Health insurance policyholders need to be careful while choosing a policy and added benefits to make sure that all their medical expense needs are met. There are common things that are not covered by your health insurance. Not paying attention to these exclusions may lead you to pay medical bills that you thought your health insurance was going to cover. The insurer can reject your claims related to the specific list of diseases that are excluded from the health insurance policy.

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Here are five such exclusions to watch out for:

Cosmetic surgeries

Cosmetic surgeries are usually not covered by health insurance policies. Procedures like Botox, liposuction, implants, and similar surgeries are excluded. Individuals need to check with their insurer if they plan to undergo any such surgery during the policy term. Unless it is a part of treatment, insurance companies do not compensate for such medical procedures.

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Infertility/pregnancy-related complications

Hospitalisation expenses related to infertility or pregnancy-linked complications like abortions, or any other treatment are excluded from health insurance coverage. However, some maternity health plans may offer coverage for these expenses, but they may be subject to waiting periods and sub-limits.

Pre-existing illnesses

This is one of the exclusions that may come as a shock to people. According to industry experts, people who have been suffering from an illness before buying a health insurance plan may not receive coverage for the disease. However, this exclusion and the related waiting periods vary from one insurance company to another.

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For instance, some insurance companies may provide coverage for diseases like diabetes, blood pressure, heart ailments, etc. However, most policies would cover such expenses only after the waiting period is completed, which can range from 12-48 months.

Hearing and vision

For hearing and vision, there may be two cases, either it is a pre-existing condition or a result of accidental damage which requires hospitalisation. In the former case, it may not be covered and in case the treatment does not require hospitalisation, then it may not be covered by the policy, according to Pankaj Arora, MD, and CEO, Raheja QBE General Insurance, as reported by Financial Express.

Dental coverage

Dental conditions are usually not covered as their treatment does not usually require hospitalisation. However, if dental treatment expenses occur due to an accidental injury, then health insurance policies cover those expenses.

Also read: March general insurance premium grows by 11%; details here

(Edited by : Shoma Bhattacharjee)

First Published:Apr 14, 2022 6:31 PM IST