Essential Knowledge: Illnesses Not Covered by Insurance and Waiting Periods Explained
Illnesses not covered by insurance are crucial details many might overlook when buying health insurance or life insurance Although insurance provides financial support during illness or emergencies, it does not cover all conditions, especially those with pre-existing conditions or exclusions as outlined in the policy after a policy is made. What is waiting periods of 90, 120, or 180 days, and which illnesses are not covered? Ignoring these details can lead to misunderstandings or disappointment when seeking coverage.
What Are Illnesses Not Covered by Insurance?คืออะไร
Why You Must Disclose Full Health Information
Medical Equipment or Medications Not Covered by Insurance
What Are Waiting Period?
What Are Illnesses Not Covered by Insurance?
Illnesses or health issues not included in the coverage are generally specified in the insurance policy. These might include:
- Pre-existing conditions: Such as diabetes or high blood pressure
- Illnesses with waiting periods: Such as illnesses within the first 90, 120, or 180 days after purchasing insurance.
- Certain chronic illnesses: Which are specified as not covered in the policy such as heart disease or chronic kidney disease.
- Mental illnesses: Or Mental health-related conditions.
- Injuries from risky behavior: For example, injuries from high-risk sports or substance abuse.
- Genetic disorders: Or illnesses that arise due to genetic abnormalities.
Remark: Exclusions may vary between insurance companies and plans. Review the policy details to ensure the coverage meets your needs.
- Disclose full health information: Providing complete and accurate health information enables the insurance company to assess your health risks, ensuring you receive suitable coverage.
- Read policy details carefully: Before purchasing an insurance policy, study the benefits and exclusions, as these can vary across insurance companies.
- Compare insurance plans: Compare insurance plans to find one that meets both your coverage needs and budget.
- Consult experts: For any uncertainties, seek advice from an insurance agent or financial advisor, or find more information on the Muang Thai Life Assurance website.
In conclusion, purchasing health or life insurance is an important step, but understanding the policy conditions is equally essential to ensure you have the most suitable coverage.
Why You Must Disclose Full Health Information
Beyond the scope of illnesses not covered by insurance, applicants must fully disclose health details before purchasing certain life or health insurance. This includes chronic illnesses, regular medications, family medical history, prior treatments, and lifestyle habits, providing a transparent health profile for the insurance company to accurately assess and offer an appropriate plan.
Reasons Why You Must Disclose Full Health Information
- To receive appropriate coverage: Accurate health disclosures allow the insurance company to design a policy that appropriately meets your needs.
- To avoid claim denials: If you omit key health details and the insurance company later discovers them, they may refuse to pay claims.
- For transparency: Providing complete health information shows responsibility and transparency to the insurance company.
- So that the insurance company can assess risks accurately: Your health information allows the insurance company to accurately assess potential risks and set the correct premium.
What Happens If Health Information Is Not Disclosed?
- Denied or no coverage: As mentioned previously, if the insurance company later discovers that you concealed significant health information, you may not receive the coverage you are entitled to.
- Possible policy cancellation: In severe cases, the insurance company may have the right to cancel your policy.
- Unreliability: Concealing health information may cause the insurance company to doubt your reliability, which could lead to refusal of insurance coverage or higher premium rates.
Therefore, disclosing accurate health information will help you receive complete coverage and avoid issues in the future.
Remark: Exclusions may vary between insurance companies and plans. Review the policy details to ensure the coverage meets your needs.
Medical Equipment or Medications Not Covered by Insurance
Medical equipment or medications not covered, or excluded, by insurance are medical equipment not directly used for treating illness or those with non-medical purposes. Examples of non-covered medical equipment include:
- Non-essential medications: Some medications may be seen as supplements or convenience products rather than necessary for illness treatment, such as certain vitamin supplements or medications for minor symptoms.
- Medications not in the list of essential medicines: Medications not included in the hospital’s essential medicine list or the insurance company’s medicine list may not be covered.
- Cosmetic medications: Medications used for cosmetic procedures or appearance improvements are not covered.
- Medications for undisclosed chronic illnesses: Medications for certain chronic conditions such as diabetes or high blood pressure may not be covered if the illness was not disclosed when applying for insurance.
- Drug abuse: For example, narcotics, will not be covered.
Remark: Exclusions may vary between insurance companies and plans. Review the policy details to ensure the coverage meets your needs.
What Are Waiting Periods?
The waiting period is a period during which illnesses are not covered. This helps prevent claims for pre-existing illnesses. Waiting periods typically range from 30 to 180 days (depending on the policy conditions).
Health insurance waiting periods of 30 days and 120 days
- 30-Day waiting period ❌ Not covered: Common illnesses such as colds and diarrhea.
- 120-Day waiting period ❌ Not covered: Serious illnesses such as tumors, hernias, tonsillitis, varicose veins, hemorrhoids, pterygium, stones, and endometriosis.
Emergency accident claims can be made immediately (within 24 hours)
Most critical illness policies have a 90-day waiting period
- 90-Day waiting period ❌ Not covered: Chronic and severe illnesses such as heart disease, cancer, stroke, muscular illnesses, and neurological illnesses.
- 90-Day waiting period ❌ Not covered: Chronic and severe illnesses such as heart disease, cancer, stroke, muscular illnesses, and neurological illnesses.
In summary, waiting periods are required to prevent immediate claims for illnesses with incubation periods, ensuring the illness was not present before purchasing the insurance. Therefore, remember to check policy details before buying health insurance to maximize your benefits.
Remark: Exclusions may vary between insurance companies and plans. Review the policy details to ensure the coverage meets your needs.
Enjoy peace of mind with lump sum insurance. Purchase it when you are in good health for full coverage.
Coverage ranges from 200,000 Baht to 100,000,000 Baht.
🛡️Coverage of critical illnesses, cerebrovascular disease, heart disease, cancer, kidney disease, dialysis, and chemotherapy without hospitalization*
🩺 Full coverage for surgeries, ICU rooms for up to 365 days*
👓 Entry age up to age 90, with coverage period up to age 99
💊 Coverage for advanced medical treatment technology
Eligible for a tax deduction of up to 25,000 Baht, or if purchased for parent(s), a deduction of up to 15,000 Baht.
For more information:
☑️ Call Tel. 1766, available 24/7
☑️ Contact life insurance agents or branches of KASIKORNBANK, and Land and House Bank
- *Coverage of Elite Health Plus Rider
Coverage conditions are as specified in the insurance policy. - Health rider must be purchased to be attached to in-force policy.
- Coverage period of the rider must not exceed the coverage period of the life insurance policy that this rider is attached to.
- Premium is eligible for tax deduction. Conditions are as specified by the Revenue Department.
- Underwriting is subject to the Company’s rules.
- Please study the details of coverage, conditions and exclusions before making a decision to purchase insurance.
- Conditions are as specified by Muang Thai Life Assurance PCL.
Sources: Retrieved on 25 October 2024