Is Pilonidal Sinus Surgery 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 a medical condition like pilonidal sinus 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 or boarding expenses
  •  Nursing expenses
  •  ICU charges
  •  Doctor consultation
  •  Surgery
  •  Additional expenses, like surgical tools, diagnostic material, etc.
• Pre and post-hospitalization expenses – A health insurance policy is more broad-based. It includes costs incurred both before and after hospitalization, like on diagnosis, doctor’s consultation charges, etc.
• Ambulance charges – In most health insurance policies, ambulance costs up to a particular limit are allowed in the claim. These costs are reimbursed by the insurance company.
• Daycare treatment – Earlier health insurance policies only covered treatment and hospitalizations that went beyond 24 hours. However, with the help of medical advancements and technology, many treatments today can be performed in less time than before. Given the fact, treatments that can be done in under 24 hours, are now introduced in health insurance policies.
• 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 today include this feature and do not differentiate a professional medical setup from a domiciliary one.

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. A health insurance policy is a more comprehensive insurance policy as it includes expenses in the pre and post-hospitalization period along with the treatment costs.

Whereas, Mediclaim insurance covers only hospitalization expenses. Also, a health insurance plan provides the advantage of add-ons like critical illness coverage, loss of income, etc. which increases the coverage available under the policy. But, Mediclaim does not provide any add-on cover.

Furthermore, health insurance operates on the principle of benefit. It means that once you fall ill and your illness is included in your health insurance plan, the insurance company will pay you a lump sum for your treatment. Whereas Mediclaim operates on the principle of indemnity. It means that one can claim refunds only after hospitalization.