Non-Medical Expenses in Health Insurance

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Non-medical expenses in health insurance refer to the cost of items or services that are not directly related to medical treatment. These include room rent, registration charges, consultation fees and the cost of consumables like syringes, bandages, and gloves. The Insurance RegulatoryAuthority of India (IRDAI) has specified a list of non-medical expenses separated into 5 different categories.

Such non-medical expenses are usually not covered by a health insurance policy, and you need to pay for them out of your pocket. However, there are some health insurance policies that do offer coverage for a few non-medical expenses like room rent and consultation fees.

List of Non-Medical Expenses in Insurance as per IRDAI

The list of non-medical expenses in health insurance has been specified by the Insurance Regulatory and Development Authority of India. As per the IRDA, the insurance company is not required to pay for these non-medical expenses as part of the health insurance claim payout. The updated guidelines for health insurance by IRDAI has split the non-medical expenses into several categories, and you can take a look at them below:

Non-Medical Expenses for Optional Items

Some examples of non-medical optional items are:

Foods and beverages
Laundry service
Nebulizer spray
Braces/Supporting belts
Containers and bags

Non-Medical Expenses in Treatment Costs

Some examples of non-medical treatment expenses include:

Hospital registration/Admission charges
Sanitizer, disinfectant, cleaning supplies, etc.
Nutritionist charges
Vaccination charges
Hospital footwear

Non-Medical Expenses in Room Charges

The non-medical expenses under room charges include the following items:

Housekeeping charges
Toiletries
Hospital gown
Oximeter
Tissue paper

Non-Medical Expenses in Procedure Costs

Some examples of non-medical expenses under the procedure costs category include:

Aprons
Surgical equipment
Saline
Hair shaver
X-ray film

Other Non-Payable Medical Expenses

Some examples of other non-payable medical expenses are:

Needles and syringes
Doctor’s fee
Gloves
Medicine set
Digestion supplements

How to Know More About Non-Medical Expenses Before Claims

It is important to understand which non-medical expenses will not be covered under health insurance so that you are not unprepared when the time comes to pay off the bills. Apart from learning about the list of non-medical expenses as prescribed by the IRDAI, it is also your responsibility to read your health insurance policy document and understand any other medical or non-medical expenses which will not be covered under the policy. Make sure you also read all the terms and conditions applicable to your health insurance.

To Conclude

We purchase health insurance in order to make sure that we do not have to pay large sums of money out of pocket in the event of a medical emergency. However, as per its nature, your insurance policy is meant to only cover your medical treatment and may not cover the various other non-medical expenses that you may incur during treatment. These may need to be paid out of your own pocket. If you are looking to purchase a health insurance policy, the Bajaj Markets website has a number of options.

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FAQs on Non Medical Expenses for Health insurance

Non-medical costs are a part of your overall treatment costs, but may not be linked specifically to your medical procedures. Thus, many insurers do not cover these expenses in their plans.

While medicines are valuable, other non-medical items in insurance such as tissue, gauze and gloves are not inherently that expensive, though these costs can add up over the course of your hospital stay. If you want extra peace of mind, you can keep track of how much is being used and when.

Generally, the pre and post hospitalisation processes are considered integral to the treatment process and are thus counted as medical costs, and not as non-medical expenses in insurance.

A non-medical expense is a type of non-reimbursable expense, meaning the insurance provider will not provide coverage for these expenses.

Ensure that you read the bill given to you by the hospital thoroughly, and check that the prices quoted for non-medical expenses seem on average, and not unusually high. It is up to the hospital to charge you fairly, and it is up to you to ensure you are not charged unfairly.