The clauses related to limitations and exclusions may seem complicated at first, but it is essential to understand them before registering. There may be some exclusions and limitations that may not affect you or your family at all, while some may be important based on your health history and hereditary family history. So while what is excluded for one person may not make a difference, it can have a big impact for another. That’s why it’s important to understand what they are and how they impact you and relate to you as an individual and to your family as a whole.

Exclusions are those conditions or expenses that are not covered by the insurance company. In such cases, the claimant will have to share a pre-arranged portion of the expenses in the claim if it is ever filed. Some insurance companies also impose a sub-limit that is within the overall sum insured. Exclusions are those expenses that the insurance company does not need to pay. The IRDA has standardized this with a list of expenses. There are also different waiting periods for different conditions.

One of the common exclusions for health insurance is pre-existing conditions. This is because the entire premise of insurance is based on uncertainty, so if you are already suffering from a disease, it will not be covered by insurance. You can usually get insurance companies to cover you for a pre-existing condition after a specified waiting period ends.

Another thing that is excluded is pregnancy and expenses related to childbirth and subsequent vaccinations. There could also be a waiting period for the pregnancy, after which there are some benefits that could be reaped. Other things that are excluded from a health insurance policy are cosmetic surgeries, dental surgeries, alternative treatments like Ayurveda and homeopathy, etc.

Sub-limits are another factor that should be carefully considered up front before investing in an insurance policy. A sub-limit is related to exclusions that are associated with medical fees, ambulance costs, hospital room rental, etc. Knowing your secondary limits keeps you prepared in case of an emergency so you know exactly what will be covered and what you will have to pay out of pocket.

There are policies that seem to have a whole list of exclusions and sub-limits and there are others that have a moderate number of them. So knowing what is excluded and what is not will help you make a better decision regarding which health insurance to choose. This can be easily done by doing a systematic and meticulous comparison of health insurance policies taken from different websites or directly from agents. Knowledge is power and knowing it in advance helps you better plan for yourself and your family’s future.