Coverage List: What’s Not Covered In Neurosurgery & Neurology Under RGHS

The Rajasthan Government Health Scheme provides a comprehensive health insurance package for government employees of Rajasthan. However, health insurance doesn’t cover every medical expense imaginable, even when it comes from the government. There is a lot of information about the coverage details for various conditions and treatments under RGHS, but do you wonder what’s not covered by the scheme? Sure, there are the basics, such as cosmetic surgery, which is not generally covered by any health insurance. But what else? Let’s find out.

Non-Medical Expenses Not Covered In Neurosurgery & Neurology Under RGHS Scheme

Neurosurgery and neurology often require serious treatment and surgical procedures to treat the patient. The medical expenses of these treatments are well-covered under the RGHS scheme. However, there are certain types of non-medical expenses that are not covered under the RGHS scheme. Here are the details.

Toiletries, Personal Comfort, Convenience, & Cosmetic Items

This is one of the sets of products that are not covered under the RGHS scheme. This means if you need to use these products during your treatment or recovery process at the hospital, the scheme will not cover the cost of these items, and you will need to pay for them. Some of the items under this set are mentioned below. You can find the complete set from this link.

  • Bottles

  • Brush

  • Baby Food

  • Powder

  • Shoe Cover

  • Beauty Services

  • Comb

  • Eau de Cologne

  • Barber Charges

  • Cold/Hot Packs

  • Caps

  • Foot cover

  • Gown

  • Laundry Charges

  • Sanitary Napkins

  • Toothpaste

  • Toothbrush

There are a few items that are generally non-payable except for specific cases under this set. They are mentioned below.

  • Belts or Braces - These items are payable in cases where the patient has gone through thoracic or lumbar spinal surgery.

  • Leggings - This item is payable in cases where the patient has had varicose vein surgery or bariatric surgery.

  • Slings - The cost of this item is borne by the scheme in cases where the patient has had an upper arm fracture. However, the coverage is only limited to one sling.

  • CD Charges: The CD charges of any procedure are not payable unless the CD is explicitly requested by the insurer or TPA; in such cases, the charges are covered under the scheme.

Specifically Excluded Items Under The Policies Of RGHS Scheme

There are certain treatments and items that are specifically not covered under the RGHS due to its policies. However, these items are currently considered non-payable. If the policies of the scheme are changed in the future, they can be updated and changed to be covered under the scheme. Some of these treatments and items are mentioned below. You can find the complete list here.

Specific Exclusions Of the RGHS Scheme

  • Cost of Hearing aids

  • Cost of Contact lenses or spectacles

Next, let’s review treatments and items that are currently not covered as per RGHS policies.

  • Hormonal treatments

  • Weight loss supplies or treatment

  • Infertility treatment

  • Psychiatric treatment

  • Obesity treatment

  • Hospitalization charges for diagnosis

  • Hospital admission fees

There are also specific treatment options that are not payable due to certain terms and conditions of the RGHS scheme.

  • HIV/AIDS Treatment: Any treatment for HIV or AIDS is not covered under the RGHS scheme. Even if HIV is discovered accidentally in the patient’s body, the scheme still doesn’t cover the treatment costs.

  • Diagnostic cost of any disease other than for which the patient is admitted to the hospital

Items Excluded Because They Are Part Of Hospital Charges

These items are not to be billed separately. They are billed inclusively among hospital charges. Some of the specific items are mentioned below. However, you can check out the complete list here.

  • Surgical blades

  • X-ray film

  • Eye kit and drape

  • Boyle’s Apparatus charges

  • Band-aids

  • Cotton

  • Apron

  • Tourniquet

  • Urine Container

Conclusion

So, that is a complete overview of all the various non-medical charges that are not covered under the RGHS scheme when you go through neurosurgery. Make sure you keep these specific details in mind when you are filling out your hospitalization details on the RGHS portal, as it will ensure your claim gets accepted and settled quicker. And if you are looking for an RGHS-compliant/partner hospital that will help you go through your treatment with the least imaginable hassle, make sure you visit MediPulse hospital. You will find the best neurological treatment options at MediPulse. For more information about the hospital or the in-house neuro department, visit the hospital website.

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