Health Insurance Exclusions
International health insurance plans will often have exclusions attached to the coverage. There are a number of standard exclusions for an international health insurance plan which we will illustrate here. It is advisable to talk to a qualified insurance intermediary when purchasing your plan in order to better understand any exclusions that may be relevant in you specific situation.
International health insurance will generally exclude all pre-existing conditions. A pre-existing condition is said to be any disease, illness, or injury that has been diagnosed or presented symptoms prior to or at the time of application for insurance that may be known to either the insurer or the insured. Pre-existing conditions can only be covered with the approval of the insurance company at the time of application.
The most common exclusions generally included with an international health insurance plan are:
- Cosmetic Surgery or treatments that are cosmetic in nature unless they have been pre approved by the insurance company.
- Surgery to correct obesity. Gastric bypass surgery, for example, would normally be excluded.
- HIV/Aids and all diseases as a consequence thereof. HIV/Aids can be covered after the start of a policy however, if it can be proven that the policyholder
contracted the disease as a result of a tainted blood transfusion or as a result of an accident during the course of their normal occupation.
- All illnesses, injuries, and diseases that are a direct result of the abuse of alcohol, narcotics, or legally prescribed medicines will not be covered.
- Any self inflicted injuries will be excluded.
- Contraceptives and any conditions as a result of contraception (i.e. sterilization) will not generally be covered.
- Induced abortions, unless medically necessary, will be excluded.
- Unless otherwise stated in the policy, all treatment relating to infertility, including tests, examinations, and treatments will be excluded.
- The treatment of sexual dysfunction, including any relevant medicines, is not covered.
- Experimental care, including stays in nursing homes, which is not part of a medical/surgical treatment, is normally excluded.
- Unless otherwise stated or approved by the insurer treatments that are naturopathic, homeopathic, or otherwise labeled as "alternative" in nature, will be excluded from coverage.
- Any disease, illness, or injury that has directly or indirectly occurred as a result of military service is excluded.
- Any disease, illness, or injury that has directly or indirectly been caused as a result of the insured actively engaging in: war, invasion, acts of a foreign enemy, civil war, terrorism, rebellion, revolution, social insurrection, civil commotion, hostilities (whether war has been declared or not), riots, military or civil coups, or participation in any lawfully constituted service (army, navy, air force) whether war has been declared or not, will be excluded.
- Nuclear reactions, detonations, fall out, or result thereof will be excluded.
- Any treatment preformed by the insured, their spouse, children, or parents or any enterprise owned by one of the aforementioned persons will not be covered unless previously approved by the insurer.
- Epidemics which have been placed under the control of public authorities and officials are excluded from cover.
- Treatment from a psychologist is normally excluded.
The exclusions that an international health insurance plan can contain may be extremely broad or very narrow in their scope. The insurer may also decide to include coverage for a commonly excluded treatment in individual cases. It is important that you know what your plan excludes when you are purchasing it. Talk to a qualified insurance intermediary to understand what exclusions will pertain to your specific situation.
For more information about international health insurance plan, exclusions, or to get a free quote, please contact us today.
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