Breast lump (benign or malignant) treatment is covered by health insurance policies. Some breast lumps can be symptomatic and cause serious problems for an individual. Thus, their treatment expenses are generally payable by most insurance plans offered by different providers.

Breast lump (benign or malignant) treatment is covered by health insurance policies. Some breast lumps can be symptomatic and cause serious problems for ... an individual. Thus, their treatment expenses are generally payable by most insurance plans offered by different providers. Read More

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Benefits of Choosing Pristyn Care Treatment with Insurance

Hospitalization Expenses

Just like every other health insurance plan, we also cover your hospitalization expenses such as room rent, ICU, investigations, surgery, doctor consultations etc due to illnesses and injuries seamlessly.

Pre & Post Hospitalisation

Cashless Payment

Types of Breast Lumps Covered under Insurance

There are various types of breast lumps, and each one of them requires the doctor to take a different approach to the treatment. In general, the treatment of the following types of breast lumps is covered by health insurance-

Breast cysts
Fibroadenoma
Hamartoma
Intraductal papilloma
Lipoma
Mastitis
Injury or tissue damage
Cancerous growth

In most cases, the breast lump is benign. However, there is a 20% chance of a breast lump becoming malignant. Thus, it is advisable to seek proper treatment for a lump in the breasts.

• Disease name

Breast Lump

• Surgery name

Lumpectomy

• Duration

60 - 120 minutes

• Treated by

Plastic or cosmetic surgeon

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How to get Insurance Coverage for Breast Lumps Treatment?

Pristyn Care emphasizes making the treatment journey hassle-free for the patients. Thus, we accept all health insurance policies and assist patients to get cashless treatment for Breast Lumps. Read the below steps to know Health Insurance claims process works differently for cashless and reimbursement claim requests.

1 Intimation

All you need to do is to fill a pre-authentication form along with relevant insurance documents for availing cashless treatment at our partner hospital.

2 Approval/Rejection

Your pre-authentication form is approved or denied based on the terms and conditions of your health insurance policy.

3 Hospitalisation

Hospitalisation can be done based on pre-authentication approval. Hence, it is advisable to finish the pre-authentication procedure beforehand.

4 Claim Settlement

At the time of discharge, we will coordinate and settle your bills directly with the hospital and insurance provider.

1 Hospitalization At Non Network Hospital

If hospitalised at a non-network hospital, you don't need to pay the medical bills. Pristyn Care will settle the bills with the hospital on your behalf.

2 Register A Claim

To register a claim, please fill in the claim form with all your receipts, reports and relevant documents received from the hospital at the time of discharge. We, at Pristyn Care will help you claim reimbursement from your health insurance company.

3 Verification

We will share all your claim-related medical documents in original with your insurance provider to check if everything is in order.

4 Claim Settlement

We will coordinate with your insurance company to reimburse the claim amount to your registered bank account. You can later pay back that amount to us as per the policy terms and conditions.

Best Doctors for Breast Lumps Treatment

Dr. Jonnalagadda Prashan...

MBBS, DNB-General Surgery & M.Ch-Plastic Surgery

15+ Yrs.Exp.

4.5/5

15+ Years Experience

Pristyn Care Zoi Hospital, ShivBagh, Ameerpet, Hyd

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080-6542-3712

Dr. Soumya Sharad Agrawa...

MBBS, M.Ch-Plastic surgery

13+ Yrs.Exp.

4.5/5

13+ Years Experience

Manorama Ganj, Old Palasia, Indore, Madhya Pradesh 452003

Call Us

080-6542-3720

Dr. Sasikumar T

MBBS, MS-GENERAL SURGERY, DNB-PLASTIC SURGERY

24+ Yrs.Exp.

4.5/5

24+ Years Experience

1st floor, No Z/281, 5th Ave, beside St Lukes church, Y Block, Anna Nagar, Chennai, Greater Chennai, Tamil Nadu 600040

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080-6541-7851

When Is Breast Lump Treatment Covered By Insurance?

Health insurance policies provide coverage for the treatment of a disease that is symptomatic and can impact an individual’s life significantly. Breast lumps are such a condition, and they also have the potential to be cancerous. Hence, their treatment is considered a medical necessity.

The insurance company will cover the breast lump treatment if the patient has any or all of the following symptoms and can provide clinical evidence (doctor’s reports) to support the claim-

A new lump has formed that hurts occasionally or all the time.
A specific part of the breast is noticeably different from the rest.
The lump is not going away after the menstruation cycle.
The lump continues to grow larger and changes frequently.
The breasts look bruised without a specific reason.
The breast skin and surrounding skin look red and puckered like an orange peel.
The nipples have become inverted.
There is a bloody discharge from the nipple.
The nipple skin is flaky and red.
The lump is causing irritation or dimpling of the skin.

