Endoscopic Sinus Surgery in Group Health Insurance


Endoscopic Sinus Surgery

Sinusitis is a condition in which the cavity around the nasal passage becomes inflated. Sinusitis is caused due to inflammation or swelling of the tissue lining the sinuses. Sinuses are the hollow spaces within the bones between the eyes, and behind the cheekbones in the forehead. These sinuses make mucus which helps in keeping the noise moist. This mucus in turn helps in preventing dust, allergens and pollutants from entering the nose. 

Sinuses are usually filled with air but when they are blocked with fluid, gems can grow inside and cause an infection.

The conditions that cause sinusitis are:- 

  1. Common cold
  2. Allergic rhinitis is the swelling of the linen of the nose caused by allergens. 
  3. Nasal polyps—small growths inside the nose on the lining. 
  4. A deviation in the nasal cavity. 

Endoscopic Sinus Surgery:– 

The most common term is interlinked with sinusitis, and what is endoscopic sinus surgery? The answer to this is given below:- 

Endoscopic sinus surgery is a procedure used to remove the blockages in the sinuses. These blockages may cause pain, swelling, recurring infections, loss of smell, or impaired breathing. It is important to treat sinusitis in the early stages to reduce the chance of surgery. Functional endoscopic surgery is recommended for serious sinus conditions and is minimally invasive. Endoscopic sinus surgery is also called functional sinus surgery as it helps to function the sinus normally. 

Sinus surgery in Group Health Insurance:- 

Group health insurance is a type of health insurance that covers the hospitalization expenses incurred by the insured due to an insured illness or disease. People taking the group health insurance policy pose a normal question on the coverage of sinusitis surgery. 

Does endoscopic sinus surgery get covered under group health insurance?

Yes. Endoscopic sinus surgery is covered by a group health insurance policy. Most insurance companies cover the entire expense of the surgery, while a few insurance companies place a capping on the surgery amount.  

For example, an insurance company might cover only up to a certain percentage of the sum insured under the group health insurance policy.

The sinusitis surgery might be done for both the nasal openings or one opening depending on the need. Since the surgery is minimally invasive, the patient would be discharged on the same day or the next day depending on the condition of the patient. 

Most insurance companies would place a cap on the surgery expenses and also not pay for the consumables under the group health insurance policy. It is important to understand the terms and conditions of the group health insurance policy regarding endoscopic Sinus Surgery before finalizing the policy. 

For more information on endoscopic sinus surgery coverage in your group health insurance policy please book a call with Ethika insurance broking to get advice from our health insurance experts.

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Susheel Agarwal

Namaste. I'm Abhinay Nedunuru, a Fellow of the Insurance Institute of India with a passion to make insurance simple and crisp. I write on insurance and investment. I have a passion for teaching and training in particular to insurance. I'm currently doing my PhD from IIM in Management.