Non-Medical Expenses in Health Insurance
  • Explore the Non-medical expenses
  • Non Medical expenses list as per IRDAI
  • Take a look at Non-payable medical expenses
non medical expenses in health insurance
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Non-Medical Expenses in Health Insurance

When you have the right comprehensive health insurance, you feel safe and secure knowing that your family is financially protected knowing that your family will get the best healthcare facilities in case of medical emergencies. But, health insurance companies follow a strict claim process as directed by the Insurance Regulatory and Development Authority of India (IRDAI).

To prevent the misuse of health insurance, the IRDAI has excluded some medical expenses, known as non-medical expenses in health insurance. We've listed the non-medical expenses under health insurance in this below article also known as insurance policy's exclusions.

What are non-medical expenses in health insurance?

Health Insurance covers the medical expenses of planned and unplanned hospitalization. However, some medical expenses are excluded from the insurance coverage and these expenses are called non-medical expenses.

Things to Remember About Non-Medical Expenses in Health Insurance

  • Non medical expenses in health insurance are those that are essential to healthcare facilities but may not be directly related to treatments.
  • To cover the cost of these non-medical expenses the policyholders can opt for available riders. Read the policy documents carefully to understand which non-medical expenses are covered and excluded.
  • The IRDAI has provided a standard list of non-payable items for the policyholders to understand what is usually excluded from their health plans.
  • Non-payable items in health insurance are categorized in 5 categories that sum up the treatment procedures which include optional items, non-medical expenses in treatments, non-medical expenses in room charges, non-medical expenses in procedure costs, and other non-payable medical expenses.
  • There is a separate list of non-medical expenses that are not covered under your room rent provided by the insurer. These include items like tissues, handwash, slippers, gowns, dental kits and many more.So, remember that your room rent will not provide for this items.
  • Non-payable items are not-provided for across the health insurance industry without any exceptions apart from taking riders.

What If I want my Non-Medical expenses Covered:

These costs cannot be ignored because they frequently result in significant increases in medical costs. Many health insurance providers include riders or built-in costs for non-medical expenses in the plan. Here are the names of the rider for Non- Medical expenses.

List of Companies That Provide Non-Medical Expenses Riders:

CompanyPlanNon-Medical Items
Aditya BirlaAditya Birla - DiamondOptional (Through Future Secure Rider)
Aditya BirlaAditya Birla - EnhanceOptional (Through Future Secure Rider)
Aditya BirlaAditya Birla - EssentialOptional (Through Future Secure Rider)
CareCare AdvantageOptional (Through Care Shield Rider)
CareCare ClassicNot Available
CareCare FreedomOptional (Through Care Shield Rider)
CareCare HeartOptional (Through Care Shield Rider)
CareCare PlanOptional (Through Care Shield Rider)
CareCare PlusNot Available
CareCare SeniorOptional (Through Care Shield Rider)
CareCare SupremeNot Available
HDFCHDFC my health SurakshaNot Available
HDFCHDFC Optima restoreNot Available
HDFCHDFC Optima SecureCovered upto SI
ManipalCignaManipalCigna - LifetimeOptional (Through Health 360 - Shield Rider)
ManipalCignaManipalCigna - Prime ActiveOptional (Through Non-Medical Items Rider)
ManipalCignaManipalCigna - Prime AdvantageOptional (Through Non-Medical Items Rider)
ManipalCignaManipalCigna - Prime ProtectOptional (Through Non-Medical Items Rider)
ManipalCignaManipalCigna - Pro Health PlusOptional (Through Health 360 - Shield Rider)
ManipalCignaManipalCigna - Pro Health PreferredOptional (Through Health 360 - Shield Rider)
ManipalCignaManipalCigna - Pro Health ProtectOptional (Through Health 360 - Shield Rider)
NivaNiva - PremiaNot Available
NivaNiva bupa health companionOptional (Through Safeguard Rider)
NivaNiva bupa ReassureOptional (Through Safeguard Rider)
SBISBI Arogya PlusNot Available
SBISBi Arogya SanjeevaniNot Available
StarFamily health optimaNot Available
StarMediclassic Individual (Basic)Not Available
StarMediclassic Individual (Gold)Not Available
StarStar Arogya SanjeevaniNot Available
StarStar AssureCovered upto SI
StarStar ComprehensiveNot Available
StarStar senior citizen red carpetNot Available
StarStar Women CareCovered upto SI
StarStar youngsterNot Available

