What is not covered?
If you have existing medical conditions before the signing of the plan, it may not be covered under your plan. However, often if you are willing to pay extra, you are able to obtain a full or partial coverage. Some insurers will offer coverage upon a certain number of claim-free years or when there is no detection of a reoccurrence after a waiting period. It is usually two to four years. To deter people from abusing the plan and buying policies only when they are diagnosed, some insurers defer the benefits. They will only pay after the insured suffers from the condition for a certain period.
The insurer can decide to cover the acute phases only. Meaning they do not pay for the routine treatments but will support you when you are in dire need of a significant and expensive treatment. You can decide on a lifetime limit with your insurer. This means that they will reimburse you for your medical expenses linked to your condition but will never pay more than the agreed lifetime limit for that condition. An annual limit can be decided, which means that each year your medical expenses will be cut-off after a certain limit but you are fully covered within that limit.
Below is a list of the common exclusions. It varies with different insurers. Some companies cover treatment but not preventive care such as screenings or vaccines, and vice versa. Some plans compensate up to a certain amount and period, or offer the coverage as an optional upgrade.
- Addictive and mental conditions and disorders
- Artificial life maintenance
- AIDS or HIV-related disease
- Birth control – contraception, sterilisation, abortion (unless medically recommended)
- Fertility treatment or fertility test
Note: Albeit an 18 month waiting period, Allianz Worldwide got you the less commonly covered infertility treatments in its Gold and Silver out-patient add-on plans.
- Sexual dysfunction
- Congenital conditions
- Conflict and disaster
- Experimental or unproven care such as Traditional Chinese Medicine
- Self-inflicted and illegal acts
- Cosmetic and plastic surgery
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