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Exclusions in Health Insurance Policies – Things That Are Not Covered Under Health Insurance Plan
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There are certain covers that you thought are not included under your health insurance plans but you can actually avail coverage for them. Let us find out more about them in this blog.
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It is very important to ensure that you know all the expenses that are covered under your health insurance before you buy a plan. Many health insurance companies do not cover certain charges. On the other hand, there are some things which are not covered by health insurance but you can actually get coverage for them. Let us learn about such covers here.
Among the various charges that are not covered by health insurance policy include the costs of diagnostic tests, cosmetic surgery, alternative therapies, infertility complications etc. which we will learn about in this blog.
However, there are some exclusions that an insured can add as riders to their health plan to avail their benefits. Let’s discuss some such coverage that you can buy as an add-on rider by paying an extra amount.
Diagnostic Tests Charges
One such charge is that of diagnostic tests that almost every person has to undergo while visiting a doctor and seeking medical help. This is because every time you visit physicians for any particular medical condition, they prescribe different diagnostic tests before finally confirming your ailment. Being too expensive, people like to have coverage for such tests so that they can undergo these tests without making a hole in their pocket.
Diagnostic tests can be any tests that the doctor prescribes to verify or to rule out any disease or health condition of a patient. These can be invasive or non-invasive and the charges for such tests vary depending on the kind, process and the advanced technology used to get such tests done.
Some of These Tests are –
- X-Rays,
- MRI,
- Ultrasound,
- CT scans,
- Fluoroscopy,
- PET Scans,
- Mammography,
- Biopsies etc.
The charges of these tests are quite expensive and might be difficult for people to afford on a frequent basis. Moreover, since most of the times when we visit a doctor, we are advised to get a few such tests to confirm the condition of our health. So, affording such tests every time becomes difficult financially.
Health Insurance from PayBima
Can an Insured Get Covered Against Diagnostic Costs? How?
There are many insurance companies offering coverage for many diagnostic tests. Some of them are blood tests, X-rays, MRIs etc. However, these tests are compensated only if the insured person availing of these expenses is admitted to the hospital for 24 hours and above.
Further, there are certain ways in which you can avail benefits of diagnostic costs coverage without getting hospitalized as discussed below:
- By procuring OPD Cover – if you avail the OPD cover, which many insurers are offering these days, you can claim many costs that are not incurred while you are hospitalized. Some of these costs include costs of pharmacy, diagnostic tests costs prescribed during regular check-ups etc. However, it depends on the insurer about what all charges they are offering. Most of these OPD covers allow the insured to claim reimbursement numerous times during the duration of the policy. Thus, health insurance with OPD cover allows you to save enough money on diagnostic costs.
- By choosing a cover on Preventive Health Check-ups – Depending on your healthcare needs, you can choose a preventive health check-up plan. With this plan, you can keep a check on your health at a cost effective premium and lower the scope of critical and other ailments.
Further to the above, there are many health plans that allow preventative health check-ups for free at the time of policy renewal. Some of the tests that are covered under such preventive check-ups are namely, lipid profile, pap smear, pelvic exam, cancer screenings, heart disease screening, and dental check-up etc.
Exclusions in Health Insurance policies
Now let us discuss some of the common exclusions in health insurance policies:
- Cosmetic Surgeries – Botox, implants, liposuction etc. are some of the cosmetic surgeries that are not covered under a health insurance plan. However, if any such surgery is done as part of a treatment, it is covered by your insurer.
- Infertility Complications – Complications related to infertility such as abortions etc. are not covered under your health insurance even if the insured gets hospitalized for the same. However, some insurers might cover them under maternity health plans. So, it is best to check with your policy provider.
- Health Supplements – Your health insurance does not offer coverage against supplements that you buy for your health like tonics etc. However, if your doctor suggests such supplements as part of your treatment, they might be covered by the insurer. So, here again you have to seek help from your insurer to get the details.
Ailments Caused Due Excess Consumption of Alcohol
If overconsumption of alcoholic substances is the cause of your disease, it might not be covered by your insurer.
Alternative Therapies Expenses
Costs that you may incur on alternative therapies such as acupressure, naturopathy, reflexology, etc. are also not covered under your health insurance coverage.
Young and healthy? Find out which of these plans rewards you with lower premiums. Click here to check now!

Author Bio
Paybima Team
Paybima is an Indian insurance aggregator on a mission to make insurance simple for people. Paybima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 21 years of experience. Paybima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.
Over to You
Health emergencies don’t come with a calendar invite. Whether you're planning for your own future or looking out for your parents, choosing the right health insurance plan can make all the difference. That’s where a deeper look at the fine print helps. When you compare Star Health’s Red Carpet Plan vs Care Health Enhance Plan, what you’re really doing is choosing the kind of financial backup you want in your corner.
The Star Health Red Carpet Plan is made with senior citizens in mind. With benefits like annual preventive check-ups, it helps you or your ageing parents get covered without the usual hassles. On the other hand, the Care Health Enhance Plan acts as a top-up cover, ideal if you already have a base health policy and want to increase your shield without increasing your premium by too much.
While health insurance takes care of medical needs, don’t forget to plan for life’s bigger what-ifs. A term Insurance policy, especially a 1 crore term insurance plan, can be the long-term security net your family needs. Health and life coverage go hand in hand. And when chosen right, they help you face the future with confidence, not chaos.
Speak to an Advisor The Star Health Red Carpet Plan is made with senior citizens in mind. With benefits like annual preventive check-ups, it helps you or your ageing parents get covered without the usual hassles. On the other hand, the Care Health Enhance Plan acts as a top-up cover, ideal if you already have a base health policy and want to increase your shield without increasing your premium by too much.
While health insurance takes care of medical needs, don’t forget to plan for life’s bigger what-ifs. A term Insurance policy, especially a 1 crore term insurance plan, can be the long-term security net your family needs. Health and life coverage go hand in hand. And when chosen right, they help you face the future with confidence, not chaos.

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