Do not ignore these exclusions in health insurance policies

Adhil ShettyBankbazaar.comHealth insurance policies can spring an unpleasant surprise if not purchased smartly and objectively. Policy purchasers tend to research and identify the inclusions, but are generally unaware when it comes to common exclusions in a policy.Many people feel let down or cheated when they come to know that their expensive root canal treatment or a cosmetic surgery would not be covered under their health insurance policy. This is despite the fact that health insurers have a clear exclusion policy in place. There are certain common exclusions that are usually not covered in all health care policies uniformly. Here is a look such common exclusions that you must know before signing up for a health insurance policy.Pre-existing diseases: If you are suffering from any diseases, you must declare it to the insurance company before taking a policy. All pre-existing diseases have a lock in period ranging from 2-4 years to get coverage. For example, if you have been suffering from some blood pressure variations, any complications arising out of it, like a low BP condition to a condition of stroke will not be reimbursed. Some conditions like varicose veins, tonsillitis, knee replacement surgery, treatments for cysts etc are also considered as pre-existing, as these do not occur suddenly.Lifestyle-induced diseases: Lifestyle induced diseases too are excluded from health insurance cover, unless it is specified at the time of application and you have paid a higher premium if it is asked by the insurer. An instance of this is alcohol or drug abuse treatments.Similarly, if you have been suffering from a lung disease and the doctor reports it as an outcome of smoking, or if a remark has been made in your medical report that the patient is a smoker, chances are that your claim will be rejected.Alternative treatments: Health insurance companies have been traditionally reluctant to offer coverage if you are opting for alternative medication for treatment. Since there are multiple alternative treatment systems like Ayurveda, Unani, Naturopathy, the costs of each of these medication systems vary, making it difficult for insurance service providers to commutate a cover.Recently some insurance companies have started offering cover for alternative treatment as well. But most such policies have a cap as all claims are covered only to a certain percentage of the sum insured for alternative treatments.Waiting period related exclusions: You cannot get a health insurance policy today and start claiming for reimbursement of medical costs the very next day. The waiting period usually ranges between 1 and 3 months from the date of policy inception. Some health insurance companies exclude certain specific diseases for the initial first year of the policy. So, make sure that you the read terms and conditions and details of waiting period for specific diseases before signing up, to avoid any miscommunication at a later stage.Pregnancy and childbirth: Majority of health insurance plans to not include coverage for pregnancy and child birth related expenses. Any medical costs for abortion and infertility treatments are also not included under the cover of many health insurance plans.If you need a health insurance plan offering coverage for medical expenses related to pregnancy and childbirth, you can opt for a specialized plan catering to pregnancy and childbirth expenses. Such health insurance plans however do offer coverage for pregnancy after a predefined waiting period. Cosmetic treatments: Cosmetic treatments may have become common and popular, but such treatments are not covered under health insurance plans. This includes eye treatments, laser treatments, surgeries like liposuction, weight loss programmes etc. All types of dental treatments are also excluded from health insurance, as it is considered as a cosmetic procedure by the insurers.While cases of pure cosmetic treatment are clearly excluded, plastic surgery if required as treatment after an accident is usually considered, if the insurance company is fully satisfied with the line of treatment and its significance.Hospital expenses: Health insurance policies have a limit on the expenses covered for room rent for hospitals, fee for ambulance, consultation charges of doctors and other miscellaneous hospital expenses. Also, expenses like taking second opinion are also not covered in a regular policy.Make sure you know the terms and conditions of the allowed hospital cost in your health insurance policy. One can pay a higher premium and get enhanced coverage for hospital related expenses including ICU, ambulance charges etc, if it is offered as riders or add-ons.War or nuclear weapon related damages: War and nuclear weapon related damages may sound insignificant, but with the uncertainty of a terrorist attack, this cannot be ruled out entirely. Health insurance companies offer no cover for any medical costs that may arise out of treatments due to any act of terrorism like bomb blasts or any non conventional war attack like chemical or nuclear weapon.Health insurance is an essential financial tool, especially with the rising medical costs. Before signing up for any health insurance plan, it is essential to understand the exclusions to avoid any heartbreak or denial of claims at a later stage. This helps set your expectations right and enables you to buy health insurance for the right reasons.