NON PAYABLE ITEMS - NEW HEALTH INSURANCE REGULATIONS

Sr. Expense Head Special Remarks

No.
1 Hair Removal Cream Not Payable
2 Baby Charges (Unless Specified/Indicated) Not Payable

3 Baby Food Not Payable

4 Baby Utilites Charges Not Payable
5 Baby Set Not Payable
6 Baby Bottles Not Payable
7 Brush Not Payable
8 Cosy Towel Not Payable
9 Hand Wash Not Payable
10 Moisturiser Paste Brush Not Payable
11 Powder Not Payable
12 Razor Payable
13 Shoe Cover Not Payable
14 Beauty Services Not Payable
15 Belts/ Braces Essential and may be paid specifically for cases
who have undergone surgery of thoracic or
lumbar spine.
16 Buds Not Payable
17 Barber Charges Not Payable
18 Caps Not Payable
19 Cold Pack / Hot Pack Not Payable
20 Carry Bags Not Payable
21 Cradle Charges Not Payable
22 Comb Not Payable
23 Disposables Razors Charges Payable for Site Preparations
24 Eau-De-Cologne / Room Freshners Not Payable

25 Eye Pad Not Payable

26 Eye Shield Not Payable
 NON PAYABLE ITEMS - NEW HEALTH INSURANCE REGULATIONS
Sr. Expense Head Special Remarks
No.
27 Email / Internet Charges Not Payable
28 Food Charges (Other Than Patient's Not Payable
Diet Provided By Hospital)

29 Foot Cover Not Payable

30 Gown Not Payable
31 Leggings Essential in bariatric and varicose vein surgery and
should be considered for these conditions where
surgery itself is Payable.
32 Laundry Charges Not Payable
33 Mineral Water Not Payable
34 Oil Charges Not Payable
35 Sanitary Pad Not Payable
36 Slippers Not Payable
37 Telephone Charges Not Payable
38 Tissue Paper Not Payable
39 Tooth Paste Not Payable
40 Tooth Brush Not Payable
41 Guest Services Not Payable
42 Bed Pan Not Payable
43 Bed Under Pad Charges Not Payable
44 Camera Cover Not Payable
45 Cliniplast Not Payable
46 Crepe Bandage Not Payable/Payable by patient
47 Curapore Not Payable
48 Diaper Of Any Type Not Payable
49 DVD, CD Charges Not Payable [However if CD is specifically sought
by Insurer/TPA then payable]
50 Eyelet Collar Not Payable
51 Face Mask Not Payable
52 Flexi Mask Not Payable
53 Gauze Soft Not Payable
54 Gauze Not Payable
55 Hand Holder Not Payable
56 Hansaplast / Adhesive Bandages Not Payable
57 Infant Food Not Payable
 NON PAYABLE ITEMS - NEW HEALTH INSURANCE REGULATIONS
Sr. Expense Head Special Remarks
No.
58 Slings Reasonable costs for one sling in case of upper
arm fractures should be considered
59 Weight Control Programs / Supplies / Exclusion in Policy unless otherwise specified
Services
60 Cost Of Spectacles / Contact Lenses / Exclusion in Policy unless otherwise specified
Hearing Aids
61 Dental Treatment Expenses That Do Not Exclusion in Policy unless otherwise specified
Require Hospitalisation

62 Hormone Replacement Therapy Exclusion in Policy unless otherwise specified

63 Home Visit Charges Exclusion in Policy unless otherwise specified
64 Infertility / Subfertility / Assisted Exclusion in Policy unless otherwise specified
Conception Procedure
65 Obesity (Including Morbid Obesity) Exclusion in Policy unless otherwise specified

66 Psychiatric & Psychosomatic Disorders Exclusion in Policy unless otherwise specified

67 Corrective Surgery For Refractive Error Exclusion in Policy unless otherwise specified

68 Treatment Of Sexually Transmitted Exclusion in Policy unless otherwise specified

Diseases
69 Donor Screening Charges Exclusion in Policy unless otherwise specified
70 Admission / Registration Charges Exclusion in Policy unless otherwise specified

