Is insurance going to pay robotic surgery? Robotic surgery is classified as robot-assisted minimally invasive surgery, therefore it is covered by any insurer that supports minimally invasive surgery.
Is robotic surgery covered under insurance?
The Insurance Regulatory and Development Authority of India (IRDAI) enacted health laws in 2019 that require all insurers to cover robotic therapies. As a result, all insurers provide it, although with various sub-limits and policy terms.
“Oncology and general surgery both use robotic surgery. The assertions aren’t common because they’re only made at higher-level centers of excellence and need substantial training. Due to the high expense of the treatment, only insured members with a large sum insured choose it. If traditional procedures are available, people with lower insurance bands may choose them. Robotic surgeries account for less than 0.02 percent of overall claims, according to Shreeraj Deshpande, CEO of Future Generali India Insurance.
“According to Nerurkar, “about 3-4 percent of overall claims may have the use of robotics in surgery as per indication.”
Fine print
Before deciding on surgery, carefully understand the terms and conditions of your insurance policy. Certain indications, such as osteoarthritis, may require a waiting time. “The indication, condition, or affliction for which robotic surgery is being performed determines its admissibility. Robotics, for example, can be employed in joint replacement surgeries such as total knee replacement. However, if the reason for the knee replacement operation is to treat degenerative disorders like osteoarthritis, there is usually a waiting period,” Nerurkar explained.
Furthermore, for the claim to be successful, your doctor must specifically specify the requirement for robotic surgery in the prognosis. “Robotic procedures are usually covered by insurance if they are recommended by a qualified medical practitioner who is familiar with the procedure. Insurers, on the other hand, check if the procedure is necessary and follows accepted international treatment protocols. Robotic surgeries are typically recommended in cases when the surgical procedure necessitates precision and skill. As a result, even if there are no particular exclusions, insurers will examine the procedure’s clinical need,” Deshpande added.
What to do?
If a policyholder is having robotic surgery, the reasons for the surgery and any related waiting periods must be checked ahead of time to ensure a smooth claim settlement. Also, look for any sub-limits, co-pays, or other cost-sharing provisions in the coverage.
How much does robotic surgery cost in India?
The cost of doing robotic surgery is slightly greater than traditional treatments due to its effectiveness and efficiency. A complicated robotic surgery will almost certainly cost nearly two times as much as a laparoscopic treatment.
An abdominal robotic surgery costs 5.25 lakh on average in India, whereas a cardiothoracic treatment costs 6.75 lakh. A gynecologic surgery costs 5,000 rupees, while a head-and-neck procedure costs 6,000 rupees.
However, if you have comprehensive health insurance with a sufficient sum insured, you do not need to be concerned about the expense of treatment because your health insurer will now cover such procedures.
Why is robotic surgery not covered by insurance?
Robotic surgery is quickly becoming the new standard. Robotic procedures are successfully conducted by experts from other countries in India’s top hospitals. Most insurance coverage, however, do not cover robotic procedures.
However, with new medical experiments ongoing, the Insurance Regulatory and Development Authority of India (IRDAI) has advised insurance firms to include robotic procedures in their health insurance coverage. If robotic surgeries are covered by insurance, Indians will no longer need to travel abroad for such procedures; they will be able to receive them in any Indian facility.
In comparison to persons who have open surgery, patients who have robotic surgery have less discomfort, less blood loss, a shorter hospital stay, and a faster return to normal activity. Patients, on the other hand, prefer not to have robotic surgeries because they are not covered by insurance, according to doctors.
Not only do patients benefit from robotic surgery, but surgeons get more precision, flexibility, control, and vision as well.
Patient Benefits
– More accurate surgery – Because of the tiny size and flexibility of robotic equipment, it is easier to remove the anomaly without damaging nearby healthy structures.
– Infection and blood loss are reduced because your surgeon uses small incisions rather than large ones, reducing the risk of infection and blood loss.
Is robotic surgery expensive?
A cost per procedure of $3568 was calculated by dividing overall spending on robotic technology by the total number of robotic procedures completed in 2017, including $1866 for instruments and accessories, $1038 for robot systems, and $663 for the service contract.
Yes.
