What are Non-Medical Expenses in Health Insurance?

Non-medical expenses are the costs that might be incurred on the items that are used during the hospitalisation. Some examples are scissors, clothes, urine containers, laundry attendant charges, and much more. As per the IRDAI, these items are excluded from the mediclaim insurance coverage. But, insurance companies offer coverage for these items too as an optional cover or health insurance riders.

When you have the right comprehensive health insurance, you feel safe and secure knowing that your family is financially protected and will get the best healthcare facilities in case of medical emergencies. However, 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 these medical expenses. We’ve listed the non-medical expenses under health insurance in this article also known as insurance policy’s exclusions.

pert Insights

Hidden within every health insurance premium lies a complex web of costs, a significant portion of which are allocated not to doctor’s visits or prescriptions, but to a category often overlooked: Non Medical Expenses.

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

Non-medical expenses in the room charges

Below 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 medical 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 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

List of Companies Providing Non-Medical Expenses Riders

What If I Want My Non-Medical Expenses Covered?

Obviously, you cannot ignore these expenses as they can significantly increase the medical bill. If you want to cover the cost choose from the health plans mentioned above. Also, consider the options mentioned below:

These costs cannot be ignored because they frequently result in significant increases in medical costs.  However, non-medical expenses are generally not covered by standard health insurance policies. Many health insurance providers include riders or built-in costs for non-medical expenses in the plan. Here are some options to explore:

• Check with your insurer: Contact your insurance provider to inquire about any available riders or add-ons that cover non-medical expenses. They can provide specific details on coverage limits, exclusions, and additional costs.
• Consider specialized plans: Some insurance companies offer specialized health plans that include coverage for certain non-medical expenses. These plans may have higher premiums but provide broader coverage.
• Explore alternative options: Depending on the specific non-medical expenses you’re interested in covering, you might consider alternative options like personal accident insurance, critical illness insurance, or disability insurance.

Do check your health insurance policy documents carefully and understand all the terms and conditions before making your decision.

Things to Remember While Buying 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 which ones are 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 into 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 be covering for these items.
• Non-payable items are not provided for across the health insurance industry without any exceptions apart from taking riders.

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, to avoid any future discrepancies.

Conclusion

To make an informed decision you must understand your health insurance coverage. Check your health insurance policy. By carefully reviewing your policy documents and seeking clarification from your insurer when needed, you can ensure that you and your loved ones are adequately protected in times of medical need.

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. Contact us today for a free consultation and let our expert advisors guide you in selecting the right health insurance plan that aligns with your specific needs and budget.