What are the Diseases not Covered by Health Insurance in India?

Health insurance policies provide financial coverage for a range of diseases, their treatment procedures, medication, etc. However, certain diseases and procedures are included in health insurance coverage. These are known as exclusions.

While buying a health insurance policy, you must check the exclusions to avoid unexpected surprises while claiming insurance coverage. Keep reading to learn more about the diseases that are not covered in a health insurance policy.

Which Diseases are Excluded from Health Insurance Coverage?

Take a look at the exclusions of the health insurance policy in India:

● Diseases Caused by Alcohol Consumption or Smoking

Individuals with drinking or smoking habits are often prone to severe diseases like mouth cancer, bronchitis, liver damage, etc. If any of these diseases are caused by drinking or smoking habits or drug addiction, health insurance will not cover them.

● Pre-existing Diseases

These are diseases that an individual already has when buying a health insurance policy. Usually, these diseases are not covered instantly by a health insurance plan. You can claim coverage only after the waiting period, which usually ranges from 1 to 3 years based on the plan.

● Epilepsy

Epilepsy is usually excluded from health insurance coverage, even for a senior citizen's health plan. So, even if you develop conditions like epilepsy after purchasing a health insurance policy, you should bear the expenses related to its doctor consultation, medication, diagnosis, treatment, etc.

● Genetic or Congenital Diseases

There are certain diseases that are caused by genetic disorders or birth defects, such as cleft lip, Down syndrome, extra skin formation, or heart issues, since birth. Treatment of such conditions is not included in health insurance coverage.

● Self-inflicted Injury

Even though your health insurance may cover you for unintentional accidents and wounds, it does not cover self-harm or intentionally causing harm to oneself.

● Sexually Transmitted Diseases (STDs)

STDs such as HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome), syphilis, etc., are transmitted through sexual contact. Though such diseases need long-term management, most insurers do not cover them.

● Cosmetic Procedures

If an insured undergoes cosmetic procedures to enhance their aesthetics that are not required medically, health insurance will not cover them. It includes liposuction, rhinoplasty, dermal fillers or Botox, anti-ageing treatments, and facelifts. However, if you need surgeries to fix deformities caused by an accident, it shall be covered by a health insurance plan.

● Alternative Therapies

Alternative treatments like homoeopathy, ayurveda, acupuncture, and chiropractic treatments are not included in conventional medicine. So, they do not have any notable clinical evidence to support severe medical conditions.

● IVF and Infertility Treatments

IVF (In Vitro Fertilisation) and other infertility treatments are scheduled events that cost a lot of money. The costs associated with any infertility treatment are therefore not covered by the health insurance policy, which only covers medical emergencies brought on by unanticipated events.

These are the common exclusions of a health insurance policy. However, the list may vary based on the insurance policy and company you choose.