Understanding Common Health Insurance Exclusions in Your Policy

Always pay attention to the common health insurance exclusions that are in the small print of your prospective policy. It’s the small details that mean the most. And the last place you want to be is stuck with an overseas insurance policy that doesn’t cover the services and treatments you expected.

Policies do vary depending on the insurance provider, which means you need to keep a keen eye on the insurance coverage options you are offered. A reliable insurance advisor or broker can help to ensure you are covered and you fully understand the common health insurance exclusions in your policy. However, you can find out more by reading below.

What Are the Common Health Insurance Exclusions in Policies?

Selecting the right insurance plan that matches your needs and budget are the only things you need to be considering. Anything else is just a waste of time, money, and effort. Be careful out there. It’s easy to get bamboozled by the vast litany of insurance providers whose sole purpose is to sell you their products. And you do not want to be lumbered with an insurance policy with health insurance exclusions that impact you negatively.

Please see a list below of the type of common health insurance exclusions in overseas policies. Also, please remember that insurance policies are varied and different and might not have the same exclusions as below. This is just a guide so you fully understand the potential banana skins when purchasing a health insurance plan.

  • Conditions that involve the misuse or abuse of illegal drugs 
  • Care that is unproven or experimental 
  • Fertility-based treatment and testing
  • Cosmetic surgery procedures 
  • Treatment of psychological problems or conditions 
  • Anything involving the termination of pregnancy (in most cases) 
  • Anything related to AIDS or HIV diseases.
  • Sterilization and contraception 
  • Epidemics that are under the direction of the authorities
  • Anything related to Obesity
  • Sexual dysfunctions and treatments
  • Any injuries that occur while in the act of terrorism 

These conditions are generally not included in the majority of overseas health insurance plans for ex-pats. However, if you suffer from any conditions that could be on the exclusion list, you must recognize this immediately so you can make the right decisions based on the facts.

More Info on Common Health Insurance Exclusions 

The list of common exclusions we stated above is a general guide, and in some cases, not very specific. If you have specific conditions, you could also have a major problem with exclusion lists from major insurance providers.

Here is a more in-depth guide to common health insurance exclusions that you might encounter on insurance provider lists:

Pre-Existing Conditions – If you currently have chronic diseases or heart failure, or even a recent problem with an injury, you seriously need to check the small print on the policy. These issues will usually not be covered in the policy or will be priced highly with its premiums. 

Personality or Behavioral Issues – If you need treatments for behavioral issues or personality disorders such as ADHD and Autism, they are most likely on the exclusion list. 

Fertility or Reproductive Treatments – Fertility treatments such as In-Vitro Fertilization and Assisted Reproductive Technology (ART) are usually not included in a health insurance policy. However, there are some countries and insurance providers that provide specialist insurance plans for such treatments.

Sleeping Disorders – If you suffer from insomnia or another sleep disorder such as obstructive sleep apnea, snoring issues, or bruxism, you will probably be on the exclusion list.

Specific Scenarios – If you have encountered an injury or illness from excluded specific scenarios, you won’t be covered by your insurance policy. These ‘specific scenarios’ could include injuries or illnesses from natural disasters, participation in illegal activities, participating in extreme sports, as part of terrorist acts, or even self-inflicted injuries resulting from hazardous activities.

Cosmetic Surgery – Treatments such as cosmetic or plastic surgeries are usually on the common health insurance exclusion list. This would include facelifts, rhinoplasties, tummy tucks, and other similar treatments.

Obesity – A policy that covers investigations into the treatment of obesity or issues about obesity are usually on the excluded list. These will exclude slimming classes and other treatments relating to obesity. 

Organ Acquisition – Anything related to the acquisition of organs for donors, harvesting, transportation of, or other issues relating to organ acquisition will be on the excluded list. 

Covering Chronic Conditions 

The definition of ‘Chronic Conditions’ is a medical issue that can be managed, but never fully eradicated. This means there will also be ongoing medical issues needed to manage the illness or condition. Good examples of these types of chronic conditions include heart disease, asthma, arthritis, and so forth. These conditions are not essentially fatal but do need to be contained and constantly treated.

These are the kind of conditions that usually affect older people. If you are a younger ex-pat considering your insurance needs, this type of coverage is probably unneeded and unnecessary. However, it can be extremely difficult to obtain overseas health insurance if you are a younger person who has one of these types of chronic illnesses. 

Medical insurance companies have placed numerous limitations and restrictions on those who have chronic conditions. And in some cases, you might not be able to obtain medical insurance for certain conditions. We can’t stress enough how these policies vary from insurance provider to insurance provider.

Some medical insurance companies will use general limitations that are normally prevalent in regards to chronic conditions:

Lifetime Limitations – There could be a lifetime limit on chronic conditions that will treat the issue in your early years with no ongoing treatments when you reach a certain age, unless you pay for more of course.

Annual Limit – Some insurers can apply a limit to expenses within a year. Anything over this will cost more. Annual limits are usually applied to those who need ongoing treatments over a year. You can then sign for this policy each year.

Are Dental and Optical Care on the Exclusion List?

We are continually asked if dental and optical care is on the common health insurance exclusions list. And the answer is a magnanimous YES. Dental and optical services and treatments are generally considered as add-ons. They fall into a similar category to cosmetic and plastic surgery treatments. Most dental and optical care is more related to cosmetic than health treatments.

However, the dental and optical insurance sector is one of the largest in the world. You can find excellent coverage by purchasing a policy that focuses primarily on these issues alone. All major insurance companies across the planet offer this type of policy. 

Getting Health Insurance for Treatments on the Excluded List 

Do some of your conditions happen to be on the excluded list? If so, don’t panic. It doesn’t mean you cannot obtain overseas insurance for your conditions. It just means that standard insurance policies do not cover these issues, and you will need something more streamlined to your needs.

It’s important to remember that just because certain conditions and treatments are on the common health exclusions list, it doesn’t mean you have no insurance options. You can still obtain insurance policies that specialize in each of those areas. You can find insurance policies that cover injuries from war and even self-harming cases. This guide is to ensure you know exactly what to look for when considering which policy to purchase.

Obtaining Medical Coverage Using a Reliable Insurance Broker

Finding the right overseas health insurance as an ex-pat is always a precarious affair. You need to do your research to ensure you are not only fully covered, but are not being overcharged by insurance companies. This is why you need to obtain the services of a reliable and reputable health insurance broker.

A health insurance broker is virtually the opposite of an insurance company or provider. It’s the broker’s job to ensure that you, their client, gets the best insurance policies to choose from that cover everything you need at the best value rates. It’s that simple.

An insurance company or provider is trying to sell you their policies. They are interested in profit margins. While the brokers are only interested in getting you the best policy that suits you and your budget.

Insurance brokers are experts on sourcing insurance plans from major insurance companies. They know the industry, can eradicate potential banana skins, and simplify your whole experience. 

Are the medical treatments and services you need on the common health insurance exclusions list? Read the small print, obtain the services of a reputable insurance broker, and you cover all bases for all your medical insurance eventualities. Be prepared, or be prepared to fail!