Critical illness insurance for open heart replacement
Critical Illness Insurance For Open Heart Valve Replacement
Any critical health emergency tremendously affects not only your health but your finances as well. Considering the steeply rising medical inflation, a few days of hospitalisation is enough to deplete a significant portion of your savings. Moreover, if the issue is graver if it involves surgery.
However, critical illness insurance may save your day under such crucial circumstances.
An open heart surgery is quite serious and involves a very high amount of risk. However, if you maintain competent critical illness insurance for open heart replacement you can ensure to retain your peace of mind without worrying about finances at such a crucial juncture.
This article will highlight all the significant aspects of critical illness insurance for open heart replacement.
Open heart replacement or repair of heart valves
As the name suggests, an open heart replacement or repair of heart valves signifies the total replacement or repair of faulty heart valves depending on the current situation. Have you ever heard of artificial prosthetic valves? They are often used to replace damaged heart valves and can work wonders in restoring the heart’s function.
Importance of critical illness insurance for open heart replacement
An open heart replacement becomes essential when the heart valves get damaged. You can well understand the seriousness of the situation. It is an expensive affair and the last thing you need at such a serious juncture is to worry about finances for treatment.
If you wisely maintain critical illness insurance for open heart replacement beforehand, it will act as a true saviour to ensure you receive the best possible medical facilities and quick recovery without worrying much about finances.
Your respective insurance provider will bear the costs and settle your claims.
Under such circumstances, the current and future of your dependents will also not be jeopardized because of your treatment. Maintaining critical illness insurance for open heart replacement will ensure that you do not have to compromise much on any front, neither family, finances, or health.
Who needs heart valve replacement surgery?
If any heart ailment is restricting it from its normal job of pumping blood, the doctors might seek surgical intervention to remedy the issue. This is termed heart valve replacement surgery. If it is not done on time it may eventually lead to stenosis or stiffness of valves, or regurgitation of valve i.e. valve leak.
However, depending on the situation, the doctors may also perform valve repair, if the damage is not too serious.
For milder symptoms, lifestyle checks, proper healthy food habits, and regular medications are enough to aid the situation.
Therefore, it is better to keep a close eye on your health as it will ensure early detection of any ailment if it sets in. It might not let the issue develop too further till surgery.
Why is it important to opt for an open heart replacement critical illness insurance policy even if you hold an indemnity health insurance plan?
Unlike traditional indemnity-based health plans, critical illness insurance policies are benefit plans. If you opt for a critical illness insurance plan for open heart repair or replacement, your insurer will pay you a lump sum amount of sum insured, once you are diagnosed with the ailment.
However, you must note that you are free to spend this amount not only for treating the health issue but for handling other financial issues as well, like closing debts, securing the future of your dependents, etc.
Treating any sort of critical ailment is an expensive affair, especially in the long run. It often requires a prolonged treatment and recovery procedure. It can grossly affect your savings and finances.
However, a critical illness insurance cover may help you handle the situation better, by acting as a protective guarding shield.
What happens during a heart valve surgery?
A normal human heart consists of four heart valves namely, the pulmonary valve, mitral valve, tricuspid valve, and aortic valve. The tricuspid and mitral valves have flaps called leaflets, while the pulmonary and aortic valves have cusps.
As the heart beats, these flaps are supposed to open and close once with every beat. If this opening and closing function gets disrupted, the blood flow in the body gets hampered.
To cure the system, the doctors may seek surgery, which can be either an open heart or a minimally invasive one.
Depending on your current heart condition, the doctors may perform complete replacement or repair of your damaged or diseased heart valve(s). The surgical procedure can be minimally invasive or open heart surgery, depending on the health condition, severity of the issue, age, etc.
There are two basic types of heart valve surgery: annuloplasty and valvuloplasty.
When the heart valve(s) loses their ability to pump blood properly, heart valve surgery becomes essential. Two very prominent heart valve problems include narrowing down of the valve(s) termed stenosis and valve leaks allowing backward blood flow called regurgitation.
Depending on the screening reports the doctor will decide if repair or replacement is essential for your case.
Before the surgery, your doctor will guide you regarding your diet, medications, lifestyle alterations, etc. and you need to maintain it till further notice.
Depending on your heart condition, heart valve surgery can be done either by using the open heart method, which cuts your chest right through the breastbone or a minimally invasive one, requiring minimal incision. Irrespective of the procedure, you will be anaesthetised prior to the surgery and connected to the heart-lung machine to ensure smooth blood circulation during the operation.
