Know your health policy exclusions

Choosing a health insurance policy calls for factoring in a number of things. One such important thing is exclusions of the policy.

Exclusions are events and conditions that the insurance policy doesn’t cover. They can be of two types: (a) Permanent exclusions and (b) Time-sensitive exclusions (Benefits with a waiting period).

1. Permanent exclusions are the events, treatments and diseases that are never covered by the policy. Cosmetic treatments, Facial surgeries, treatment of HIV/AIDS and war related injuries are some of the permanent exclusions. Every policy lists out an exhaustive list of these exclusions.

2. Some benefits of the policy require you to wait for a specified period of time before they can be availed. These are time-sensitive exclusions or benefits with a waiting period. For instance, the first waiting period, also called “cooling off period”, is 30 days long, after which most of the policy benefits come through.

Every policy clearly names treatments that you can’t make a claim for in the first 2 (or 3) years of the policy. Common among them are treatments pertaining to cataract, hernia, varicose veins, osteoporosis, non-infective arthritis and many more. In addition, specific benefits like maternity coverage come through after a waiting period of 9 to 48 months depending on the policy. Pre-existing diseases too are covered only after the lapse of specified waiting period.

The law demands these exclusions to be specific and precise as they are not part of the coverage (or imply conditional coverage). In case there happens to be considerable difference in the interpreted meaning, the law sides with the policyholder by applying a possible restrictive definition. Visit our website to compare and buy health insurance.

Read more about Separate health insurance plans for parents of floater?

Read also An anatomy of an health insurance plan

Read more about Dejargonizing health insurance terms

Leave a Reply

Your email address will not be published. Required fields are marked *