List of Non Payable Items in Health Insurance

Quick Overview

Non payable items in health insurance are non-medical or personal convenience medical expenses incurred during hospitalization that insurers do not cover, as per IRDAI guidelines. They usually make up 5% to 15% of a hospital bill, depending on the medical procedure.

These exclusions include toiletries, food (other than hospital diet), attendant charges, and personal items such as diapers or slippers, which are often listed under the non-medical expense list in the health insurance policy wording.

Non payable items may seem minor, but they quietly add up to a big shock to the final bill. When clubbed together, these small exclusions can eat into your savings without warning.

This guide walks you through the items excluded from your health cover, plans that cover these, and ways to minimize non-medical expenses.

What Are Non Payable Items in Health Insurance?

Non payable items in health insurance are expenses incurred during hospitalization that insurers do not cover because they are considered non-medical or related to personal comfort, like attendant charges and consumables like gloves.

IRDAI excludes these items to prevent misuse, so insurers will not pay for them, and you must bear these costs yourself. IRDAI has grouped these non payable expenses based on the type of treatment and hospital stay.

Why Does IRDAI Exclude These Items?

These costs are excluded to curb overbilling of small items, keep premiums affordable, and ensure insurance focuses on essential treatment costs rather than comfort or administrative expenses.

Check out the infographic about common non payable items you may be charged for during hospitalization.

Types of Non Payable Items in Health Insurance

Non Payable Items Category	Examples	Reason for Exclusion
Consumables	Gloves, cotton, syringes, and bandages	Part of the daily routine of hospital supplies
Administrative and service charges	Registration and admission charges, data handling, and documentation	Counted as hospital overheads, not direct treatment costs
Personal items	Tissues, slippers, toiletries, and water bottles	For patient comfort/ convenience, and are not medically necessary
Food and beverages	All meals, irrespective of the frequency (doctor-prescribed diet for treatment may be payable)	General meals are non-medical in nature
Non-Medical Equipment	Oxygen masks and external prosthetics	Reusable or durable equipment billed separately (excluded unless policy explicitly covers)

Note: Such exclusions regarding non payable items in health insurance vary from policy to policy. Download the PDF to view the IRDAI list of non payable items in health insurance.

IRDAI List of Non Payable Items in Health Insurance

IRDAI List of Non Payable Items in Health Insurance.pdf

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How Does Non Payable Items Affect Your Final Claim?

Non payable items affect both reimbursement and cashless claims by increasing what you pay from your own pocket. In a reimbursement claim, these charges are deducted from the approved amount. In a cashless claim, the hospital bills you directly for non payable items at discharge, even if the rest of the bill is settled by the insurer.

For instance, if the insured undergoes surgeries above ₹2 lakh, they often pay an extra ₹15,000 to ₹25,000 out of pocket for non payables. Certain comprehensive health plans like HDFC ERGO Optima Secure and Aditya Birla Activ One Max have in-built consumable cover features, which save you from paying non payable items out of your own pocket.

However, such non payable items are not covered under some policies. In case you wish to purchase comprehensive plans like Care Supreme and Niva Bupa Reassure 2.0 (Platinum), you can purchase their add-ons for consumable cover.

Annual Premiums for Care Supreme

Profile	Premium	(Claim Shield plus) Add-on	Total Premium
Individual (Age-25)	₹13,942	₹1,169	₹15,111
Couple(Age 32 and 31)	₹19,873	₹1,654	₹21,527
Couple and child (Age - 32,30, and 5)	₹25,044	₹2,116	₹27,160
Senior citizen couple(Age - 63 and 61)	₹72,595	₹6,328	₹78,923

Note: Listed premiums are for a sum insured of ₹15 lakh, residing in Delhi. The premiums include add-ons like an annual health check-up and a cumulative bonus super. The premiums can vary according to the medical underwriting and the city you reside in.

