Does BMI Affect Coverage for Robotic Surgeries?

The introduction of robotic surgery options in India has proven to be a step that ensures rapid recovery, enhanced precision, and reduced complications. Usually, the insurers place them under the "modern treatment" category, implying that there are various sub-limits, limits, and pre-authorisations associated with the policy.

Usually, the cost of this medical procedure is massive, making it a must to have an insurance policy that offers a robust financial backup. However, if a person has a high BMI, their policy features can be notably affected.

What are the Coverages Available for Robotic Surgeries?

In robotic surgeries, the surgeons use robotic technology to perform complex surgeries with precision. The robotic arm equipped with surgical instruments makes smaller incisions during surgery, ensuring less noticeable scars. The surgeons mainly use this type of treatment for gynaecological surgery, prostatectomies, and cardiac valve repair.

Today, most of the insurers cover robotic surgery as per the instructions of IRDAI. This implies fewer out-of-pocket expenses and adequate coverage against rising medical procedure costs during emergency or planned treatments. Additionally, it protects the hard-earned savings of the policyholder so they can use the money in other aspects.

The health insurance policy covers various inpatient hospitalisation costs, pre- and post-hospitalisation expenses, room charges, daycare treatment procedures, ICU costs, surgeon's charges, nursing costs, ambulance charges, preventive health checkups, post-surgery medications, and so on.

However, it is essential to note that at times, insurers can associate various limitations and conditions with these policies. For proper coverage, it is essential that the surgeon has adequate training in robotic procedures. Additionally, insurers often impose sub-limits and waiting periods of two to three years or even more.

The coverage and policy terms for robotic surgery vary from one insurer to another. Hence, it would be prudent to go through the terms of the insurance policy purchased to get a clear idea about coverages, sub-limits, and waiting period.

What are the Impacts of BMI on the Insurance Coverages for Robotic Surgery?

Body Mass Index, or BMI, is a value that indicates the percentage of fat in a person's body. Usually, if a person has a high BMI, their policy purchase requests can get rejected. Moreover, they might have to pay a high premium amount, submit a comprehensive medical report, experience long waiting periods, and face extra scrutiny during claim approval.

It is so because, if it is more than 30, the person can develop various weight-based health conditions. This can imply going through various medical procedures in a single year to treat those conditions. Thus, policyholders are expected to raise numerous claims in a single year, leading to losses for the insurer.

Final Thoughts

Having a high BMI does have a prominent impact on various aspects of the insurance plans for robotic surgeries. However, for adequate coverage, they can purchase a separate policy that covers those conditions. Also, they can get pre-authorisation for planned treatment from the insurers for assured claim approvals.