6 Things Your Mediclaim Doesn’t Cover

Mediclaim provides a list of exclusions under their plans that are in adherence to the guidelines given by IRDAI

6 Things Your Mediclaim Doesn’t Cover
6 Things Your Mediclaim Doesn’t Cover
Titlee Sen - 05 July 2021

Health insurance is necessary to alleviate the financial burden that might develop as a result of a medical emergency, surgery, or serious disease. Different insurance firms provide a variety of health insurance plans with various add-on coverage and perks. You should choose the insurance that best meets your requirements and provides you with relief at tough times, such as when you or a loved one is hospitalised due to an unforeseen injury or sickness. At the same time, it's critical to understand which treatments and health problems your medical insurance policy excludes.

  1. Cosmetic procedures

Cosmetic procedures such as Botox, Liposuction, implants, and other comparable procedures are not covered by health insurance. If you plan to have such surgery within the insurance period, you should verify with your insurer. Insurance companies do not cover such medical treatments unless they are part of the therapy.

  1. Previous ailments

Pre-existing diseases (PEDs) and their associated waiting periods vary by the insurance company. Some insurance companies may cover diabetes, high blood pressure, heart disease, and other conditions. Most health plans would cover such expenditures only after the waiting period, which can be anywhere from 12 to 48 months, has passed.

New health plans, on the other hand, are being introduced that cover PEDs from day one. In some situations, the insurer will cover pre-existing conditions in exchange for a higher premium.

  1. Supplements

The insurer does not pay the cost of health tonics and supplements under your mediclaim coverage. If the treating physician recommends them, the costs may be reimbursable. However, if you take it without a prescription, it will not be covered by your insurance. Refer to the policy wording for further information.

  1. Testing procedures

A Mediclaim does not cover the costs of identifying the virus or pathological surveillance (blood tests, CT scans) of your body at a hospital or nursing home.

  1. Pregnancy and abortions

Pregnancy and abortion-related medical expenditures are not covered by health insurance. Hospitalization costs linked to infertility and pregnancy problems, such as abortions, are not covered by health insurance. These costs may be reimbursed by certain maternity health policies, but they are not covered by basic health insurance.

If you're searching for coverage for pregnancy-related expenditures, examine your policy's wordings. The matter should be presented to the insurance company once a medical practitioner has certified it.

  1. Specific conditions

Registration fees, entry fees, and service fees are not eligible for reimbursement under a medical insurance plan.

If any sickness is linked to excessive alcohol intakes, such as liver damage or other issues, the insurance provider has the authority to deny your health insurance claim.

Alternative therapies such as naturopathy, acupressure, naturopathy, acupuncture, reflexology, and other similar treatments are not covered by health insurance.

To avoid the dreaded experience and better manage your funds, read your policy wordings all the way through to get a better understanding of both the inclusions and the ailments that are not covered by health insurance.



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