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Did You Know About These Exclusions In Family Health Insurance Plan?

Published On Sep 01, 2022

Exclusions from insurance coverage are situations for which the insurance company does not give coverage because they are not included in the insurance contract. Every insurance policy has specific limitations, which means they do not cover the insured for certain things, including during a medical emergency.

Policyholders must be informed of the health insurance exclusions in order to avoid any financial difficulties that may arise during a medical emergency. Exclusions, or medical disorders and diseases that practically all insurers will not cover, are a reality of life in all insurance policies. The potential policyholder will be able to select the appropriate health insurance plan and be aware of the medical issues that are not covered if they are aware of these exclusions. To know more about exclusions in family health insurance plans in India, read on.

Did You Know About These Exclusions In Family Health Insurance Plan?

What Are Some Exclusions In Family Health Insurance Plans?

Before purchasing, it is essential to go over the policy's fine print. By doing so, you can better understand some of the exclusions that are most frequently encountered. Following are some of the exclusions in family health insurance plans that an individual should know -

  1. Pre-Existing Ailments - If the policyholder has a medical condition, it will be categorised as one of the pre-existing diseases that are not covered because insurance is meant to cover unforeseen events. If the insurer agrees to add it, there is a waiting time of two to four years or more depending on the kind of sickness and its risk.
  2. Pregnancy-Related Issues - One of the most frequent exclusions in medical insurance policies is this one. A standard health insurance policy does not provide coverage for pregnancy or other associated conditions. Pregnancy is a dangerous situation for most women. Therefore, it is advised that the plan paperwork be thoroughly reviewed in order to fully understand the exclusions before purchasing.
  3. Cosmetic Procedures - The goal of cosmetic procedures is to make a person's face and other body parts seem better. As a result, this does not qualify as a medical emergency and cannot be covered by a health insurance plan. However, they are only covered if a certified medical professional makes the recommendation after an accident and injury. Additionally, dental care and joint replacement treatments are included in the exclusions of health insurance policies.
  4. Alternative Treatments - When traditional allopathic treatment does not provide relief, some people prefer alternative means of treatment. Natural medicine, acupressure, Ayurveda, magnetic therapy, etc. are some of the unique therapies. Medical health insurance does not cover any of these types of care.
  5. Self Harm - Any health plan does not cover wounds and sufferings brought on by intentional injury or efforts to end one's life. This is an essential factor to be remembered at all times.

Rushing into an insurance without carefully reading its exclusions might get you into difficulty later on. Every policyholder should be aware of the exclusions in health insurance plans before purchasing a plan.

Accidents, illnesses, hazards, and other aspects of your health are not all covered by a single insurance. Every insurance policy has restrictions, so picking one that meets your needs is an art. Not all policies have exclusions, but there are several that the policyholder should be aware of when buying health insurance.


It's crucial that you thoroughly study the paperwork before making a purchase because health insurance coverage varies greatly from one another. Clarity on what is and is not covered by the health insurance plan will be provided. Pick comprehensive insurance with essential add-ons including coverage for serious illness, post-hospitalisation, and pre-hospitalisation rather than a basic one to obtain the best benefits.

Also read: All About the Maternity Rider in Health Insurance Plans

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This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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