Know What Exclusions are when you buy Health Insurance

Health Insurance is a plan that comes with its own inclusions and exclusions. It should therefore come as no surprise that the chosen health insurance plan may not cover all the medical expenses that one might incur. The only way to stay out of the dark and not suffer a rude shock is to scrutinize the fine print of your health insurance document before you ever need to make a claim. In order to do that, one must first understand what “exclusions” are in a health insurance plan.

The term “Exclusion” could refer to a medical condition that is experienced by the patient or it could also mean an expense that is not covered under the existing plan. The money that you would spend on either of the above, cannot be recovered from your health insurance provider.

It is advisable to look at the exclusions and inclusions in a health insurance plan and not just what offers you receive from the policy. To make it easier for you, listed below are a few of the most common “exclusions” that are looked over in health insurance policies:

  1. <h2>Pre-existing medical conditions:</h2> If policy beneficiaries are suffering from any pre-existing medical conditions, it is usually considered an exclusion. However, they do get included within coverage after a certain waiting period. When the beneficiary has a specific pre-existing condition, there may be scope to claim insurance, after the waiting period. This depends on the terms and conditions of the insurer and the health condition of the insured.
  2. <h2>30 Days Initial Waiting Period:</h2>Some of the insurance policies incorporate a 30-day waiting rule. It is always good to check with an agent/company before you buy a health insurance policy. Follow the policy “always be prepared”.
  3. <h2>Pregnancy & Childbirth:</h2>Most health insurance plans do not cover maternity expenses. However, there is a clause for the same under the individual’s health insurance plan. To get that coverage, you might require a special add-on feature. An important point to be noted – costs for treating infertility and abortion are not commonly covered under any medical insurance.
  4. Cosmetic surgery: Cosmetic surgery is generally used to enhance the appearance of a person, so all kinds of cosmetic procedures are not covered under health insurance. However, in cases of accident or injury when plastic surgery is a requirement, insurance can be claimed.
  5. Treatment of mental illness: Although this is an important health condition that requires attention, most insurance policies do not cover costs for the treatment of mental illness, stress, psychiatric or psychological disorders.
  6. Dental, hearing, and vision: Dental, vision & hearing procedures come under exclusions as they mostly don’t require hospitalisation. Even so,  when the need arises for hospitalization, it has to be covered. This is an exclusion that comes with a clause that can be cross checked with the insurance provider. Sometimes such benefits can be bought as add-ons in your health insurance plan.

Save yourself and your loved ones from nasty surprises that you might approach, as some might know “chance favors the prepared mind”. Having said that, health insurance policies differ based on the provider. It is advised to compare multiple policies from various insurers before making your decision.

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