The Kidney is a bean-shaped organ that acts as a filter system to remove waste and fluid from the body to maintain the chemical balance. It is responsible for maintaining minerals like sodium and potassium in the blood. Along with that, the kidneys regulate those hormones that are responsible for creating red blood cells. Hence, proper kidney functioning is essential for overall health and well-being.
However, when the kidneys stop functioning properly, the body undergoes systemic malfunction that adversely affects the other organs. Damage to the kidneys happens over a period of time, and is characterized by swelling of the feet due to fluid retention, decreased urination and sometimes, fatigue along with weight loss. The consulting medical specialist would advise dialysis as a form of treatment for moderate to acute kidney damage or failure.
When is Dialysis needed, and what are the procedures?
In severe cases, the toxic level of waste in the blood increases and it needs to be removed immediately. At this stage, doctors may recommend dialysis to restore the body’s health and balance, and to compensate for the poor functioning of the kidneys. The form of dialysis to be undergone is recommended based on the patient's age, overall health and other medical conditions.
There are two major forms of dialysis that are recommended to patients, namely:
- Hemodialysis: In this dialysis process, the blood is taken out of the body, cleaned via a filter, and returned into the body in a continuous process. This dialysis process can be done either at home or at a dialysis facility center.
- Peritoneal Dialysis: In this dialysis process, blood is cleaned in the body itself. A fluid is put into the abdomen to absorb waste from the blood. This fluid is then flushed out after a few hours along with the waste, and a fresh bag of fluid is dripped into the abdomen. Typically, this type of dialysis is performed at home.
Can I Pay for Dialysis without having Health Insurance?
Dialysis treatments are usually recommended for a long period of time and at regular intervals. Patients suffering from End-Stage Renal Failure (ESRF) are advised to undergo Hemodialysis 3-4 times per week, or Peritoneal Dialysis 3 times a day, depending upon the extent of kidney malfunction. For example, the cost of a single session of Hemodialysis could be anywhere between Rs. 1,800 to Rs. 3,000 or more.
Given that dialysis is an expensive and recurring procedure, it is likely to cause a huge dip in personal savings if it is to be paid out-of-pocket. The added stress of arranging funds to manage sustained treatment costs, along with the anxiety of living with such a debilitating health condition can cause turmoil in the lives of the patient as well as the family members. The financial burden can be lessened to a great extent with the help of the right health insurance policy that covers dialysis procedures, along with providing coverage for other related medical expenditures.
Factors to consider while buying Health Insurance to cover Cost of Dialysis Treatments
- Stages of Kidney Failure and Types of Dialysis: Many health insurance policies cover moderate kidney malfunction up to end-stage renal failure (ESRF). When purchasing a health insurance plan to cover related expenses, it is advisable to ensure that both forms of dialysis - hemodialysis and peritoneal dialysis - are included.
- Organ Transplant Expenses: In acute cases in which the kidneys have stopped functioning altogether, doctors advise the patient to undergo kidney transplant. Hospitalization and other related expenses are covered under “Organ Donor” or “Organ Transplant” clause in the health insurance plan. It is important to check whether the selected health insurance policy covers such expenses, and to what extent (preferably up to Sum Insured).
- Day Care Treatment: Dialysis procedures are usually covered under day-care treatment in regular health insurance policies as part of base or basic coverage. Preferably choose a health insurance plan that covers all day-care procedures, to ensure that dialysis is also included.
- PED and Exclusions: Patients with kidney damage generally experience other health ailments such as hypertension, diabetes, weak bones and nerve damage. These conditions fall under pre-existing disease (PED), which have to be declared at the time of applying for health insurance. Furthermore, some conditions might be declared as Exclusions in the policy terms and conditions document, which means that any resulting expenses due to such conditions will not be considered for claims settlement. Hence, it is important to check for PED and Exclusions clauses in the Policy Wordings or Customer Information Sheet.
- Network hospitals: There are two types of hospitalization facilities available with health insurance companies - Network hospitals and Non-network Hospitals. Cashless facility of a health insurance plan is available at network hospitals, while non-network hospitals admit patients on reimbursement basis. Thus, before selecting the health insurance plan, check for the list of insurer network hospitals available in your area, their specialty, dialysis charges, and doctors' information
- Additional Benefits: You must choose health insurance that provides additional benefits like alternative treatments and annual health check cover, along with the dialysis cover. This will effectively reduce overall treatment expenses.
- Regular Health Insurance v/s Critical Illness Plans: Typical health insurance plans may offer coverage for extended treatment of kidney failure by means of add-on or optional covers for additional premium. Since the treatment is long drawn and involves a host of ancillary or supporting costs such as diagnostic tests and specific medications, it would be more advisable to opt for Critical Illness Health Insurance Plans that cater to all associated expenditure. These plans extend coverage to pre-and post-hospitalization charges, OPD treatment, organ transplants, day-care procedures and more.
Choosing the right health insurance plan that is all-inclusive and comprehensive might be difficult. This is where SANA.Insure can be of assistance.
We have carefully constructed our health insurance portal, https://sana.insure/, to give you all the information you need to make your decision process easy. Log on to https://sana.insure/critical-illness-insurance to learn more about Critical Illness Health Insurance. You can always get in touch with us via WhatsApp chat on 827827181, or call us on 1800 202 8118 to speak to a Health Insurance Expert at SANA.Insure, who can guide you through every step of the way.
Wish you a healthy and happy life!