Is Fistula Treatment Covered Under Health Insurance?

Cost Covered Under Health Insurance Policy

Some of the costs that are covered under a health insurance policy are:

• In-patient hospitalization – In case you are hospitalized because of an illness, like a fistula, that is covered by the health insurance plan, the hospitalization expenses will be borne by the insurance company. In-patient hospitalization costs include:
  • Room rent cost
  • Nursing expenses
  • ICU charges
  • Doctor consultation
  • Surgery
  • Additional expenses, like surgical tools, diagnostic material, etc.
• Pre-hospitalization costs – Pre-hospitalization costs are medical expenses that are incurred by an insured person before getting admitted to a hospital. These include doctor consultations, preliminary procedures, diagnostic tests, preventive surgeries, medicines, etc.
• Post-hospitalization costs – Post-hospitalization costs are medical expenses incurred by an insured person once discharged from the hospital. These include post-hospitalization consultation, diagnostic tests, medicines, drugs, etc.
• Home treatment features – Sometimes people with a conventional mindset want to be treated in the comfort of their homes instead of going to the hospital due to personal preferences. Almost all health insurance plans include this feature and do not differentiate a professional medical setup from a domiciliary one.
• Cash allowances  – Daily Cash allowance is a unique feature under health insurance, and not many insurance service providers offer that. The family becomes liable to pay a huge amount when it comes to food, transportation, accommodation, etc while taking care of their loved ones who are admitted to the hospital. These little expenses are a huge burden to the family. Keeping such liabilities in mind, health insurance policyholders are provided cash allowances where a predetermined amount is given to make ends meet.

What Is The Difference Between Health Insurance And Mediclaim?

Mediclaim and health insurance are two terms that people use interchangeably, but these two are different from each other. One of the major differences between Mediclaim and health insurance is that a health insurance plan is far more complete in comparison to Mediclaim. 

It provides comprehensive medical coverage against hospitalization expenses, pre-hospitalization charges, post-hospitalization charges, ambulance costs, etc. Whereas, a Mediclaim plan provides coverage only against hospitalization that occurs due to illness, surgery, and pre-existing illnesses up to a pre-specified limit. 

A health insurance plan provides flexibility to enhance or reduce coverage, whereas under Mediclaim there is no flexibility when it comes to coverage. Also, to claim a Mediclaim policy, the insured person should be hospitalized otherwise they won’t be able to get the claim. But, there is no such requirement if you are using a health insurance policy to get treatment for anal fistula.