What is covered by Health Insurance and what isn’t

What is covered by Health Insurance and what isn’t

Health insurance is a vital aspect of looking after one’s health and well-being. It is an agreement between the policyholder and the insurer, wherein the insurer agrees to cover the costs of medical expenses, provided the policyholder pays the premiums on time. It is important to note that not all medical expenses are covered by health insurance, and it is essential to understand what is and what is not covered.

What is covered by Health Insurance?

Health insurance typically covers expenses related to hospitalization or medical treatment, including consultation fees, diagnostic tests, and surgeries. Health insurance policies also cover the cost of medications and other medical supplies prescribed by doctors.

In-patient hospitalization: In-patient hospitalization is covered by almost all health insurance policies. It includes the cost of the hospital room, surgeon and anesthetist fees, lab tests, and other medical expenses incurred during hospitalization.

Out-patient treatment: Several health insurance policies also cover the cost of out-patient treatment. This includes visits to a doctor or specialist, lab tests, and other medical examinations.

Emergency services: Emergencies related to accidents or illnesses are typically covered by health insurance policies. The insurer covers the cost of the hospitalization, surgery, and other medical treatments required by the policyholder.

Pre-existing conditions: Health insurance policies also cover pre-existing conditions, albeit after a waiting period. Pre-existing conditions may include chronic illnesses like diabetes, hypertension, and asthma.

What is not covered by Health Insurance?

Cosmetic procedures: Health insurance policies do not cover the cost of cosmetic procedures unless they are medically necessary. Examples of medically necessary cosmetic procedures may include reconstructive surgeries due to accidents or burns.

Dental procedures: Some health insurance policies cover dental procedures, but most do not. Policyholders may need to purchase separate dental insurance to cover dental treatments.

Medical treatments outside the policy country: Health insurance policies may only cover expenses related to medical treatments within the policy country.

Alternative therapies: Alternative therapies like homeopathy, Ayurveda, or chiropractic treatment may not be covered by health insurance policies. Some policies may offer coverage for specific alternative treatments like acupuncture, but it varies from policy to policy.

In conclusion, it is essential for policyholders to carefully read and understand their health insurance policy to be aware of what is covered and what is not. It is also essential to keep in mind that policy coverage varies from insurer to insurer and policy to policy. Hence, it is crucial to perform thorough research and choose a policy that best suits individual needs.