The Top Most Common Exclusions of Any Health Insurance Plan

In the current realm of insurance, there are several health insurance plans available for the consumer. Every insurance policy has some ‘exclusions’ - which effectively means that they do not cover and support the insured for certain aspects, even during a medical emergency. It is necessary for policyholders to be aware of these ‘exclusions’ to keep away from financial predicament possible during a medical crisis. The fact, as mentioned is that all insurance plans have exclusions – these would be medical conditions and illnesses that almost all insurers refuse to cover. Being aware of these ‘exclusions’ would enable the prospective policyholder to buy the most appropriate health insurance plan, and also know which medical conditions are not covered by the plan. It is extremely vital to read all the details of the policy before buying, and this exposition is meant to help you understand some of the top most common exclusions.

· Pre-existing Health Conditions 

This essentially means the illness or medical condition that the insured may be suffering from at the time of buying the health insurance plan. Insurance plans usually cover unforeseen medical situations, which negates coverage of existing medical conditions. Pre-existing health conditions are covered with a clause of a waiting period – meaning that the insured would be able to claim reimbursement of the medical expenses of a pre-existing condition only after ‘waiting’ for a period, ranging from 2 to 4 years depending on the insurer and the illness being covered.

· Cosmetic Surgeries 

Cosmetic procedures are meant to enhance the look and appearance of a person’s face and other parts of the body. Therefore, this does not fall under the umbrella of a medical emergency, which means that it cannot be covered under a health plan. However, they are covered only when recommended by a registered medical practitioner (specialist or general physician) following an accident and injury. In addition to these, dental treatment and joint replacement surgeries are also part of the common exclusions in health insurance plans.

· Pregnancy-related Conditions

With regard to pregnancy, events such as abortion, regular checkups, childbirth and other related situations are never covered under an insurance policy. Some health plans are available that offer coverage for pregnancy-related treatment and medications, but with the waiting period clause as would be mentioned in terms of the policy. Pregnancy, however, is a crucial condition for most women. Thus, it is recommended that the plan documents are read carefully to learn about the exclusions in detail before purchasing.

· Injuries due to Intentional Harm and Suicide Attempt 

Sufferings and injuries caused to oneself from intentional harm/attempts to end one’s life are not covered under any health plan and under any circumstance, waiting periods included. This is an essential factor to be kept in mind at all times.

· Therapies and Alternative Treatment  

Some people prefer alternative methods of treatment on finding no relief from their regular allopathic treatment. The other therapies and special treatments include acupressure, naturopathy, magnetic therapy, Ayurveda, and more. None of these alternate forms of treatment is covered under many medical health plans.

It is important to understand that no one policy is the same as another, and neither is the health conditions of the insured the same as other policyholders. It is therefore advisable to read various plan documents carefully, check for inclusions and exclusions, before buying any health insurance. Without complete knowledge, especially of the most common and significant exclusions can prove to be financially disastrous.