insurance is specially designed to cover expenses related to the treatment of kidney ailments. Kidney health plans are critical insurance plans and pay out the sum insured as lump sum upon the diagnosis of a kidney ailment. Insurance for kidney covers
ailments such as kidney failure, kidney stone and more.

How will I know if my policy will expire?

Most critical insurance and kidney insurance policies are for the duration of one to three years, after which they have to be renewed. Health insurance policies have to be kept valid by paying the premium, at the most by the grace date. The health insurance companies
intimate the policyholder about the expiry date through messages, calls and emails well in advance. The policyholder can check the hard copy or the soft copy of the insurance policy which clearly mentions the expiry date.

How can I buy a kidney plan online?

All insurance companies have their own websites that provide the option of buying insurance online. All websites have a request or make a purchase section. Customers can fill in all the necessary information and complete the process of purchasing with a few clicks.
Here are the steps:

● Search for your choice of kidney insurance on insurance websites
● Most insurance companies have an online premium calculator on their website
● Find the calculator and fill in the details as required
● Select options according to your requirement – type of plan, number of members, age,
and sum insured, etc.
● Share your contact details
● Click on calculate the premium
● The insurance company will share the premium amount on your contact details

● Once the plan is selected, make the premium payment to buy the policy

What are the special features of kidney insurance?

Kidney health insurance is specially designed to cover expenses related to the treatment of kidney ailments. Kidney health plans are critical insurance plans and pay out the sum insured as lump sum upon the diagnosis of a kidney ailment.

Insurance for kidney covers ailments such as kidney failure, kidney stone and more. Some health insurance plans with coverage for kidney diseases offer additional benefits. Some benefits that are additionally available in kidney insurance plans are organ donor charges, ambulance, room rent and free annual health check-ups.

What are the benefits one can enjoy under kidney insurance?

Apart from the common benefits such as tax exemption under Section 80D, no-claim bonus (NCB), discounts and rewards, when buying a health insurance plan that covers kidney diseases, it is important to check the additional benefits that the plans offer. Some benefits that are additionally available in kidney insurance plans are organ donor charges, ambulance, room rent, and free annual health check-ups on a regular basis.

How do I claim kidney insurance claims?

Kidney insurance plans are critical insurance plans that generally give lump sum payout. The claim process for kidney insurance can be of two types: cashless or reimbursement. The claim process for kidney insurance is all about making the request - from a policyholder to the insurance company - to receive the payment for the medical treatment costs incurred by the policyholder. There are two types of claims:
1. Cashless
2. Reimbursement

For both types of claims, health insurers follow a set of processes, which has to be completed within a few days to a few weeks of the hospitalization. Typically, the process involves informing the insurance company about the medical procedure/emergency within a specified time frame, submitting a claims form and the required documents. The insurance company then investigates the documents to release the payment.

How many dialysis sittings does kidney insurance cover?

The clauses and the fine print in the kidney insurance plan are contingent on the insurance company and the plan chosen. Different insurers might offer different kinds of coverage. Some kidney insurance plans pay a 100% sum insured as lump sum, while some might pay a part of the sum insured. The number of dialysis sittings covered in a kidney insurance plan depends on the plan chosen.

Do I get tax benefits under kidney insurance?

Yes, kidney health insurance policyholders can avail tax exemptions on the premium paid towards the policies under Section 80D of the Income Tax Act. Individual or all family members below 60 years of age can avail up to Rs.25,000 as exemption, which can be deducted from the taxable income by the person paying the premium.

This Rs.25,000 should have been paid as premium or towards preventive health check-up. Individuals, family members and parents under 60 years can avail of up to Rs.25,000 as a deduction from the total taxable income. In the case of parents who are senior citizens, the separate exemption slab gets enhanced to Rs.50,000 per financial year.

Can I get insurance for a pre-existing kidney failure illness?

Yes, many health insurance companies offer insurance for pre-existing kidney failure illness. It may come at a higher premium and might have a longer waiting period. However, it would depend on the extent to which your kidney condition has really deteriorated.

Can I get insured if both the kidneys have failed?

Some insurance companies offer insurance if both kidneys have failed, however, such an insurance plan comes at a high premium and with a longer waiting period. The clauses too might be different from that of the policy of a policyholder without kidney ailments.
Generally, it is not permitted.

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