Prostate Restored
Photo by KoolShooters Pexels Logo Photo: KoolShooters

Why is robotic surgery not covered by insurance?

Robotic surgeries are covered under health insurance only if the surgery has been advised by a qualified surgeon trained in the technique. Without the recommendation of a qualified surgeon, insurance companies will deny the claim.

What are the 5 warning signs of prostate cancer?
What are the 5 warning signs of prostate cancer?

What are 5 Common Warning Signs of Prostate Cancer? Pain and/or a "burning sensation" when urinating or ejaculating. Frequent urination, especially...

Read More »
How do you function without a prostate?
How do you function without a prostate?

So if we remove the prostate, what is starting stopping urinary flow? The answer is nothing! If there is urine in the bladder (and there always...

Read More »

What is Robotic Surgery? Robotic surgery is a type of surgery performed with the help of tiny tools attached to a robotic arm. It allows surgeons to perform complex surgical procedures with better precision, control, and flexibility as compared to traditional techniques. Under this surgery, the surgeon directs the movement of the robot while sitting at the computer station. Mostly, robotic surgery is required for brain surgery, heart replacement surgery and cancer of vital organs amongst other conditions. However, robotic surgery is an expensive procedure in India. Usually, the cost of robotic surgery ranges from Rs 1.4 lakh to Rs 11 lakh depending on the type of surgery and the city where the surgery will take place. For example, the cost of cardiothoracic robotic surgery is more than an abdominal robotic surgery. Similarly, robotic surgery costs more in metropolitan cities like Delhi than in tier 2 cities like Varanasi. As a result, robotic surgery is difficult to afford for most people in India. Is Robotic Surgery Covered by Health Insurance Plans in India? Yes. Health insurance plans in India cover the cost of robotic surgery. As per the guidelines issued by the Insurance Regulatory & Development Authority of India (IRDAI) in 2019, all health insurance companies have to mandatorily provide coverage for robotic surgeries. As a result, every insurance company covers robotic surgery costs in at least one of their plans under modern treatment. The coverage for a robotic surgery includes the cost of hospitalization, surgery fees, doctor’s fees, nursing charges, ICU charges, etc. The plan also covers the pre-hospitalization and post-hospitalization expenses associated with the surgery. Some insurance companies may also cover the cost of the ambulance services used to transport the patient to the hospital. Conditions Applicable Under Health Insurance Plans for Robotic Surgery Coverage Robotic surgeries are covered under health insurance only if the surgery has been advised by a qualified surgeon trained in the technique. Without the recommendation of a qualified surgeon, insurance companies will deny the claim. Moreover, if the surgeon recommending robotic surgery is not trained in the technique required to perform the surgery, the claim will get rejected. Besides, the coverage for robotic surgeries may be subject to sub-limits. This means that the insurance company will cover the cost of robotic surgery as per the pre-specified limit. The remaining expenses will have to be paid by the policyholder. For example, if robotic surgery comes with a sub-limit of 1% of the sum insured and the sum insured if Rs 10 lakh, the policy will cover surgery costs of up to Rs 1 lakh only. Health Insurance Waiting Period for Robotic Surgery Robotic surgeries are not covered under health insurance plans from day 1. Instead, policyholders need to wait out a pre-defined waiting period to avail coverage for robotic surgery. The waiting period may vary as per the disease or medical condition that requires a robotic surgery. For example, if robotic surgery is required for knee replacement surgery, a waiting period of 2-3 years may apply. But in case the insured was diagnosed with a medical condition requiring a robotic surgery before purchasing the policy, the waiting period for pre-existing diseases will apply. This is because the said disease or medical condition will be considered pre-existing in this case. Usually, pre-existing diseases are covered by health insurance plans after a waiting period of 2 to 4 years.

Why do older males get BPH?
Why do older males get BPH?

Hormones from the testis may be the main factor. For example, as men age, the amount of active testosterone in the blood declines. Estrogen levels...

Read More »
What is the best vitamin for tiredness?
What is the best vitamin for tiredness?

The 5 Best Vitamins for Energy & Tiredness Vitamin B1 (Thiamin) ... Vitamin B2 (Riboflavin) ... Vitamin B3 (Niacin) ... Vitamin B5 (Pantothenic...

Read More »

Can high PSA mean nothing?
Can high PSA mean nothing?

Elevated PSA levels can indicate the presence of cancer, but high PSA levels can also be a result of non-cancerous conditions like benign prostatic...

Read More »
What is the best exercise to lower blood pressure?
What is the best exercise to lower blood pressure?

Some examples of aerobic exercise that can help lower blood pressure include walking, jogging, cycling, swimming or dancing. Another possibility is...

Read More »
Why should men sit when they pee?
Why should men sit when they pee?

Doctors added that when people sit, pelvic and hip muscles are relaxed, making urination easier. Associate Clinical Professor at the UCLA...

Read More »
What are the 5 life domains?
What are the 5 life domains?

Life domains Daily life and employment. What a person does as part of everyday life — school, employment, volunteering, communication, routines,...

Read More »