Summary of this article
Brain tumor treatment needs both health and critical illness insurance coverage.
Health insurance covers hospitalization, surgery, and treatment up to the sum insured.
Critical illness plans pay a lump sum on diagnosis for income protection.
Experts recommend Rs 30–35 lakh health cover plus Rs 50 lakh critical policy.
A brain tumor sounds scary, but with modern science, treatment is possible. However, comprehensive coverage against brain tumors or any other critical illness requires a two-pronged strategy.
First, there is comprehensive health insurance. A comprehensive health insurance plan pays your actual medical expenses for brain tumor treatment, up to the sum insured. “This usually includes hospitalization, surgery, ICU, room rent, medicines, MRIs/CT scans, radiation, chemotherapy, where covered, ambulance, and pre- and post-hospitalization costs. It can be used multiple times in a year for any covered illness, not just pertaining to brain tumors,” says Arti Mulik, Chief Technical Officer, Universal Sompo General Insurance.
Next come critical illness policies. “Critical illness policies work differently—they provide a lump sum payout immediately upon diagnosis of a benign brain tumor, regardless of actual medical expenses. This money can be used for anything—income loss, business disruptions, lifestyle modifications, rehabilitation, or even debt repayment,” says Siddharth Singhal, head of health insurance, Policybazaar.
The key difference: comprehensive plans cover medical bills; critical illness policies protect your income and financial stability during treatment and recovery. Both should work together, not as alternatives.
What To Look For
In the case of a comprehensive policy, it is important to look at waiting periods, sub-limits, room rent limits, and other features like co-pays and deductibles, which mean you have to pay a portion of the bill from your own pocket.
For benign brain tumors, insurers typically require a specialist diagnosis with MRI/CT evidence and a permanent neurological deficit. “Not all critical illness policies automatically cover brain tumors—verify the policy schedule explicitly lists it as a covered condition,” says Singhal.
“Also, for critical illness covers, look for exclusions such as pre-existing disease or radiation-related illness that may be excluded from coverage,” says Mulik.
Your Coverage Strategy
Comprehensive brain tumor treatment, including diagnostics, surgery, and post-operative care, costs Rs 7-10 lakh, with complex cases reaching Rs 50 lakh.
Have a base health insurance of Rs 30-35 lakh minimum for metro cities.
For critical illness coverage, the sum insured should cover treatment costs plus income replacement and financial commitments during recovery. Industry guidelines suggest up to 10 times annual income or unlimited.
“A practical combination would be Rs 30-35 lakh health insurance plus a Rs 50 lakh critical illness policy, which provides comprehensive protection for both medical expenses and the 18-24 month income loss during treatment and recovery. Families should also consider policies with restoration benefits to replenish the sum insured if exhausted during treatment,” says Singhal.
