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Posted by akanshasingh in Finance on August 6th, 2016

What does a health insurance not cover i.e exclude?

The moment of truth in an insurance policy is at the time when a claim arises. One of the most common reasons for a health insurance claim not being paid by an insurance company is when they say that the particular disease is not covered by the policy and is “exclusion". It leaves a bitter taste in the mouth of the policyholder and can sometimes put the policyholder in great financial difficulty. Thus, it is very important to know in detail about the exclusions in a health insurance before purchasing it. In our opinion, it is a far more important variable than price. A policy might be 10% cheaper than a competitor's policy but might have many more exclusion clauses-in such a case, the policy with the lesser number of exclusion clauses would be the better choice for the policyholder.

In this article, we deal with some of the common exclusion clauses in a health insurance. Of late, we are seeing some innovation in this area with the new companies not excluding certain ailments which had traditionally been within the exclusions area

Maternity: In most cases, maternity and maternity related expenses are not covered in an individual or family floater health insurance. Maternity is typically covered in a group policy. In certain cases, we are seeing maternity being covered after 5 years into the policy.

Diseases or illness contracted within the first 30 days of the policy. The insurance company does this to safeguard itself against customers buying a policy immediately after a disease has been detected

Cataract, Prostrate, Hernia, Piles, fistula, gout, rheumatism, kidney stones, tonsils and sinus related disorders, congenital disorders, drug addictions, non allopathicalternate treatments, self-inflicted injuries, hysterectomy, fertility related treatments, etc. are normally not covered under a health insurance. Dental treatment and cosmetic surgery is also typically excluded. Contact lenses cost is also not covered. HIVAIDS is excluded, which has been a subject of great debate and criticism in the last few weeks. Some insurance companies do not cover treatment incurred outside the country, so you should check once before buying the policy

Preexisting diseases are not covered in a health insurance. Preexisting means a disease that you have had prior to joining a health insurance. The policyholder may or may not have been aware of the pre-existing disease. Further complications which arise due to the preexisting disease are also not covered. For example, renal problems which arise due to a person having diabetes at the start of the policy would not be covered. This can sometimes lead to a lot of confusion and heartburn. Someone gets admitted for a kidney related treatment, and the insurance company turns down the claim saying the kidney problem has arisen because the patient had diabetes, and rejects the claim. It can get a little grey here as medical science cannot sometimes clearly pinpoint the root cause of a particular disease outbreak. In most cases, preexisting diseases are covered after 3 or 4 consecutive policy years. This is the single biggest reason why one should buy a health insurance at a young age, and continue with the same insurer. Because if you shift to a new insurer, you lose your previous credit and a d. Cheap Shirts   Cheap Nike NBA Hats   Cheap Hockey Shirts   Cheap NCAA Shirts China   Cheap MLB Shirts China   Cheap College Shirts China   Cheap Jerseys China Wholesale   Cheap NHL Jerseys From China   Cheap Football Jerseys   Cheap Soccer Jerseys China Wholesale