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With health care costs soaring beyond affordability, people are realizing the need for purchasing a health insurance policy. But don’t be impulsive and buy the first policy that you read about or one that an insurance agent forces on you. You need to exercise caution and carefully consider the inclusions and exclusions. Read on to acquire a comprehensive idea of what you should expect your policy to cover.

Inclusions that a good health insurance policy should provide:

1. Inpatient hospitalization

You have to be hospitalized for at least 24 hours to avail of the following benefits:

  • Room Rent
  • Intensive Care Unit rent
  • Charges for OT
  • Fees for doctors, nurses and surgeons, and anesthetists
  • Expenses on medicines, IV units, oxygen, prosthetics, blood bags, etc

2. Pre and post hospitalization charges

All the expenses you might require before you are hospitalized and after you are discharged as part of your post-treatment therapy will be covered by your insurance policy.

3. Ambulance charges

A good health insurance policy will cover the cost of commute that an ambulance will charge to transport you to the hospital.

4. Day care treatment

Many health insurance policies today do not require you to be hospitalized for 24 hours in order to qualify for an insurance payout. They have also started covering daycare procedures such as dialysis, chemotherapy, and radiotherapy. 

5. Health check-ups

A positive trend that has permeated the insurance industry is the inclusion of free health check-ups. A policy will cover any Out Patient Department consultation that you might require.

6. Organ donation

Most health insurance schemes cover the costs incurred in organ transplant surgeries. Moreover, they also include the charges of harvesting an organ from a donor.

7. AYUSH therapy

Yet another heartening trend is the coverage of treatment sought through non-conventional modes of therapy such as Ayurveda, Unani, Siddha, and Homeopathy. 

8. Domiciliary treatment

This refers to treatment at home. A need for this type of treatment may also arise when the patient is too sick to be transported to a hospital. 

Common exclusions in health insurance policies:

  • Pre-existing Illnesses are illnesses that you had already been diagnosed with when you decide to purchase the health policy
  • If you contract an illness or are diagnosed with one before the waiting period is up, your policy will not come to your aid
  • In the first 2-4 years of buying the policy, your plan will not cover joint replacement surgeries, treatment of hernia or piles
  • Self-inflicted injuries
  • Drug or alcohol abuse-related conditions
  • If you want to avail of maternity benefits, you have to purchase a separate cover and again the benefits will kick in after a certain waiting period has elapsed
  • Permanent exclusions in health insurance include cosmetic surgeries to enhance your appearance, injuries obtained in a war zone, nuclear contamination, and HIV/AIDS


A health insurance policy should not be an impulsive purchase. So meticulously go through the details and use your discretion before arriving at a decision.




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