List of Different Types of Non-Medical Expenses in Health Insurance

  • Author :
  • TATA AIG Team
  • Published on :
  • 21/11/2023

When you buy medical insurance, you expect to be covered for all costs associated with hospitalisation. However, it is important to remember, that as per the guidelines set by the Insurance Regulatory and Development Authority of India (IRDAI), a health insurance plan covers only the medical expenses. This means that all non-medical expenses incurred during hospitalisation are not covered.

As a policyholder, you must be aware of all the inclusions and exclusions of the policy. Hence, it is important to go through the following non-medical expenses list that is not covered by health insurance.

Understanding Non Medical Expenses in Health Insurance

When a patient is hospitalised either for surgery or treatment, a lot of things are needed. Of these, some things are deemed necessary for medical treatment and are covered by the health insurance plan. Others are clubbed together as a list of non medical items as per IRDAI. These are costs that are not covered by the policy. The IRDAI created this list to ensure that medical insurance is not misused by people or hospitals.

List of Different Types of Non-Medical Expenses in Health Insurance

IRDAI has created a list of different types of non payable items in mediclaim that are excluded from the coverage of a health insurance plan. The list is followed by all insurers and is standard across the health insurance industry.

This means that all these non-medical expenses will have to be borne by the policyholder. The categories are as follows:

Treatment Costs: This list includes items that are used as a part of the treatment.

Hospital Room Charges: While the policy includes the hospital room cost, the following items are not covered under a health insurance plan.

Procedure Costs: If there is a surgical procedure, then the policy covers all costs associated with the surgery except for the following items.

Others (including optional costs)

Here is the list of non payable items in health insurance:

Digestion gels
Health Insurance: Non Medical Expenses List IRDAI
Treatment Costs
Registration/admission charges Disinfectant, spirit & hydrogen peroxide
Nutritionists or dietician charges Diabetic footwear
Urine container Antiseptic mouthwash
Blood reservation cost Vaccination cost
HIV kit Infusion pump charges
Hospital Room Charges
Gown Hand wash
Pulse oximeter charges Housekeeping charges
Tissue paper Hot pack/ cold pack
Toothbrush & toothpaste Comb, slippers & caps
Foot cover Buds
Procedure Costs
Surgical blades Harmon scalpel blades
Bandages & cotton Eye pad
Disposable razors Hair removal cream
Arthroscopy and Endoscopy instrument charges Surgical drill
Gauze blades Apron
Others
Needles, syringes & sterilised injections Paper gloves
Medicine box Washing charges
Referral doctor’s fees Barber charges
Optional Items
Thermometer Nebulizer kit
Food (apart from hospital food) Belts/braces
Mineral water Carry bags
Laundry/ attendant charges Beauty services
Laundry/ attendant charges Beauty services
Baby food

Do Policyholders Have to Bear These Costs?

As per the guidelines set by the IRDAI, the standard health insurance plan does not cover these costs. However, to help make things easier for policyholders, many insurers offer a rider/add-on cover to manage the costs of most of these consumables.

When you buy health insurance online, you can look at the add-ons offered and select the Consumables Benefit cover. By paying a small additional premium, you can get rid of the hassle of paying for consumables associated with the treatment. However, make sure to go through the inclusions and exclusions of the add-on before buying.

Conclusion

It is important to remember that while there are certain guidelines for regulating health insurance policies, every insurer offers a unique package to policyholders. Therefore, before making the purchase, it is important to read the fine print and ask questions.

You should know everything about the inclusions and exclusions of the policy, limits (if any), and any other factor that can impact the claim.

With Tata AIG, you can enjoy various benefits of health insurance, like quick claim settlement, easy online policy renewals, exhaustive list of network hospitals, and several health insurance add-ons, including the consumables benefits.

FAQS

What are the non-medical expenses?

In health insurance, non-medical expenses are costs incurred on a range of items during hospitalisation that are not covered under the policy. The IRDAI creates a list of all items that constitute non-medical expenses and every insurer refers to it while processing claims. Hence, these are items that the policyholder needs to pay for.

Which type of expenses will be covered under health insurance?

While the list of inclusion can vary from one insurer to another, generally, a health insurance policy covers the following expenses:

In-patient treatment costs

Pre-hospitalisation expenses

Post-hospitalisation expenses

Day Care Procedures

Medical and surgical expenses of the organ donor

Domiciliary Treatment

AYUSH treatments

Ambulance expenses

Health checkup costs

Do health insurance policies in India offer riders or add-ons to cover non-medical expenses?

Yes, many insurance companies offer riders to help you manage the above mentioned non-medical expenses.

The riders may not cover the entire list but still offer respite from otherwise having to manage a sizable portion of the overall bill. While buying or renewing your health insurance policy, talk to the insurer about this add-on cover.

How can I best manage and budget for non-medical expenses when seeking healthcare treatment?

While one option is to buy a rider that offers coverage for these expenses, if you do not want to do that, then you need to start budgeting for these costs.

There is no benchmark available on how much these expenses add up to. However, you can talk to the hospital administrative staff to get an idea.

Are non-medical expenses consistent across all health insurance policies, or do they vary among insurers?

Since the list of non-medical expenses is created by the IRDAI, it is standard across all policies. This means that no insurer will offer coverage for the expenses specified under the list. However, they offer riders at an additional cost to help people get these expenses included in the scope of the policy.

Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

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