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.
Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024. The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918
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.
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.
FAQs on Non Medical Expenses for Health insurance
Why do we have to pay non-medical costs?
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.
Who decides how much non-medical equipment is to be used?
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.
Are pre and post-hospitalisation costs considered to be non-medical expenses in health insurance?
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.
What is a non-reimbursable expense?
A non-medical expense is a type of non-reimbursable expense, meaning the insurance provider will not provide coverage for these expenses.
How do I keep my non-reimbursable expenses down?
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.
