Health Insurance Plans

pays for your hospital bills for diagnostics, surgery etc.

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Knowing Your Health Plan Exclusions

| | Health Insurance

Health Insurance in India

The quality of medical infrastructure in a nation is a true reflection of the commitment of the nation to the health of its citizens. Over the last few years, we have seen medical expenditure in India spiraling and Hospitalization costs becoming more or less unaffordable for a common man. The rising cost is attributable to an improvement/upgradation in overall medical infrastructure (hospitals and diagnostics) and growing fees/salaries of doctors. In order to make sure that the common man gets access to the best medical care, promoting Health Insurance is of paramount importance.

What is health insurance?

A health insurance is basically a contract between an insurance (risk cover) provider and an individual under which the insurance provider guarantees payment of medical treatment costs subject to a pre-agreed limit, while an individual agrees to make annual payments (health insurance premium) to the insurance provider.

Buying Health Insurance

There are several companies in India that provide health insurance. Apart from variations in the sum Assured and the insurance Premium amount there are host of other clauses in the Policy which can have material implication for you in case you need to seek a claim. It is important to closely compare the policy, especially with respect to the important terms in the policies. Apart from understanding what each health insurance policy would cover and the key features, it is equally important to know what each of these will not cover. The policy exclusion clause in a health insurance policy would primarily discuss those aspects of insurance which would disallow Coverage under certain conditions.

Policy Exclusions

All policies would have clauses that would carve out condition or cases which are excluded from policy coverage and insurance companies would not bear the cost in case such a situation arises. The various Exclusions commonly found in insurance policies include:

  • Pre–existing illness - From the day you buy your first health insurance policy, upto a few years the coverage of Pre-existing illness is disallowed under most policies. The duration for which the coverage is disallowed may vary from policy to policy. It is generally two to four years.
  • A few specified illnesses are not covered in the first year of purchase of policies. Make it a point to check this list of specified illness. If Domiciliary Hospitalization is covered under your policy, there would be a separate list of specified illness which may be excluded from the domiciliary hospitalization for specified duration from the first purchase of policy.
  • Check if your policy covers or excludes costs related to treatment of HIV/AIDS
  • Treatment due to abuse of alcohol or intoxicants is excluded in some policies.
  • Most policies would exclude costs related to vaccination and inoculation.
  • Most policies would exclude costs related to vaccination and inoculation.
  • Nuclear and war perils is not included in health insurance policy.
  • Naturopathy treatment may not be covered in health insurance policy.
  • If you are looking to buy health insurance policy for yourself, you can do an online comparison of premiums and health insurance exclusions and buy the best health insurance policy for yourself. Online health insurance companies such as easypolicy.com allow you to compare health insurance offered by reputed insurance companies conveniently and free of cost.