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  • Writer's pictureNiharika Joshi

Is Hypospadias surgery covered by insurance in India?: Exploring Insurance Coverage

In today's world of advancement, science has thrived at a larger scale where several diseases have effective treatments to rectify. However, when it comes to congenital disease, no such luck prevails. When a child is diagnosed with any such disease, it not only provides discomfort to them but also to parents. 




Although, many congenital diseases can be corrected with surgical methods. But this implies a long expensive affair which can evaporate all your savings as a parent. That's where health insurance comes in which can help not only to save your hard-earned money but also to provide benefits until all is said and done.  


Within this article, we will be plunging to know whether health insurance covers congenital diseases like hypospadias in broader terms.


Understanding Hypospadias

To address the first question which pops in mind i.e., ‘What is Hypospadias?’ Hypospadias is a congenital disease in which the male children have their urethra underside of the penis instead of the tip. It is called congenital because such conditions are often predicted during or after birth. 

In this condition, male children face the problem of urinating while standing, and later in life can face the issue of having sexual intercourse if not treated. This condition can be treated with surgery which is often consulted to be done between 6 months and 12 months old. However, that depends upon how complex the condition is.


Hypospadias Surgery: How much does it cost? 

As mentioned hypospadias surgery is an expensive affair. The procedure of surgery consists of a layered process and goes through different stages. Hypospadias repair is generally considered safe for healthy infants. However, the cost of it depends upon various factors including the risk profile of the infant. 

However, in general, hypospadia surgeries without insurance can cost anywhere up to 1.5 lakhs. Having health insurance covering it can be a great benefit to compress the cost.


Insights into Hypospadias Surgery Insurance: What's Covered in India? 

Now the most important question is whether hypospadias are covered by health insurance or not. Well, there is no concrete answer to it. In India, IRDAI (Insurance Regulatory & Development Authority of India) issued a guideline that declared the coverage of congenital diseases.

Following the guidelines, many insurers are up to cover various kinds of congenital diseases including hypospadias as well. However, what needs to be noted is that not every congenital disease is being covered. Only internal congenital diseases are being covered as per the guidelines. 

Also, some health insurance plans for newborn babies cover the expenses only after a certain age limit. Usually, when they complete 3 months.

 Besides this, many insurance companies cover the expense of hypospadias after they age 2 years. In such cases, a child can't be much helped if the doctor consults to get surgery before the child completes 2 or at earliest. If you bought an insurance plan before the child's birth, in that scenario detection of hypospadias will be considered as pre-existing disease. This again brings us to the point that hypospadias have a chance to get covered under pre-existing disease coverage. 



Factors to consider while buying Health Insurance plan 

If your child is suffering from any such congenital disease or is prone to it, it is best in the interest of having a health insurance plan for the betterment of the child’s future. Here are a few points to consider while buying health insurance for a newborn baby: 


  • First and foremost consider to read thoroughly the prospectus of the insurance plan. 

  • Evaluate the concession or coverage for the congenital external as well as internal disease. 

  • Go through the list of congenital diseases that are usually covered by the insurance company to avoid last-minute surprises. 

  • Usually, health insurance for newborn babies is considered eligible after 90 days. So, look for a plan that covers your child's medical needs at the earliest so that the surgery for hypospadias can take place at soonest.


Read our blog to know more about how child insurance plans work (if uploaded the blog, please do the internal linking) 


Summing up, 


To sum up, the coverage of hypospadias surgery totally depends on the insurance plan you are buying. By considering health policies with a keen eye, one can end up saving a good amount of money. To have health insurance for a child is armoring their future with well-being which makes it the best decision as a parent for securing the child’s future. 




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