Does Health Insurance Cover Angioplasty?

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Angioplasty surgery is a minimally invasive procedure where the plaque or a layer of fat is removed from the arteries, promoting unrestricted blood flow. It's a safe way to improve cardiovascular health, given that one has recently suffered a heart attack.


However, it is a high-cost medical procedure in India. Read ahead to learn whether Angioplasty is covered under health insurance.


Does Health Insurance Cover Angioplasty in India?


As a medically necessary treatment, angioplasty is covered by health insurance in India. This is relevant under standard, comprehensive, and cardiac-specific policies. Coverage generally includes hospitalisation, surgical charges, and pre- and pre/post-hospitalisation expenses.


Here are the key aspects of the health insurance in India for angioplasty:



  1. Waiting Periods


One might have pre-existing conditions that would mandate a waiting period of 2 - 4 years. As per new policies, there shall instead be a 30 - 90-day waiting period.



  1. What is Covered


Policies typically cover hospitalisation room rent, surgeon charges, ICU fees, and diagnostic costs, possibly resulting from ECG, MRA, etc.



  1. Limits and Sub-limits


While they are covered, certain plans have caps on the total claim amount/specific sub-limits for room rent. So, full expenses may not be reimbursed.



  1. Cashless Treatment


Treatment across a wide network of hospitals associated with medical coverage providers allows for cashless claims.



  1. Pre/Post-Hospitalisation Fees


Policies now cover pre- and post-hospitalisation expenses associated with inpatient hospitalisation. Medical charges for tests/consultations within a specified period prior to admission constitute pre-hospitalisation fees.


Post-hospitalisation charges for follow-up sessions that have to do with medications/tests after discharge are also covered (for a specified time period only).


What are the Types of Angioplasty Covered by Health Insurance in India?


Health insurance covers the following two types of angioplasty based on the artery targeted:



  1. Coronary Artery Angioplasty: The procedure targets the coronary arteries. These are the arteries that transfer blood from different parts of the body to the heart.



  1. Peripheral Artery Angioplasty: The procedure targets arteries that carry blood from the heart to other parts of the body.


Angioplasty may be conducted via different methods. These are also covered by health insurance:



  1. Balloon Angioplasty: In this procedure, a balloon is placed at the end of a catheter. It is inflated to tip off the plaque/fat towards the artery’s side walls.



  1. Excimer Laser Coronary Angioplasty or ELCA: This is an uncommon alternative to the typical angioplasty procedure. It uses a laser instead of a balloon to get rid of the plaque that's built up in the arteries.



  1. Stents’ Placement: Stents are not required to be mandatorily placed, as they are commonly positioned after the angioplasty surgery concludes. This is done to keep the artery open and allow for blood flow to occur without hindrance.


Final Word


Health insurance in India covers angioplasty as long as it is medically prescribed by a registered doctor. It’s a standard inpatient procedure for coronary artery blockages. The costs associated with hospitalisation, surgeons, ICU stay, stent charges, medicines, and related diagnostics are payable.


Coverage also depends on the sum insured, waiting periods for already-existing conditions, and any other sub-limits on cardiac procedures/consumables.