What typical exclusions apply to health insurance?

What typical exclusions apply to health insurance?

Health insurance plans help provide financial protection to an individual or their loved ones during medical emergencies. A good health insurance plan will pay for your hospital and other medical-related bills and make sure you are recovering and not worrying about your medical bills.

Health insurance covers most common illnesses, but every plan has its own exclusions.

Exclusions are defined as types of medical conditions or circumstances that are not a part of your coverage or certain diseases that can be compensated for only after a certain period of time. Health insurance plans differ from insurer to insurer, however, in this article, we have listed common health insurance exclusions. Read below to know more.

 Waiting period: A waiting period is an amount one needs to wait for before some or all of their health insurance coverage comes into effect. Most insurance companies have rules in regard to certain illnesses or ailments that are not covered until the end of the waiting period.

Policyholders need to wait for a pre-determined time period in order to benefit from their health insurance policy. Until the waiting period is over, you cannot make any medical claims.  Pre-existing diseases: Any illnesses that a policyholder may have before purchasing health insurance can be defined as pre-existing diseases. Health insurance companies will have a waiting period upon types of diseases that can last for 2-4 years. Pre-existing diseases can include heart diseases, cataracts, etc.  Permanent exclusions: Permanent exclusions in health insurance are listed as types of medical treatments that are never covered in a health insurance policy for the whole life of the policy.

Congenital diseases, damages occurred during war or nuclear weapons are permanent exclusions and are not included in health insurance coverage.

 Maternity expenses: Make sure that your health insurance coverage includes maternity expenses like prenatal, postnatal care, new-born cover, etc. Most insurers provide maternity related expenses after a waiting period of few years after which you can use your coverage. It is important to read up on the coverage of maternity expenses in your policy brochure.  Other treatments: Cosmetic treatments such as plastic surgery, enhancement surgery, body contouring, etc. are usually not covered under health insurance coverage. Similarly, health insurance does not provide coverage for sexually transmitted diseases (STD). In most plans, dental treatments are not included in health insurance plans unless the need for dental treatment arises due to an accident. Self-inflicted injuries or any illnesses occurred due to attempted suicide are not included in health insurance.

One should not be too quick when buying health insurance plans. First, you should consider the medical needs of you and your family members and make a list of what should be included in your plan and select the plan accordingly.

Every policy has its own set of exclusions, which is why you should thoroughly read the exclusions in your policy before making a purchase. Knowing everything about the policy will not only help you budget for expenses that are out of pocket but also make the claim settlement easier.

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