List of Common Exclusion in Health Insurance Policies

A health insurance policy indemnifies you from making unexpected financial expenses that may arise because of hospitalization. Besides, it covers other medical related costs such as diagnostic tests, doctor’s consultation, and cost of medicine, among others.

A health insurance cover, therefore, reduces your financial burden and allows you to receive quality treatment without having to worry about making financial arrangements. It also acts as an income replacement as your medical condition may not allow you to work for a certain period of time. You may, therefore, consider investing in a health insurance policy and enjoy financial security at all times.

It is important to note that health insurance plans come with certain exclusions. The list of exclusions varies from policy to policy and hence you may choose the one that meets your requirements.

8 Common Exclusions in Health Insurance Policies.

1. Pre-existing Diseases

   If you are already suffering from a disease at the time of purchase of the policy, it will be considered as a pre-existing ailment. Certain health insurance plans do not cover pre-existing diseases, as the risk is higher. Generally, such plans come with a certain waiting period. The duration of the waiting period depends on the type of the condition and the risks associated with it. Common pre-existing ailments not covered by health policies include joint treatment, cataract, arthritis, and kidney stones, among others.

2. Pregnancy

   Some insurance providers do not cover pregnancy-related costs under your health plan. This could include expenses towards childbirth, pregnancy-related tests, and vaccination costs. Health plans generally cover maternity expenses after a certain waiting period. You may, therefore, consider the waiting period in case you wish to expand your family.

3. Cosmetic Treatment

   One of the common health insurance exclusions include expenses incurred towards cosmetic treatment. An increasing number of people are undergoing cosmetic treatments to enhance their looks. However, you may note that cosmetic surgery in case of an accident or injury is generally covered.

4. Medical Expenses to Treat Injuries Resulting From Suicide Attempts

   Health policies do not cover expenses related to injuries in case the policyholder harms himself intentionally. This includes all injuries caused due to self-harm or suicide attempts.

5. Alternative Treatments

   One of the other health insurance exclusions includes cost incurred for alternative treatments and therapies. This covers magnetic therapy, acupressure, naturopathy, homeopathy, Ayurveda, and other treatments. The good news is that health plans cover allopathic treatment-related costs.

6. Lifestyle-related Diseases

   Lifestyle-related diseases are on the rise. Some health plans do not cover lifestyle-related diseases. However, you may obtain coverage for the same by paying a higher premium. Common examples of lifestyle diseases not covered by health plans include liver cirrhosis due to excessive drinking or lung diseases caused due to smoking.

7. Limit on Hospital Costs

   Most health plans come with an upper limit on room-rent, ambulance costs, and doctor’s expenses, among others. This means that in case your policy allows INR 2000 per day on room rent and the hospital charges INR 2500, you may have to pay the balanced INR 500. To avoid such a situation, you may read the policy document carefully.

8. Diagnostic Tests

   Many individuals often make a claim towards expenses incurred for diagnostic tests. It is important to note that such costs are not covered under health insurance plans. However, in case the tests yield positive results, and you are required hospitalization for that particular disease, the insurance provider is liable to cover the costs.

   Before purchasing a health cover, it is imperative to do your due diligence and go through the exclusions carefully. However, do not be deterred by the list of exclusions. A health plan offers the much-needed financial protection at times you need it the most. You may, therefore, purchase health insurance policy online or visit your nearest branch, and get insured at the earliest.