The symptoms of breast lumps (benign and malignant) are very similar and it’s impossible to differentiate them based on their appearance. But the symptoms indicate that the lump is bothersome and its removal is medically necessary.

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When Breast Lump Treatment is Not Covered by Insurance?

There are several types of breast lumps, such as fibrocystic changes, milk cysts, fluid-filled cysts, etc., which often don’t require intervention and resolve on their own. Even if they don’t go away, they can be removed through aspiration and drainage which is not a major procedure or require hospitalization.

If the patient has such a breast lump, the insurance policy won’t cover the cost of treatment under any circumstance.

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FAQs around Breast Lumps and Insurance Coverage

Which expenses of breast lump treatment are not covered by health insurance?

Whether the breast lump is cancerous or benign, all expenses incurred during the treatment are covered by health insurance. Some post-surgery expenses, such as medications, compression garments, etc., may not get covered in case the lump is benign.

Is it possible to claim health insurance twice a year?

Yes, health insurance can be claimed multiple times in a year as required, given that the patient has a policy whose sum insured can be reinstated after the claim. Some policies may also have restrictions over the number of times the insurance policy can be claimed in a year.

How long does it take for the reimbursement claim to process?

Typically, the insurance company may take up to 21 days to review and validate the required medical documents and bills. Once the claim is approved, the reimbursement amount is processed and transferred directly to the patient’s bank account.

When can my insurance claim get rejected?

An insurance claim can get rejected in the following scenarios- - The waiting period is not over yet. - The illness is not covered by the policy. - The documents are falsified.

How to avail No-Cost EMI service at Pristyn Care?

To avail of the No-Cost EMI service, the patient only needs to file a request. Our care coordinators will handle the formalities and verify whether or not the patient is eligible for the No-Cost EMI service. Once approved, the patient can choose a tenure and monthly EMI plan according to his/her convenience.

Get Cashless Service At Pristyn Care for Breast Lump Treatment

Pristyn Care is dedicated to patient-first care and provides optimal care under all circumstances. We accept all health insurance policies to provide advanced care for benign and cancerous breast lumps. Our cashless payment service allows the patients to utilize health insurance or a mediclaim policy to cover the breast lump treatment cost.

The cashless claim facility is processed in the following steps-

Our care coordinators gather the insurance documents from the patients and talk to the insurers to validate them.
The patient is asked to fill out the cashless claim form and provide the necessary documentation.
The hospital’s TPA team submits the claim form, and the patient is updated regarding the same.
Once the claim amount is approved, the patient will get confirmation through an email or SMS.
The sanctioned amount is credited to the hospital’s account, and the medical bills are settled with minimal involvement by the patient.

Expenses Covered by Health Insurance

The surgeon and anesthetist’s fee
Diagnostic tests performed before and after the surgery
Hospital admission and discharge fee
Operation theater and ICU charges (charged on an hourly basis)
Cost of medicines prescribed before, during, and after the treatment
Medical consumables, including staples, sutures, bandages, syringes, etc.
Room rent (calculated on the basis of room chosen on a daily basis)
Post-surgery follow-up consultations
Second opinion
Nursing fee

How to Claim Health Insurance for Breast Lump Treatment?

Whether the breast lump is benign or malignant, the insurance claim process remains almost the same. There are two ways a patient can claim health insurance for breast lump treatment- cashless and reimbursement.

Cashless Claim Process

Through cashless claims, the medical bills of the patient are settled between the insurer and the hospital. Typically, to avail the cashless facility, the patient needs to inform the insurance company at least two days before the surgery (in case of planned hospitalization) or within 24 hours of hospitalization (in case of emergency).

An individual can only get the cashless facility while getting treatment at a network hospital. The hospital’s TPA (third-party administrator) team will contact the insurance company and send a pre-authorization form to initiate the claim settlement process. The steps are explained below-

Provide the insurance card and ID proof to the hospital authorities at the insurance desk.
Fill out the cashless claim form and submit the required documents at the hospital. To expedite the process, it’ll also be better to inform the health insurance provider.
The insurance provider will review the application and documents submitted by the hospital and provide confirmation via SMS or email.

The hospital bills will be settled before the discharge as per the terms and conditions of the insurance policy.

