As much as it is crucial to understand what your health insurance will cover, it is equally essential to understand what it may not cover. Here's a list of things you need to know about, that your medical policy most likely will not cover.

Health insurance policies are a great way to cover unexpected medical expenditures. Insuring yourself and your family with a policy is not only good for saving taxes, but it also protects you from a financial setback at the times of needs. Although most policies cover the basic requirements, many things are not included in the policy. This might come as a shock to you if you decide not to go through the clauses.

Therefore, to make things clear for you, here is a brief list of claims that your health insurance will not cover.

Advanced Treatment Procedures:

Any procedure that is experimental or new, and is not based on proven medical practices, your health cover most likely will not provide coverage for it. Although advancements in technologies are being made every day, insurance companies take their fair share of time to cope-up with them.

  1. Illnesses Caused by Substance Abuse:
  2. Even though the sickness could be critical, if it is caused due to excessive alcohol consumption or smoking; your insurance company can deny covering the claim. In these cases, you may have to incur the charges from your pocket. However, you can raise a dispute about this.

  3. Acupuncture and Other Such Therapies:
  4. This clause mainly depends on your reason for taking up massages, acupuncture, or therapies. If the reason you take up these services is merely for your general wellness, your health insurance coverage might not include it. If any of these services are being taken up as a part of your treatment, the policy might cover them.

  5. Cosmetic Surgeries:
  6. Again, the above rule applies for cosmetic surgeries also. If the operation is happening because it's medically necessary, it will be covered. However, if you're getting a weight loss surgery done or a facelift done just to look better, your medical insurance might not cover it.

  7. Other Things that are not Covered:
  • Travel Vaccinations: While general vaccinations come under preventative care, travel vaccines do not, and thus are usually not included.
  • Dental, Vision, and Hearing: Most plans do not cover claims relating to dental, vision, and hearing.
  • Maternity Care: Unless otherwise stated, maternity care is not included in most policies.
  • Diagnostic Expenses: Diagnostic tests done to identify a disease, done at the lab or hospital are usually paid from your own pocket.

It is essential to read through the lines of the terms and conditions of every health cover insurance. It is equally important to have a general idea of what may be and what may not be included in your policy.

Learn more about Health Insurance Plans here.


The information contained herein is generic in nature and is meant for educational purposes only. Nothing here is to be construed as an investment or financial or taxation advice nor to be considered as an invitation or solicitation or advertisement for any financial product. Readers are advised to exercise discretion and should seek independent professional advice prior to making any investment decision in relation to any financial product. Aditya Birla Capital Group is not liable for any decision arising out of the use of this information.

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