A hernia is a widespread medical disorder that occurs in different individuals irrespective of their age. It arises where an organ or tissue bulges through a weak point in the muscles and causes pain, discomfort, and occasionally visible swelling. Although the treatment of a hernia often involves surgery, the expense may be the primary concern of numerous families.

Health insurance comes in here to make a difference. The big question here is whether hernia treatment is a health insurance-covered procedure in India. The answer would be yes in most scenarios, but coverage varies depending on the type of policy you have. In this blog, Dr. Sandip at Pelvinic Clinic covers all you need to know about hernia treatment and insurance coverage.

What is a Hernia?

A hernia happens when an internal organ or tissue pushes through a weak spot in the muscle or tissue around it. This bulge can appear in areas like the abdomen, groin, or chest.

Common signs of a hernia include:

• A noticeable lump or swelling
• Pain or discomfort when lifting, coughing, or bending
• A heavy feeling in the abdomen

Is Hernia Covered by Insurance in India?

Yes, the majority of health insurance plans in India cover surgery for a hernia. Yet, it is dependent on the form of insurance cover and the terms of the policy.

Here are a few details you should know.

• Coverage for Surgery: Hernia surgery is covered by most health insurance plans up to the limit of the insurance policy, which includes hospital, doctor, anaesthetic, and pharmaceutical costs. This will also lessen the economic burden on patients requiring surgical care for a hernia.
• Sub-Limits May Apply: Certain policies impose a sub-limit to such surgeries, irrespective of the total coverage you have. For example, you may only have 50,000 when you are insured with 5 lakhs to pay the surgical expenses. Be sure before receiving treatment.
• Waiting Period: Most health insurance plans have a 24–48-month exclusion period before a hernia procedure is covered. This implies that you cannot lay a claim on hernia surgery during this time, which is why buying insurance early is vital.
• Exclusions: Some health insurance policies will exclude certain types of hernia or complications related to them. You would have to read your policy document carefully to note the exclusions so that you do not run into a hole in the process of the treatment.
• Cashless Treatment: Most insurers offer cashless treatment in case of hernia surgeries when you visit a network hospital. With such plans, the hospital is paid by the insurance company, and you do not have to make huge payments during your stay in the hospital.

Is Hernia a Pre-Existing Condition?

When diagnosed with a hernia before purchasing a health insurance policy, the condition is regarded as a pre-existing condition. Generally, most insurance companies impose a waiting period of 2-4 years before they cover the cost of treating such conditions. This implies that you cannot claim due to the lost hernia surgery during this period.

In case you had an insurance policy and during the course of it, the hernia occurred, you would still be covered once the waiting period is over. To prevent such delays and to cover up mentalities more easily, one should buy health insurance as early as possible. It will cover you against medical cost emergencies and make you secure in the future.

Consult the Experts at Pelvinic Clinic

If you suspect a hernia or need guidance on treatment options, Pelvinic Clinic offers expert care and advanced treatment under the guidance of Dr. Sandip. Our team also helps patients understand insurance coverage so that treatment is both safe and affordable.

Ending Note

A hernia treatment must never be left long, as it can worsen to cause complications. The positive aspect is that hernia surgery has coverage under most health insurance policies in India, with waiting periods, sub-limits, and certain exclusions.

Learning how your policy works, you can prevent unexpected costs and concentrate on your recovery. Dr. Sandip and his team in the Pelvinic Clinic specialise in the diagnosis, surgical intervention, and insurance management factors.

Once you suspect that you have a hernia, do not neglect it and seek insurance coverage to ensure your health and financial safety. Make an appointment at the Pelvinic Clinic today.