Annual Premiums for Niva Bupa Reassure 2.0 (Platinum)

Profile	Base Premium	(Safegard Benefit) Add-on	Total Premium
Individual (Age - 25)	₹10,381	₹890	₹11,271
Couple (Age 32 and 31)	₹17,662	₹1,514	₹19,176
Couple and child (Age - 32, 30, and 5)	₹23,050	₹1,976	₹25,026
Senior citizen couple (Age - 63 and 61)	₹62,851	₹5,388	₹68,239

Note: Listed annual premiums are for a sum insured of ₹15 lakh, residing in Delhi. These premiums can vary according to the medical underwriting and the city you reside in.

Key Takeaway: Choosing the consumables add-on usually increases the premium by only about 8–10%, but it can save a significant amount during a claim by covering everyday medical items that are otherwise paid out of pocket. This makes it a cost-effective option for better overall protection.

Real Claim Scenario

A Ditto customer undergoing ACL reconstruction surgery chose Care Supreme’s Claim Shield add-on by paying just ₹697 extra. His total cover was ₹10 lakh, and he stayed in the hospital for 3 days. The final bill came to ₹2.4 lakh, including room and nursing charges (₹24,000), OT and surgeon fees (₹1,05,000), medicines and diagnostics (₹28,500), implants (₹37,500), and consumables worth ₹45,000.

Normally, consumables like sutures, cannulas, syringes, and surgical disposables are not fully covered. But because of the add-on, the entire ₹45,000 consumables cost was approved, eliminating the biggest deduction.

Result: The customer paid nothing for consumables and saved ₹45,000. Even if only 70% had been approved, he would still have saved ₹31,500.

Why this matters: Surgeries like ACL reconstruction are consumables-heavy. A low-cost add-on can prevent large out-of-pocket expenses during claims.

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Things to Remember About Non Payable Items in Health Insurance

Even with a consumables add-on, some costs can still be out of pocket because coverage is limited to items listed in the policy’s annexure.
Any consumables not mentioned in the approved list will have to be paid for by you.
All base policy rules, exclusions, and conditions still apply to your health claim.
Expenses that go beyond your available sum insured are not covered.
Deductions can also happen due to policy features like co-pay, deductibles, room-rent limits, or disease-specific sub-limits.

Ditto’s Advice: Pick a plan with no room-rent cap, no co-pay, and no sub-limits, and add a consumables cover to keep out-of-pocket expenses low. We recommend that our customers opt for consumable add-ons, which help mitigate the extra consumable charges.

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Conclusion

Exact inclusions, exclusions, and the final item list can vary by plan. Always verify against the latest policy wording and annexure for your specific plan.

If you are looking for a health plan from insurers with established track records, we recommend comprehensive plans for 2026, which align with your long-term goals. Explore more about how our experts evaluate health plans through Ditto’s cut.

Note: All information in this article is based on details available on IRDAI’s official website and publicly available data.

Frequently Asked Questions

What are consumables in health insurance?

These are items that cannot be reused after treatment, such as gloves, syringes, masks, cotton, and disinfectants. They are commonly used during procedures but are often excluded from standard health insurance coverage unless you have a consumables add-on.

What are the most common non payable items in a health insurance claim?

Common non payable items include toiletries, food, attendant charges, personal items (slippers, diapers), routine consumables (gloves, syringes), and hospital overheads like registration or documentation fees.

What are the non-medical expenses?

Non-medical expenses are hospital costs not related to actual treatment, like gloves, masks, admission charges, food for attendants, or administrative supplies. IRDAI lists these as exclusions, so insurers usually do not cover them unless you buy an add-on

What is the CGHS non payable list?

The list refers to the non payable list under the Central Government Health Scheme (CGHS). This includes specific items, medicines, and services that the government does not reimburse. Even if you are treated at an empanelled private hospital, these costs must be borne by the beneficiary.

What is the IRDAI non payable items list?

The IRDAI non payable Items List is a standardized catalog of non-medical or consumable expenses that health insurance companies in India are generally not required to pay under a standard policy. The list consists of over 200 items divided into 4 categories.

Last updated on: 15 Feb, 2026