If you are shopping for health insurance, you must ensure that you get the best possible coverage for yourself. This means you need to make sure that your chosen policy covers important treatments if not all of them. Medical insurance provides coverage for the financial burden in the event of an unexpected medical emergency. However, medical insurance also follows a rigorous claim process as prescribed by the Insurance Regulatory and Development Authority of India (IRDAI). You can visit the official website of IRDAI for further details.

To prevent medical insurance abuse, IRDAI excludes certain medical expenses referred to as non-medical expenses in health insurance. Read this article to know what these non-medical expenses are in health insurance in India and how they affect the policy:

What are the non-medical expenses in health insurance?

Health insurance provides financial coverage for medical treatment at the time of planned and unplanned hospitalization. However, there are many expenses that are not part of the treatment. Such expenses are often for products and services that act as support for the actual treatment. Since these products and services are not directly part of the medical treatment, they are not included in the health insurance policy’s coverage. The money you would have to spend on these comes under the category of non-medical expenses.

List of non-medical expenses

According to IRDAI guidelines, some alternative medicines used during treatment or hospitalization when settling insurance claims are not considered medical expenses. The list of non-medical expenses is classified based on treatment and hospitalization. You can visit the official website of IRDAI for further details.

Optional items

  • Meals (other than what the hospital supplies)
  • Mineral water
  • Baby food
  • Nebulizer kit
  • Laundry/Attendant Fee
  • Thermometer
  • Belts/braces
  • Beauty services
  • Carry bags

* Standard T&C Apply

Non-medical expenses in treatment cost

During your stay at the hospital, healthcare professionals use certain items for treatment. Moreover, there are certain expenses that you would have to make to get the treatment. These expenses are also counted as non-medical expenses. They include:

  • Registration/Admission fee
  • Spirit, disinfectant, hydrogen peroxide
  • Urine container
  • Infusion pump fee
  • Blood reservation cost
  • Nutritionist or dietitian fee
  • Vaccination cost
  • Antiseptic mouthwash
  • HIV Kit
  • Diabetic shoes

* Standard T&C Apply

Non-medical expenses in room charges

Here is a list of non-medical expenses related to room charges at the time of hospitalization:

  • Handwash
  • Tissue paper
  • Housekeeping fee
  • Comb, hat, sandals
  • Toothpaste and toothbrush
  • Pulse oximeter charge
  • Gown
  • Foot cover
  • Cold pack/hot pack
  • Buds

* Standard T&C Apply

Non-medical costs in procedures

The prevailing notion is that health insurance covers all costs of medical procedures. However, there is a difference between the notion and what is health insurance’s actual policy towards surgery expenses. The following are items that can be considered non-medical expenses during medical procedures.

  • Surgical blade
  • Hair removal cream
  • Straps, cotton
  • Reusable razor
  • Surgical drill
  • Apron
  • Arthroscopy and endoscopy equipment fees
  • Harmon scalpel blade
  • Gauze blade
  • Eye pad

* Standard T&C Apply

Other medical expenses that are not payable

There are additional non-medical costs involved in health insurance. They include:

  • Barber fee
  • Syringe, needle, sterilized injection
  • Washing fee
  • Medicine box
  • Paper gloves
  • Digestive gels
  • Referral doctor fee

* Standard T&C Apply

How to know more about non-medical expenses before making claims?

Since this is the IRDAI’s policy, these exclusions are incorporated throughout the health insurance industry. IRDAI has specified the list of non-medical expenses that are not covered, and this list is given on every insurance company’s website. To become a smart health insurance buyer, you must be aware of your policy’s inclusions and exclusions to avoid any surprises in the future, especially during unforeseen hospitalizations. While you are checking inclusions and exclusions, you should also investigate other features such claims policy of the insurer. For example, you should whether the company offers cashless health insurance or not. You can visit the official website of IRDAI for further details. * Standard T&C Apply

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.