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List of Non-Medical Expenses in Health Insurance

Health Insurance is designed to act as the seat belt during health turbulence. It protects your finances in case of such an emergency by providing coverage for medical expenses. However, certain expenses are not covered by health insurance and need to be paid out of pocket. These are known as Non-Medical Expenses.

Health insurance protects us from skyrocketing medical costs, but it must also ensure that it’s not misused. These non-medical expenses curb the misuse of health insurance.

This article discusses non-medical expenses and their complete list so you know your insurance coverage and exclusions.

Team Digit

What are Non-Medical Expenses in Health Insurance?
List of Non-Medical Expenses in Health Insurance
How to Check Non-Medical Expenses?
Important Things to Remember
Do Policyholders Have to Pay Non-Medical Expenses?
How to Cover Non-Medical Expenses in Claims?
Frequently Asked Questions

What are Non-Medical Expenses in Health Insurance?

Health Insurance provides you coverage for medical expenses. To maintain its sanctity and prevent misuse, IRDAI has allowed the exclusion of certain expenses under health insurance.

These are mostly optional items utilised during the treatment or hospital stay and are not considered medical expenses when settling insurance claims. These expenses are known as non-medical expenses and are not covered by your insurance provider.

List of Non-Medical Expenses in Health Insurance

The non-medical expenses are categorised based on the treatment, usage and hospitalisation. As per IRDAI (Insurance Regulatory and Development Authority of India), there are a total of 199 items that can be classified into different groups:

Below is the list of non-medical expenses in health insurance, as listed below:

How to Check Non-Medical Expenses Before Filing a Claim?

The list given above is indicative and mentions only some common Non-Medical Expenses out of everything listed by IRDAI. However, as an aware and smart insurance buyer, you must know the exclusions and inclusions of your policy completely to avoid any surprises in the future, especially during the time of claims.

Although non-medical expenses are low and generally affordable, it is best to be aware of your probable share in the cost. Knowing the complete details about your insurance coverage, especially the inclusions and exclusions, would help you be better prepared for the future and avoid any unforeseen circumstances or financial losses.

Before raising a claim, it’s essential to understand what’s included and excluded to avoid surprises. Here’s how you can stay informed:

Check Your Policy Document: Look for the list of exclusions.
Ask Your Insurer: Contact customer support for clarity.
Review the Hospital Bill: Identify non-payable charges like gloves, masks, and administrative fees.

Remember, before buying insurance, you must check out the list carefully and understand the terms and conditions thoroughly.

Important Things to Remember About Non-Medical Expenses in Health Insurance

Here are some points to keep in mind regarding non-medical expenses in mediclaim insurance:

Do Policyholders Have to Pay for Non-Medical Expenses?

According to the IRDAI's standards, these expenses are not covered by any standard health insurance plan. However, many insurers provide rider/add-on coverage to help policyholders manage the expenses of the majority of these consumables.

You can choose the consumables benefit cover in health insurance and review the available add-on coverage while purchasing health insurance online. You can avoid the inconvenience of paying for treatment-related consumables by paying a little extra premium.

Always remember to review the add-ons inclusions and exclusions.

How to Cover Non-Medical Expenses in Health Insurance Claims?

Yes, there is a way to cover the cost of non-medical costs in health claims. While health insurance covers hospitalisation costs, certain non-medical expenses like gloves, syringes, administrative charges, and consumables may not be included.

But don’t worry, 🙂 here’s how you can plan smart and manage these costs:

Opt for a Riders/Add-on Cover: Some insurers offer add-ons or riders in health insurance to cover the cost of consumables.
Check Employer Health Benefits: Some corporate policies cover non-medical expenses in their standard policy by increasing the premium. Look out for such policies.
Maintain a Health Fund: Keeping emergency savings can help with uncovered costs.

FAQs about Non-Medical Expenses in Health Insurance

All

What are non-reimbursable medical expenses? Are these the same as non-medical expenses?

Yes. Non-Reimbursable Medical Expenses are the same as Non-Medical Expenses. These are the medical expenses that are not covered by health insurance plans.

Are pre and post-hospitalisation expenses considered as Non-Medical Expenses?

Pre and Post Hospitalisation expenses are not considered Non-Medical Expenses and are generally covered by the insurance provider. However, you must always refer to your policy document for the complete details on exclusions.

Can I cover Non-Medical Expenses in my health policy?

