Does Health Insurance Cover Brain Tumor Surgery?

Posted on: Jun 7, 2024 | 3 mins | Written by: HDFC ERGO Team

Does Health Insurance Cover Brain Tumor Surgery?

We buy a health insurance policy because we want to protect ourselves financially during medical emergencies. But when we think of ailments or injuries, we stay prepared, maybe for a few days of hospitalisation. Anything beyond that can be scary. Now imagine how an illness like a brain tumor would take a toll on patients and their families. Although surgery can be used to treat brain tumors, the treatment can be a complex and expensive procedure. One question immediately arises in the patient's mind: Will the insurance policy cover the expenses? Let’s learn if having health insurance can provide financial security and peace of mind during this challenging time.

What is Brain Tumor?

Our brain is like a supercomputer, and the nerves are like circuits. Just like a glitch can happen while you are working on the computer, a tumor can affect the functioning of the brain. Well, on a more scientific note, a brain tumor happens when the brain cells start growing uncontrollably and form a mass. Now, these masses can be of two types — benign (i.e., not cancerous) and malignant (cancerous). It can develop in any part of the brain or skull, and the speed of the tumor’s growth can vary from person to person. The tumor’s genesis can be in the brain itself, or it could have sneaked in from another body part.

Symptoms

The signs and symptoms of a brain tumor depend on the lump’s size, location, and type. Some of the most common symptoms are:

• Headaches that get worse in the morning

• Difficulty thinking, speaking, understanding

• Seizures

• Vision and hearing problems

• Nausea and vomiting

• Dizziness or loss of balance

• Weakness or paralysis on one side or one part of the body

• Loss of memory

• Confusion and disorientation

• Personality changes

• Slurred speech

• Fatigue

Risk Factors of a brain tumor

Some factors which increase the risk of a brain tumor include:

• When a person is exposed to ionising radiation, which is strong enough to cause DNA changes in the body’s cells, it could lead to tumors and cancer. Examples of ionising radiation are exposure to atomic bombs or radiation therapy used to treat cancer.

• The risk increases with age, though brain tumors can occur at any age.

• Heredity accounts for about 10% of all cancers, but some inherited conditions can increase the risk of developing tumors, such as Lynch syndrome, neurofibromatosis, Li-Fraumeni syndrome, familial adenomatous polyposis, Cowden syndrome, tuberous sclerosis, Gorlin syndrome, etc.

• Being exposed to cancer-causing chemicals found in workplaces

• Trauma to head or seizures

Treatment

Doctors generally use a combination of therapies based on the overall health condition of the person, the type of tumor, size, grade, location, and whether it is cancerous or non-cancerous. The common treatment methods include chemotherapy, radiation, surgery, targeted therapy, immunotherapy, and radiosurgery. Chemotherapy and radiation are commonly used for treating malignant, persistent, and recurring tumors, but the course of treatment can differ from person to person.

Prevention

Unfortunately, brain tumors cannot be prevented, though you can reduce the risk by avoiding exposure to the above-mentioned risk factors. However, if you have a family history of brain tumors or inherited conditions, you are at greater risk of developing it. So, you should talk to your doctor, who may recommend genetic counseling and regular screening tests. Genetic counseling can help identify if you have inherited the gene that can increase your risk. Screening tests will help detect it at an early stage, and treatment can be started early.

Will your health insurance cover brain tumor surgery?

Yes. Indemnity health insurance plans cover brain tumor surgery. All hospital expenses incurred during the surgery are covered, including hospitalization, pre- and post-hospitalization, ICU charges, OT charges, room rent, and other expenses up to the sum insured. However, buying critical illness insurance is recommended. If you are diagnosed with a critical illness covered in the policy, the insurer will provide a lump sum compensation equal to the sum insured. The payout can be used for medical as well as non-medical expenses, such as paying off debts, children's education, compensating for loss of income, etc. The standard health plans will cover the actual expenses incurred, but critical illness policies will offer you a lump sum benefit.

It is important to note that to be eligible for compensation, the patient must survive for at least 30 days (this can vary from insurer to insurer) after being diagnosed with a brain tumor. This is called the survival period. There's also a waiting period of 90 days from the date of policy purchase to claim the medical expenses of brain tumor surgery.

Conclusion

A brain tumor is a critical illness, and treating a critical illness can drain your savings. This can leave you financially and emotionally broke. To ensure you have enough financial protection without worrying about the surgery costs, it is important to have critical illness insurance. A critical illness plan will offer a lump sum compensation equal to the sum insured on being diagnosed with any covered critical illness like a brain tumor.

Disclaimer The above information is for illustrative purposes only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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