List of non-medical expenses in Health Insurance as per IRDAI guidelines

According to IRDAI guidelines, some optional medical items used during treatment or hospitalization are not considered medical expenses. Let us have a look at the list of non-payable items in health insurance:

  • Food (other than provided by the hospital)
  • Carry bags
  • Baby food
  • Nebuliser kit
  • Laundry/attendant charges
  • Mineral water
  • Thermometer
  • Beauty services
  • Belts/braces

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How to Know More About Non-Medical Expenses Before Claims

These non-medical expenses in health insurance are commonly excluded from the policies. IRDAI has established guidelines for health insurance claim settlement and has given a list of non-medical expenses which is available on the insurer’s website. It is important to be aware of the list before buying any plan. You should understand the inclusions and exclusions of the mediclaim policy to avoid any surprises in the future, especially in times of emergencies.

Do read the terms and conditions mentioned in the policy document to understand all the exclusions and inclusions of the health insurance plan, in order to avoid any future discrepancies.

Non-medical expenses in the room charges

Below-mentioned is the list of non-medical expenses in the room charges during hospitalization.

  • Hand wash
  • Housekeeping charges
  • Tissue paper
  • Comb, caps
  • Slippers
  • Toothpaste and toothbrush
  • Pulse oximeter charges
  • Buds
  • Gown
  • Foot cover
  • Cold pack/hot pack

Non-medical expenses in treatment cost

Certain items are used by healthcare professionals to treat patients while they are hospitalized. The following are the non-medical costs incurred during treatment.

  • Registration/admission charges
  • Spirit, disinfectant, hydrogen peroxide
  • Nutritionist or dietician charges
  • Infusion pump charges
  • Urine container
  • Blood reservation cost
  • Vaccination cost
  • Diabetic footwear
  • Antiseptic mouthwash
  • HIV kit

Non-medical expenses in procedure costs

The items listed below are considered non-medical expenses in procedural costs.

  • Hair removal cream
  • Surgical blades
  • Disposable razors
  • Bandages, cotton
  • Surgical drill
  • Harmon scalpel blades
  • Apron
  • Arthroscopy and Endoscopy instrument charges
  • Eye pad
  • Gauze blades

Other Non-payable medical expenses

Below-mentioned is the list of additional non-medical expenses in health insurance.

  • Barber charges
  • Syringes, needles, sterilized injections
  • Washing charges
  • Referral doctor’s fees
  • Digestion gels
  • Paper gloves
  • Medicine box

Conclusion

The above mentioned are the non-medical expenses incurred during hospitalization and treatment, and they are very expensive. These are non-admissible costs that aren't covered under any health insuranceplan. Sometimes, people are unaware of such non-medical expenses that they have to bear these expenses on their own. As a result, it's always a good idea to read the terms and conditions of a health plan before choosing it.

When purchasing health insurance, it is a good idea to compare plans from different insurers to understand the exclusions and select the best health insurance plan. Also, read the fine print of the policy to make an informed buying choice.

Non-medical expenses in Health Insurance : FAQ

1. What are the non-payable items in health insurance?

The non-payable items are ones standardized by the IRDAI that are not covered by your health insurance policy. These items are gloves, baby food, nebuliser kit, tissue papers, handwashes and much more.

2. Do common health insurance policies pay for non-medical costs?

No, a policyholder must purchase additional riders or a plan with built-in coverage for non-medical costs if they want their regular health insurance to cover them.

3. What are the non-medical costs that riders do not even cover?

Treatments not covered by non-medical riders include cosmetic surgery, weight loss plans, fertility treatments, LASIK operations, and alternative therapies.

4. Do non-medical costs for braces qualify?

They do, in fact, pay for braces.

5. Does the cost of a vaccination fall under non-medical expenses?

Yes, the cost of vaccinations is included in non-medical expenses.

6. Do dietician fees fall under non-medical expenses?

Yes, nutritionist and dietician fees are covered by non-medical costs.

7. What are the non-payable items in health insurance?

Non-payable items include expenses that are not considered part of the medical treatment and are excluded from health insurance coverage.

8. Do common health insurance policies pay for non-medical costs?

No, common health insurance policies typically do not cover non-medical expenses.

9. What are the non-medical costs that even riders do not cover?

Riders may not cover expenses like dental kits, grooming services, or non-medical items used during hospitalization.

10. Do non-medical costs for braces qualify?

Non-medical costs for items like braces generally fall under non-payable expenses in health insurance.

11. Does the cost of a vaccination fall under non-medical expenses?

Yes, the cost of vaccination is often considered a non-medical expense in health insurance.

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Naval Goel

Reviewed By : Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.