71 Hospitalisation For Evaluation / Exclusion in Policy unless otherwise specified

Diagnostic Purpose
72 Expenses For Investigation / Treatment Exclusion in Policy unless otherwise specified
Irrelevant To The Disease For Which
Admitted Or Diagnosed
 NON PAYABLE ITEMS - NEW HEALTH INSURANCE REGULATIONS
Sr. Expense Head Special Remarks
No.
73 Any Expenses When The Patient Is Not Payable as per HIV/AIDS Exclusion
Diagnosed With Retro Virus + Or
Suffering From HIV / AIDS Etc Is
Detected / Directly Or Indirectly
74 Stem Cell Implantation / Surgery And Not Payable except Bone Marrow
Storage Transplantation where covered by policy
75 Ward And Theatre Booking Charges Payable under OT Charges, not Payable
separately
76 Arthroscopy & Endoscopy Instruments Rental charged by the hsopital Payable. Purchase
of instruments not Payable
77 Microscope Cover Payable Under OT Payable under OT Charges, not Payable
separately
78 Surgical Blades, Harmonic Scalpel, Payable under OT Charges, not Payable
Shaver separately
79 Surgical Drill Payable under OT Charges, not Payable
separately
80 Eye Kit Payable under OT Charges, not Payable
separately
81 Eye Drape Payable under OT Charges, not Payable
separately
82 X - Ray Film Payable under Radiology Charges, not as
consumable
83 Sputum Cup Payable under Investigation Charges, not as
consumable
84 Boyles Apparatus Charges Payable under OT Charges, not Payable
separately
85 Blood Grouping And Cross Matching Of Not Payable, Part of cost of blood
Donors Samples
86 Antiseptic Or Disinfectant Lotions Not Payable, Part of Dressing Charges
87 Band Aids, Bandages, Sterlile Injections, Not Payable, Part of Dressing Charges
Needles, Syringes
88 Cotton Not Payable, Part of Dressing Charges
89 Cotton Bandage Not Payable, Part of Dressing Charges
90 Micropore / Surgical Tape Not Payable-Payable by Patient when prescribed
otherwise included as Dressing charges
91 Blade Not Payable
92 Apron Not Payable, Part of Hospital Services /
Disposable Linen to be part of OT / ICU Charges
 NON PAYABLE ITEMS - NEW HEALTH INSURANCE REGULATIONS
Sr. Expense Head Special Remarks
No.
93 Torniquet Not payable (service is charged by hospital,
consumables cannot be separately charged.
94 Orthobundle, Gynaec Bundle Not Payable, Part of Dressing Charges
95 Urine Container Not Payable
96 Luxury Tax Actual tax levied by government is Payable. Part
of charge for room sub limits
97 HVAC Not Payable, part of room charge
98 Housekeeping Charges Not Payable, part of room charge
99 Service Charges Where Nursing Charge Not Payable, part of room charge
Also Charged
100 Television & Air Conditioner Charges Not Payable, part of room charge
101 Surcharges Not Payable, part of room charge
102 Attendant Charges Not Payable, part of room charge
103 IM IV Injection Charges Not Payable, part of Nursing charges
104 Clean Sheet Not Payable, pat of laundry / housekeeping
105 Extra Diet Of Patient (Other Than That Patient Diet provided by hospital is Payable
Which Forms Part Of Bed Charge)
106 Blanket / Warmer Blanket Not Payable, part of room charge
107 Admission Kit Not Payable
108 Birth Certificate Not Payable
109 Blood Reservation Charges And Ante Not Payable
Natal Booking Charges
110 Certificate Charges Not Payable
111 Courier Charges Not Payable
112 Convenyance Charges Not Payable
113 Diabetic Chart Charges Not Payable
114 Documentation Charges / Administrative Not Payable
Expenses
115 Discharge Procedure Charges Not Payable
116 Daily Chart Charges Not Payable
117 Entrance Pass / Visitors Pass Charges Not Payable
118 Expenses Related To Prescription On To be claimed by patient under post
Discharge hospitalization expenses, if admissible
 NON PAYABLE ITEMS - NEW HEALTH INSURANCE REGULATIONS
Sr. Expense Head Special Remarks
No.
119 File Opening Charges Not Payable
120 Incidental Expenses / Misc. Charges (Not Not Payable
Explained)
121 Medical Certificate Not Payable
122 Maintenance Charges Not Payable
123 Medical Records Not Payable
124 Preparation Charges Not Payable
125 Photocopies Charges Not Payable
126 Patient Identification Band / Name Tag Not Payable
127 Washing Charges Not Payable
128 Medicine Box Not Payable
129 Mortuary Charges Payable upto 24 Hours. Shifting charges not
Payable
130 Medico Legal Case Charges (MLC Not Payable
Charges)
131 Walking Aids Charges Not Payable
132 Bipap Machine Not Payable
133 Commode Not Payable
134 CPAP / CAPD Equipments Device Not Payable
135 Infusion Pump - Cost Device Not Payable
136 Oxygen Cylinder (For Usage Outside The Not Payable
Hospital)
137 Pulse Oxymeter Charges Device Not Payable
138 Spacer Not Payable
139 Spirometer Device Not Payable
140 Sp02 Probe Not Payable
141 Nebulizer Kit Not Payable
142 Steam Inhaler Not Payable
143 Arm Sling Not Payable
144 Thermometer Not Payable ( paid by patient)
145 Cervical Collar Not Payable
146 Splint Not Payable
147 Diabetic Foot Wear Not Payable
148 Knee Braces (Long / Short / Hinged) Not Payable
 NON PAYABLE ITEMS - NEW HEALTH INSURANCE REGULATIONS
Sr. Expense Head Special Remarks
No.
149 Knee Immobilizer / Shoulder Immobilizer Not Payable

