Understanding Mediclaim Better – Exclusions in Mediclaim

 

 

 

Investing in a good medical insurance policy has become more crucial than ever, especially with the increase in lifestyle related and other diseases. However, before signing up for any health insurance, it is absolutely necessary to understand what it entails and most importantly what it does not.

 

This article is aimed at enlightening you more on what your mediclaim policy might not cover. This is important information, as ignorance about it can cause stress and worries if you find out at any other stage that the treatment you are seeking does not get covered by your insurance.

 

Restriction in Your Mediclaim Policy

 

• Limit On the Maximum Cover

 

Learn about the maximum cover your insurance offers. So, in case of any medical emergency you must be aware of how much of the expenses will be paid by the insuring company.

 

• Expenses  Borne on Treatment of Pre-existing Diseases

 

Many mediclaim policies do not cover the expenses for any disease that the insurer may have had before availing the insurance.

 

• Terms And Conditions For Reimbursing Hospitalization Bills

 

Many mediclaim insurance policy companies require the patient to be hospitalized for at least 24 hours for consideration for medical bill reimbursement. The mediclaim policy may also be restricted for certain treatments and medical procedures such as:

 

a. Eye Surgery
b. Dental surgery due to accident
c. Dialysis
d. Coronary Angioplasty and Angiography
e. Kidney Stone Removal
f. Treatment of fractures / dislocations excluding hairline fractures
g. Surgery of Appendix, Gall Bladder, Pancreas, Bile Duct, Hernia, Prostate and ENT
h. Radiotherapy.

i. Alternate Therapy

j. Cosmetic Surgery

 

• Domiciliary Expenses

 

Domiciliary expenses are not covered by all mediclaimpolicies. Be aware about your insurance company’s conditions for claiming reimbursement on domiciliary expenses.

 

• Diagnostic Charges

 

Any charge incurred for a diagnostic process that does not define any ailment or conclusion of sickness is mostly not covered by the mediclaim policy.

 

• Medical Expenses Incurred In The Waiting Period

 

Most mediclaim policies have a waiting period (approximately 30 days) after the insurance is bought. The plan is effective only after this waiting phase. Therefore, any treatment or medical expenses borne during this period is not incurred by the mediclaim company.

 

The exclusions for each medical insurance company may vary. Read all the terms and conditions carefully before signing any document so that you make an informed choice.  This will also save you from being unprepared in cases of medical emergencies that do not get covered under your mediclaim benefits.

 

 

Read more about mediclaim insurance by HDFC Life.

 

About HDFC Life:

 

HDFC Life, one of India’s leading private life insurance companies promoted by HDFC Ltd. & Standard Life Ltd., offers a range of individual and group insurance solutions