Organ Donor Expenses: Does Your Health Insurance Cover Them?

Posted on: Dec 15, 2022 | | Written by:

Organ Donor Expenses: Does Your Health Insurance Cover Them?

Published on December 15, 2022. EST READ TIME: 4 minutes

There are times when certain organs in the body, such as the liver or kidneys, stop functioning and pose a major threat to life. This is when organ transplantation becomes important. Organ transplantation is an important medical procedure in which the donor’s organ is placed in the recipient’s body.

Thanks to medical advancements, people can now donate a kidney, a lung or a part of the liver, intestine or pancreas to their family, friends and other close associates. Organ donation gives a new lease of life to the receiver; hence it is always wise to take a health insurance plan, covering organ donor expenses. With some of the best family floater and individual health insurance policies covering organ donor expenses, finding one should not be a problem. These health plans cover the surgical expenses of harvesting a major organ from the donor’s body, thereby saving the donor from bearing the expenses from his pocket. In simple terms, the organ receiver’s health insurance cover takes care of the donor’s medical and surgical expenses.

Does Health Insurance Cover Organ Transplant Expenses?

Health insurance policies cover medical emergencies as well as planned procedures and surgeries of the policyholders and save them from financial setbacks. When it comes to organ transplant expenses, most health insurance companies do cover the expenses but up to the sum insured or as mentioned in policy terms and conditions.

Organ transplantation is an expensive procedure and not having adequate health insurance cover can burn a hole in the pocket. Apart from hospitalisation and surgery expenses, a good health insurance policy also covers pre and post hospitalisation expenses of the insured and saves him from major financial setbacks.

Why Are Organ Donors Eluded from Health Plans?

Most health insurance plans do not cover organ donor expenses for one simple reason – providing an organ to someone will not help the donor (policyholder) in any way. On the contrary, organ donation exposes a healthy individual to the risk of major surgery. He may also face certain health complications, such as allergic reactions, blood clots and damage to nearby organs and tissues.

In some cases, donors face problems with the functioning of the remaining organ and go through psychological issues as well. Mental health issues, such as anxiety and depression are quite common among organ donors. All these can increase their healthcare expenses, creating an additional burden on the insurance company.

Organ donation is not limited to organ harvesting or removing the organ from the donor’s body for transplantation. Several tests and procedures are done before and after the surgery, and the entire process can take several weeks and cost huge bucks. Hence, organ donors are eluded from health insurance policies.

What Is the Solution?

In most cases, organ donors have to meet the surgery and recovery expenses from their pocket and this is something that keeps them from donating organs. However, if the receiver has organ donor coverage, his health insurance company will cover the surgical expenses of harvesting a major organ from the donor’s body.

For instance, A is the donor and B is the receiver. B has a health insurance policy with organ donor coverage. Hence, B’s insurance company will cover the cost of harvesting a major organ from A’s body. This will help B receive the required organ in time and save him from major health complications. Since B’s insurance company will cover organ harvesting expenses, donor A will not have to spend anything from his pocket.

Health insurance companies accept both cashless and reimbursement claims for organ donation. For cashless claims, the insured and the donor must opt for the medical procedure in a network hospital. In case of a non-network hospital, the insured will settle the bills from his pocket and then file a reimbursement claim with the insurance company.

How to Include Organ Donor Coverage in Your Health Plan

Some health insurance plans cover organ donor expenses without any extra premium charges. It is more like a built-in benefit to policyholders. Others may offer this benefit as an add-on cover. Hence, when you are buying health insurance, go through the policy inclusions and exclusions minutely and look for organ donor coverage. In case a family floater or individual health insurance policy does not cover organ donor expenses, you can take it as an add-on cover by paying an extra premium for the same.

Policyholders can take organ donor expenses add-on cover any time during the policy tenure or at the time of policy renewal. Since the benefits of this add-on cover are seldom used by policyholders, its premium is usually on the lower side. Hence, it will not be an additional financial burden either.

Conclusion

Health insurance plans covering organ donor expenses make the entire process of organ harvesting and transplantation easier and financially feasible for the donor and receiver. Hence, it is always wise to take health insurance cover with this benefit. You can also take it as an add-on cover if need be. If the insured requires organ transplantation, his family floater or individual health insurance policy will cover the surgical expenses of the donor. This will save the donor from exorbitant hospital bills and help the insured get the required organ in time.

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

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