What Your Health Insurance Policy Will NOT Cover

The best way to protect you from the rising medical costs is to avail of health insurance plans. Various insurance companies offer different types of health plans. It is important that you choose the best one that provides comprehensive coverage.

Most health plans cover hospitalization expenses, pre- and post-hospitalization costs, room rent, and doctor and nursing fees. Certain health policies may include ambulance charges, daycare treatment costs, domiciliary hospitalization, and organ donor expenses. Moreover, insurers provide value-added benefits, such as chronic management program, health check-ups, wellness coach, and cumulative bonus in the case of no claims during the policy period.

Knowing what is included in the health plan is important. Similarly, it is equally critical is to know the policy exclusions, which mean what is not covered under the plan. Here are five such exclusions.

  1. Cosmetic surgeries

Surgeries that are optional like Botox, liposuction, and other cosmetic procedures are not covered under the health insurance plans.

2. Pregnancy and abortion

Generally, pregnancy-related expenses are not covered under health plans. Even if there are complications or a caesarean is required, the costs need to borne by you. Moreover, insurers do not cover abortion expenses (unless it is necessary to save the policyholder’s life) under health insurance.

3. Pre-existing conditions

Most insurers do not cover any pre-existing ailments that you may have at the time of purchasing the policy. However, it is recommended you check the pre-existing illnesses that are not covered as these vary from one insurer to another. Some insurers may provide coverage for these under a medical insurance policy after the waiting period. This may range from one year up to four years. Insurance companies may also cover pre-existing conditions before the waiting period if you are willing to pay an additional premium.

4. Health supplements

If you use any health supplements, such as protein shakes or tonics that are prescribed for any medical conditions, the costs of these are excluded from your health insurance plan. However, the expenses incurred to consume such supplements as a part of your treatment during hospitalization may be covered under the policy.

5. Diagnostic and miscellaneous expenses

Generally, diagnostic tests, such as CT scan, ultrasound sonography, and pathological surveillance like blood tests are not covered under a mediclaim policy. In the case of hospitalization expenses, such as admission fees, registration charges, and other miscellaneous costs are excluded from the health plan. When you avail of insurance, it is important to read the policy document in detail. In addition to understanding the definitions and terminologies, it is crucial you understand the terms and conditions and the inclusions and exclusions to avoid any unpleasant surprises in the future.

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Author: Eddy

Eddy is the editorial columnist in Business Fundas, and oversees partner relationships. He posts articles of partners on various topics related to strategy, marketing, supply chain, technology management, social media, e-business, finance, economics and operations management. The articles posted are copyrighted under a Creative Commons unported license 4.0. To contact him, please direct your emails to editor.webposts@gmail.com.