Team AckoDec 9, 2021
If you are shopping for the right health insurance, you want to be sure that it covers important treatments, if not all of them. Medical insurance mitigates financial losses, especially during unforeseen medical emergencies. But, medical insurance also follows a strict claim process as directed by the Insurance Regulatory and Development Authority of India (IRDAI).
The IRDAI has excluded some medical expenses, referred to as non-medical expenses in health insurance, to curb misuse of medical insurance. In this article, we have listed the non-medical expenses in medical insurance so that you are aware of the policy’s exclusions.
Health insurance offers financial coverage during planned and unplanned hospitalisation. However, there are several items charged during your hospitalisation which are excluded from the insurance coverage. The cost of these excluded items is known as a non-medical expense.
As per the IRDAI’s guidelines, some optional medical items utilised during the treatment or hospitalisation are not considered as medical expenses when settling insurance claims. The non-medical expenses list is categorised based on the treatment and hospitalisation.
Food (other than provided by the hospital)
During hospitalisation, healthcare professionals use certain items for treatment. Here are the non-medical expenses incurred in treatment.
Spirit, disinfectant, hydrogen peroxide
Infusion pump charges
Blood reservation cost
Nutritionist or dietician charges
Here is the list of non-medical expenses about the room charges during hospitalisation.
Comb, caps, slippers
Toothpaste and toothbrush
Pulse oximeter charges
Cold pack/hot pack
Following are the items that are considered as non-medical expenses in procedural costs.
Hair removal cream
Arthroscopy and Endoscopy instrument charges
Harmon scalpel blades
Here are additional non-medical expenses in health insurance.
Syringes, needles, sterilised injections
Referral doctor’s fees
The exclusions are followed across the health insurance industry. The IRDAI has specified the list of non-medical expenses and is listed on the insurer’s website. To be a smart health insurance buyer, you must know of the inclusions and exclusions of the policy to avoid any surprises in the future, especially during unforeseen hospitalisation.
Read the terms and conditions and understand what is not covered in health insurance so that you can avoid unforeseen surprises and financial losses.
Understanding the non-medical expenses in health insurance is not a cumbersome task. Insurers such as ACKO provide buyers with access to vast amounts of information via secure websites. This information can enable you to select the right health insurance plan.
While non-medical expenses are to be paid out-of-pocket, the cost of these items is generally lower. You must read the inclusions and exclusions of a health insurance plan before finalising the right plan for you and your family.
Here are some of the common questions about non-medical expenses in health insurance.
Non-reimbursable medical expenses are also called non-medical expenses. Medical expenses that are not covered by the health insurance plan are known as non-reimbursable medical expenses.How can I cover non-medical expenses in my health insurance policy?
Several insurers offer add-on covers for non-medical expenses for an additional premium. You can opt to buy the non-medical expenses add-on cover to increase the scope of the primary health insurance coverage.Is diabetic footwear considered a medical expense in health insurance?
No, diabetic footwear is considered a non-medical expense in health insurance.Are pre and post-hospitalisation expenses considered non-medical expenses in health insurance?
Relevant pre and post-hospitalisation expenses will be considered as medical expenses and covered by the health insurance policy. However, it depends on the insurer and the type of policy you opt for.
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