What does your health insurance policy not cover?

The health insurance policy covers a variety of expenses, but some of them are excluded from the plan’s coverage. Research and planning can be done before selecting a health plan of an individual’s choice. Therefore, a person should choose a plan that has minimum exclusions and maximum coverage.

Thus, an insured must read the wording of the policy from beginning to end. For clarity on disease inclusions and exclusions.

Health insurance is a contract that is used by most Indian citizens. The contract is between the insurer and the policyholder where the insurance company offers medical coverage to the insurer under a certain limit.

There are several benefits of health plans like pre and post hospitalization, medical examinations, room rent coverage, cashless facilities, etc. The health insurance benefit is provided in the event of a medical emergency.


1. Cosmetic procedure

Nowadays, people are more concerned about transforming appearance through cosmetic surgeries like botox, liposuction and implants which are excluded from health insurance policy. Insurance companies do not encourage treatments based on medical procedures.

2. Fertility treatments

Health insurance companies do not include surgery related to complications such as infertility, abortions, and pregnancy-related issues.

There is an exclusive maternity health plan that covers all pregnancy-related expenses, but not basic health plans.

There might be women-specific health plans to cover these expenses.

3. Health supplements

Health tonics and supplements are not covered by health insurance plans.

On the recommendation of the attending physician, costs may be claimed.

Supplements taken without a prescription are not covered by the policy.

4. Diseases related to alcohol abuse

People who have developed a disease due to excessive alcohol consumption can damage organs like the liver and kidneys. In such cases, insurance companies have the right to reject such insurance claims.

5. Diagnostic costs

Diagnostic or pathological services, including scans, blood tests and body tests that may be performed at the nursing home or hospital, are excluded.

Thus, it is possible that the policy specifically covers them where this is required as part of the treatment.