When most people think about health insurance, they imagine a financial safety net that covers everything from admission to discharge. But a closer look at a hospital bill often tells another story. Alongside the medical charges are dozens of smaller items that your insurer will not pay for, even though they are part of your hospital stay.
These are called non-medical expenses.
They include everyday items like gloves, tissues, registration fees, PPE kits, baby food, or even air-conditioning. They are the silent costs that add up quickly and often surprise patients when their claim is settled.
To bring transparency to this process, the Insurance Regulatory and Development Authority of India (IRDAI) standardised all such costs into three categories:
| Category | Description |
| Category 1 | Non-payable items that are never reimbursed under standard policyAn insurance policy is a legally binding contract between an insurance company (insurer) and an individual or business (policyholder). It More terms |
| Category 2 | Optional items that insurers may cover if the policyAn insurance policy is a legally binding contract between an insurance company (insurer) and an individual or business (policyholder). It More includes an add-on |
| Category 3 | Items already included in other charges, which cannot be billed separately |
Understanding these categories helps both individuals and employers design smarter health insurance coverage and avoid claim disputes.
This master guide explains all three, one category at a time.
Table of Contents
Category 1: Everyday Hospital Costs That Are Not “Medical”
Category 1 includes the most familiar list of non-medical expenses. These are items or services that do not contribute directly to treatment and are considered either comfort-related, administrative, or operational in nature.
The IRDAI list includes over 70 such items, which can be grouped into six themes for clarity.
1. Comfort and Convenience
These are facilities or utilities that improve comfort but not medical care.
Items:
- Air conditioner or heater charges
- Attendant bed charges
- Attendant food charges
- Attendant or visitor pass
- Baby cradle charges
- Barber services
- Beauty services
- Bottle (water or otherwise)
- Bucket, mug or personal utensils
- Cleaning or housekeeping charges
- Convenience kit (comb, mirror, soap and similar)
- Dry cleaning or laundry
- Entertainment charges such as TV, cable or Wi-Fi
- Foot cover, shoe cover or visitor cover
- Guest meals or services
- Housekeeping charges
- Laundry charges
- Linen, blanket, pillow or cushion hire or replacement
- Mattress, foam pad or room accessories
- Paper towels or tissue boxes in room
- Room freshener or air freshener
- Table fan or cooler if billed separately
- Telephone or TV remote usage
- Towels or bedsheets if replaced or extra
- TV, music or Wi-Fi charges
- Water bottle or drinking water
2. Personal Hygiene and Grooming
These are everyday toiletries or personal items that you would use at home.
Items:
- Arm slings used for comfort rather than treatment
- Brush, comb or personal toiletries
- Cap for visitors or non-sterile use
- Comb, hair oil or talcum powder
- Creams or lotions that are not medicated
- Hair removal cream, razor or shaving kit
- Mouthwash, toothpaste or toothbrush
- Nail cutter or nail file
- Sanitary napkins
- Shampoo, soap or powder
- Shaving kit or razor
- Slippers or personal footwear
- Soap, shampoo, oil or powder
- Tissues, napkins or wet wipes
- Toothbrush or toothpaste
- Towels for personal use
3. Administrative and Admission Formalities
Hospital paperwork, documentation, and general administrative materials.
Items:
- Admission or registration charges
- Admission kit with file, folder or pen
- Certificate or documentation charges
- Courier or postage charges
- Cradle or baby cot charges
- Discharge summary charges if billed separately
- File opening, record keeping or stationery charges
- Photocopy or document charges
- Registration fees
- Stationery, pen, file or zip folder for reports
4. General Consumables
Disposable items that are necessary for hospital operations but not tied to any specific procedure.
Items:
- Alcohol swabs, spirit or disinfectant
- Bandages, cotton or gauze for general use
- Belts, braces or elastic bandages unless prescribed
- Blood grouping and cross-matching when part of package rate
- Blood storage charges if billed separately
- Disposable razors or blades
- Eye pad or eye shield for non-surgical use
- Gloves for general use
- Masks that are non-surgical
- Nebulizer kit if disposable
- Oxygen mask not part of treatment package
- Paper gloves or paper towels
- PPE kit for general ward use
- Pulse oximeter used temporarily
- Shoe covers
- Spirit, antiseptic lotion or disinfectant
- Syringes, needles, IV sets or catheters not procedure-specific
- Thermometer not prescribed
- Waste disposal or bio-waste handling for general area
- X-ray film if extra copy or part of package
5. Housekeeping and Utilities
Operational costs that are part of hospital maintenance.
Items:
- Air-conditioning or electricity surcharge if shown separately
- Cleaning or housekeeping including mopping and janitorial work
- Laundry services for bed linen or gowns
- Linen, bedsheet or pillow cover charges
- Waste disposal or biomedical handling
- Water, lighting or generator use charges
6. Baby and Miscellaneous
Maternity-related and general non-clinical items.
