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Things That Your Health Insurance Plan Does Not Cover You For

Published On Sep 01, 2021 11:00 AM By InsuranceDekho

When buying a health insurance cover, the most important factor that influences the choice of the customers is the coverage of the plan. Customers usually look for plans with comprehensive and exclusive coverage at an affordable price. The terms of the policy mention the inclusions of the cover which help the customers determine the coverage of their policy. Depending on the type of plan chosen the coverage of the plan can differ from one insurer to the other. But, along with the inclusions, the policy comes with a defined set of exclusions where the insurer specifies the excluded conditions from the coverage of the purchased health insurance policy.

A customer must carefully go through the policy related documents to make sure that all the necessary inclusions have been made and to keep in mind the listed exclusions which help the customers to avoid inconvenience at the time of claim settlement process. The exclusions are predefined by the insurer and no claim is issued for any medical treatment mentioned under the excluded list.

Things That Your Health Insurance Plan Does Not Cover You For

Things That Are Not Covered Under A Health Insurance Policy

There are certain medical conditions for which the insurer does not provide the monetary compensation to the policyholders. Let us look at some of the things which are generally excluded in a regular health insurance policy by most of the health insurance providers:

  • Pre-Existing Illness

Pre-existing diseases are usually not covered under the coverage of the purchased health insurance policy. The claim for such diseases can be made after a specified waiting period which is decided by the insurer and can range from 2 to 5 years. Before the waiting period, the insurer does not provide compensation for the pre-existing diseases. Therefore, you must buy health insurance cover as early as possible to get over the waiting period for your pre-existing diseases.

Must Read: Benefits of Comparing Health Insurance Plans Online

  • Abortion And Pregnancy Expenditures

Abortion expenses are usually excluded from the health insurance policies along with the other materntiy expenses like delivery costs irrespective of the type of delivery. To include the maternity expenses, you must buy an add-on cover or a separate cover including maternity benefits.

  • Cosmetic Surgeries

Surgeries conducted to improve the overall appearance of an individual are not included under the health insurance policies. Cosmetic surgeries required in case of an accident can be covered by some insurers. Dental procedures are also not a part of the health insurance coverage.

  • Diagnostic Expenses

Expenses incurred due to identification of a pathological surveillance or virus of an individual's body is excluded from the coverage of a health insurance cover.

  • Health Supplements

Health supplements like protein shakes, etc. are not included under the coverage until prescribed by the doctor to overcome an ailment at the time of hospitalization as a part of the treatment.

  • Fertility Treatments

Health insurance providers are supposed to provide compensations for expenses incurred due to the testing done for an infertility diagnosis but they exclude fertility treatment coverage from their plans.

  • Vision And Hearing

Products for hearing and vision impairment are not included in the coverage offered under regular health insurance policies. But, the insurer provides compensation for treatments received during hospitalization due to vision and hearing impairment.

  • Disease Due To Alcohol Consumption

Diseases caused due to the consumption of alcohol or any other injurious substances are not covered under the health insurance policies. Diseases like liver damage due to alcohol overconsumption are excluded from its coverage. For people who smoke or take tobacco, the premium rates are higher than usual as they are more prone to contract life-threatening diseases like cancer, lung diseases, etc.


If a policyholder makes a claim for any of the above-mentioned medical conditions, then the claim will not be approved by the health insurance provider. To know about all the exclusions of your purchased health insurance cover, you must carefully read the fine print of your policy.

Also Read: Common Exclusions in Health Insurance Plans

Disclaimer: 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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