150 Lumbosacral Belt Essential and should be paid specifically for

cases who have undergone surgery of lumbar
spine.
151 Nimbus Bed Or Water Or Air Bed Charges Payable for any ICU patient requiring more than
Payable For Any Icu 3 days in ICU, all patients with paraplegia /
quadripiegia for any reason and at reasonable
cost of approximately Rs. 200 / day
152 Ambulance Collar Not Payable
153 Ambulance Equipment Not Payable
154 Microshield Not Payable
155 Abdominal Binder Essential and should be paid in post-surgery
patients of major abdominal surgery including
TAH, LSCS, incisional hernia repair, exploratory
laparotomy for intestinal obstruction, liver
transplant etc.
156 Betadine \ Hydrogen Peroxide \ Spirit \ May be Payable when prescribed for patient, not
Disinfectants Etc. Payable for hospital use in OT or ward or for
dressings in hospital
157 Private Nurses Charges- Special Nursing Post hospitalization nursing charges not Payable
Charges
158 Nutrition Planning Charges - Dietician Patient diet provided by hospital is payable
Charges / Diet Charges
159 Sugar Free Tablets Payable. Sugar free variants of admissible
medicines are Not excluded
160 Creams Powders Lotions (Toiletries are Payable when Prescribed
not Payable, only prescribed medical
pharmaceuticals Payable)
161 Digestion Gels Payable when prescribed
162 ECG Electrodes Upto 5 Electrodes Are Upto 5 electrodes are required for every case
visiting OT or ICU. For longer stay in ICU, may
require a change and at least one set every
second day must be Payable.
163 Gloves Sterilized Gloves Payable. Unsterilized Gloves
not Payable
164 Hiv Kit Payable for pre-operative screening
 NON PAYABLE ITEMS - NEW HEALTH INSURANCE REGULATIONS
Sr. Expense Head Special Remarks
No.
165 Listerine / Antiseptic Mouthwash Payable when prescribed
166 Lozenges Payable when prescribed
167 Mouth Paint Payable when prescribed
168 Nebulisation Kit If used during hospitalization is Payable
reasonably
169 Novarapid Payable when prescribed
170 Volini Gel / Analgesic Gel Payable when prescribed
171 Zytee Gel Payable when prescribed
172 Vaccination Charges Routine Vaccination not Payable. Post Bite
Vaccination Payable
173 AHD Not Payable. Part of hospital's own internal cost
174 Alcohol Swabs Not Payable. Part of hospital's own internal cost
175 Scrub Solution / Sterillium Not Payable. Part of hospital's own internal cost
176 Vaccine Charges For Baby Not Payable
177 Aesthetic Treatment / Surgery Not Payable
178 TPA Charges Not Payable
179 Visco Belt Charges Not Payable
180 Any Kit With No Details Mentioned Not Payable
[Delivery Kit, Orthokit, Recovery Kit, Etc]
181 Examination Gloves Not Payable
182 Kidney Tray Not Payable
183 Mask Not Payable
184 Ounce Glass Not Payable
185 Outstation Consultant's / Surgeon's Fees Not Payable, except for telemedicine
consultations where covered by policy
186 Oxygen Mask Not Payable
187 Paper Gloves Not Payable
188 Pelvic Traction Belt Should be Payable in case of PIVD requiring
traction as this is generally not reused
189 Referral Doctor'S Fees Not Payable
190 Accu Check (Glucometery/ Strips) Not Payable pre hospitalization or post
hospitalization / Reports and Charts required/
Device not payable
 NON PAYABLE ITEMS - NEW HEALTH INSURANCE REGULATIONS
Sr. Expense Head Special Remarks
No.
191 Pan Can Not Payable
192 Sofnet Not Payable
193 Trolly Cover Not Payable
194 Urometer, Urine Jug Not Payable
195 Ambulance Payable-Ambulance from home to hospital or
inter hospital shifts is Payable / RTA as specific
requirement is Payable
196 Tegaderm / Vasofix Safety Payable - maximum of 3 in 48 hrs and then 1 in
24 hrs
197 Urine Bag Payable where medically necessary till a
reasonable cost - maximum 1 per 24 hrs
198 Softovac Not Payable
199 Stockings Essential for case like CABG etc. where it should
be paid.

This document has been prepared solely for the client to whom it is addressed, for their internal use.
It is not to be distributed more widely without the prior written permission of Future Generali India
Insurance.