What Is Not Covered Under Mediclaim Policies


Medical technology has helped reduce the mortality rate of humans and improve the recovery rate from diseases. Hospitals have seen a sharp spike in expenses for medical procedures. It is crucial and essential to enrol in a health insurance policy for yourself and your family. Health insurance and mediclaim policy coverage have a lot of benefits.

What is the Mediclaim policy?

A mediclaim policy is a type of health insurance policy where the insurance company reimburses the expenses incurred by the insured for treatment of their medical condition.

What are the features of the Mediclaim policy?

For individuals who are suffering from various diseases, the medical policy can help them get financial assistance in their hour of need. The benefits of a mediclaim policy are:

1)You can avail yourself of the cashless facility at network hospitals.

2)It provides tax benefits on the annual premium.

3)Mediclaim policy is available for both individuals and families.

What are the types of Mediclaim policies?

  • <h3>Individual policy: </h3>

An individual policy is for one person, and only the designated person can avail of the benefits listed under the policy.

Family Floater:

The Family Floater Coverage is given to one individual who can further extend this to his or her entire family.

Senior Citizen Policy:

This policy is granted to people who are more than 60 years old. It covers the hospitalisation expenses of that age group.

Critical Illness Mediclaim:

A critical illness policy helps in curbing those expenses by paying a lump sum amount on diagnosis of the disease, like cancer, kidney failure, heart disease, etc.

Personal Accident Policy:

This policy offers protection against accidental death, permanent total disability, permanent partial disability, and temporary total disability.

Aspects Not Covered Under Mediclaim Policy:

 Cosmetic Surgery:

This surgery is not covered under medical insurance plans because they are not considered to be crucial or life-saving. Cosmetic Surgery includes treatments like lips fillers, breast augmentation, botox injections, facelifts, etc

Health issues from intoxicant substances:

Drugs, alcohol, and smoking are highly injurious to health and can be fatal. Regular consumption of these substances can cause severe damage to your lungs, liver, and mouth which can cause cancer and stroke. Insurance companies consider such claims on a case-by-case basis.

Congenital Diseases or Genetic Disorders:

This is a type of condition with which a person is born with. This can be internal such as an exceptionally weak internal organ or external condition such as a recurring skin condition.

Transmitted diseases:

Many health insurance policies in India, do not cover transmitted diseases like HIV, gonorrhea, and Sexually Transmitted Diseases (STD). These diseases run for the life of an individual and are very expensive.

Self- inflicted Injury:

Self-harm or intentional injuries inflicted on oneself are not covered in your medical insurance plan. It is important to get professional health for your mental well-being.

Infertility Treatment:

Tests and treatments relating to infertility and in Vitro fertilization cannot be claimed in the mediclaim policy.

Rachel Crib
Rachel Crib
Rachel has lived in Lancaster her whole life. Trish has worked as a journalist for nearly a decade having contributed to several large publications including the Yahoo News and the Lancaster Post. As a journalist for The Tiger News, Cristina covers national and international developments.

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