Adequate health insurance helps ease the financial burden that arises due to a medical emergency. There are many health insurance plans offered by different insurance companies. However, choosing the right one for yourself could be a difficult task.
Pankaj Arora, MD and CEO, Raheja QBE General Insurance, says, “One should opt for the policy that best suits one’s needs and provides support in difficult times, such as hospitalization due to injury or illness, etc.”
Here are some common exclusions listed as a ready reference for people who want to buy health insurance;
Pre-existing Illness
According to industry experts, this point holds true for people who have been suffering from illness before buying health insurance.
Arora explains, “If one is suffering from a condition before they purchased the policy, it is not covered on day one of the policy coverage.” Such cases are known as pre-existing conditions and are generally covered only after a waiting period of 2-4 years or more depending on the type of disease and its risk
Pregnancy and Childbirth
Conditions related to childbirth are not included in a general health insurance policy. This includes pregnancy and conditions arising out of it, abortion and any treatment which arises from or traces back to pregnancy.
“Few health insurance policies offer coverage (with a sub-limit) for pregnancy and child berth after a waiting period of 2-4 years,” says Arora.
Cosmetic Surgery
Cosmetic surgery is generally used to enhance a person’s appearance and is not a life or health-threatening activity. Cosmetic surgery is a personal decision and is elective in nature. It is not a necessity; hence, all kinds of cosmetic procedures are not covered under health insurance.
Arora points out, “Plastic surgeries are not vital medical procedures undertaken to protect the life of an individual and that is another reason why they’re not covered by any health insurance. Having said that, in cases of accident or injury when plastic surgery is a requirement, it is generally covered.”
Dental Coverage
Dental conditions generally do not require hospitalization and are not covered by health insurance plans. Having said that, the dental treatment expenses are covered only when required due to an accidental injury.
Hearing and Vision
With hearing and vision, Arora explains, “there could be two kinds of cases here, either it is a pre-existing condition, or it is a result of accidental damage which requires hospitalization. Again, treatments that don’t require hospitalization are not covered under a health insurance policy.”
Not all health insurance plans are alike and hence, you need to check on the coverage available for basic treatments and look for additional coverage depending on your requirement. “Additional coverage can always be opted for by an individual, that generally comes with an additional premium for health insurance,” adds Arora.
