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ENT Insurance: Problems, Treatments, And Cover

Team AckoNov 20, 2023

Increased healthcare costs in India, the number of competitors, and consumer demands have led to the introduction of Ear, Nose, and Throat (ENT) insurance in many health insurance plans. ENT health insurance covers most daycare treatments that do not require your loved ones to stay for extended durations at the hospital. Higher medical costs for treatments mean many patients do not have the option to avail quality medical care. Keeping this in mind, a health insurance plan covering ENT procedures helps hedge financial risks. The article discusses points to understand all facets of ENT health insurance and coverage details.

ENT Insurance



Does health insurance cover ENT procedures?

Some health insurance plans cover ENT procedures along with critical and chronic illnesses. With increasing healthcare costs, many insurers have started to cover ENT procedures in health insurance. You would find that regular ENT check-ups and annual health check-ups have been covered in some insurance plans along with the advanced ENT treatments. Regular check-ups coverage in the health insurance policy is particularly important for aged customers, who may require frequent doctor visits.

Since most ENT treatments are handled in daycare treatments, unlike the scenario a few years ago, most insurers provide cashless claims and allow for reimbursements in hospitals that are not in their network.

It is better to check individual plans for ENT coverage before buying one. A recommendation is to include ENT insurance in healthcare plans to expand coverage.

What is covered under ENT health insurance?

Usually, health insurers cover advanced ENT procedures that may require daycare treatment at a hospital. The treatments covered may vary under each plan. Always check individual plans to ensure and understand coverage and claim settlement.

ENT procedures covered

The procedures that are covered under ENT health insurance plans are as follows:

  • Throat surgery

  • Nasal surgery

  • Ear surgery

  • Sinus surgery

  • Adenoidectomy

  • Mastoidectomy

  • Palatoplasty

  • Balloon Sinuplasty

  • Thyroplasty

  • Septoplasty

  • Myringoplasty

  • Tympanoplasty

ENT problems, signs, and symptoms

ENT treatments usually cover anything related to the ear, nose, and throat. Treatments can be minor or severe; however, since these impact the sensory organs of a person, an individual needs to be treated via diagnostic, surgical, or advanced ENT treatments.

ENT issues such as impaired hearing, sinus, cold, sore throat, etc., are all treated by ENT specialists. ENT specialists handle the mentioned and can take care of significant issues like blocked airways, middle ear hearing impairment, and head, neck, and throat cancer. 

Issues faced under ENT conditions can disturb your quality of life and be life-threatening if not treated in time.

The following are some common ENT issues faced by patients:

Advanced ENT treatments

These ENT treatments range from simple to severe categories. ENT issues can get tricky and expensive for patients today.

Some advanced ENT treatments covered under health insurance are as follows:

  • Adenoidectomy: This advanced ENT treatment is to remove adenoids. Adenoids are glands located behind the roof of the mouth and nose. These glands restrict problems-causing germs in the nose. These glands can swell or enlarge and cause breathing and sleeping problems in some cases. Medications usually treat these. However, ENT specialists opt to remove adenoids without complications if drugs fail.

  • Mastoidectomy: This advanced ENT treatment includes surgical removal of an infected part of the mastoid bone. The mastoid bone is the prominent bone in the skull located behind the ear.

  • Palatoplasty: This ENT treatment is reconstruction or correction of the palate, i.e., the roof of the mouth. This treatment closes the unusual opening between the nose and the mouth.

  • Balloon Sinuplasty: Under this treatment, ENT specialists insert small, thin tubes to widen the blocked nasal passage into the nostrils. This treatment helps patients breathe normally.

  • Thyroplasty: To correct vocal cord paralysis due to a surgical injury, cancer, stroke, or a virus. In this, ENT specialists fix the position of the vocal cord by a surgical procedure.

Benefits Of Health Insurance Having ENT Procedures Covered?

Some key reasons why you should have ENT health insurance coverage are as follows:

Increasing healthcare costs: With the advancement of technology and overall inflation, healthcare costs have risen consistently. It is important to have ENT health insurance coverage to hedge against the possible financial burden that may come with ENT issues.

Financial cover: ENT problems are very common in today’s time with the modern lifestyle. ENT health insurance cover helps finance costs of the ENT treatments that may otherwise burn a hole in your pocket.

Short-stay requirement: Most ENT procedures fall under daycare treatment, and you do not need to stay in a hospital overnight to claim health insurance. Earlier, patients used to stay overnight in a hospital to claim health insurance for the medical treatments as there was no coverage for ENT or daycare treatments.

Financial stability: ENT health insurance coverage helps maintain financial stability and lets you focus on what is important - you and your loved ones’ health and safety.

Do group health insurance plans cover all ENT treatments?

If you’re looking particularly for ENT coverage, group insurance might not be the best option for you. Group insurance usually does not cover ENT treatments, even if it does only certain treatments will be covered. It is best to opt for a comprehensive insurance plan to take care of all your ENT needs. Make sure to talk to a representative before you narrow down on a plan, they will explain in detail about the various plans available and also the treatments covered.

In a nutshell

ENT insurance helps cover the financial risk of additional health issues in sensory organs like the ear, nose, and throat. It is recommended that you check the health insurance plan you hold and add ENT health insurance coverage as part of your health insurance. In case you plan to buy a new health insurance plan to safeguard yourself, it is suggested that you have the ENT health insurance cover from day one. Due to the rising inflation, healthcare costs have gone through the roof. Therefore, it is essential to have adequate health insurance to safeguard from possible health expenses.

Frequently Asked Questions

What is ENT Robotic Surgery?


ENT robotic surgery is a minimally invasive surgery that uses a sophisticated automated system to treat ENT (ear, nose, and throat) conditions.

On average, how much does a standard ENT treatment cost?


The cost of the ENT treatment depends on the diagnosis and condition of the patient. Typically, an ENT treatment may cost between Rs. 25,000 to Rs. 4,00,000. The cost is subject to changes.

Is ENT coverage a health insurance add-on?


ENT coverage is offered as part of several general insurers' comprehensive health insurance policies. It is usually not provided as an add-on but as part of the overall insurance plan.

Will having ENT health insurance increase the cost of my policy?


Including ENT health insurance as a part of the selected health insurance plan may increase the policy cost by a small fraction and help cover risks against the standard and advanced ENT procedures.

What should I expect on my first ENT doctor's visit?


One can expect a visual and physical examination of the affected area and a discussion with the ENT specialist that will help prescribe a future course of action and medications.

Are ENT disorders life-threatening?


ENT disorders can disrupt the quality of life and can even be life-threatening.

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Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet; and is subject to changes. Please go through the applicable policy wordings for updated ACKO-centric content and before making any insurance-related decisions.

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