Circumcision is a commonly performed urological procedure that involves the removal of the foreskin. Circumcision can be performed for a wide variety of reasons.
Sometimes, it can be performed due to religious or cultural significance. While in some other cases, it can be performed as an effective treatment for various foreskin issues such as phimosis, paraphimosis, and balanitis.
Circumcision surgery is generally covered by most health insurance plans in India, but only if certain criteria are met. If you are looking to undergo a circumcision procedure, it is important to have an in-depth understanding of the financial aspects of the surgery.
Is circumcision covered under insurance? Does having or not having insurance affect the cost of circumcision in India? In this blog, we will answer all your questions regarding circumcision and its insurance coverage in India.
Is Circumcision Covered Under Insurance Or Mediclaim?
Yes, circumcision surgery is covered by both mediclaim and most health insurance plans in India but only if it is deemed to be a medical necessity by your healthcare provider. If circumcision is performed for aesthetic or religious reasons, insurance coverage for the procedure is highly unlikely.
It is also to be noted that some health insurance plans may cover all or part of the cost of circumcision, while others may not cover it at all.
Prior to surgery, it is best to have a detailed discussion about the inclusions and exclusions of your procedure with your insurance provider.
When the foreskin causes functional problems, circumcision is considered to be a medical necessity. Therefore, most insurance plans across India provide coverage for the procedure. Some conditions that are generally covered under insurance plans in India are given below:
- Recurrent Balanitis
- Recurrent Posthitis
- Trauma to foreskin
- Lacerations on the foreskin, etc
If you are struggling with any of the above-mentioned foreskin issues, insurance coverage for your circumcision procedure is highly likely.
Circumcision procedures that are covered by insurance
There are primarily 3 procedures that come under circumcision surgery. Depending on the one you choose or one that is recommended to you by your urologist, the extent of your insurance coverage may vary. The 3 surgical procedures and their respective costs are given below:
- Laser Circumcision: Rs. 26,000 to Rs. 34,000
- Stapler Circumcision: Rs. 26,500 to Rs. 35,000
- Open Circumcision: Rs. 20,000 to Rs. 35,000
How Much Does Circumcision Surgery Cost With/Without Insurance?
The average cost of circumcision surgery in India without insurance can range anywhere from Rs. 26,000 to Rs. 35,000. As previously mentioned, if you are undergoing circumcision for religious or cosmetic reasons, insurance coverage is unlikely. Therefore, you must bear the expenses of the procedure out of your own pocket. Depending on various factors such as the city you are in, the method of surgery and choice of hospital, the overall surgery cost may differ as well.
On the other hand, if a procedure is covered by health insurance, you do not have to pay for any expenses out of your own pocket. However, in some cases, there are policy clauses, such as co-pays and deductibles that may require you to pay for some expenses incurred during treatment.
Prior to surgery, it is best to consult your insurance provider regarding such clauses and if you need to bear payment for some expenses during treatment.
Factors that Affect Cost of Circumcision Surgery in India
Some factors that may affect the average cost of your circumcision surgery in India are given below:
- Consultation and Operating Fees: Generally, surgeons with more experience charge higher consultation and operating fees as compared to surgeons with less experience. The number of consultations you require prior to surgery may also add up and affect the overall cost of your circumcision surgery as well.
- Hospital Charges: These generally include admission charges, operating room charges, anesthetists fees, medications, and discharge formalities. The cost of these services and amenities may add up and affect the average cost of your circumcision surgery.
- Method of Surgery: There are primarily 3 methods of performing a circumcision surgery. Depending on the one you choose or the one recommended to you by your urologist, the overall surgery cost will likely vary. Due to its minimally invasive nature, laser circumcision costs more as compared to conventional methods such as open circumcision.
- Preoperative Diagnostic Tests: Prior to surgery, your urologist will likely perform a series of simple diagnostic tests. For circumcision, these generally include physical examination, routine blood tests, urinalysis, and a swab test. The cost of these tests will likely add up and cause the exact surgery cost to vary.
