Inside your health insurance policy: What's in and what's out


23 Nov 2023

Maximize Your Health Coverage with Kotak: Understanding Policy Inclusions and Exclusions

A health insurance policy is a major life requirement. Healthcare is very expensive these days, and in the absence of health coverage, it becomes very difficult for you to afford the best treatment when there is a need for it. The modern-day health plans are very well-designed and go a long way to cover all your health-related needs. Take a look at this article to learn more about health insurance policy inclusions and exclusions and see how you can get the best coverage for yourself especially by opting for the Kotak health insurance plan.

Health insurance coverage details - Understanding what’s in your health insurance plan

Let us start by understanding the health insurance plan components. In a standard medical insurance policy, you can expect to find the following covers:

In-patient care

You get compensated for your hospital stay. Your bed and room charges are covered under a standard mediclaim policy.

Pre and post-hospital cover

Most plans also cover any pre or post-hospital treatment that you may require. These must be related to your main treatment and endorsed by your physician.

Domiciliary cover

If you need to set up a hospital at home, either due to the unavailability of a hospital bed or due to mobility issues, you can make a claim on your health insurance policy.

Daycare procedures

Certain procedures do not require an overnight hospital stay, but they require you to get admitted for a few hours. These are known as daycare procedures and are included in your comprehensive health plan.

Surgery costs

Any surgery that you may have to undergo, either due to an illness or an injury, is covered under your health plan.

Physician and nursing charges

Your health plan covers the physician fees and nursing charges incurred during your hospital stay.

ICU charges

ICU charges, if any, are also included in your comprehensive health insurance plan.

Ayush cover

Most comprehensive medical insurance plans in India have provisions for Ayush health care as well.

Maternity benefits

After a waiting period of about 3 or four years, you can get your maternity expenses covered as well.

These are some of the important health insurance plan components. You will find these covers in most of the comprehensive plans from the leading health insurance providers in India.

Health insurance coverage details - Understanding what’s not in your health insurance plan

While a good mediclaim policy offers a comprehensive set of covers, there are some permanent exclusions listed under such a plan. They include:

  1. Cosmetic procedures like plastic surgeries

  2. Dental treatment expenses

  3. OPD expenses, unless specified by the caregiver or health insurance provider

  4. Expenses related to treatment for self-inflicted injuries

Keep these exclusions in mind to help you in understanding your mediclaim policy.


Now that you know more about the policy inclusions and exclusions, you can use your health coverage more effectively. Get a good plan from a leading insurer like Kotak health insurance to ensure you get the highest amount of coverage. Use your plan to your advantage and keep the wellness of your entire family secured.

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Team Kotak GIC

The content of this blog has been created and carefully reviewed by the esteemed team at Kotak General Insurance, with the sole purpose of providing valuable guidance and sharing insights on the importance of general insurance. Our objective is to assist users in making informed decisions when purchasing or renewing insurance policies for their cars, bikes, and health. Our expertly curated information aims to empower our readers with the knowledge they need to protect their valuable assets and financial interests.