Major Exclusions Of Health Insurance Plans
Every health insurance plan has a list of exclusions, which include all uncovered perils. The insurer does not offer coverage for these incidents, if the insured comes across them. This is one of the main clauses that a person should go through carefully before purchasing health insurance so that no confusion arises at the time of claim.
Some of the main exclusions of a health policy are given below.
- 1 Pre-existing diseases i.e. Any condition, ailment or injury or related condition(s) for which insured person had signs or symptoms and/or was diagnosed and/or received medical advice/treatment within 48 months prior to his/her health policy with the company. Pre existing diseases will be covered after a maximum of four years since the inception of the policy
- 2. Any disease contracted during the first 30 days of inception of policy except in case of injury arising out of accident
- 3. Certain diseases such as cataract, piles, hernia, and sinusitis etc. are excluded for specified periods if contracted or manifested during the currency of the policy.
- 4. Injury or Diseases directly or indirectly attributable to War, Invasion, Act of Foreign Enemy, and War like operations.
- 5. Cosmetic, aesthetic treatment unless arising out of accident.
- 6. Cost of spectacles, contact lenses and hearing aids. Some insurance plans cover these up to a specified limit.
- 7. Dental treatment or surgery of any kind unless requiring hospitalization
- 8. Charges incurred at Hospital or Nursing Home primarily for diagnostic, x-ray or laboratory examinations, without any treatment.
- 9. Naturopathy or other forms of local medication
- 10. Pregnancy & childbirth related diseases
- 11. Intentional self-injury / injury under influence of alcohol, drugs
- 12. Diseases such as HIV or AIDS
- 13. Expenses on vitamins and tonics unless forming part of treatment for disease or injury as certified by the attending physician.
- 14. Convalescence, general debility, run-down condition or test cure, congenital external diseases or defects or anomalies, sterility, venereal disease.