Ultrasound is an essential medical test used to examine internal organs, monitor pregnancy, and diagnose various health conditions. However, many people wonder, “How much does an ultrasound cost with insurance?” In this article, we will provide a detailed breakdown of the cost, coverage, eligibility, and required documents.
%20(1).png) |
| How Much Is an Ultrasound with Insurance? Complete Guide |
How Much Does an Ultrasound Cost with Insurance?
The cost of an ultrasound with insurance depends on several factors, including:
- Location – Whether it’s a government or private hospital
- Type of Ultrasound – Abdomen, pregnancy, heart, etc.
- Health Insurance Plan – Coverage limits and terms
- Hospital Charges – Additional fees may apply
Average Cost of an Ultrasound in India:
- Without Insurance: ₹800 to ₹5000
- With Insurance: ₹0 to ₹2000 (depending on coverage)
Some health insurance plans fully cover ultrasound costs, while others may require a co-payment (partial payment) by the patient.
Process to Get an Ultrasound with Insurance
To get an ultrasound covered by insurance, follow these steps:
- Check Your Insurance Policy – Confirm whether ultrasound is included in your health plan.
- Visit an Empanelled Hospital – Choose a hospital or diagnostic center affiliated with your insurance provider.
- Get a Doctor’s Prescription – Most insurance companies require a doctor’s referral for approval.
- Pre-Authorization (if needed) – Some insurers need prior approval before covering the cost.
- Undergo the Ultrasound Test – Schedule and complete your ultrasound.
- Submit Necessary Documents – Provide bills and reports if reimbursement is required.
Important Documents Required
To claim insurance for an ultrasound, you may need the following documents:
- Doctor’s Prescription
- Health Insurance Card
- Hospital Bills & Payment Receipts
- Diagnostic Reports
- Pre-authorization Letter (if applicable)
Eligibility Criteria for Insurance Coverage
Not all insurance policies cover ultrasounds. The eligibility criteria generally include:
- Type of Health Insurance Plan – Comprehensive plans often cover diagnostic tests.
- Medical Necessity – The ultrasound should be prescribed by a doctor for a valid medical reason.
- Waiting Period – Some policies have a waiting period before covering diagnostic tests.
- Network Hospital Requirement – Many insurers cover tests only at specific hospitals.
Does Government Health Insurance Cover Ultrasounds?
Yes, government health schemes like Ayushman Bharat (PMJAY) and State Health Insurance Plans often cover ultrasound costs at government hospitals and empanelled private centers.
Key Benefits of Government Health Schemes:
✔ Free or low-cost ultrasounds in selected hospitals
✔ Full coverage for maternity-related ultrasounds
✔ No additional charges for eligible patients
Conclusion
The cost of an ultrasound with insurance varies based on your policy, hospital, and test type. While many health insurance plans cover ultrasounds, it’s essential to check your policy details and eligibility before getting the test done. If you’re covered under government schemes, you may get an ultrasound for free at designated centers.
For the best experience, always consult your insurance provider and confirm the coverage in advance.