Repairing heart valves include:
• Patching any holes in the valve(s)
• Reconnecting the cusps and/or leaflets
• Removal of additional valve tissues to ensure firm closure of cusps and/or leaflets
• Replacing the cords to ensure better structural support
• Separating fused valve flaps
• Reinforcing or tightening the valve annulus
Doctors might use a catheter, a narrow and long tube to perform balloon valvuloplasty. Here, the doctor inserts the catheter with a balloon attached to it inside any prominent artery either on your groin or arms to reach the affected valve.
Once positioned, the balloon is inflated, which eventually expands the heart valve opening. Then the balloon is deflated and the catheter and balloon are removed.
Risks of heart valve repair or replacement surgery
Some probable risks involved in heart valve repair or replacement surgery include the following:
• Bleeding
• Cardiac arrest
• Infection
• Dysfunction of valves affecting the replaced or repaired valves
• Arrhythmia or irregular heartbeat rhythm
• Stroke
• Death.
List of insurance policies for open heart replacement
Some of the prominent health insurance with cardiac coverage plans include:
NAME OF THE INSURANCE PROVIDER | CARDIAC HEALTH PLAN | SUM INSURED (INR) | AGE CRITERIA |
Aditya Birla Health Insurance | Activ Secure Critical Illness Insurance | Up to INR 1 crore | 5-65 years |
Bajaj Allianz Health Insurance | Critical Illness Insurance | 1 lakh-50 lakhs | 91 days-80 years |
Bharti AXA Health Insurance | Critical Illness Insurance Plan | 3 lakhs | 3 months-55 years |
Care Health Insurance | Care Heart Plan | 3 lakhs-10 lakhs | 18 years onwards |
Chola MS Health Insurance | Critical Healthline Plan | 3 lakhs, 5 lakhs and 10 lakhs | 18-65 years |
Future Generali Health Insurance | Future Generali Heart and Health Insurance | 5 lakhs-50 lakhs | 18-65 years |
Manipal Cigna Health Insurance | Lifestyle Protection Critical Care Health Plan | 1 lakh-25 crore | 18-65 years |
Inclusions and exclusions of critical illness insurance for open heart replacement
Inclusions
Some standard inclusions of critical illness insurance for open heart replacement include:
• Pre-hospitalisation cost
• Screening costs
• Ambulance charges
• Hospitalisation costs
• Doctors’ fees
• Surgery expenses
• Nursing charges
• ICU expenses
• Post-hospitalisation and recovery costs up to a pre-determined tenure
• Cost of second opinion if required, etc.
Exclusions
Every critical health insurance plan strictly maintains certain exclusions including:
• Any self-inflicted injury leading to suicide or attempted suicide
• Injuries caused by any warlike situation, riots or other similar violent events
• Injuries caused due to involvement in any violent, defence, or adventurous activities
• Any venereal ailments or STDs like HIV/AIDS
• Maternity coverage
• Any congenital ailments
• PEDs
• Any health issue arising within 90 days of plan issuance
• Injuries or ailments occurring due to an overdose of intoxicating elements, etc.
Eligibility for critical illness insurance for open heart replacement
Every insurance provider maintains certain basic eligibility criteria for purchasing critical illness insurance, which include the age of the policyholder must range between 18 and 65 years. You may need to undergo certain specific health check-ups at your own cost before policy issuance.
However, people belonging to certain specific categories must seek to purchase this cover beforehand to ensure a smooth life and efficient money management:
1. Breadwinners of the family:
If you are the sole breadwinner in the family, it is natural that your entire family depends on your income only. This implies that your life is very precious not only for you but for them too. Under such circumstances, you should take proper precautions for your health both physically and financially to ensure better protection of yourself and your family.
2. Hereditary history:
If your family shows examples of critical heart ailments, your risk increases manifolds. To lessen your worries and for efficient finance management, you can seek to purchase critical illness cover for open heart replacement if you face any such situation ever.
3. Self-employed individuals:
If you are the proprietor of your personal business or a freelance worker, then you might not be able to enjoy certain benefits like group insurance coverage like salaried employees. Moreover, your income is also not fixed and guaranteed. It might be a tough challenge if you encounter a serious heart issue under such circumstances. Critical illness insurance might save your day.
4. Any individual without substantial savings:
If you do not have considerable savings, overcoming a critical heart ailment might prove to be a tough challenge. However, a competent critical illness insurance cover might act as a saviour under such circumstances.
