A Guide to Modern Treatments in Health Insurance Coverage

Modern healthcare involves advanced treatments. Learn how health insurance in 2024 covers new-age procedures and technologies for better care.
Check health insurance plans that cover all advanced level treatments
3 min
14-May-2025

Medical care is evolving fast—robotic surgeries, laser therapies, and gene-based treatments are no longer futuristic concepts. They're here, saving lives, improving precision, and accelerating recovery. But there’s a catch: they’re expensive, and not all insurance plans cover them.

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This guide helps you decode which modern treatments are covered, which plans support them, and how to secure your access to the best medical tech—without last-minute surprises.

What are modern treatments in Health Insurance

Modern treatments use advanced tools and techniques to deliver safer, more targeted care. These include:

  • Robotic-assisted surgeries
  • High-precision laser procedures
  • Regenerative stem cell therapies
  • Genetic and immunotherapy in cancer care

These methods reduce pain, shorten hospital stays, and improve outcomes. But they’re not automatically included in every health insurance plan.

Your recovery shouldn’t depend on outdated coverage.Ensure your policy includes next-gen procedures.Check coverage for robotic, laser, and gene-based treatments

Are modern treatments covered under health insurance?

Several health insurance plans in India now include coverage for modern medical treatments. These plans typically cover in-patient hospitalisation, domiciliary care, day care procedures, and both pre- and post-hospitalisation expenses. According to guidelines by the Insurance Regulatory and Development Authority of India (IRDAI), health insurance policies must cover up to 12 advanced procedures under the “Modern Treatment Benefit”, enabling policyholders to access cutting-edge healthcare without facing financial stress.

However, some mediclaim policies may place sub-limits on certain modern treatments. This means the insurer may cap the reimbursement amount for specific procedures. To avoid unexpected out-of-pocket costs, it’s crucial to review your policy documents for any applicable sub-limits on these advanced treatments.

Pro Tip

Opt for disease-specific health insurance if you have a family history of critical illnesses. It offers targeted coverage and financial support for treatments like chemotherapy, dialysis, and specialized care.

List of modern treatments covered by health insurance

As per IRDAI regulations, several advanced medical treatments are now included under health insurance policies. Here are 12 such modern procedures typically covered:

  • Immunotherapy
    A cutting-edge cancer treatment that boosts the body’s immune response to target and destroy cancer cells. It enables more focused and personalised cancer care.
  • Oral Chemotherapy
    This involves taking cancer medication in pill or capsule form, allowing patients to undergo treatment at home. It’s a more flexible and less invasive alternative to traditional IV chemotherapy.
  • Intra Vitreal Injections
    These injections deliver medicine directly into the eye’s vitreous chamber, commonly used to manage retinal disorders like age-related macular degeneration (AMD) and diabetic retinopathy.
  • Stem Cell Therapy
    In this treatment, stem cells from the patient’s own body are used to regenerate or repair damaged tissues. It’s showing promise in treating conditions like Parkinson’s disease, heart failure, and multiple sclerosis.
  • Robotic Surgeries
    Robotic-assisted surgeries offer enhanced precision with minimally invasive techniques. Surgeons operate through a console, guiding robotic arms for better accuracy and quicker recovery.
  • Stereotactic Radiosurgery (SRS)
    Despite the name, this is a non-surgical procedure that delivers focused radiation to brain and spine abnormalities. It targets tumours with precision while sparing healthy tissues.
  • Deep Brain Stimulation (DBS)
    This neurological treatment involves implanting electrodes in specific brain areas to deliver controlled electrical impulses. It helps manage conditions like Parkinson’s disease and essential tremors.
  • Bronchial Thermoplasty
    A procedure for severe asthma, this technique uses controlled heat to reduce the smooth muscle lining the airways, making breathing easier for chronic asthma patients.
  • Uterine Artery Embolization & HIFU
    Both these minimally invasive techniques are used to treat uterine fibroids. They offer faster recovery and fewer complications compared to traditional surgical options.
  • Intraoperative Neuro Monitoring (IONM)
    IONM tracks electrical signals in the nervous system during high-risk surgeries. It helps surgeons avoid nerve damage by providing real-time feedback.
  • Balloon Sinuplasty
    Used to treat chronic sinusitis, this procedure involves inserting and inflating a small balloon inside the nasal passages to clear blockages and ease symptoms without incisions.
  • Prostate Vaporization (GreenLight Laser Therapy)
    This laser-based treatment removes excess prostate tissue to relieve urinary symptoms. It’s a safe, bloodless option for patients with benign prostate enlargement.

Is Robotic Surgery or Laser Therapy Covered by Insurance?

Yes—but it depends on the plan. Here's how it works:

1. Robotic Surgery

Covered in many comprehensive health insurance plans when medically necessary and performed in empanelled hospitals.

2. Laser Therapy

Generally covered for medical use (e.g., kidney stones, tumour removal). Cosmetic procedures are excluded.

3. Pre-authorisation Required

Most modern procedures need advance insurer approval and proper medical documentation.

4. Hospital Infrastructure Matters

Insurers may only allow cashless claims for advanced procedures at certified, high-tech facilities.

