Understanding the health insurance policy document is not easy. There are many difficult terms and conditions mentioned in this. Many people do not pay attention to the conditions of the policy, which may lead to further remorse. Many times the policyholders are shocked by the claim rejection or the short payment. Through this article, we are telling you what is not covered in your health insurance policy.
1. New or Advanced Treatment Procedure:
There are continually new ways of treatment. Insurance companies take time to approve them. Robotic Surgery or Cyber Knife is not part of policy, hence the claim will not be received. Stem cell therapy is also not covered in the insurance policy. A policy holder should take care of it whether the treatment advised by doctor is covered in it or not.
2. Disease due to Excessive Alcohol or Cigarette:
If there is a disease due to excessive alcohol or cigarette then you may have to pay with your pocket for treatment. However, this is a complex issue. There is no claim to be received for a lot of alcohol or cigarette smoking. If you do not keep an eye on the insurance company's opinion then you can challenge it. In such cases, the company has to prove the claim rejection.
3. Charges of Resident Doctors:
If the hospital shows the room rent and resident doctor's charge separately in the bill, then the insurance company will probably not pay them. Technically, the resident doctor's charge should be included in the room rent. Therefore, insurance companies do not pay the resident doctor's charge separately.
4. Dental and Skin Problems:
Dental and skin problems are not covered in most policies. Except from beauty makeover and special cases, there is no cover for plastic surgery.
5. Treatment at Home:
In the absence of hospitalization, many companies cover treatment at home. Payment is limited to 10% of the sum assured. This cover is not available in a disease like asthma, even if the patient meets the conditions of treatment at home.
6. Registration Charge and Admission Deposit:
Registration charge paid while admitting the patient in hospital is not received as claim. Admission deposit also is not covered as claim. Most people do not know that insurance companies do not pay for shampoo, powder or other non-medical items.
7. Claim for Some Medicines:
Insurance companies do not allow blanket approval for all the treatment procedures for cancer. Some insurance companies do not pay claims for certain cancer medicines. For example, some chemotherapy medicines offered by nerves are covered in the policy but there is no claim for oral medicine. Similarly, most of the medicines under immunotherapy is not covered in the policy.
8. Many Visits of Specialist Doctor in a Day:
This cover may or may not be in the policy. We pay specially for all visits of the doctor, but in some policy products a specialist may not be included in the payment for many visits.
9. Miscellaneous Charges:
Claim is not received on Donor Screening Charges, Registration and Discharge Charges, Mental Illness, Hearing Aid and Contact Lenses, Helpful mobility, Laundry Charges, Bed Pan Charges, Diapers, Toilet Items, and Baby Food.
(Also read: Avoid these 5 big mistakes while buying Health Insurance)
(Also read: Now insurance company will cover mental illness)
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