Exclusions and limitations of private medical insurance

Exclusions and limitations of private medical insurance
  • Pre-existing Conditions: Most PMI plans exclude coverage for pre-existing conditions for a set period (often 2-5 years). This means they won’t cover treatment related to those conditions until the exclusion period has passed. Be upfront about your medical history when applying for PMI to avoid claim denials.
  • Specific Treatments: Some plans might have limitations or exclusions for specific treatments (e.g., cosmetic surgery, certain mental health conditions). Always check the details of your plan to understand what’s covered.
  • Maternity Care: Coverage for maternity care can vary depending on the plan. Some might offer comprehensive cover, while others might have limitations or require additional premiums.
  • Premiums Can Increase: PMI premiums can increase over time, especially as you age or if you make claims. Be prepared for potential cost adjustments when renewing your plan.
  • Renewals and Medical History: During policy renewals, your PMI provider might ask for updates on your medical history. Any changes could affect your premium or even your coverage.