General Exclusions

International medical insurance plans will more often than not have some items excluded from coverage. Most international medical insurance policies have a number of standard exclusions which are illustrated below. It is recommended that you talk to a qualified insurance intermediary when purchasing a policy in order to have a better understanding of any exclusions in you plan that pertain to your particular situation.

International medical insurance will generally exclude all pre-existing conditions. A pre-existing condition is defined as any illness, injury, or disease that has been diagnosed or has presented symptoms prior to or at the time of application for insurance that may be known to either the insurer or the insured. Pre-existing conditions can only be covered if the insurance company approves cover of the condition at the time of application.

The most common exclusions generally found in an international medical insurance plan are:

  • Any treatments cosmetic in nature, including cosmetic surgery, unless approval has been given by the insurance company before receiving the treatment.
  • Diagnostics and treatment pertaining to obesity.
  • HIV/Aids and all diseases resulting from infection. However, after the start of a policy, HIV/Aids can be covered if it can be proven that the policyholder
    contracted the disease due to either a tainted blood transfusion or an accident during the course of their normal occupation.
  • All illnesses, injuries, and diseases that directly result from substance abuse will not be covered. This includes the abuse of alcohol, narcotics, or legally prescribed medicines.
  • All self inflicted injuries will be excluded.
  • Contraceptives and any conditions resulting from use of contraception, such as sterilization, will not generally be covered.
  • Unless medically necessary, induced abortions will be excluded.
  • Unless the policy states otherwise, all infertility treatment, including tests, examinations, and treatments will be excluded.
  • The treatment of sexual dysfunction, including any relevant medicines, is not covered.
  • Experimental care is normally excluded. This includes stays in nursing homes, if they are not part of a medical or surgical treatment.
  • "Alternative" treatments, including naturopathic and homeopathic treatments will be excluded from coverage, unless otherwise stated or approved by the insurer.
  • Any injury, illness, or disease that is the direct or indirect result of military service is excluded.
  • Any injury, illness, or disease that is the direct or indirect result of the insured actively engaging in: civil commotion, rebellion, revolution, riots, acts of a foreign enemy, invasion, civil war, war, terrorism, social insurrection, hostilities (whether war has been declared or not), military or civil coups, or participation in any lawfully constituted service (army, navy, air force) whether war has been declared or not, will be excluded.
  • Treatment for any medical conditions arising from chemical contamination, nuclear reactions, detonations, fall out or radioactivity will be excluded.
  • If the insured, their spouse, children, or parents are a medical practitioner, or own any medical enterprise, any treatments from these sources will not be covered unless previously approved by the insurer.
  • Any epidemics or outbreaks which have been placed under the control of public officials and health authorities are excluded from cover.
  • Treatment from a psychologist is usually excluded.

The exclusions included in an international medical insurance plan can be either extremely far reaching or very narrow in their scope. In individual cases, the insurer may also decide to include coverage for a treatment that is usually excluded. It is very important that you are aware of what exactly your plan includes or excludes from coverage when purchasing it. Talk to a qualified insurance intermediary to better understand what exclusions pertain to your specific situation, and how they can affect your insurance.

If you would like to get a better understanding of exclusions, get more information about international medical insurance plan, or to get a free quote, please contact today.

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