Medical Costs Not Covered Under The RGHS Scheme For Sports Medicine Treatment
The Rajasthan Government Health Scheme is the premier health insurance scheme offered by the state government for its employees. However, as with any health insurance, some charges are not covered by the insurance because of the policy. When it comes to sports treatment, where invasive procedures are pretty common, there are still some charges that the policy does not cover. What are the costs not covered under RGHS for sports medicine treatment? Let’s find out.
Which Medical Costs Are Not Covered Under RGHS For Sports Medicine Treatment?
Sports medicine deals with many injuries that require medical attention, but most often, it’s not emergency treatment. Doctors take time to assess the damage and plan a course of treatment that would be appropriate in helping the sportsperson recover best. However, during the course of treatment, here are some of the costs that the policy does not cover.
Non-medical consumable item costs
Items excluded explicitly from RGHS by policy
Hospital charges
The charges mentioned above are not covered under RGHS. However, there are various particulars inside each of these categories that you must know. So, let’s explore each of these categories and the individual costs that are not covered under RGHS from each of these categories.
What’s Not Covered Under Non-Medical Consumable Items?
Non-medical consumable items include and are not limited to toiletries, convenience, personal comfort, and cosmetic items. These items are considered non-medically essential in the treatment process, which excludes them from coverage according to the policy. Here are some of the items which are considered non-medical consumables.
Beauty services
Combs
Barber charges
Eau de Cologne
Sanitary napkins
Toothpaste and toothbrush
Gown
Caps
Foot cover
There are exceptions to this category, which are covered only under special or specific conditions. Here are the products covered under special circumstances under non-medical consumables.
CDs: Exception is made if the CD of the procedure is requested to be submitted by the insurer.
Slings: There are exceptions to slings, as patients can be eligible for one sling in specific circumstances, such as a fracture in the upper arm.
What’s Not Covered Under Specific Exclusions of RGHS?
Specific exclusions are not covered under RGHS currently. However, if there are any changes to the policies of RGHS, their coverage status can be changed in the future. Let’s review the exact particulars that are not covered under RGHS.
Spectacles or contact lenses
Hearing aids
Hormonal treatments
Psychiatric treatments
All of these treatments are not covered under the RGHS scheme as per the current policies. If the guidelines are changed, they may be included in the coverage list in the future.
What’s Not Covered Under Hospital Charges Under RGHS?
Hospital costs include costs that are either already billed to the insurer in a different section or are not covered at all and need to be paid by the patient. These items include regular hospital items as well as intensive care items. The particulars are mentioned below.
Tourniquet
Urine collector
X-ray film
Surgical blades
Cotton
Boyle’s Apparatus charges
These charges are included in other sections and, as such, must not be billed separately when you are submitting your billing information at the RGHS portal.
Conclusion
This article is a short overview of some of the charges not covered by RGHS policies. To better understand all the charges, you can check out the official non-coverage list of RGHS on the official website (rghs.rajasthan.gov.in). So, to ensure that your sports medicine treatment is done by the most experienced doctors at our hospital who partner with RGHS and understands their billing processes thoroughly, visit MediPulse hospital. You can find more information about sports medicine treatment at MediPulse on the hospital website.