Govt plans making organ transplant insurance affordable, address gap of limited donor cover
The National Organ and Tissue Transplant Organization will meet Irdai to discuss insurance coverage for organ donors as demand for transplants rises and costs remain prohibitive.
In an effort to improve access to life-saving surgeries, the National Organ and Tissue Transplant Organization (NOTTO), an agency under the health ministry, is set to meet the Insurance Regulatory and Development Authority of India (Irdai) to explore ways to make organ transplant insurance more affordable and comprehensive, according to a government official and documents reviewed by Mint.
The meeting, expected in the coming weeks, aims to close a long-standing gap in India’s health insurance ecosystem—limited or no coverage for organ donors—even as demand for transplants rises and costs remain prohibitive.
"In India, health insurance is not unlimited; it has a certain sum assured and specific conditions. Essentially, insurance companies are interested in patient outcome data for those who have undergone organ transplants. So, we are asking hospitals to share this data to move this initiative forward," said the official, requesting anonymity.
India faces a critical shortage of organs for transplantation, with demand far exceeding supply. While the country has achieved record numbers of transplants, with 18,900 procedures in 2024, the gap remains significant, according to the health ministry data.
The waiting list for kidneys alone is estimated to be as high as 175,000, with a waiting time of three to five years. The annual demand for livers is also massive, with an estimated 25,000-30,000 patients in need, but only a small fraction of these procedures are performed. This immense discrepancy is a major challenge for the healthcare system.
The plan is to create standardized insurance products for patients that can cover both transplant procedures and long-term post-operative care. "The entire idea is to alleviate financial stress, and maintaining insurance on the transplant procedure and postoperative care is a key factor, given the huge burden on patients in India who require organ transplant services," the official added.
According to the documents, reviewed by Mint, health insurance policies in India generally cover life and disability but do not specifically address living organ donation. The documents suggest that health insurance should be made mandatory and insurers should compete on pricing and coverage to ensure affordability.
It said Irdai needs to collaborate with health authorities to develop guidelines and protocols for organ transplants and encourage insurers to cover a broader range of transplant types and related expenses.
Organ transplant costs in India pose a significant financial burden, with a large portion of expenses paid out-of-pocket. Kidney transplants typically range from ₹5 lakh to ₹15 lakh, while more complex liver transplants can cost between ₹18 lakh and ₹35 lakh.
These figures are subject to change based on the hospital, type of procedure, and any complications. The high cost forces many families to deplete their savings or go into debt. The lack of widespread and comprehensive insurance coverage for these procedures remains a major barrier to access.
The government informed Parliament in July that India’s organ donation rate in 2024 stood at just 0.81 deceased donations per million population, underscoring the need for stronger systems of support and awareness.
Queries sent to the health ministry, Irdai, and ICICI Lombard were not immediately answered. Insurance companies like HDFC Life, Star Health, and Zurich Kotak declined to comment on the matter.
As part of its broader reform push, the government has also rolled out India’s first digital organ transplant registry, designed to bring transparency to the allocation process and curb the role of middlemen. Hospitals are mandated to update transplant data regularly, with penalties for non-compliance.
- The initiative aims to standardize insurance coverage for organ transplants, addressing the critical shortage of organs.
- Affordable insurance could alleviate the financial burden on families, making transplants more accessible.
- The collaboration between NOTTO and Irdai is a significant step towards comprehensive healthcare reform in India.
New NOTTO guidelines are also being introduced to make the system more equitable—offering priority to female patients on waiting lists and ensuring that families of deceased donors receive priority access if they ever require transplants in the future.
According to Dr. Rajkiran K. Deshpande, organ transplant surgeon at Sparsh Hospital, Bengaluru, the proposed NOTTO–Irdai collaboration could be a game-changer.
If affordable premiums and standardized coverage for both donors and recipients are introduced, this framework could make organ transplants more equitable and accessible, he said.
High treatment costs and the absence of standardised package rates remain key challenges, said Dr. Bhabatosh Mishra, director & chief operating officer, Niva Bupa Health Insurance Company. “A data-driven approach, supported by outcome-based insights, will be critical to help design fair and sustainable coverage as the sector evolves," he added.
“At Niva Bupa, organ transplant is covered across all our products. In cases where the insured is the receiver, the entire procedure—including both receiving and harvesting of the organ—is covered, even if the person donating the organ is not insured with us," Niva Bupa said.
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