Surgery benefits for most health insurance cover surgical procedures in their inpatient hospital treatments. Surgery means the treatment of injuries or disorders of the body by incision or manipulation, especially with instruments.


So, when claiming for surgery benefit from your health insurance, you should ensure you have the necessary information and proof before submitting your claim.

Types of Surgery Cover

Health insurance usually covers a standard list of surgical procedures. They are categorised in the following areas:


An implant is a medical device manufactured to replace a missing biological structure, support a damaged biological structure, or enhance an existing biological structure.


Medical implants are man-made devices and the surface of implants that contact the body might be made of a biomedical material such as titanium, silicone or apatite depending on what is the most functional. Benefit for such coverage is either per treatment or per admission basis up to the amount reimbursed by the selected plan.


Depending on the health insurance plan and premium, the benefits will vary. Before you decide which health insurance plan is suitable for you, it is good to do a comparison and read through the coverage and benefits of the policy.


Also known as outpatient surgery, this covers for less complex to simple surgical procedures that do not require an overnight hospital stay. Benefit for such coverage is similar to inpatient surgery mentioned above.


This covers complex to very complex surgical procedures that require the patient to be admitted to the hospital for a few days. Some health insurance provider cover based on the complexity of the surgical procedure, while other providers may base it on per disability and sanction separate limits.


In the latter, a maximum limit applies allowing full reimbursement and together with an overflow limit allowing co-sharing reimbursement.



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