Items:
- Baby food or formula
- Baby utilities such as wipes, diapers or lotion
- Cradle or baby cot
- Diapers or nappies
- Feeding bottle or spoon
- Personal clothing or dressing gown
- Thermometer for home use
- Visitor pass or attendant ID band
- Zip folder or file for discharge papers
What Employers Can Do
- Educate employees: Share this list so that hospital claims do not come as a surprise.
- Encourage clarity: Work with the insurer or TPA to ensure non-medical charges are flagged at pre-authorisation.
- Explore add-onsAdd-ons, also known as riders or optional covers, are additional benefits that can be purchased along with a standard insurance More: Some insurers now provide optional “Consumables Coverage” to reduce these out-of-pocket costs.
Category 2: The Optional Zone (Items Insurers May Cover)
If Category 1 was the list of clear exclusionsExclusions in insurance refer to specific conditions, treatments, or circumstances that are not covered under a policy. These exclusions define More, Category 2 sits in the middle. These are items that the Insurance Regulatory and Development Authority of India (IRDAI) classifies as optional or discretionary.
Insurers can choose to include them under special add-onsAdd-ons, also known as riders or optional covers, are additional benefits that can be purchased along with a standard insurance More such as Consumables Cover, Non-Medical Items Cover, or through customised corporate extensions. Whether these are covered depends entirely on how your group policyAn insurance policy is a legally binding contract between an insurance company (insurer) and an individual or business (policyholder). It More has been designed.
These items are directly used in treatment and are often necessary for hospital procedures, but they are not part of the default coverage unless specifically added.
1. Medical Consumables and Disposables
These are single-use or low-cost items that are part of patient care but often excluded in basic plans.
Items:
- Bandages, gauze pads and dressing pads
- Catheters including IV, Foley and suction
- Cannulas and infusion sets
- Syringes and needles
- Gloves and masks used during procedures
- Oxygen mask, tubing and connectors
- Surgical blade, knife handle, mop and sponge
- Drip sets, IV tubing and fluid administration sets
- Disposables used in ICU such as suction catheters, airway tubes and feeding tubes
- Endotracheal tubes and nasogastric tubes
- Specimen containers and urine bags
- Surgical drapes, gowns, caps and sterile gloves
- Swabs, cotton rolls and band aids
- Surgical tape and adhesive plaster
- Infusion pumps and associated tubing
- Suture materials, staples and skin adhesives
- Spinal needles and lumbar puncture kits
- Nebulizer masks, filters and mouthpieces
2. Operation Theatre and Procedure-Related Items
These are materials and accessories used in theatres, intensive care or diagnostic procedures that may be covered under advanced policies.
Items:
- ECG leads and electrodes
- Monitoring cuffs and sensors
- Surgical sutures, ligature clips and staples
- Antiseptic solution and cleaning fluids
- Diathermy pads and cautery accessories
- Microscope covers and probe covers
- Disposable laparoscopic instruments
- Catheterisation sets and irrigation tubing
- Surgical trays, kidney trays and sterile covers
- Endoscopy accessories such as biopsy forceps and specimen retrieval bags
- Surgical mesh, grafts and implants not included in the primary package
- PPE kits for doctors and nurses in sterile zones
- Suction jars, tubing and bacterial filters
3. Diagnostic and Laboratory Consumables
These are items used to perform diagnostic tests or for routine monitoring during hospitalisation.
Items:
- Test strips for glucose and ketones
- Sample collection needles and vacutainers
- Slides, coverslips and pipettes
- Reagents for pathology and microbiology
- Control solutions for blood analyzers
- Urine dipsticks and sterile containers
- Blood bags and tubing used in transfusions
- X-ray films or digital printing materials
- Ultrasound gel, ECG paper and printer ribbons
- Specimen transport boxes and ice packs
4. Critical Care Equipment Accessories
Devices and parts used for intensive care or continuous monitoring. Some insurers include these under critical illness or extended hospitalisation riders.
Items:
- Ventilator tubing and circuits
- Humidifiers and filters for oxygen therapy
- Suction catheters and liners
- Infusion pumps and syringe driver accessories
- Defibrillator pads and batteries
- Pulse oximeter probes and sensors
- CPAP and BiPAP masks, hoses and filters
- ECG electrodes and leads for reusable monitors
- Arterial line kits and pressure monitoring sets
5. Patient Support and Mobility Aids
Prescribed items that assist recovery and mobility. These are reimbursed only if mentioned in the policyAn insurance policy is a legally binding contract between an insurance company (insurer) and an individual or business (policyholder). It More.
Items:
- Walking aids such as crutches or walkers
- Cervical collars, lumbar belts and wrist splints
- Arm and leg braces for post-operative support
- Orthotic devices prescribed by the doctor
- Elastic bandages for specific recovery needs
- Backrest and air cushions for long-term care
- Traction kits, pulley sets and slings used in physiotherapy
How Employers Can Benefit
- Add a consumables rider: A small rider can prevent employees from paying for consumables out of pocket.
