Health Insurance 353 views March 8, 2021

A health insurance plan helps people overcome a medical emergency without having to pay from their pocket. Several insurance companies provide health insurance plans to customers according to their requirements. But you also need to know the diseases or conditions for which you won’t get any cover from the health insurance company. Understanding this aspect can help you choose a suitable health insurance plan.

Health Insurance

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These are known as health insurance exclusions for which your health insurance policies will not provide any coverage. Let’s understand this with an example. Suppose you’re an AIDS patient but your health insurance plan does not cover any expenses related to the treatment of AIDS. So, this plan will be of no use to you! This is why it is important to understand the common exclusions under a health insurance policy. However, these exclusions may change from one policy to another. So, check your policy documents closely before making a final decision.

In this article, we will be discussing the kind of treatments and conditions that are not covered under a health insurance plan. The first one is pre-existing diseases. Keep reading to know more!

Pre-existing Diseases

This is one of the most important exclusions that an individual should know before choosing a health insurance plan. Pre-existing diseases are those diseases that an individual has before the start of a new health insurance plan. These conditions can be diabetes, hypertension, cancer, sleep apnea, cancer, etc.

Some insurers have a certain waiting period of 24 to 48 months from the policy start date only after which they start to get coverage against pre-existing diseases. Also, some insurance companies provide the option to pay an additional premium to get coverage for pre-existing diseases without any waiting period. There could also be some pre-existing diseases for which you won’t get any cover from the health insurance company.

Cosmetic Surgery

Surgeries that are done for any kind of body feature enhancement and are not medically necessary will not be covered under health insurance policies. Such surgeries can be liposuction, botox, implants, or similar kinds of plastic surgeries.

Maternity Expenses

Similar to pre-existing diseases, not all health insurance companies provide coverage against expenses incurred on maternity or childbirth. So, when you choose a health insurance plan, it is important to check whether a plan is providing coverage against medical treatment expenses related to pregnancy, childbirth, miscarriage, abortion, and related complications due to it. However, individuals can choose from different plans designed according to maternity needs. These plans provide coverage against expenses related to maternity or childbirth. Some of them are Aegon Joy Life, Care Joy Tomorrow Plan, Max Bupa Heartbeat plan, etc.

Health Supplements

Unless it is prescribed or recommended by a medical practitioner, a health insurance plan will not cover any expenses related to the tonics or protein shakes. However, if these come under a part of the ongoing treatment, you can receive coverage against these expenses.

Self-inflicted Injuries

The health insurance plan does not cover any expenses incurred on the treatment of self-inflicted injuries or illnesses such as suicide or attempted suicide. Other than this, any expenses arising out of direct or indirect usage/misuse of alcohol or drugs will not be covered under a health insurance plan.

Diagnostic Expenses

Some health insurance plans also do not provide coverage against the expenses incurred on diagnostic expenses such as blood tests, CT scans of your body, ultrasound, etc. However, this may change from one plan to another.

Permanent Exclusions

There are some permanent exclusions under a health insurance plan that you should know before choosing a plan. These exclusions are any injuries resulting from direct or indirect result of war, riot, strike, nuclear weapon or radioactive materials where you need hospitalization.

So, these are the exclusions that are not covered under a health insurance plan. It is crucial to check the policy document closely to choose a suitable plan for yourself.

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