Yes, some insurers provide the option of an Add-on for Non-Medical Expenses wherein you can purchase an Add-On Cover for an additional premium and cover the Non-Medical Expenses.

Does health insurance cover diabetic footwear as a medical expense?

No, diabetic shoes are not covered by health insurance as non-medical expenses.

Who pays for the non-medical expenses of health insurance?

Non-medical expenses in health insurance are typically paid out-of-pocket by the policyholder. These expenses are not covered by standard health insurance policies and include costs such as hospital registration fees, toiletries, food charges (other than the diet provided by the hospital), and other miscellaneous items.

What are non-medical expenses in health insurance?

Non-medical expenses are costs incurred during hospitalisation that are not directly related to medical treatment. These include items like hospital registration fees, sanitisers, disinfectants, toiletries, and other miscellaneous charges that are not covered by health insurance policies.

Why are non-medical expenses not covered by health insurance?

Non-medical expenses are excluded to prevent misuse of health insurance and to keep premiums affordable. These costs are considered additional and not essential to the medical treatment itself.

Can non-medical expenses be covered by any health insurance plans?

Some health insurance plans offer riders or add-ons that can cover certain non-medical expenses. It's important to check with your insurer to see if such options are available.

What are some common examples of non-medical expenses?

Common non-medical expenses include hospital registration fees, food charges (other than the diet provided by the hospital), laundry charges, toiletries, and attendant charges.

How can I manage non-medical expenses during hospitalisation?

To manage non-medical expenses, you can set aside a separate budget for these costs, inquire about the hospital's policies on such charges and consider purchasing a rider that covers non-medical expenses if available.

Are non-medical expenses the same across all hospitals?

No, non-medical expenses can vary significantly between hospitals. It's advisable to check with the hospital beforehand to understand their specific charges.

Do non-medical expenses affect the overall cost of hospitalisation?

Yes, non-medical expenses can add up and significantly increase the overall cost of hospitalisation. Being aware of these costs can help you plan better financially.

Can I claim non-medical expenses under any circumstances?

Generally, non-medical expenses are not claimable under standard health insurance policies. However, if you have a rider or add-on that covers these expenses, you may be able to claim them.

What should I look for in a health insurance policy to avoid high non-medical expenses?

Look for policies that offer comprehensive coverage, including riders for non-medical expenses. Additionally, choose hospitals within the insurer's network that have transparent billing practises.

Are there any regulations governing non-medical expenses in health insurance?

Yes, the Insurance Regulatory and Development Authority of India (IRDAI) has guidelines that specify which items are considered non-medical and are not covered by health insurance.

How do non-medical expenses impact the claim settlement process?

Non-medical expenses can complicate the claim settlement process as they are not covered by the policy. This can lead to out-of-pocket expenses and potential disputes with the insurer.

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List of Non-Medical Expenses in Health Insurance

Table of Contents

What are Non-Medical Expenses in Health Insurance?

List of Non-Medical Expenses in Health Insurance

Optional Items

Non-Medical Expenses in the Room Charges

Non-Medical Expenses in Procedure Cost

Non-Medical Expenses in Treatment Cost

Additional Non-Payable Medical Expenses

How to Check Non-Medical Expenses Before Filing a Claim?

Important Things to Remember About Non-Medical Expenses in Health Insurance

Always Check the Policy Document

Reduce Out-of-Pocket Expenses

Available as Rider or Add-on

Do Policyholders Have to Pay for Non-Medical Expenses?

How to Cover Non-Medical Expenses in Health Insurance Claims?

FAQs about Non-Medical Expenses in Health Insurance

What are non-reimbursable medical expenses? Are these the same as non-medical expenses?

Are pre and post-hospitalisation expenses considered as Non-Medical Expenses?

Can I cover Non-Medical Expenses in my health policy?

Does health insurance cover diabetic footwear as a medical expense?

Who pays for the non-medical expenses of health insurance?

What are non-medical expenses in health insurance?

Why are non-medical expenses not covered by health insurance?

Can non-medical expenses be covered by any health insurance plans?

What are some common examples of non-medical expenses?

How can I manage non-medical expenses during hospitalisation?

Are non-medical expenses the same across all hospitals?

Do non-medical expenses affect the overall cost of hospitalisation?

Can I claim non-medical expenses under any circumstances?

What should I look for in a health insurance policy to avoid high non-medical expenses?

Are there any regulations governing non-medical expenses in health insurance?

How do non-medical expenses impact the claim settlement process?

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