The cost of robotic surgery is slightly higher than that of open or laparoscopic surgery. However, there are numerous reasons why the higher expense of robotic surgery for cancer surgery is justified.
Robotic surgery is far less difficult to master than the other two types of procedures. After a few surgeries, anyone should be able to do any procedure, including robotic surgery. The use of a robotic surgical method speeds up the process of gaining skill. The surgeon’s job is made easier by the robotic platform, which also makes surgery more precise and possible in some difficult scenarios, adding value to the process when compared to a minimally invasive technique.
Many aspects of cancer surgery have improved thanks to the robotic surgery platform. In gynecologic tumors, for example, the robot can help obtain a high yield of lymph nodes for full dissection while also bringing a high level of precision to sentinel lymph node dissection, both of which increase the odds of a better outcome. Furthermore, because postoperative discomfort is usually mild, the robotic platform allows for early release. The costs saved by reducing hospital stays do not include the higher costs of the treatment.
For minimal-access surgery, several surgeons employ the robotic platform. If the robot wasn’t accessible, many patients would have to endure open surgery, which is associated with higher blood loss and a longer stay in the hospital, as well as complications that could cost money in the long term. Due to the steep learning curve involved with straight stick laparoscopy, it is not a comparable choice in this sense.
One essential factor to remember is that robotic surgery, which has a low rate of morbidity and improves recovery, can make it simpler for eligible patients to get chemotherapy sooner after surgery, which can improve treatment outcomes. Data from a variety of disciplines suggests that how quickly patients begin chemotherapy after surgery matters, with delayed chemotherapy having less favorable outcomes. Others say that laparoscopy can achieve the same benefits, although this is considerably more difficult to accomplish.
The conversion rate of straight stick laparoscopy to open surgery was 25% in one gynecologic research of laparoscopic hysterectomy. When it comes to the robotic platform, the conversion rate is often less than 5%, which means less morbidity and blood loss.
The robotic platform is relatively new; it was approved by the FDA in 2005, so the robot’s lifespan has been less than 12 years. Senhance Surgical Robotic System (TransEnterix) is the latest robot to hit the market, and I have no doubt that more will follow. The cost of the robot if it is more than that of another modality is only a temporary issue, as costs are likely to fall dramatically in the near future as more robots enter the market and competition increases. I have little doubt that the cost debate will shift, and that many more doctors will migrate to robotic surgical platforms, which will benefit everyone, especially patients.
Home care services
These devices are covered by most insurance plans and Medicare. They may, however, appear on your hospital bill or another account as additional charges.
If you are unable to return home right away and must spend time in a rehab or nursing facility for additional care, there will be additional fees.
Home modifications
Remember to account for lost income if you need to take time off work for surgery or recovery. Find out if you qualify for any disability insurance options that cover time off work by speaking with your employer and insurance provider.
Disability insurance is a sort of insurance that pays a portion of an employee’s salary if they are unable to work due to an injury or disability. It may cover the time you need off for procedures like TKRs.
How many hospitals use robotic surgery in India?
“A great surgeon is one who possesses courage and presence of mind, a hand free of perspiration, tremor less grip of sharp and good instruments, and who carries his operations to the success and advantage of his patient who has entrusted his life to the surgeon,” Sushruta said in his Sushruta Samhita.
Following the FDA approval of the da Vinci system in the United States in 2000, India received its first urologic robotic installation in 2006 at the All India Institute of Medical Sciences in New Delhi. The following decade saw an unprecedented growth of robotic surgery in India, with 66 centers and 71 robotic installations as of July 2019, and more than 500 trained robotic surgeons. Over 12,800 surgeries have been performed with robotic assistance in these 12 years.
Is robotic surgery open surgery?
Because robotic surgery allows Dr. Klause to make a very small incision, it is considered minimally invasive surgery. When compared to standard open surgery, risk factors and recovery durations are sometimes considerably reduced with a smaller incision.
Why are robots used in surgery?
Robotic surgery, also known as robot-assisted surgery, allows doctors to conduct a wide range of complex procedures with greater precision, flexibility, and control than traditional approaches allow. Minimally invasive surgery, or procedures conducted through small incisions, is often coupled with robotic surgery.