It is a known fact that health insurance always comes with its own set of terms and conditions. Hence it is essential to know what is covered under your policy and what is not. Every insurer provides a list of inclusions and exclusions approved by the IRDAI. Based on these conditions, your claim can get accepted or rejected. So, it is advisable to check and plan before selecting a health plan that suits you the most. Though every insurance company has its own limitations, there are certain sets of exclusions that are common. Let’s take a look at them.

List of Diseases Not Covered Under Health Insurance

The diseases not covered under any health insurance include;

  • Cost of contact lenses, spectacles or hearing aids
  • Dental surgery or treatment
  • Congenital external defects
  • Cosmetic surgeries like Botox, Liposuction, Implants or similar surgeries
  • Convalescence
  • Venereal disease
  • Pre-existing diseases like diabetes, blood pressure or heart ailments
  • General debility
  • Use or overconsumption of intoxicating drugs or alcohol or smoking
  • Self-inflicted injuries
  • AIDS
  • Diagnosis expenses
  • Infertility treatment or pregnancy complications
  • Hospitalization expenses related to IVFs or Abortions
  • Naturopathy treatment
  • Health tonics and supplements
  • Illness tracked to overconsumption of alcohol like liver damage
  • Expenses incurred on alternative therapies like acupressure, acupuncture or reflexology
  • Diagnostics or Pathological charges like scans or blood tests
  • Hospitalization expenses for the injuries caused due to war, riots, strike or nuclear weapon attack
  • Cancer of Oral, Oropharynx and respiratory system caused by use of tobacco
  • Injuries or illnesses resulting from engaging in adventure sports

The clauses under the inclusions and exclusions under health insurance vary from one health insurance provider to another. However, these diseases are usually not covered under any health insurance policy by any provider. So, make sure to take a look at these before making any claim as it may get rejected based on these exclusions.The best way to adopt is to manage your finances better and read the insurance policy wordings carefully to have better clarity on both the inclusions and the diseases excluded from the scope of the health insurance plan from your insurer.

FAQs – Frequently Asked Questions.

Let's take a look at some frequent queries on the List of diseases not covered by health insurance;

Q. Why is it that health insurance providers exclude certain claims?

The health insurance providers exclude certain claims as the risk attached is enormous and it involves a large sum of amount for a more extended period.

Q. Can extra coverage be purchased for diseases that are not covered under health insurance?

Many insurers provide customized add-on coverage that you can opt for while buying health insurance plans. You can check for additional coverage needed as per your requirements.

Q. Are all lists of these diseases excluded from health insurance plans by all the insurers?

Every insurer has a different set of terms and conditions towards health insurance plans and many have a waiting period option too under some diseases that can be covered. You need to read the policy carefully before purchasing it.

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Insurance Companies