What is Covered in a Health Insurance Plan?

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Most health insurance plans in India cover the following medical expenses:

In-patient Hospitalization Expenses –The hospitalization expenses incurred during the treatment of an illness or injury are covered, provided the hospitalization is for more than 24 hours.
Pre-existing Illnesses or Diseases – After the completion of the waiting period, you can file a claim for the expenses incurred on the treatment of any pre-existing illness or condition.
Pre and Post Hospitalization Expenses – Medical expenses incurred on blood tests, x-rays, and other medical check-ups required before hospitalization are covered by the insurance company. Similarly, the cost of medicines and preventive health check-ups done to ascertain your recovery after discharge from the hospital is also covered under most health insurance plans.
Ambulance Charges – Although the coverage amount varies from insurer to insurer, most medical insurance plans cover emergency ambulance charges.
Maternity Cover – Medical expenses incurred during the pregnancy and delivery are covered along with newborn baby expenses.
Preventive Health Check-ups – Regular health check-up facilities are also made available in most health insurance plans in India.
Day-Care Procedures – Day care treatments are covered by health plans where hospitalization of more than 24 hours is not required. It includes eye surgery, dialysis, and other common day care surgeries, as mentioned in your policy document..
Home Treatment Cover – It also covers the expenses incurred on getting medical treatment at home on the advice of a medical practitioner.
AYUSH Benefit – A health insurance plan also reimburses the hospitalization costs incurred on availing Ayurveda, Unani, Siddha, Yoga or Homeopathy treatment up to the specified limit.
Mental Healthcare Cover – All health plans in India cover mental illnesses as per the Mental Healthcare Act, 2017. IRDAI had directed all insurers to amend health policies to cover the in-patient treatment of mental illnesses, like acute depression, bipolar affective disorder, schizophrenia, etc., by 31st October 2022.