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6 common health insurance exclusions to look out for

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6 common health insurance exclusions to look out for

Post by Pal » Tue, 09 May 2017 12:54 am

In a nutshell, health insurance exclusions are the services that your policy will not pay for. The fact of the matter is that health insurance plans won’t cover everything, so familiarizing yourself with the “exclusions” section of your policy Terms and Conditions is definitely a good idea. By doing so, you’ll be able to avoid being faced with an eye-wateringly expensive bill that you originally assumed was covered by your medical insurance. This article by the insurance experts over at Pacific Prime Singapore, a world leading insurance broker, uncovers the following 6 common health insurance exclusions you should look out for.

Pre-existing conditions

A pre-existing condition is any illness or injury that you already have, or have previously had, of which you are aware of, or have received treatment for prior to taking out your health insurance plan. That being said, please bear in mind that the definition of pre-existing conditions in policies may vary. You’ll often see this as a common exclusion in plans, although a number of insurers do provide the option of covering your pre-existing condition(s).

For example, an insurance provider may place a loading on your plan, which means that your annual premium will rise by a certain amount so that it covers your pre-existing conditions. You may also see some insurers offer the option of placing a waiting period on your plan, which is a specified duration of time you’ll have to wait before your plan will cover that particular condition.

Miscellaneous hospital stay charges

It’s common to see health insurance policies exclude “non-medical charges”. This means cover for costs such as guest meals, TV, use of the hospital room telephone, extra pillows, medical report charges and the like will usually be excluded. These costs can stack up, so be sure to check exactly what is and isn’t covered by your policy.

Cosmetic surgery

This is quite an obvious one, as almost all health insurance plans will only cover care deemed medically necessary. With this in mind, it’s likely that your plan won’t cover elective surgeries, which are a type of procedure that is scheduled in advance and does not entail a medical emergency. So, if you’re looking to improve your aesthetic appearance through surgery, be sure to bear in mind that virtually all policies won’t cover cosmetic procedures (e.g. facelifts, breast augmentation, etc).

Fertility treatment

In Singapore, fertility treatments can be very expensive, especially in private clinics. For example, you can expect to pay anywhere between SGD 14,000 to 20,000 for an IVF cycle, including medication and doctor visits. While Singaporean Citizens, Permanent Residents, and foreigners married to a citizen are eligible for government subsidies on IVF treatments, the amount of co-funding will vary significantly depending on the citizenship status of the couple. On the other hand, if both partners are foreigners, then they will not be eligible for these subsidies, so having health insurance that covers fertility treatment can be beneficial.

That being said, a lot of plans won’t cover fertility treatment, although there are comprehensive policies out there that do cover certain fertility procedures such as IVF. One thing to be aware of here is that some insurers may require both partners to secure the plan before the mother can receive coverage for such treatments. Other caveats may also apply, so being sure of all plan stipulations by talking to an experienced broker like Pacific Prime Singapore can really help resolve any uncertainties you may have regarding your policy.


Maternity-related expenses (e.g. the delivery of your baby, prenatal ultrasounds, etc.) are a standard exclusion in general health insurance policies. Instead, maternity insurance is typically available as an add-on benefit on top of your health insurance plan. However, as insurers face high payout costs with the maternity benefit, most maternity plans come with a waiting period of at least 10 to 12 months, meaning it will need to be secured well before conception.

Coverage outside of Singapore

If you’ve got a local Singapore health insurance plan, you’ll only be eligible for coverage within Singapore and likely won’t have any coverage benefits outside the country. For greater geographical flexibility, you may want to consider international health insurance for globally portable coverage. These plans can be the perfect solution for frequent travellers and expats, as policyholders will get to enjoy coverage for virtually any hospital, anywhere in the world. There’s also the option of purchasing travel insurance to protect yourself abroad, although please bear in mind that these policies are designed to cover the costs of seeing you well enough to get home in the event of a medical emergency.

On the lookout to find the best health insurance plan for your needs? Get in touch with the expat insurance experts at Pacific Prime Singapore today for impartial advice, as well as a free quote!

By Pacific Prime
Singapore Expats

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