Reimbursement Claim Process

With a reimbursement claim, the patient needs to pay the treatment expenses upfront and later on request to get reimbursement from the insurance provider. Unlike a cashless facility, the reimbursement claim is handled by the patient without much assistance from the hospital authorities.

Follow the steps below to get a reimbursement claim-

Inform the insurance provider regarding the hospitalization within 48 hours of being admitted.
Make the payment directly to the hospital.
Obtain the claim form from the insurance agent or online and fill in the details.
Provide the required documents and submit the form within 30 days of discharge.
The insurance company will review the documents, and when approved, the amount paid at the hospital will be credited to the patient’s account.

Note: There is a standard condition that the patient needs to meet, i.e., hospitalization for 24 hours to file a claim.

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Pristyn Care has taken the latest medical technologies to ensure consistent quality of advanced surgical care in 30+ cities of India including Ahmedabad , Bangalore , Bhubaneswar , Chandigarh , Chennai , Coimbatore , Delhi , Faridabad , Ghaziabad , Gurgaon , Hyderabad , Indore , Jaipur , Kochi , Kolkata , Kozhikode , Lucknow , Madurai , Mumbai , Nagpur , Nashik , Noida , Patna , Pune , Raipur , Ranchi , Thiruvananthapuram , Vijayawada and Visakhapatnam .

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Patient Name

Mobile Number

Select City

Select Disease

Proctology

","

Pilonidal Sinus

","

Piles

","

Rectal Prolapse

","

Fissure

","

Fistula

","

Fecal Incontinence

","

Constipation

","

Hemorrhoids

","

Laparoscopy

","

Umbilical Hernia

","

Hydrocele

","

Inguinal Hernia

","

Incisional Hernia

","

Appendicitis

","

Gallstone

","

Hernia

","

Achalasia Cardia

","

Acid Reflux Surgery

","

Large Intestine

","

Indirect Hernia

","

Small Intestine

","

Colonoscopy

","

Gastric Bypass Surgery

","

Gynaecology

","

Pain During Intercourse

","

Vaginoplasty

","

Labiaplasty

","

Vaginal Discharge

","

Laser Vaginal Tightening

","

Vaginal Dryness

","

Ovarian Cyst

","

Hysterectomy

","

Hymenoplasty

","

Clitoral Hoodoplasty

","

Abortion

","

Hysteroscopy

","

Pap Smear

","

Vaginal Rejuvenation

","

Ectopic Pregnancy

","

Laser Vaginal Rejuvenation

","

Vaginal Recurrent Infection

","

Pelvic Pain

","

Female Urinary Problems

","

Lichen Sclerosus

","

Menstrual Disorders

","

Preconception Care

","

Uterine Fibroid

","

Pcos Pcod

","

Pregnancy Care

","

Medical Termination Of Pregnancy

","

Laser Vaginal Bleaching

","

Anal Bleaching

","

Vaginal Wart

","

Molar Pregnancy

","

Bartholin Cyst

","

Miscarriage

","

Endometriosis

","

Adenomyosis

","

Myomectomy

","

Dilation And Evacuation (D&E)

","

Polypectomy

","

ENT

","

Turbinate Reduction

","

Uvulopalatopharyngoplasty

","

Adenoidectomy

","

Myringotomy

","

Microlaryngeal

","

Mastoidectomy

","

Tongue Base Reduction

","

Tonsils Removal

","

Deviated Nasal Septum

","

Eardrum Surgery

","

Sinus Surgery

","

Thyroidectomy

","

Tonsillectomy

","

Ear Surgery

","

Sinusitis

","

Tympanoplasty

","

Fess Surgery

","

Stapedectomy

","

Septoplasty

","

Tonsillitis

","

Adenoids

","

Hearing Problem

","

Thyroid Infection

","

Chronic Sinusitis

","

Recurrent Sinusitis

","

Subacute Sinusitis

","

Mastoiditis

","

Parotidectomy

","

Nose Surgery

","

Vocal Cord Polyps

","

Adenotonsillectomy

","

Otitis Media

","

Nasal Polyps

","

Turbinoplasty

","

Ear Infection

","

Ear Hole

","

Throat Infection

","

Middle Ear Perforation

","

Urology

","

Urinary Tract Infection

","

Urinary Incontinence

","

Erectile Dysfunction

","

Urethral Stricture

","

Stress Urinary Incontinence

","

Circumcision

","

Kidney Stones

","

Male Urinary Tract Infection

","

Prostate Enlargement

","

Phimosis

","

Paraphimosis

","

Foreskin Infection

","

Balanoposthitis

","

Balanitis

","

Frenuloplasty

","

