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:

Company Plan Non-Medical Items
Aditya Birla Aditya Birla - Diamond Optional (Through Future Secure Rider)
Aditya Birla Aditya Birla - Enhance Optional (Through Future Secure Rider)
Aditya Birla Aditya Birla - Essential Optional (Through Future Secure Rider)
Care Care Advantage Optional (Through Care Shield Rider)
Care Care Classic Not Available
Care Care Freedom Optional (Through Care Shield Rider)
Care Care Heart Optional (Through Care Shield Rider)
Care Care Plan Optional (Through Care Shield Rider)
Care Care Plus Not Available
Care Care Senior Optional (Through Care Shield Rider)
Care Care Supreme Not Available
HDFC HDFC my health Suraksha Not Available
HDFC HDFC Optima restore Not Available
HDFC HDFC Optima Secure Covered upto SI
ManipalCigna ManipalCigna - Lifetime Optional (Through Health 360 - Shield Rider)
ManipalCigna ManipalCigna - Prime Active Optional (Through Non-Medical Items Rider)
ManipalCigna ManipalCigna - Prime Advantage Optional (Through Non-Medical Items Rider)
ManipalCigna ManipalCigna - Prime Protect Optional (Through Non-Medical Items Rider)
ManipalCigna ManipalCigna - Pro Health Plus Optional (Through Health 360 - Shield Rider)
ManipalCigna ManipalCigna - Pro Health Preferred Optional (Through Health 360 - Shield Rider)
ManipalCigna ManipalCigna - Pro Health Protect Optional (Through Health 360 - Shield Rider)
Niva Niva - Premia Not Available
Niva Niva bupa health companion Optional (Through Safeguard Rider)
Niva Niva bupa Reassure Optional (Through Safeguard Rider)
SBI SBI Arogya Plus Not Available
SBI SBi Arogya Sanjeevani Not Available
Star Family health optima Not Available
Star Mediclassic Individual (Basic) Not Available
Star Mediclassic Individual (Gold) Not Available
Star Star Arogya Sanjeevani Not Available
Star Star Assure Covered upto SI
Star Star Comprehensive Not Available
Star Star senior citizen red carpet Not Available
Star Star Women Care Covered upto SI
Star Star youngster Not 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.

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