5. Individuals involved with high-stress jobs:
Stress is a major contributing factor to any sort of heart ailment. So, if you find that the nature of your job involves a lot of risk and stress, it is better to keep yourself prepared with critical illness insurance cover for open heart valve replacement beforehand. This is so because, when the need arises, you enjoy a comfortable position.
Treatments or medical procedures covered
The standard treatments and medical procedures that are usually covered by a critical cardiac insurance plan include:
• Primary cardiac arrest of specific severity
• Pericardectomy
• Open chest coronary artery bypass graft
• Surgical procedure for inserting Ventricular assist devices
• Surgery to cure cardiac arrhythmia
• Minimally invasive aortal surgery
• Open heart repair or replacement of heart valves
• Primary Pulmonary Arterial Hypertension
• Implantable Cardioverter Defibrillator
• Angioplasty
• Pacemaker insertion.
Who should buy a cardiac health insurance plan?
Cardiac ailments are witnessing a steady, steep rise and affecting the younger generation too. The prolonged treatment procedures can prove to be quite burdensome, especially in the long run and enough to challenge your savings. So, cardiac health plans have been specially crafted for individuals who are at the risk spot for getting heart ailments in future. Individuals with pre-existing heart conditions and/or a hereditary history of heart ailments are in more need of purchasing heart health coverage insurance policies.
Considering the steep inflation in the medical sector, handling a heart patient can prove to be financially challenging in the long run. Therefore, maintaining cardiac care critical illness insurance is essential to avail of the best medical facilities available during needs without worrying much about finances.
Tax benefits of open heart replacement insurance
Since open-heart replacement insurance is a critical health insurance plan, you are eligible to enjoy tax benefits under Section 80D of the Income Tax Act, of 1961. The tax benefits work as follows:
POLICY FOR | DEDUCTION LIMIT FOR SELF AND FAMILY (INR) | DEDUCTION FOR PARENTS (INR) |
Self and family all being below 60 years | 25000 | – |
Self and family + parents (all being below 60 years) | 25000 | 25000 |
Self and family being non-senior citizens + parents above 60 years | 25000 | 50000 |
Self, family and parents all are senior citizens | 50000 | 50000 |
Members of HUF (non-senior citizen members) | 25000 | 25000 |
HUF members (with at least 1 senior citizen member) | 50000 | 50000 |
Key factors to consider while buying critical illness insurance for an open heart replacement
The following is the list of insurance policies covering Parkinson’s Disease:
Certain crucial factors that you need to consider before purchasing a critical illness insurance cover for open heart replacement include the following:
1. Survival period:
The survival period implies the tenure till which the policyholder needs to survive after the concerned critical illness is diagnosed. No claim raised during this period will be entertained. Once this period is over, your insurance provider will offer all the associated benefits according to your chosen plan.
2. Coverage span:
Not all critical illness cardiac plans offer the same coverage. You must compare different plans to know which one is the best in this respect, as compared to the premium payability amount.
3. Common inclusions and exclusions:
You must be clearly aware of the inclusions and exclusions of your chosen insurance plan, as all plans maintain a specific set of inclusions and exclusions.
4. Coverage type:
You can purchase a standalone cardiac critical illness insurance coverage plan which ensures that you receive a lump sum on the diagnosis of the critical heart ailment. You can also purchase an add-on cover to your existing health plan, but in that case, your benefits will become restricted when compared to a separate standalone cover.
5. Making the right choice:
You must undertake a critical comparative study and research of several health plans to know which one suits your requirements the best. The sum assured amount must be sufficient enough to cover your needs.
The cost associated with open heart replacement
The average cost of open heart surgeries may vary from one place to another, the severity of the condition, and the surgical procedure undertaken. Considering all these factors, we can say that the average cost of open heart replacement surgery in India may range between INR 2 lakhs and INR 6 lakhs.
A competent critical cardiac cover insurance policy can take care of the finances well if taken at the proper time.
Frequently Asked Questions:
Heart health critical illness covers are specifically crafted to cater to the needs of heart treatments and therapies. It is beneficial for individuals with heart ailments or risks of developing such heart issues.
Yes, a standard cardiac critical illness plan covers angioplasty.
The major symptoms of primary heart attack or myocardial infarction include severe stabbing chest pain, changes in ECG graphs, enhancement of the infarction enzymes and similar other biochemical makers, etc. Cardiac arrest is not covered by cardiac health plans but critical illness policies.
This coverage varies from one insurer to another, you must read the policy wordings carefully to understand this.
Yes, depending on the terms of the concerned insurance provider and the chosen plan, there can be specific sub-limits.
Leading Health Insurance Companies
