Why is heart surgery so costly?

The heart is a critical organ, and any health issue related to it can be life-threatening. Therefore, getting accurate diagnosis and treatment is crucial, even though the costs can be high. Several factors contribute to the expensive nature of heart treatment.

Hospital Factors:

Type of Hospital: Government, trust, and private hospitals have varying charges, with private hospitals being the most expensive and government hospitals being the cheapest. However, the higher costs also ensure that you get the best treatment from the most experienced doctors and nursing staff.

Hospital Reputation: Well-known hospitals often charge higher fees due to their perceived prestige. The more prestigious hospitals often have the most experienced and well-studied doctors available to ensure the best possible treatment for you or your loved ones.

Medical Factors:

Surgery Type: Different heart surgeries have varying levels of complexity and associated costs. But any surgery related to the heart is a complex and delicate procedure only conducted by the most seasoned doctors.

Technology Used: Advanced technologies like laser surgery can be more expensive than traditional methods for heart surgery. These technologies have greatly increased the success rate of heart surgeries by providing doctors with precise critical information.

Doctor's Expertise: Highly skilled and experienced surgeons typically charge higher fees for their services. 

Patient Factors:

Patient's Health: Pre-existing conditions or complications can necessitate additional care and increase costs as they often require additional precautions and procedures.

Diagnosis: The specific heart condition diagnosed influences the type and extent of treatment required, for example: the number of stents required will directly affect your expense for treatment.

Room Type: Choosing a private or deluxe room will add to the overall hospital bill you will incur.

Additional Care: Needs for medications, therapies, or extended hospital stays contribute to the expenses as well.

What costs are covered under health insurance?

Inpatient Hospitalisation:

This is the core of most health insurance plans. It covers expenses incurred during a hospital stay, including:

Room Rent: The cost of your hospital room, often with daily limits depending on your policy.

Doctor's Fees: Consultation and treatment fees by the attending physician and specialists.

Nursing Charges: Costs for the nursing care you receive during your stay.

OT Charges: Fees for the operation theatre when you undergo surgery.

ICU Charges: Costs for intensive care as required.

Medicines and Consumables: Drugs, medical supplies, and other items used during your treatment.

Pre and Post-Hospitalization:

Health insurance often extends beyond the hospital stay itself. It can include:

Pre-Hospitalization: Medical expenses incurred in the days leading up to hospitalisation, such as doctor's consultations and diagnostic tests.

Post-Hospitalization: Medical expenses after discharge, like follow-up visits, medications, and therapies.

Ambulance Charges:

The cost of ambulance transportation to and from the hospital is usually covered, subject to limits.

Other Medical Expenses:

Depending on your policy, it might cover:

Organ Donor Expenses: In the case of organ transplant surgery, some policies also cover the donor's medical expenses.

How to choose the best health insurance plan for a heart patient?

If you have a history of heart problems, investing in a Health insurance plan with high coverage is crucial to protect yourself from the high costs of medical emergencies related to heart conditions. When choosing a sum insured, consider not only the surgery cost but also pre- and post-hospitalization expenses, rehabilitation costs, and related tests.

Be transparent about your medical history with your health insurance provider to avoid claim rejections. Familiarise yourself with the policy's terms and conditions, particularly the waiting and survival periods. A clear understanding of the policy will ensure a smoother experience for both you and the insurance company during treatment and recovery.