Health Insurance: Which diseases are not covered under mediclaim?

The recent advancements in the field of medicine have led to a range of improvements in the diagnosis, treatment, and prevention of many diseases and health conditions. This has also led to a sharp rise in medical expenses, which can be difficult for many to afford. This is where health insurance plans or mediclaim policies come to rescue.

It has become the need of the hour to enroll in health insurance plans or mediclaim policies, in case of any future emergencies. These plans help to cover medical expenses including hospitalisation incurred due to illness or injury.

Health insurance policies and mediclaim policies are different from each other and their coverage also varies. In this section, let's detail the important aspects of a mediclaim policy, its coverage and what it excludes.

What is a Mediclaim?

A type of health insurance, mediclaim policy is something that covers the hospitalisation charges of the insured person in case of any illness or injuries. The policy generally covers hospitalisation costs, medical treatments and other related expenses. In this plan, the insured pays a premium to the insurance company in exchange for help in medical expenses up to the coverage limit specified in the policy.

Both cash and cashless coverage are provided to the insured in case of a medical emergency. Mediclaim policies do not cover a wide range of ailments or may have a waiting list before one can avail the offered benefits. Individuals must read the policy terms properly before signing the dotted line.

What is not covered under Mediclaim policy?

There are certain things that are not covered under the plan. Some of these are:

1. Any sort of plastic surgery, implants, or cosmetic corrections are not covered under the policy.

2. Expenses for congenital illnesses or birth defects are not considered to be part of mediclaim.

3. Treatment costs related to infertility and in vitro fertilisation are not counted as part of mediclaim.

4. Mediclaim policies do not include cover for sexually transmitted diseases like HPV, HIV, Syphilis and Herpes.

5. Diseases whose symptoms manifest within the initial 30 days of policy start date are not considered eligible for mediclaim.

6. Self-inflicted injuries due to drug overdose, alcohol consumption, or suicide attempt are not covered under the policy.

7. Under mediclaim, war, nuclear strike induced hospitalisation and riots are not considered.

8. Certain pregnancy related treatments due to complications in caesarean operation are not part of the policy.