Cystoscopy

","

Cystolithotripsy

","

DJ Stent

","

cystolithotomy

","

Urethral Stricture

","

pyeloplasty

","

nephrostomy

","

Corn Removal

","

Vasectomy

","

Toenail treatment

","

Testicular Torsion

","

Epididymal Cyst

","

Vascular

","

Varicose Veins

","

Varicocele

","

Diabetic Foot Ulcer

","

AV Fistula For Dialysis

","

Deep Vein Thrombosis

","

Spider Veins

","

Aesthetics

","

Gynecomastia

","

Liposuction

","

Lipoma

","

Sebaceous Cyst

","

Breast Lift

","

Rhinoplasty

","

Breast Reduction

","

Breast Augmentation

","

Breast Lump

","

Hair Loss

","

Breast Surgery

","

Axillary Breast

","

Abdominoplasty

","

Double Chin

","

Buccal Fat

","

Earlobe Repair

","

Blepharoplasty

","

Hair Fall PRP

","

Orthopedics

","

Carpal Tunnel Syndrome

","

Knee Replacement

","

Spine Surgery

","

Hip Replacement

","

Arthroscopy

","

ACL Tear

","

Rotator Cuff Repair

","

Bankart Surgery

","

Bankart Repair

","

Meniscus Repair Surgery

","

Shoulder Replacement Surgery

","

Discectomy

","

Laminectomy

","

Acdf Surgery

","

Spinal Fusion

","

Ligament Injury

","

Knee Arthroscopy

","

Shoulder Arthroscopy

","

Femur Fracture

","

Ophthalmology

","

Lasik

","

Cataract

","

Squint Surgery

","

Glaucoma Surgery

","

Retinal Detachment Surgery

","

Diabetic Retinopathy Treatment

","

Intravitreal Injections

","

Vitrectomy

","

Monofocal Lens

","

Multifocal Lens

","

Toric Lens

","

PRK Lasik

","

Smile Lasik Surgery

","

Femto Lasik Surgery

","

ICL Surgery

","

Macular Edema

","

Retinal Surgery

","

Contoura Vision

","

Phaco Surgery

","

Pterygium

","

Dentistry

","

Teeth Alignment (Fix)

","

Dental Others

","

Crossbite Teeth

","

Overbite Teeth

","

Openbite Teeth

","

Weight Loss

","

Bariatric Surgery

","

SPATZ Intragastric Balloon

","

Intragastric Balloon

","

Weight Loss Surgery

","

Weight Loss

","

Dermatology

","

Scar Removal

","

Beard Transplant

","

Face Threadlift

","

Botox

","

Derma Fillers

","

Vampire Facial with Dermaroller

","

Hair Transplant

","

Hair Reduction

","

Fat Loss

","

Allergan for Double Chin

","

Allergan for Arms

","

Allergan for Underarm Fat

","

Allergan for Tummy

","

Allergan for Inner Thigh

","

Allergan for Outer Thigh

","

Anti Aging

","

Uneven Skin Tone

","

Acne & Scar

","

Pigmentation

","

Tattoo removal

","

Hair Treatment

","

Vitiligo for Face

","

Roascea (Gold Toning laser)

","

Dark Circle & Puffy Eyes

","

Foundation full Face

","

Acne Scar

","

Fertility

","

Male Infertility

","

Female Infertility

","

Ivf

","

Iui

","

Embryo Transfer

","

ICSI Treatment

","

Neurology

","

Headache or migraine

","

Neurology-Others

","

Nephrology

","

Chronic kidney disease (CKD) follow-up

","

Pulmonology

","

Chest pain or tightness

","

Oncology

","

Oncology

","

General Physician

","

General Physician-Others

","

Diabetes

"]" data-all-dropdown-items-arr="[]">

Breast Lump Treatment Under Insurance - 100% Cashless

Types of Breast Lumps Covered under Insurance

When Is Breast Lump Treatment Covered By Insurance?

When Breast Lump Treatment is Not Covered by Insurance?

Pristyn Care’s Free Post-Operative Care

FAQs around Breast Lumps and Insurance Coverage

Which expenses of breast lump treatment are not covered by health insurance?

Is it possible to claim health insurance twice a year?

How long does it take for the reimbursement claim to process?

When can my insurance claim get rejected?

How to avail No-Cost EMI service at Pristyn Care?

Get Cashless Service At Pristyn Care for Breast Lump Treatment

Expenses Covered by Health Insurance

How to Claim Health Insurance for Breast Lump Treatment?

Cashless Claim Process

Reimbursement Claim Process

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