Understanding What Your Health Insurance Doesn't Cover

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Understanding What Your Health Insurance Doesn't Cover

Health insurance is a must today, as episodes of hospitalisation can prove to be costly. However, health insurance does not cover all costs associated with healthcare.

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What should policyholders know?

Certain healthcare treatments are excluded from health insurance cover. This is because they are considered elective procedures for physical enhancement or personal convenience. The difference lies in medical urgency and requirement.

What Your Health Insurance Doesn't Cover (AI Generated Image)

Non-Medical And Consumable Expenses

When someone is admitted, a variety of consumables are required, including gloves, syringes, and masks, among others. The cost of consumables can be 5-15 per cent of the hospital bill. So, you need to have a consumable add-on added to your health policy if you want that to be included in your cover.

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Outpatient Department (OPD) Expenses

Routine doctor visits, diagnostic tests, and medicines that are prescribed on a regular basis are also not covered under standard health insurance policies. To get these covered, you will need an OPD add-on to your base health insurance policy.

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Pre-Existing Diseases

Irdai cut the waiting period on pre-existing diseases to three years. Some plans offer day 1 coverage for extra cost, but certain conditions still have waiting periods.

What Your Health Insurance Doesn't Cover (AI Generated Image)

Routine Dental Care

Dental procedures, such a root canal treatment can be expensive, but standard health insurance policies do not cover them.

What Your Health Insurance Doesn't Cover (AI Generated Image)

Non-Allopathic Treatments

Irdai mandates AYUSH coverage, but limits still apply. Always check what treatments are included. For instance, cancer immunotherapy is usually covered, but often with sub-limits.

What Your Health Insurance Doesn't Cover (AI Generated Image)

What it means for policyholders

Health insurance doesn’t cover everything. Review exclusions, waiting periods, and limits carefully. Always read your policy before buying.

What Your Health Insurance Doesn't Cover (AI Generated Image)

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