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IHHP Health Plan | Exclusions

The insurance shall not cover expenses incurred for any disease, illness or injury known to the policyholder and/or the insured at the time of application, unless agreed upon with the Company.

Furthermore, the Company shall not be liable to pay reimbursement for expenses which concern, are due to or are incurred as a result of:

  1. non-medically essential and cosmetic surgery and treatment unless medically prescribed and pre-approved by the Company,
  2. obesity surgery and treatment (including diet pills),
  3. venereal diseases, AIDS, AIDS-related diseases and diseases relating to HIV antibodies (HIV positive). However, diseases relating to AIDS and HIV antibodies (HIV positive) are covered, if proven to be caused by a blood transfusion received after the commencement of the policy. The HIV-virus will also be covered if proven to be contracted as the result of an accident occurring during the course of only the following occupations: doctors, dentists, nurses, laboratory personnel, ancillary hospital workers, medical and dental assistants, ambulance personnel, midwives, fire brigade personnel, policemen/-women, and prison officers. The insured shall notify the Company within 14 days after such accident and at the same time provide a negative HIV antibody test,
  4. any use or misuse of alcohol, drugs and/or medicines unless it can be documented that the illness or injury is unrelated thereto,e) intentional self-inflicted bodily injury,
  5. contraception, including sterilisation,
  6. induced abortion unless medically prescribed,
  7. any kind of fertility test and/or treatment, including hormone treatment, insemination or examinations and any procedures related hereto, including expenses for pregnancy, pre- and postnatal treatments of the mother and the newborn child/children. An application must therefore be submitted for children born as a result of fertility treatment and/or born by a surrogate mother. The application will undergo the standard underwriting procedure, according to Art. 1,
  8. sexual problems and gender issues: sexual problems, such as impotence, whatever the cause, or sex changes or gender re-assignments,
  9. hospital accommodation when it is used solely or primarily for any of the following purposes: receiving general nursing care or any other services which do not require the insured to be in a hospital and could be provided in a nursing home or other establishment that is not at hospital; receiving services which would not normally require trained medical professionals (eg help in walking and bathing) and pain management,
  10. treatment by naturopaths or homoeopaths and naturopathic or homoeopathic medications and other alternative methods of treatment, unless specified in the List of Reimbursements,
  11. health certificates,
  12. treatment of diseases during military service,
  13. treatment for sickness or injuries directly or indirectly caused while actively engaging in: war, invasion, acts of a foreign enemy, hostilities (whether war has been declared or not), civil war, terrorist acts, rebellion, revolution, insurrection, civil commotion, military or usurped power, martial law, riots or the acts of any lawfully constituted authority, or army, naval or air services operations whether war has been declared or not,
  14. nuclear reactions or radioactive fallout,
  15. treatment performed by an unrecognised medical practitioner, provider or facility,
  16. epidemics which have been placed under the direction of public authorities,
  17. treatment by a psychologist,
  18. treatment or surgery to correct refractive errors in the eyesight (due to eg myopia, hyperopia/ hypermetropia, astigmatism and presbyopia) such as laser treatment, refractive keratotomy and photorefractive keratectomy, clear lens extraction, or accommodative intraocular lenses,
  19. any treatment or medicine which is experimental based on acceptable evidence, unless undertaken as part of a registered clinical trial,
  20. any treatment or medicine which is not proven to be effective based on acceptable evidence,
  21. medication and equipment used for purposes other than those defined under their licence.

Please make sure you download a copy of the plan brochure which contains the full plan exclusions, as the listed exclusions here are just a summary.