Common Health Insurance Exclusions

Understanding your Health Insurance Exclusions at the start of your policy is perhaps the most prudent step you will take as a consumer of health insurance products. Whilst understanding what benefits you are entitled to under your policy is massively important, perhaps more crucial is understanding exactly what you are not covered for. Benefits and exclusions are likely to vary on an insurer-to-insurer basis. It’s crucial you understand these points by examining the table of benefits of the product you buy and also the policy wordings. Whilst there are differences among providers there are also similarities. The following article will examine some common exclusions that apply to health insurance policies.

1. Pre-Existing Conditions. As an individual purchaser of health insurance, it’s almost guaranteed that your pre-existing conditions will not be covered. Although the time limits in which these conditions occurred prior to starting a policy may vary from provider to provider, recent conditions will not be covered. Some insurers may accept to cover pre-existing conditions and may load the premium to compensate for the increased risk.

2. Alcohol/Substance Abuse: If you have an accident whist under the influence of drink and/or drugs then you will not be covered. Insurers typically set the acceptable alcohol limit as under 150 mg. If you are under the influence of banned substances then you will be excluded automatically.

3. Sexually Transmitted Infections: Infection resulting from sexual activity will not be covered by insurers. In many cases this policy will also apply to HIV/AIDS. If you require cover for this illness then be sure to check with your insurer if it is covered.

4. Cosmetic Surgery: The purpose of health insurance is to protect you against unforeseen circumstances. You will not be covered for surgery intended to make you look better. Thus, Botox, breast reduction/enlargement and tummy tucks, as examples, would not be covered.

5. Dangerous sports. Participating in sports deemed ‘dangerous’ could lead to any potential claim being excluded. Common examples of dangerous sports include scuba diving, skydiving, and car racing. Please also note that if you professionally play sport you will need to purchase special cover as such professions are excluded from standard health insurance plans. As to which sports are classed as ‘dangerous’ will vary on a provider-to-provider basis. Therefore if you plan on partaking in activities which could be dangerous, check with your agent or insurer before hand to make sure you are covered.

6. Insurrection/Protests: Whilst it’s neither common practice, nor something that everyone does, participating in protests or insurrections will not be covered under health insurance policies. Over the last decade Thailand has seen its fair share of protests. Just remember that if you partake in such activity then you will need to cover the bills should you get hurt.

7. Non-Modern Medicine: Health insurance in Thailand covers standard modern medicine. For those who wish to use alternative medicine routes then costs may need to be met personally. This could include homeopathic medicine and Traditional Chinese Medicine.