- Negotiate inclusions during renewal: Group policies allow customisation with minimal premium difference.
- Inform employees: Awareness reduces confusion and improves the claims experience.
Category 3: The Subsumed Items (Costs Already Included Elsewhere)
Some items on a hospital bill are neither excluded nor optional. They are simply not payable separately because they are already included in another charge. The IRDAI classifies these as subsumed items.
Hospitals often list them individually to show itemized transparency, but insurers treat them as already paid for under room rent, procedure charges, or package costs. This avoids duplication and ensures uniformity in claim settlements.
1. Items Subsumed Under Room Rent
Room rent is a bundled cost that already includes several utilities and services. Any additional charge under these heads is considered duplication.
Items:
- Patient’s diet or hospital food
- Housekeeping and room cleaning
- Patient’s linen, pillow, blanket and bed sheet
- Nursing charges and patient monitoring
- Utility charges such as electricity, air conditioning or water
- In-room toiletries provided as part of standard care
- Room service, maintenance and basic hygiene supplies
- Television, telephone or other room amenities
- Waste disposal or biomedical handling
2. Items Subsumed Under Procedure Charges
When a patient undergoes a surgery or a specific medical procedure, many consumables and professional fees are already built into the procedure cost. These cannot be billed separately.
Items:
- Surgeon, anaesthetist and assistant surgeon fees
- Operation theatre charges including lighting, equipment and staff
- Standard surgical consumables such as gloves, masks and gowns
- Sterilization and instrument cleaning materials
- Basic medications and drips used during surgery
- Diagnostic materials used during procedures such as ECG paper or ultrasound gel
- Sutures, staples and dressing materials included in the surgical kit
- Disposable items that are part of the operation set
- Pre-procedure and post-procedure observation costs
- Anaesthesia gases, oxygen use and suction lines within the theatre
3. Items Subsumed Under Investigation Charges
Laboratory and imaging investigations include several smaller items and consumables within the package rate. Insurers treat those as built-in costs.
Items:
- Reagents, slides, stains and pipettes used in lab tests
- Test tubes, syringes and collection needles
- Urine containers, swabs and sample labels
- Control materials for laboratory calibration
- Film, plates or digital printing for radiology
- Contrast agents or dyes for imaging when included in package
- Disposables such as gloves or masks used by technicians
- Electricity and equipment maintenance within lab costs
- Report printing, filing and courier of results
4. Items Subsumed Under Nursing Charges
Hospitals often bill nursing activities separately, but standard inpatient care includes these tasks as part of the room rent or package. Insurers reject duplicate billing.
Items:
- Vital sign monitoring such as temperature, pulse and blood pressure
- Daily medication administration
- Wound dressing and bandage change
- Catheter and IV line care
- Oxygen administration under doctor’s advice
- Documentation, patient charting and record updates
- Routine hygiene care and mobility assistance
- Use of wheelchairs and stretchers within ward
- Night supervision and patient observation
5. Items Subsumed Under Package Charges
When the hospital issues a package rate for treatment, all elements required for that package are included in one consolidated amount. No line items beyond the package are payable.
Items:
- Pre-operative consultation and investigations
- Hospital stay, nursing and diet
- Operating theatre and surgeon’s fee
- Anaesthesia and consumables
- Drugs, fluids and standard dressing materials
- Follow-up dressing, wound checks and removal of sutures
- Equipment use such as monitors, ventilators and defibrillators during the procedure
- Patient counselling and post-operative care
What Employers Should Know
- Clarify with network hospitals: Ensure that hospital billing formats align with IRDAI norms so employees are not charged twice for the same service.
- Encourage pre-authorisation: For package treatments, pre-approved rates prevent disputes over subsumed items.
- Educate employees: Explain that insurers reject these not to reduce benefits but to avoid double payment for the same service.
Putting It All Together
Understanding all three categories gives employees and employers a complete view of how hospital bills are assessed during insurance claims.
| Category | Description | Coverage Possibility |
| Category 1 | Non-payable items that are excluded under standard policyAn insurance policy is a legally binding contract between an insurance company (insurer) and an individual or business (policyholder). It More terms | Not covered |
| Category 2 | Optional items that insurers may cover through add-onsAdd-ons, also known as riders or optional covers, are additional benefits that can be purchased along with a standard insurance More or riders | Covered if add-on chosen |
| Category 3 | Items already included in other service charges | Not payable separately |
Final Thoughts
Health insurance is meant to protect you from medical risk, not from every hospital expense. Many of the costs people assume are “medical” are actually operational, personal or already priced into larger charges.
For employers, understanding these categories helps in choosing better group coverage and communicating transparently with employees.
For individuals, it prevents surprise deductions and encourages better financial planning during hospitalisation.
When you know what is and is not payable, your insurance claim stops being a mystery and starts working as it should.