- City where you undergo the treatment: Surgeries of any kind are generally more expensive in metropolitan cities across India as compared to non-metropolitan cities. Depending on your location, surgery cost will likely vary.
- Postoperative Follow-ups and Medications: After your circumcision surgery, your urologist may schedule some follow-up consultations. The aim behind these follow-up sessions is to ensure a smooth recovery and timely identification of any complications. Your urologist may also prescribe you some medications for pain relief (if there is any) and better healing. These postoperative consultations and medications may add up and cause the overall cost of your circumcision surgery to differ from the average cost.
Top Health Insurance Plans for Circumcision Surgery
To help you decide, we have a list of some of the top health insurance providers in India that cover circumcision surgery in their insurance plans:
- Bajaj Allianz Health Insurance Plan
- Care Health Insurance Plan
- GoDigit Health Insurance Plan
- ACKO Health Insurance Plan
- Star Health Insurance Plan
- HDFC ERGO Insurance Plan
- Tata AIG Health Insurance Plan
Cost Covered Under Health Insurance Policy
The cost elemets that are generally covered by most health insurance plans in India are given below:
- In-patient hospitalization: Circumcision surgery is typically performed on an outpatient basis, meaning you can likely go home on the same day of surgery. However, in case you may be required to spend at least a night at the hospital.
In such cases, the hospitalization expenses will be borne by the insurance company. In-patient hospitalization costs include:
- Room rent or boarding expenses
- Nursing expenses
- ICU charges
- Doctor consultation
- Additional expenses, like surgical tools, diagnostic material, etc.
- Pre-hospitalization costs: All medical expenses incurred before you are hospitalized, up to a pre-specified period, are included in the health insurance plan. These include doctor consultations, preoperative procedures, preventive surgeries, preoperative diagnostic tests, etc.
- Post-hospitalization costs: All costs involved in your care after your surgery are covered by healthcare insurance. These include post-hospitalization consultation, diagnostic tests, medicines, drugs, etc.
- Cash allowances: A daily cash allowance under health insurance is a fixed amount that can be availed to pay for the added inadmissible expenses when you are hospitalized. The amount is normally fixed at the time of availing the insurance policy and is fixed until the end of the policy tenure.
Frequently Asked Questions
Is circumcision covered by Star Health Insurance?
Yes, circumcision surgery is covered by most health insurance plans in India including Star Health Insurance.
When Does Insurance Cover Circumcision Surgery?
To get your circumcision surgery covered by insurance, you first need to make an insurance claim. An insurance claim is a request made by a policyholder to the insurance provider for medical benefits and services covered in the insurance policy. In order to file a health insurance claim, you will likely require documents such as:
- Health Insurance ID card
- Consultation papers provided by your urologist
- Competely filled-in claim form
- Investigation and diagnosis reports such as blood reports, swab test reports and urinalysis reports.
- Any other relevant documents requested by the insurer
When is circumcision covered by insurance?
Circumcision is covered by insurance plans when it is deemed to be a medical necessity by a qualified urologist. For example, if you are struggling with phimosis and previous non-surgical methods have been ineffective, a circumcision surgery will likely be deemed medically necessary.
What is a cashless health insurance?
A cashless insurance is one in which the insurer settles all the medical bills with the hospital directly. To avail of this advantage, the policyholder must get approval from the insurance company at least 48 hours before actual hospital admission in case of planned surgeries. For emergency hospitalization (which could be the case for conditions like paraphimosis), the claim must be made within 24 hours of hospital admission.
Most health insurance plans in India generally cover circumcision surgery as long as it is deemed a medical necessity. If you have a high deductible (the fixed amount of money you pay out of your own pocket towards a covered claim) or the procedure costs less than your deductible, you may find that you have to pay the full cost yourself.
2Therefore, it is advised to have an in-depth discussion about your insurance plan with your insurance provider to avoid any unexpected charges.