Health Insurance

List of Non-medical Expenses of Health Insurance That You Must Know

By Juhi Walia
24 August 2022, 10:55 AM

Health insurance protects you and your family in difficult times and saves you from getting hit by a significant financial jolt. Hence, it becomes more important that you choose a suitable health insurance policy that provides maximum benefits. It is very important to check the exclusions listed as non-medical expenses so as to ensure balancing the medical preparations and expenses during hospitalization. We have tried to introduce you here to such items as well as educate you more about them.

The Importance of Having a Health Insurance Policy

An agreement of health insurance commits the insurance company to guarantee payment for medical costs in the event that the insured becomes ill or has an accident that necessitates hospitalisation. Typically, insurance companies partner with top hospitals to offer cashless care to their insured customers. If the insurance company has no affiliation with the hospital, they compensate the insured's expenses. The government also encourages the purchase of health insurance by offering an income tax deduction under Section 80D of the Income Tax Act.

Purchasing a health insurance policy is critical because medical care is costly, particularly in the private sector. Being hospitalised can break the bank and ruin your finances. If the individual who brings in the money is suddenly lying in a hospital bed, things will get increasingly harder. Paying a small annual premium would alleviate your concern in the event of medical crises and allow you to avoid all of this. A good health insurance plan will often pay for costs associated with doctor visits, medical tests, ambulance services, hospital stays, and, to a limited extent, post-hospitalization recovery costs.

Read more - Benefits of Health Insurance in India

Understanding Non-medical Expenses

Non-medical costs are those associated with a variety of things used in hospitals but not covered by health insurance. In order to prevent manipulation, the IRDAI has excluded such costs from health insurance coverage.

As a result, you will be required to cover your non-medical costs out of your own money during claim settlement since your health insurance company will not cover them.

The List of the Elements Coming Under Non-medical Category

The IRDAI has classified non-medical expenses according to hospitalisation and treatment received. Additionally, it provides a list of extras that health insurance plans do not cover. Here are some examples of the many non-medical expense categories provided by IRDAI:

Treatment Category

  • Charges for admission
  • Spirit, disinfectant, and hydrogen peroxide
  • Charges for infusion pumps
  • Fees for dieticians or nutritionists
  • Container for urination
  • Footwear for diabetics
  • Mouthwash
  • The cost of blood reservations
  • Vaccination
  • HIV test kit

Hospital Rooms

  • Housekeeping
  • Paper napkins
  • Hand wash
  • Gown
  • Charges for pulse oximeter
  • Hot or cold pack
  • Toothbrush and paste
  • Caps, slippers, and combs
  • Foot cover
  • Buds

The Cost of Procedures

  • Apron
  • Cotton and bandages
  • Throwaway razors
  • Gauze blades
  • Surgical blades
  • Harmon scalpel blades
  • Surgical drill
  • Instrument costs for endoscopy and arthroscopy
  • Eye pad
  • Hair removal cream

Other Non-medical Expenses

  • Washing charges
  • Medicine box
  • Physician referral fees
  • Digestion gels
  • Paper gloves
  • Barber charges
  • Sterilized needles, syringes, and injections

Optional Elements

  • Thermometer
  • Food, excluding hospital food
  • Mineral water
  • Laundry and staff fees
  • Baby food
  • Nebulizer set
  • Belts/braces
  • Carry bags
  • Beauty services

Important Points to Note about Non-medical Expenses in Health Insurance 

Here are a few things to keep in mind regarding non-medical expenses:

  • According to IRDAI regulations, any non-medical costs incurred while you are hospitalised will not be covered by your health insurance plan.
  • The non-medical charges specified by the IRDAI are typical and can be found in your policy paperwork as well.
  • Check your insurance documents to learn about the non-medical costs that are not covered by your health insurance plan. You can prevent unpleasant shocks during health insurance claim settlement by doing this.
  • You can reduce your deductibles by being aware of the non-medical charges covered by your policy. It will keep you from spending a lot of money on things that aren't covered by your insurance, lowering your out-of-pocket expenses.
  • Some health insurance plans offer to cover non-medical costs under riders. You can purchase this cover for an additional premium payment to prevent any out-of-pocket costs.

How to Know More about Non-medical Expenses Before Claiming

The health insurance business adheres to some exclusions. On the website of the insurer, the IRDAI has outlined a list of non-medical charges. To purchase health insurance wisely, you must be aware of the policy's coverage and exclusions to prevent unpleasant surprises in the future, particularly during an unanticipated hospitalisation. Read the fine print and learn what is and isn't covered by health insurance

Conclusion

It is not difficult to comprehend the non-medical costs of health insurance. Customers can obtain a plethora of information from health insurance companies through their secure websites. This knowledge might help you choose the best health insurance plan.

Non-medical costs must be covered out-of-pocket, but they are typically less expensive. Before deciding on the best health insurance plan for family and yourself, you must carefully review the plan's coverage and limitations.

Read more - Why You Must not Ignore Pre and Post-hospitalisation Expenses in a Health Insurance Cover

FAQs
1. Is the cost of diabetic shoes covered by health insurance?

No, according to health insurance, diabetic footwear counts as a non-medical expense.

2. What medical costs cannot be reimbursed?

Non-medical expenses is yet another name for non-reimbursable medical costs. The health insurance policy does not pay for the non-reimbursable health care expenses.

3. Are pre- and post-hospitalization costs included in the definition of non-medical costs for health insurance?

Pre and post-hospitalization costs that are pertinent will be regarded as medical costs and reimbursed by the health insurance plan. But it depends on the insurer and the kind of coverage you choose.

4. How can I get my health insurance coverage to pay for my non-medical expenses?

For an added charge, several insurers offer rider coverage for non-medical costs. To broaden the coverage of your primary health insurance, you can choose to purchase the non-medical expenses riders.

5. Can we file OPD expenses for insurance?

OPD insurance is offered as an optional cover, and under it, the insured may submit a claim for payment for an amount equal to their actual out-of-pocket medical expenses. You can choose an OPD coverage amount between INR 5,000 and INR 50,000 depending on your needs. Up until the age of 60, there is no co-payment for members.

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