How Has IRDAI Made Modern Treatments Affordable Through Insurance?

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Medical technology has rapidly evolved, thus transforming the most complicated surgeries into less invasive and highly accurate approaches. These innovations offer clinicians improved visualisation and their patients improved healing periods.


Even though a high-end procedure might be more costly initially than traditional ones, regulations in India have been shifting towards the goal of making modern healthcare affordable through comprehensive health insurance coverage.


Continue reading to know more about modern treatment coverage in health insurance.


The 12 Mandated Modern Treatments in Health Insurance


In 2024, the Insurance Regulatory and Development Authority in India stated that all health insurance companies must include 12 modern treatments in their policies. These procedures include the use of advanced technologies such as robotics, lasers, and cell therapy to treat conditions that were previously difficult to treat.


In the traditional indemnity plans, they were often treated as an exclusion. However, they are now treated as a normal benefit, although there might be some sublimits based on the policy type and insurer.


Here is a detailed overview:


























































Treatment Name



Clinical Application



Robotic Surgeries



Minimally invasive, precision-guided surgical operations.



Stem Cell Therapy



Regenerating or regulating damaged tissues with one's own cells



Immunotherapy



Increasing the immune response against the cancer cells



Oral Chemotherapy



Home-based oral cancer medication



Deep Brain Stimulation



Neurological disorders such as Parkinson's treatment



Balloon Sinuplasty



Minimal invasive surgery for chronic sinusitis



Intra-Vitreal Injections



Direct therapy of retinal and eye diseases



Stereotactic Radiosurgery



Non-surgical, focused radiation for brain/spine tumours



Bronchial Thermoplasty



Reducing the airway muscle lining in case of severe asthma



Vaporisation of the Prostate



Laser therapy for benign prostate enlargement



IONM



Intraoperative monitoring of the nervous system



Uterine Artery Embolisation



Minimal recovery period for the treatment of uterine fibroids



Clinical Advantages of Robotic-Assisted Procedures


Robotic surgery involves the use of specialised instruments mounted on robotic arms, enabling surgeons to operate through small incisions with a greater range of motion than the human wrist. For patients, the major advantage is a much quicker recovery, enabling them to resume their daily routine sooner than with standard open surgery.


These procedures are linked to reduced mortality, less intraoperative bleeding, and reduced hospitalisation. Indicatively, open heart surgery in India can cost as much as ₹1,50,000 to ₹5,00,000, but robotic cardiac surgery can range from ₹3,00,000 to ₹10,000,000 because of the expertise and technology.


Immunotherapy and Oral Chemotherapy


Modern oncology has changed its focus to treatments with targeted cancer markers while sparing healthy tissue. Immunotherapy uses the body's immune system to recognise and kill abnormal cells. This may result in lower side effects than conventional chemotherapy, which usually kills normal cells along with the cancerous cells.


Similarly, oral chemotherapy provides an equally convenient option in that the patient can take pills at home and does not need to have invasive intravenous (IV) infusion therapy or visit the hospital regularly.


Thus, when you buy a health insurance plan, it is crucial to check out the coverage for these 12 modern treatments, their sublimits, copayment clauses, etc. They may cost more than conventional treatment methods, but ensure faster recovery and a better standard of living post-treatment.