How Corporate Insurance Can Cover EECP as Preventive Health Care in India

With preventive care now a key component in many corporate health insurance policies, more organizations are exploring how EECP treatment in India can be included under coverage, benefiting both the employer and employee.

In this blog, we’ll look at how corporate insurance works, the place of EECP within preventive cardiology, and how Indian companies can begin including EECP therapy as a reimbursable benefit.

Why Preventive Heart Care Matters in the Corporate Sector

Heart disease is no longer a condition of the retired. In India’s urban offices:

• 1 in 3 employees over 40 shows early signs of cardiac stress
  
  

• Long hours, sedentary work, poor diets, and high stress are widespread
  
  

• Health insurance claims for heart procedures are rising steadily
  
  

• Employees on medical leave due to cardiac conditions cost companies productivity
  
  

By focusing on preventive care like EECP, employers can:

• Reduce long-term health claim costs
  
  

• Retain skilled staff by promoting health
  
  

• Encourage proactive, rather than reactive, healthcare
  
  

What Is EECP?

Enhanced External Counter Pulsation (EECP) is a non-surgical, outpatient cardiac treatment that:

• Uses inflatable cuffs on the legs
  
  

• Pumps rhythmically in sync with the heartbeat
  
  

• Increases blood flow to the heart
  
  

• Stimulates the development of natural bypass vessels
  
  

• Improves oxygen supply and cardiac function
  
  

It is typically given in 35 one-hour sessions over 6 to 7 weeks and is FDA-approved and used worldwide.

The Financial Case for Including EECP in Insurance Plans

1. Lower Cost Compared to Surgery

An angioplasty or bypass surgery in India can cost between ₹2 lakh and ₹5 lakh.
EECP costs a fraction of this amount, often under ₹1 lakh for a full treatment cycle.
This is appealing to:

• Corporate insurers looking to minimize high-ticket claims
  
  

• Employers trying to lower insurance premiums
  
  

2. Reduces Future Claims by Preventing Surgery

Employees who complete EECP therapy often:

• Delay or avoid invasive cardiac procedures
  
  

• Reduce the need for long-term medication
  
  

• Minimize hospital readmissions
  
  

This lowers recurring claim cycles and helps employees stay productive and healthy.

3. Meets the Definition of Preventive Care

EECP, when used early in stable angina or mild coronary artery disease, qualifies as preventive or rehabilitative therapy, as it:

• Manages symptoms non-surgically
  
  

• Prevents disease progression
  
  

• Aids in cardiac recovery after early intervention
  
  

This aligns with the IRDAI’s guidelines, which now encourage preventive health services under group insurance plans.

Current Landscape: What Insurance Covers EECP?

While awareness is growing, coverage for EECP depends on:

• The TPA (Third Party Administrator)
  
  

• The insurance provider (public or private sector)
  
  

• Whether EECP is listed under Day Care Procedures or Outpatient Benefits
  
  

Several corporate plans under providers like:

• Star Health
  
  

• ICICI Lombard
  
  

• New India Assurance
  
  

• HDFC Ergo
  now allow partial or full reimbursement for EECP, especially when prescribed by a cardiologist.
  
  

How Employers Can Integrate EECP into Coverage

1. Negotiate with Insurance Partners

Employers can request:

• Inclusion of EECP as a day-care treatment
  
  

• EECP under preventive OPD services
  
  

• Customized add-ons for high-risk groups (like senior employees)
  
  

2. Offer EECP Under Annual Wellness Benefits

Many companies offer employees annual wellness budgets (₹5,000–₹25,000). These can be used for:

• EECP screenings
  
  

• Pre-treatment consultations
  
  

• Session packages at partner centers
  
  

3. Partner with EECP Providers for Corporate Plans

Some hospitals and EECP clinics provide:

• Direct billing (cashless)
  
  

• On-site or near-site therapy packages
  
  

• Bulk discounts for multiple employees
  
  

• Health tracking and reports for HR wellness teams
  
  

4. Include EECP in Executive Health Checkups

Executives often get yearly health packages. Adding an EECP eligibility assessment:

• Helps detect early cardiac issues
  
  

• Encourages non-invasive action
  
  

• Reduces late-stage disease costs
  
  

Real-World Example: A Tech Firm in Bengaluru

A mid-sized IT company in Bengaluru had several senior staff on high BP and cholesterol medication. After two cardiac claims in one year, HR worked with their insurer to:

• Include EECP in their day-care list