Common exclusions in health insurance policy
It is no secret that health insurance plans do not cover every medical expense. Irrespective of the insurer you buy a policy from, all health insurance plans have notable exclusions which you as a policyholder or buyer should be aware of. A careful scrutiny of such exclusions will save you from a nasty surprise later on. On the ET Money Show, we discussed the most important exclusions with Siddharth Singhal, Business Head - Health Insurance, Policybazaar.com.
Some of the most common exclusions include
Pregnancy & Related Conditions
Any medical treatment arising from pregnancy, childbirth, and abortion are not covered under health insurance plans. While some insurers do provide coverage under certain plans, even they come with a certain waiting period.
Dental, Hearing, Vision Procedures
While there are certain exceptions, but health insurance plans usually do not cover any dental, hearing, or vision procedures since they don’t require hospitalisation. Ideally, you should check with your insurer since these can be covered under additional riders along with your health insurance policy.
Cosmetic Surgery
All kinds of cosmetic surgeries are not covered under health insurance plans. But in case of an accident or injury resulting in plastic surgery, it can be covered.
Pre-existing Conditions
In case, an individual suffers any illness or medical condition prior to buying health insurance, that illness will not be covered under a health insurance plan. Such pre-existing conditions are usually covered after a 2-4 year waiting period or sometimes more. The time period varies depending on the disease and the risk involved.
Alternate Therapies
Most insurers do not provide coverage for treatment under alternative therapies such as naturopathy, acupressure, magnetic therapy, etc. This is mostly because alternative treatments or therapies remain largely unregulated and costs involved vary a lot.
Injuries Due To Self-harm
Injuries arising out of any kind of self-harm or suicide attempt are not covered by health insurance policies.
Permanent Exclusion
There are certain exclusions which are permanent exclusions in health insurance policies. This includes injuries in war, intentional injuries, or diseases such as HIV or congenital diseases. It is important to clarify a list of such exclusions with your insurer before you buy a health insurance policy.