What are Exclusions?

Exclusions to your health care insurance are things that are not part of the terms of your policy. Things that you will not be covered for. When choosing health cover it is just as important to find out about exclusions as it is to know what you will be covered for. Additionally all policies vary in what they do and do not cover so it is important to read the small print.

Typical exclusions
Pre-existing conditions: this is very important. Sometimes even previous symptoms of an undiagnosed condition will be treated as an exclusion.

Chronic conditions: private medical insurance is only designed to treat short term illness or infection.

Emergency treatment: private hospitals are not geared to look after emergency cases.

Routine pregnancy care: this is hardly ever covered with any policy although some companies, for example, Norwich Union Healthcare, offer you a cash lump sum with each child you have. An exception to this is Standard Life who do cover normal pregnancy as long as you have been on their Primecare Gold policy for at least two years. Complications of pregancy are covered by several companies however.

Cosmetic surgery
Infertility
Addictive conditions
HIV/AIDS related conditions
Drugs or Alcohol related conditions
Illness or treatment resulting from terrorism, criminal activity or war
Out-patient drugs and dressings
Professional sports related injury
Self-inflicted injury
Gender Reassignment
Dangerous Sports
Radioactive accidents

Sometimes Covered
Psychiatric care: Mental illness is not part of all standard policies but can usually be added as part of an extended policy.

Alternative therapies: Some policies cover alternative and complimentary therapies and others do not. Usually the more expensive policies include it.

Experimental Treatments: Normally experimental treatments are not included within your medical cover. However, as part of their comprehensive cancer treatment PruHealth will in some cases allow their customers to have experimental treatments 'provided it is within the context of a properly controlled trial.'

Ambulance cover: Very few medical insurance companies cover private ambulances to take you from your home to your treatment destination. Tesco health insurance, which is underwritten by AXA PPP, does however.

Organ transplants: Most companies do not cover organ transplants.
Bupa's Select Heart and Cancer Policy however does provide cover for transplant of either of these organs.