Written By: Anshika Ojha

Anshika Ojha

Health Insurance

Anshika Ojha is a content writer with more than 2 years of experience and holds expertise across various formats of content. She focuses on simplifying health insurance jargon and making it easy for readers to understand.

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Reviewed By: Raj Kumar

Raj Kumar

Health Insurance

Raj Kumar has more than a decade of experience in driving product knowledge and sales in the health insurance sector. His data-focused approach towards business planning, manpower management, and strategic decision-making has elevated insurance awareness within and beyond our organisation.

Updated on Jan 19, 2026 5 min read

What are the Inclusions in Health Insurance?

Health insurance policies cover specified expenses, specific to the policy. These are known as inclusions in health insurance. Depending on the insurance company and plan that you are purchasing, inclusions can include medical treatments, medications, health checkups, etc.

Before you buy any health insurance policy, it is strongly advisable to check the inclusions and ensure that you are aware of all aspects that the policy covers. This ensures that you make the right decision and buy the policy most suitable for you.

Best Health Insurance Plans in India in 2025

The Inclusions of health insurance vary depending on the plan and insurance company you are purchasing from. We have listed the top health insurance plans and their inclusions.

15 Key Inclusions of Health Insurance in India

Mentioned below are the most common inclusions of health insurance in India:

1. In-patient Hospitalization

   If a patient is in the hospital for more than 24 hours, it is known as in-patient hospitalization. Some insurers count hospitalization even if it’s more than 2 hours (based on discharge summary). This includes the cost of hospital room, Intensive Care Unit (ICU) treatment, nursing care, medicines & drugs, diagnostic tests, operation theatre charges, etc.

2. Pre-hospitalization Expenses

   Most health insurance policies offer coverage for expenses that occur before hospitalization. These costs include Doctor consultation fees, diagnostic tests, prescribed medicines, OPD expenses, pre-surgery evaluations, specialist review fees, etc.

3. Post-hospitalization Expenses

   Even after the patient has been discharged, most health insurance policies cover expenses such as the cost of follow-up consultations, medical tests, medications, and any necessary treatments during the recovery period. Post-hospitalization expenses are usually covered for up to 60, 90, or 180 days.

4. Day Care Treatments

   Daycare treatments are those that do not require a 24-hour hospital stay. Procedures such as Cataract surgery, chemotherapy, dialysis, radiotherapy, tonsillectomy, sinusitis treatment, etc, come under day care treatments.

5. Pre-existing Diseases

   A pre-existing disease is disclosed to the insurance company before the insurance policy has been purchased. Health insurance plans cover these diseases after a waiting period of 2 to 3 years. It is necessary to let the insurance company know about any pre-existing diseases at the time of purchasing the policy. Few companies provide add-ons to reduce the PED waiting period.

6. Ambulance Expenses

   Health insurance plans also cover ambulance expenses. This ensures that the person in need receives quick medical assistance. You should definitely check for this inclusion before purchasing a health insurance policy.

7. Consumables Cover

   Consumables cover is a common inclusion in health insurance plans. It covers the costs of non-medical items such as PPE kits, sterile dressings, syringes, packaged water, disposable gloves, paper tissues, etc.

8. Organ Donor Expenses

   In case of a transplant surgery, insurance companies offer plans that cover the cost of harvesting the organ donated for a transplant surgery. Organ donor expenses include the costs of organ matching tests, hospital stay, expenses before and after admission, post-operative care, and healing support.

9. Modern Treatment

   IRDAI has provided a list of 12 modern treatments that health insurance plans need to cover. As per this list, insurance companies cover the cost of procedures such as immunotherapy, oral chemotherapy, intravitreal injections, robotic surgeries, stereotactic radio surgeries, bronchial thermoplasty, HIFU, etc.

10. Domiciliary Treatment

    Domiciliary treatment means treatment taken at home. Sometimes, due to the patient’s condition or other issues, hospitalization may not be possible. In such a case, the person is treated at home, at the recommendation of an attending doctor. The coverage generally includes expenses like medications, nurse charges, doctor visits, etc. Coverage applies if it is medically necessary and doctor-advised, hospitalization of 3+ days is needed but not possible due to the patient’s condition or lack of beds.

11. Maternity Benefit

    Maternity benefits usually have a waiting period that can range from 9 months to 4 years, depending on the policy. Both normal deliveries and C-sections are covered under this benefit. In most cases, pre and postnatal costs are also covered.

12. Mental Health Cover

    IRDAI has mandated all insurance companies to provide mental health cover as a part of their inclusions. The costs incurred in treating mental health issues such as acute depression, anxiety etc, are covered by health insurance companies.

13. AYUSH Treatment

    AYUSH treatments have conditions applied to this coverage. Most plans cover inpatient treatment, but IRDAI mandates full coverage at recognized facilities, and some now include AYUSH OPD or wellness benefits. It is also mandatory for the insured to be admitted to a government hospital or institute recognized and/or accredited by the Quality Council of India or the National Accreditation Board.

14. Preventive Health Check-ups

    Preventive health check-ups include basic tests such as blood test, urine test, blood sugar, lipid profile, liver function test, kidney function test, ECG, etc.

15. Second Medical Opinion

    Under this cover, the insured can consult another specialist for a second diagnosis or perspective. You should check for this inclusion if you are buying a critical illness health insurance plan.

Why Should You Check the Inclusions of a Health Insurance Plan Before Buying?

It is necessary to check the inclusions of a health insurance policy for the reasons mentioned below.

Conclusion

This article covers the inclusions that are most commonly offered by health insurance companies. Checking inclusions in your health insurance policy helps you understand what the policy covers, avoid claim issues, and choose the right plan.

To know more about health insurance plans, you can visit PolicyX.com. If you are looking for real insurance advice, you can book an appointment with us today.

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