What does Health Insurance not cover? 5 common exclusions

May 14, 2020

What does Health Insurance not cover? 5 common exclusions

While people focus on the inclusions or what is covered in a health insurance policy when making a purchase, most overlook the exclusions. Read this post to know five things that are generally not covered in health insurance.

Search for tips for selecting the best health insurance policy, and you are sure to come across experts recommending people to check what is covered in the policy thoroughly. While there is no denying the fact that one should carefully check all the inclusions before selecting a health plan, it is also equally important to check the exclusions or things that are not covered in the policy.

What is not covered by Health Insurance?

Here is a list of 5 common exclusions in health policies

1. Pre-Existing Ailments

  • If you are already suffering from a medical condition, the chances are that your health insurance policy will not offer coverage for expenses arising from such ailments. For instance, if you have diabetes or high blood pressure, the policy will not cover the expenses resulting from the treatment of these conditions.
  • There are only a few policies that permanently do not cover pre-existing conditions. Most policies generally have a waiting period of 12-60 months, after which the existing conditions are covered as well. If you are suffering from an ailment, it is better to consider a policy that comes with a waiting period for pre-existing illnesses.

2. Pregnancy and Abortion

  • Most health plans do not cover pregnancy. No matter if it is a normal delivery or the baby was delivered through caesarean, it will generally not be covered in your health insurance policy. Pregnancy or delivery-related complications will also not be covered.
  • Similarly, abortion is a common exclusion in medical insurance plans as well. But some policies do cover abortion if it was done to save the mother's life. Also, some insurers do offer health plans with maternity benefits. 

3. Lifestyle Related Ailments

  • Ailments that are an outcome of a particular lifestyle habit are generally not covered in most health plans. For instance, if you are a smoker and suffering from lung cancer or consume alcohol and are suffering from liver cirrhosis, your health policy will not cover these conditions.
  • In most cases, smokers and people who consume excessive alcohol are generally required to purchase more expensive health plans that offer coverage for conditions that might arise from such habits.

4. Cosmetic Surgery

  • Cosmetic surgeries are now very commonly used by people to improve their appearance. These expensive procedures are generally not covered by health insurance policies.
  • However, if the policyholder suffers from an accident and cosmetic surgery is recommended as part of the overall treatment, your health insurance policy will mostly cover it. Similarly, dental procedures for improving the appearance of teeth are not covered in health insurance plans.

5. Hearing and Vision

  • Hearing and vision-related medical procedures generally do not require hospitalisation. As a result, they are mostly not included in health insurance coverage.
  • But if any of the hearing or vision-related treatment requires hospitalisation, the policy might offer coverage for the same.

Understanding the exclusions of Health Insurance Policies

Not that every insurer and health insurance policy is different. The inclusions and exclusions can significantly vary between insurers and health policies. Make sure you give equal attention to the inclusions as well as the exclusions of the policy before deciding.It will ensure that you are fully aware of what you are purchasing and can make the best use of a health insurance policy.

 

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