Health Insurance Plans

pays for your hospital bills for diagnostics, surgery etc.

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must know about exclusions in mediclaim

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Buying a Health Insurance Policy safeguards you against any unforeseen circumstances aroused due to any disorders related to health and well being. There is no question why one should not have a medical insurance policy. However, there are some Exclusions under which you cannot raise mediclaim. Here is a quick snapshot of those barrings you must keep in mind

Preexisting conditions:

A health policy does not cover any expenditure related to the treatment of disorders which exist during the time of buying the policy. The same condition applies to injuries also. If a person is already injured while applying for a health policy, then treatment of this injury would not be covered under the policy.

The logic is quite clear and justified. The Insurer would always request for a health checkup in this case, before issuing the policy. The report clarifies what all health problems are already there and would not be covered. You should also be aware that the policy would also not cover any complications arising out of Pre-existing disorders. For instance, any problem caused due to pre-existing diabetes is not covered in the policy and a Policyholder could not raise claims against it.

Applicability of coverage:

Many insurers put conditions on the applicability of coverage. For instance, there may be a clause for a certain period of time, that no claims would be entertained before 30 days of issuing the policy. The period may differ from company to company. However, this may not be applicable for the treatment of diseases and planned Hospitalization only and not injuries and accidents.

An insurance company may also have conditions to not cover treatment of certain types of ailments. For example, there are companies which do not consider the treatment of cataract, sinusitis, piles, hernia, hydrocele, benign prostatic hypertrophy and fibromyoma. The company is liable to provide you a list of all the disorders which are not supposed to be covered under the policy for a certain period of time or for always.

Supplements and health care:

A medical policy is not expected to cover any expenditure incurred towards food supplements; vitamins, protein and minerals for that matter. Any expenses towards maintaining and improving health through supplements are not considered as part of the medical policy as it mainly covers treatment. Plastic surgery done with an objective of beautification and aesthetics also would not be covered. Expenses towards yoga and other natural therapies are not covered under medical policy.

Maternity:

A health insurance policy does not cover expenses towards pregnancy and maternity. In fact, any aspects that traces to pregnancy is not covered under the policy.

Other exclusions:

A policy may not cover injuries caused due to suicide attempt, war or warlike, operations and vaccination.