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Uterine Fibroids Treatment Under Insurance - 100% Cashless

Treatment for uterine fibroid is covered under both health insurance and mediclaim. Pristyn Care strives to make the treatment almost cashless for patients who have a valid medical or health insurance policy.

Treatment for uterine fibroid is covered under both health insurance and mediclaim. Pristyn Care strives to make the treatment almost cashless for patients ... Read More

Uterine Fibroids Treatment Insurance Claim

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Uterine Fibroid Treatment with Insurance at Pristyn Care

Is Treatment For Uterine Fibroids Covered Under Insurance Or Mediclaim?

One of the most frequent questions patients ask after being diagnosed with uterine fibroids is- does insurance cover uterine fibroid removal? If you are suffering from any symptoms of uterine fibroids like pelvic pressure or pain, difficulty emptying the bladder, constipation, etc., the last thing you need to worry about is paying for treatment.

Treatment of uterine fibroids is covered under both mediclaim and health insurance. However, the terms and conditions around the coverage and the amount you can claim under health insurance and mediclaim may differ for each patient. Hence, you must check the details of the insurance policy before purchasing it.

• Disease name

Uterine Fibroids

• Surgery name

Myomectomy Surgery

• Duration

2 Hours

• Treated by

Obstetrician/Gynecologist or a gynecologic oncologist

Uterine Fibroids Surgery Cost Calculator

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How to get Uterine Fibroids Treatment under Insurance?

Pristyn Care emphasizes making the treatment journey hassle-free for the patients. Thus, we accept all health insurance policies and assist patients to get cashless treatment for Uterine Fibroids Treatment. Read the below steps to know Health Insurance claims process works differently for cashless and reimbursement claim requests.

1 Intimation

All you need to do is to fill a pre-authentication form along with relevant insurance documents for availing cashless treatment at our partner hospital.

2 Approval/Rejection

Your pre-authentication form is approved or denied based on the terms and conditions of your health insurance policy.

3 Hospitalisation

Hospitalisation can be done based on pre-authentication approval. Hence, it is advisable to finish the pre-authentication procedure beforehand.

4 Claim Settlement

At the time of discharge, we will coordinate and settle your bills directly with the hospital and insurance provider.

1 Hospitalization At Non Network Hospital

If hospitalised at a non-network hospital, you don't need to pay the medical bills. Pristyn Care will settle the bills with the hospital on your behalf.

2 Register A Claim

To register a claim, please fill in the claim form with all your receipts, reports and relevant documents received from the hospital at the time of discharge. We, at Pristyn Care will help you claim reimbursement from your health insurance company.

3 Verification

We will share all your claim-related medical documents in original with your insurance provider to check if everything is in order.

4 Claim Settlement

We will coordinate with your insurance company to reimburse the claim amount to your registered bank account. You can later pay back that amount to us as per the policy terms and conditions.

How To Avail Cashless Claims For The Treatment Of Uterine Fibroids?

Here’s how you can avail cashless claims for the treatment of uterine fibroids:

You can opt for cashless hospitalization when treated for uterine fibroids. It means your health insurance company will bear the expenses of hospitalization. Under cashless claims, you will only have to pay those parts that the health insurance company does not include per the insurance regulations. Your insurance claim is approved according to the terms and conditions of the health insurance plan. In addition, the respective hospital should be a part of the insurer’s network of healthcare providers.
You must fill out a pre-authorization form submitted at the third-party administration (TPA) counter at admission. Inform the insurance company beforehand, as the TPA sends over the form for their final approval.
The TPA counter will take into submission any relevant documents. It includes the cashless health care provided by your insurer. Also, copies of certain KYC documents will be kept for verification purposes.
By this time, your insurance company gives the cashless approval for the hospitalization for your uterine fibroids treatment.
The claims will be settled easily if you follow the above mentioned guidelines. Ensure that all medical reports, discharge bills, etc. are intact with you. Furthermore, all this documentation must be kept for future requirements.

