What Does Health Insurance Not Cover?

13 Nov 2021|

1 min read |

by ICICI Securities Team

Introduction

In a bid to choose the 'perfect Health Insurance', many policyholders overlook the exclusions. It is, of course, essential to know the benefits offered by your Health Insurance Plans. But it is equally important to understand what gets covered under Health Insurance as it saves you from hassles at the time of raising the claim. Here is a quick look at the standard exclusions:

Pre-Existing Illnesses

Have you been suffering from diseases such as high blood pressure or diabetes even before applying for a Health Insurance Plan? The chances are that your insurance provider will not offer any coverage for expenses incurred to treat these diseases. Make sure to check if your Health Insurance has any waiting period after which you can make reimbursements for pre-existing illnesses.

Cosmetic surgery

Any procedure undertaken to enhance your appearance gets excluded from Health Insurance Plans. This is also true for any dental treatments undertaken to improve the aesthetics. However, if any cosmetic procedure is recommended because of an accident, your Health Insurance Policy offers coverage.

Pregnancy and abortion

Expenses incurred for pregnancy and abortion are not part of most Health Insurance Plans. Many insurers do not consider these as diseases requiring Health Insurance cover. While voluntary abortion does not get any coverage under Health Insurance, your Insurance provider may offer coverage for abortions undertaken for saving the mother's life.

Similarly, infertility treatments get excluded from Health Insurance cover. Make sure to check with your Insurance company before you sign the dotted line.

Diagnostic expenses

If you need to undergo procedures such as MRI, X-ray, or USG or send your blood samples to the laboratory for tests of any health condition, your Health Insurance does not provide coverage for the same. However, if the same tests get conducted as part of your treatment plan when you are admitted to the hospital, you can raise a claim under your policy.

Health supplements

Health tonics and protein shakes are readily available in the market and bought by anyone without a doctor's prescription. If you are buying these supplements to prevent the occurrence of certain diseases, you cannot claim them under your Health Insurance Plan. On the other hand, if such supplements get prescribed by your doctor as part of your treatment plan when you are hospitalised, then you enjoy the coverages under the plan.

Illnesses related to hearing and vision

Most procedures for ears or eyes do not require hospitalisation. Hence, it is not uncommon for Health Insurance Plans to provide any coverage for the same. However, in the event of any hospitalisation, you can raise a claim under the plan.

Conclusion

Remember that no two Health Insurance Plans are the same. Knowing the exclusions of your Health Insurance is essential when buying offline or online so that you make an informed choice.

Disclaimer

ICICI Securities Limited has its registered office at ICICI Venture House, Appasaheb Marathe Marg, Prabhadevi, Mumbai - 400025, India, Tel No:- 022 - 2288 2460, 022 - 2288 2470. The non-broking products / services like iLearn and Financial Learning are not exchange traded products / services and ICICI Securities Ltd. is just acting as a distributor/ referral Agent of such products / services and all disputes with respect to the distribution activity would not have access to Exchange investor redressal or Arbitration mechanism. iLearn is not an exchange traded product/service of ICICI Securities Ltd. All disputes with respect to the activity on the platform would not have access to Exchange investor redressal or Arbitration mechanism.

ICICI Securities Ltd. is a Member of National Stock Exchange of India Ltd (Member Code :07730), BSE Ltd (Member Code :103) and Member of Multi Commodity Exchange of India Ltd. (Member Code: 56250) and having SEBI registration no. INZ000183631. ICICI Securities Ltd. is a SEBI registered with SEBI as a Research Analyst vide registration no. INH000000990. Name of the Compliance officer (broking): Mr. Atul Agrawal, Contact number: 022-69997051, E-mail address: complianceofficer@icicisecurities.com Investments in securities markets are subject to market risks, read all the related documents carefully before investing. The contents herein above shall not be considered as an invitation or persuasion to trade or invest. ICICI Securities Ltd. and affiliates accept no liabilities for any loss or damage of any kind arising out of any actions taken in reliance thereon. Such representations are not indicative of future results. The securities quoted are exemplary and are not recommendatory. AMFI Regn. No.: ARN-0845. PFRDA registration numbers: POP no -05092018. ICICI Securities Ltd. acts as a Composite Corporate agent having registration number -CA0113. Mutual Fund Investments are subject to market risks, read all scheme related documents carefully. Please note, Mutual Fund, Corporate Fixed Deposits, Bonds, Alternate investment funds, Tax planning, Succession planning, NPS, IPO, Investment Advisory and Loans related services are not Exchange traded products and ICICI Securities Ltd. is acting as a distributor to solicit these products. Please note, Insurance related services are not Exchange traded products and ICICI Securities Ltd. is acting as a corporate agent to solicit these products. All disputes with respect to the distribution activity, would not have access to Exchange investor redressal forum or Arbitration mechanism. The non-broking products / services like Research, etc. are not exchange traded products / services and all disputes with respect to such activities would not have access to Exchange investor redressal or Arbitration mechanism. The contents herein above are solely for informational purpose and may not be used or considered as an offer document or solicitation of offer to buy or sell or subscribe for securities or other financial instruments or any other product. Investors should consult their financial advisers whether the product is suitable for them before taking any decision. The contents herein mentioned are solely for informational and educational purpose.

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