Common exclusions from health insurance
In order to avoid misunderstandings regarding the benefits of a health and provident insurance contract, here is a list of the exclusions we encounter most frequently.
It is very important to know them, they are always detailed on the general conditions of your contract which unfortunately nobody consults.
- Treatment requiring prior agreement provided without prior agreement (physiotherapy, speech therapy, dentures, implants, orthodontics, usually most serial treatments).
- Ancillary costs (other than those provided for in the Table of Benefits) for Hospitalisation or extravagant, unreasonable or unusual costs in relation to the country in which they were incurred.
- Psychologist consultations, psychotherapy treatments.
- Parapharmacy fees, cosmetic care, hygiene products, sun and/or moisturizing creams, make-up products, comfort treatments, vitamins and minerals, food supplements, diet products, baby food, mineral waters.
- Treatment of alcoholism, drug addiction or any other addiction or disease related to such addiction; stays in gerontology, medical-pedagogical institutes and similar institutions.
- Stays in a rest or convalescent home not following a hospitalization related to a Critical Illness ?or an accident.
- Growth hormones.
- Aesthetic surgery.
- The use of alcohol and its consequences in accordance with the legislation in force in the country of occurrence.
- Pre-existing accidents or illnesses prior to the effective date of the contract, subject to relapse or unconsolidated, congenital illnesses or malformations and not declared at the time of enrolment.
- Participation in all sports competitions and training sessions, the practice of sports within the framework of a club or a federation in a professional capacity, as well as any sport requiring the use of any land, water or air locomotion device.
- The practice of dangerous sports such as : driving a car, motorcycle or karting, parachuting, mountaineering, climbing (except on artificial supports), rock climbing, scuba diving (except freediving at less than 50 meters), speleology, skeleton, ski jumping, bobsleigh, bungee jumping, rafting, canyoning, kitesurfing, hot air ballooning, jet-skiing, as well as the following sports practiced off-piste: skiing, cross-country skiing, tobogganing, snowboarding.
Stays in a rest or convalescent home not following a hospitalization related to a Critical Illness ?or an accident.
Accidents or illnesses prior to the effective date of the contract, subject to relapse or unconsolidated, congenital illnesses or malformations and not declared at the time of enrolment.