All Major Insurance Accepted

What Is The Difference Between Health Insurance And Mediclaim?

Mediclaim	Health insurance
Mediclaim covers only hospitalization expenses.	Health insurance is a more comprehensive insurance policy because it covers medical expenses in the pre and post-hospitalization period along with the treatment costs.
It does not provide any add-on coverage.	Add-ons increase the coverage available under the policy. Some essential add-ons are critical illness cover, accidental disability, personal accident cover, loss of income, etc.
The features of a mediclaim policy are fixed according to the insurance provider, and no customization is possible.	More flexibility is available to the policyholder to choose the kind of coverage needed. In addition, as the premiums are determined according to the features selected, policyholders can customize their coverage under the policy according to their requirements.
The cost of a mediclaim policy does not vary over the years.	The cost of a health insurance policy can vary as the policyholders can get discounts for no claims lodged or on insurance policies of longer duration, like two- or three-year policies.
When using a cashless payment method, payments are either repaid to the policyholder or made directly to the hospital.	When using a cashless payment method, the policyholder is either refunded, the hospital receives payment, or a lump sum payment is made in circumstances like critical illness, specific illness policies, etc.
Another fixed aspect is the maximum coverage available which is Rs. 5 lakhs.	It does not have an upper limit and depends on the policyholder’s age, assessment of health status, and ability to pay the determined premium. It can even be as high as ₹2 crores.
Mediclaim policies can be taken on behalf of another person, like an employer for their employees.	In health insurance policies besides individual personal health insurance policies, there can be health insurance for parents and dependent members.
Floater coverage under the mediclaim policy may or may not be allowed, according to the insurer.	All insurers allow family floater health insurance policies. It can cover self and family members in a single policy and provide coverage at a more reasonable cost.

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FAQs around Uterine Fibroids Treatment

What is not covered in cashless health insurance?

Although most cashless insurance plans cover all emergencies and medical conditions, certain specific exclusions in your insurance policy may not be covered. For instance, pre-existing illnesses like HIV/AIDS, non-medical expenses, or illegally caused damages.

Is my insurance policy for uterine fibroids treatment valid pan-India?

This is one of the most crucial health insurance questions to be considered because medical emergencies can arise anywhere and anytime. Usually, insurance plans cover the treatment cost of uterine fibroid anywhere in India, but you should make sure of this clause before buying your policy. Also, find out whether the claim settlement in the policy has any geographical limitations. Specific insurance plans offer international coverage too.

What if I am admitted to a non-network hospital for my treatment of uterine fibroids?

In an emergency, you can be admitted to a non-network hospital for your treatment of uterine fibroids. Always keep in mind that treatment in a non-network hospital would always be on a reimbursement basis, where you need to pay for your medical bills and then later get them reimbursed from the insurer.

What are the documents required for claiming insurance for uterine fibroids treatment?

This is one of the most common health insurance questions. The company asks for valid identity proof, health card, hospital bills, etc., at the time of an insurance claim. In addition, a pre-authorization form is needed for cashless claims to be submitted to the TPA. Other documents are also needed, and you should know the required documents to get your claim processed smoothly.

How are health insurance claims usually settled?

Health insurance claims are settled in a cashless manner, or they are reimbursed. The claims settlement process is one of the most important aspects of an insurance policy, especially if it is a health cover. A policyholder ‘s health insurance claim can get settled by an insurer in two ways: third-party administrators ( TPA ) and through the insurer’s in-house claims processing department.

What Is Cashless Insurance?

When you go for cashless insurance, you need not worry about arranging cash for your medical expenses. Instead, the insurance company will directly pay the hospital expenses. The only condition here is the total medical or hospitalization expenses should not be more than the sum assured coverage, and the hospital chosen should be a network hospital.

This kind of insurance is highly beneficial in case of planned or sudden medical emergencies. Under a cashless policy, the insurance company bears all the costs of hospitalization and treatment expenses upfront. It thus gives you more time to concentrate on other important matters, such as making arrangements for treatment or hospital admission formalities.