For most people and organizations, the process of settling on a medical insurance provider comes down to the cost. However, considering the cost on its own without getting into the finer details has left many people dissatisfied with their medical insurance provider. One of the things you must consider is medical insurance sub-limits.

What is a Sub-Limit on a Medical Insurance Policy

A sub-limit is a cap on the total amount the insurance company can pay for a specific disease or type of treatment. For example, if you purchase an inpatient policy of 5 million your policy may come with a sub-limit of 500,000 for cancer treatment.

Below are some of the most common medical insurance sub-limits.

Common Types of Medical Insurance Sub-Limits

Sub-limits will typically be imposed for the following diseases and treatment:

  • Pre-existing conditions and chronic conditions.
  • Newly diagnosed chronic conditions after the inception of cover.
  • Cancer treatment.
  • HIV / AIDS and related conditions.
  • Post-hospitalization treatment related to the cause of pre-authorization.
  • Inpatient non-accident related eye treatments.
  • Gynaecological surgery.
  • Organ transplantation.
  • Internal and external surgical implants, appliances, joint replacement and prostheses.
  • Psychiatry and psychotherapy.
  • Illness related to reconstructive/plastic surgery.
  • Congenital defects and genetic disorders.

Sub-Limits: The Takeaway

So, before you sign-up, find out about the sub-limits on your policy to avoid any nasty surprises. The cheapest quotation often has the highest sub-limits because the potential liability of the insurance company is much lower.

In addition to sub-limits, there are other factors which may make one quotation appear more affordable than another. For example, waiting periods, co-payments and exclusions. For a comprehensive explanation on medical insurance sub-limits and a quotation from leading medical insurers, do not hesitate to request a quote.

One of our Insurance Gurus is standing by to provide you with the assistance you need.

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