Fractures in Health Insurance
Treating a fracture usually does not require hospitalization, and is therefore treated as an outpatient (OPD) case. Usually, health insurance do not provide special or direct coverage for fractures or bone dislocations. However, most health policies cover the treatment of bone fracture caused by an accident.
Treatment of fractures can range from minor casts or braces to surgical fixation. Depending on the type of fracture treatment, the medical expense can vary from marginal to substantial. Hence, you must read the policy wording carefully to ensure your health plan covers fractures and provides comprehensive coverage.
How are Fractures Covered in Health Insurance?
People often ask, ‘can we claim insurance for a fracture?’ There are different conditions for fractures in health insurance. Situations where a broken arm or a fractured leg is covered in health insurance are as follows:
-
OPD Treatment
If you get minor fractures and visit the doctor, they will be treated as part of the outpatient (OPD) visit. If your health insurance covers OPD expenses, you can raise a claim for fractures. However, you must carefully review the policy wordings to understand whether your policy covers only OPD consultations or the treatment as well.
-
Accidental Injuries
Most health insurance plans cover accidental injuries, including broken bones. Hence, if your fracture is due to an accident, it will be covered per the sum insured mentioned in the policy copy.
-
Policy Inclusion
Fractures are covered by a health insurance policy if their treatment requires in-patient hospitalization for over 24 hours.
-
Add-ons and Riders
If your health insurance plan does not specifically cover fractures or provide OPD coverage, you can opt for add-ons or riders covering accidental injuries or OPD expenses.
Now, you need not wonder whether a fractured bone is covered by insurance or not. You can easily raise a fracture insurance claim in the situations mentioned above.
