World Heart Day: High Surgery Costs, Rising Cardiovascular Illnesses Make Health Insurance A Must

India’s growing burden of heart disease is not just a medical concern, but also a severe financial one. A glance at hospital bills will explain why. A heart transplant that cost under Rs 10 lakh in 2013 now averages to Rs 34 lakh (in 2024) or more in the current year. This is a more than threefold rise in just over a decade. Even less complex procedures like angioplasty or bypass surgery often run into several lakhs, with hospitalisation adding further strain.

The numbers tell a stark story: high-end surgeries for the critically ill are becoming crushingly expensive. Cancer treatment costs have nearly quadrupled in the same period, touching over Rs 50 lakh on average in 2024. In such a landscape, health insurance has moved from being a financial buffer to an absolute necessity.

Siddharth Singhal, Head of Health Insurance at Policybazaar, points out that coverage for people with cardiac history has improved significantly. “Earlier, people with a history of heart conditions had very limited options, only two or three plans were available, and these often came with mandatory co-payments of 20 per cent or more. Today, new-age health insurance plans cater specifically to customers with heart conditions or past medical history, even those who have undergone major heart surgeries within the last seven years,” he said.

The flexibility has improved, too. With Day-1 cover riders, insurers now allow customers to start coverage after just a short 30-day waiting period, compared to the longer waits of traditional policies.

For a slightly higher premium, around 15 to 20 per cent more, buyers can access these plans that cover hospitalisation, surgery costs, post-operative care, and complications from pre-existing heart conditions.

Cardiac-Specific Plans vs General Health Insurance

For those weighing options, the difference between cardiac-specific plans and general health insurance is important to note. Cardiac-focused plans offer broader and more detailed coverage for heart treatments, often with higher limits. The trade-off is a slightly higher premium.

In contrast, general health insurance provides coverage for a wide range of illnesses, including heart conditions, but the specified limit for cardiac treatments is usually lower.

This difference can influence decisions, especially for people with higher risk factors. This includes someone with a family history of heart disease or early signs of hypertension, as they may find it worthwhile to invest in a cardiac-specific plan. For others, a general policy may be sufficient, as long as it comes with riders that strengthen cardiac protection.

Navigating Waiting Periods

One challenge that often deters people from getting insured late is the waiting period for pre-existing diseases (PEDs). For conditions like hypertension, waiting periods in most standard policies range from two to four years.

However, some insurers do offer riders that can reduce PED waiting period, sometimes even to day zero. However, the most practical solution typically is to buy health insurance early at a younger age, before there’s a risk of developing conditions like hypertension or diabetes - which can otherwise complicate the health insurance buying process.

Should you look for riders with critical illness for extra coverage?

Insurance buyers may also wonder if they should look for critical illness riders or maintain the coverage provided under their standard health plans. To understand simply in the context of heart diseases, a critical illness rider focused on cardiac cover would pay out a lump sum upon diagnosis of a major heart condition and provide immediate coverage for the treatment costs.

However, they would push the cost of your insurance higher, an increase which may be nominal for a younger, healthier individual. One should consider whether the benefit of having a critical illness rider outweighs the added expense.

Why Timing Matters

For younger buyers, there is a clear advantage in starting early. The cost of premiums is lower, waiting periods are less of a burden, and coverage can be more comprehensive. But even for those who delay, today’s insurance market is far more accommodating than it was a decade ago, offering flexibility and dedicated plans for people with past cardiac history.

On this World Heart Day, the message is simple: medical advances can help you recover from a heart condition, but financial preparedness determines how smoothly you can access that care. Health insurance is no longer an optional backup; it is a vital part of heart health protection.