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When you have a robust health insurance policy, you feel safe and secure knowing that your family members are sufficiently protected against medical emergencies. You can also breathe a sigh of relief knowing that you can provide the best medical facility to your family. Lastly, it gives you the financial cushion to meet the medical expenses without disturbing your savings.However, do you know that the IRDA (Insurance Regulatory and Development Authority) has strict claim settlement norms? To restrict the misuse of health insurance , the IRDA has segregated certain expenses that you may incur during hospitalisation as non-medical expenses. The insurance companies are not obliged to compensate the same during claim settlement.As a health insurance policy buyer, you must know about these expenses for a hassle-free claim settlement.
Let us look at the various non-medical expenses as listed by the IRDA
Optional items
As per the IRDA mandate, certain optional items that you may use during hospitalisation or treatment do not qualify for reimbursement by the insurer. These include –
- Mineral water
- Food (other than the diet provided by the hospital)
- Braces/belts
- Laundry/attendant charges
- Thermometer
- Nebuliser kit
- Baby food
Non-medical room charges
The non-medical expenses subsumed into room charges include-
- Tissue papers
- Hand wash
- Toothpaste and toothbrush
- Comb, caps, slippers
- Housekeeping charges
- Pulse oximeter charges
Non-medical charges subsumed into procedure charges
The IRDA excludes certain expenses that you may incur during treatment procedures. These include –
- X-Ray film
- Cotton, bandages
- Arthroscopy and Endoscope instrument charges
- Disposable razors
- Apron
- Surgical blades, gauze, Harmon scalpel
- Surgical drill
Non-medical charges subsumed into treatment cost
When you are hospitalised, the medical staff may use certain times for administering treatment. The expenses related to such things also come under the non-payable non-medical expenses. These include -
- Registration charges for getting admitted to the hospital
- Urine container
- Blood reservation charges
- HIV Kit
- Antiseptic mouthwash
- Spirit, disinfectant, hydrogen peroxide
- Infusion pump cost
- Dietician charges, nutrition planning charges
- Vaccination charges
Additional non-payable non-medical expenses
Apart from the costs listed above, there are other additional non-payable items. These include-
- Syringes, needles, sterilise injections
- Paper gloves
- Washing charges
- Medicine box
- Digestion gels
- Referral doctor’s fee
Thus, there are many non-medical expenses that you may incur during treatment. However, these costs don’t contribute much to the overall treatment expenses. In most cases, these expenses are manageable, and you can afford to pay from your pocket. When you file a claim, it is vital that you avoid including the non-payable items in your claim request to avoid unnecessary delay in the settlement process.When you buy a health insurance policy , it is advisable to compare the plans from different insurers to know the exclusions to choose the right plan that provides maximum coverage. Also, be sure to read the fine print of the policy so that you can make an informed buying choice.
DISCLAIMER
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.