Your insurer shouldn’t hold back your doctor’s tools.Choose a plan aligned with top hospitals using advanced tech.Compare now

How to Choose a Plan That Supports Advanced Medical Treatments

You don’t just need coverage—you need compatibility with modern care. Here’s what to look for:

 

Inclusions for robotic, laser, stem cell therapies

Ensure your plan explicitly mentions these treatments in its policy wordings.

Empanelled high-tech hospitals

The wider and more advanced the hospital network, the better your access to next-gen care.

No hidden sub-limits

Avoid policies that quietly cap payouts on specific surgeries or technologies.

Critical illness add-ons

These often extend cover to therapies like immunotherapy and gene-based treatments.

Future-ready claims process

Check if the insurer offers digital authorisations, fast-track approvals, and a 24/7 medical helpline.

Your needs evolve. Your plan should too.Upgrade to insurance that supports evolving treatment technologies.Start your plan comparison now

Things to keep in mind while claiming modern treatment in health insurance

When filing a claim for modern medical treatments, here are a few important factors to consider:

  1. Sub-Limits on Coverage
    Many health insurance policies apply sub-limits on advanced treatments such as robotic surgeries or specialised therapies. This means the insurer may only reimburse a fixed portion of the treatment cost, rather than covering the full amount.
  2. Waiting Periods
    Most health insurance plans come with an initial 30-day waiting period before covering any treatment, including modern procedures. If the treatment relates to a pre-existing condition, a longer waiting period—typically ranging from 2 to 4 years—may apply. This duration varies depending on the insurer and policy terms.
  3. Mandatory Medical Prescription
    Modern treatment costs are reimbursed only if the procedure is deemed medically necessary. To support the claim, policyholders must provide a prescription or recommendation from a certified medical professional, clearly stating the need for the treatment.

Conclusion

From robotic arms in OT to genetic tweaks in labs, healthcare is moving at warp speed. And with the right insurance, you don’t have to be left behind. Many Indian insurers now support a wider range of advanced treatments, but coverage varies by plan—don’t assume, always verify.

Be covered for care that’s smarter, faster, and safer.Get a health plan that keeps pace with medical innovation.

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Frequently asked questions

Are all modern treatments covered in standard health insurance policies?

No, standard health insurance policies do not cover all modern treatments. Advanced procedures like robotic surgery, gene therapy, or immunotherapy may be excluded or limited. You’ll need to check specific plan inclusions or opt for premium policies for broader coverage.

Do I need to pay extra premium for modern treatment coverage?

Yes, insurers may charge a higher premium for policies that include modern treatment options. These plans often come with a higher sum insured and fewer exclusions. The extra premium reflects the high cost of advanced medical technologies and specialist procedures.

Which insurance companies offer the best coverage for modern procedures?

Leading insurers like HDFC ERGO, Niva Bupa, Star Health, and Tata AIG offer policies with coverage for robotic surgeries, laser therapy, and immunotherapy. Always compare features, sub-limits, and hospital networks before choosing a policy for advanced treatment inclusion.

What is Modern Treatment in Health Insurance?

Modern treatments refer to advanced medical procedures and technologies that go beyond traditional methods of diagnosis and treatment. These include minimally invasive surgeries, targeted therapies, robotic procedures, and personalised medicine approaches. Recognising their growing importance in improving patient outcomes, the Insurance Regulatory and Development Authority of India (IRDAI) has mandated that most health insurance policies must cover a list of specified modern treatments—ensuring that policyholders are financially protected even when opting for newer, costlier procedures.

How Many Modern Treatments Are Covered in India?

As per IRDAI guidelines, there are 12 modern treatments that must be covered by all comprehensive health insurance policies offered in India. These treatments span across oncology, neurology, pulmonology, urology, ophthalmology, and other specialties, ensuring that patients have access to cutting-edge care without worrying about affordability.

What are the types of modern treatments in health insurance?

Below are the 12 modern treatments typically covered under health insurance plans in India:

  • Immunotherapy – Boosts the immune system to fight cancer more effectively.
  • Oral Chemotherapy – Cancer-fighting drugs administered via oral tablets or capsules.
  • Intra Vitreal Injections – Eye injections used to treat retinal disorders.
  • Stem Cell Therapy – Uses the patient’s own stem cells to repair damaged tissues.
  • Robotic Surgeries – Enhances surgical precision using robotic assistance.
  • Stereotactic Radiosurgery (SRS) – Non-invasive radiation treatment for brain and spinal tumors.
  • Deep Brain Stimulation (DBS) – Implants electrodes in the brain to treat movement disorders.
  • Bronchial Thermoplasty – Minimally invasive asthma treatment using heat therapy.
  • Uterine Artery Embolization & HIFU – Non-surgical methods to treat uterine fibroids.
  • Intraoperative Neuro Monitoring (IONM) – Monitors nerve function during complex surgeries.
  • Balloon Sinuplasty – Minimally invasive sinus surgery using balloon dilation.
  • Prostate Vaporization (GreenLight Laser) – Treats enlarged prostate with laser-based techniques.

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