Many people believe that surgery with insurance is going to cost more. However, the truth is quite the opposite. Insurance companies have a network of hospitals and clinics across the country, where they can negotiate significant discounts on the services provided. This reduces the overall expense of the treatment.
Generally, without insurance, breast reduction cost in India around Rs. 60,000 to Rs. 1,50,000. However, while paying with insurance, the treatment cost would be reduced and likely cost around Rs. 1,25,000.
Expenses Covered by Insurance for Breast Reduction Surgery
We are providing a list of top health insurance providers that offer ample coverage with various benefits.
The following expenses incurred during breast reduction are covered by health insurance-
- Pre-op and Post-op Tests- Various tests that are performed before and/or after breast reduction are covered by insurance. The common tests include mammography, MRI, X-ray, etc.
- Hospital Admission and Discharge Fee- The fees charged by a hospital are fixed by the administration, and it is payable by insurance in entirety.
- OT and ICU Charges- The insurance policy covers the cost of the operation theatre and intensive care unit, whose charges are calculated on an hourly basis.
- Surgeon, Attendant, Nursing, and Anesthetist’s Fee- The fees charged by each of these individuals are calculated separately. The insurance policy covers the fees charged by the surgeon, attending surgeons, nurses, anesthetists, and medical staff.
- Medical Consumables- During the hospitalization period, several expenses incur that are considered under medical consumables. These expenses include the price of syringes, sutures, catheters, gloves, masks, adhesives, bandages, IV bags, etc. All these expenses are covered by health insurance policies.
- Room Rent- Breast reduction surgery requires hospitalization, and the expenses are payable by insurance. However, there might be some capping on the room rent depending on the patient’s choice of room (single, double, or sharing). And the charges are calculated on a daily basis.
- Post-surgery Consultations- The fees charged by the surgeon for post-surgery follow-up consultations can also be paid by the health insurance.
Besides the above-mentioned expenses, patients can customize their insurance policy and get add-on coverage for other expenses associated with breast reduction surgery and/or other treatments.
How to Claim Health Insurance for Breast Reduction?
There are different criteria to get a claim for surgical treatment. As breast reduction is a pre-planned procedure, it can be covered using a cashless mode with planned admission or with a reimbursement claim. The mode of claim will be determined based on the hospital you choose. If you are undergoing surgery at an insurance-network hospital, you will be eligible for a cashless claim. If not, then you’ll have to get a reimbursement claim.
The steps you need to follow for cashless breast reduction are-
- Choose a hospital from the network of the insurance company.
- Inform the TPA (third-party admin) 3 days prior to your admission and provide your insurance ID.
- Fill out the cashless claim form and submit it with the required medical records to the TPA.
- The TPA team will inspect the documents and approve the claim.
- Once approved, the insurance company will settle the hospital bills.
If the claim is disapproved, you can file for a reimbursement claim using the following steps-
- Pay for the treatment yourself and get discharged as usual.
- Get in touch with the insurance company and provide your ID.
- Present the bills, discharge summary, prescriptions, and other necessary documents while requesting reimbursement.
- Fill out the reimbursement form and submit all the medical records with it to the insurance company.
- When approved, a cheque will be disbursed by the insurance company.
For reimbursement claims, the request must be submitted within 30 days of discharge. It will be best if you talk to your insurance agent.
Contact Pristyn Care to Undergo Cost-Effective Breast Reduction
If you wish to undergo breast reduction surgery, you can contact Pristyn Care and consult the best doctors. We provide affordable treatments and accept health insurance for breast reduction and other procedures as well. We also provide No-Cost EMI service to patients who don’t have health insurance or whose claim is not approved by the insurance company.
The No-Cost EMI service divides the treatment cost into easy installments that can be paid by the patient conveniently. We also provide other services, such as free consultations, free pick-and-drop, and free post-surgery follow-ups, to further reduce the expense of breast reduction at the patient’s end.
To learn more about our services or to consult with the best plastic surgeons, you can give us a call or fill out the appointment form.
