Product Reform
Medical Diagnosis List by Category
The table below can be referred to check members eligibility for medical admissions. It has only limited examples. Hence in case of doubt, it is advised to refer to corresponding health insurance to check eligibility.
Download Excel version here
| Clinical Category | Medical admission examples |
|---|---|
| Rehabilitation | Minimum Benefit Requirements |
| Palliative Care | Minimum Benefit Requirements |
| Hospital Psychiatric Services | Minimum Benefit Requirements |
| Mental & Behavioural Disorders due to Drug Addiction (includes withdrawal) | |
| Schizophrenia / Schizoaffective Disorder | |
| Delusional Disorder | |
| Psychosis (nonorganic) | |
| Bipolar Disorder | |
| Manic/Mania or Hypomanic Episode | |
| Depression / Depressive Episode | |
| Cyclothymia / Dysthymia / Persistent Mood Disorder | |
| Unspecified Mood Disorder | |
| Anxiety | |
| Adjustment Disorder | |
| Dissociative Disorder / Trance / Possession Disorder | |
| Somatoform / Pain Disorder | |
| Neurosis / Neurotic Disorder | |
| Eating Disorder (Anorexia, Bulimia, Overeating) | |
| Sexual Dysfunction / Excessive Sexual Desire | |
| Postnatal / Postpartum Depression | |
| Harmful Use of Nondependence substance | |
| Personality Disorder | |
| Psychosexual Disorder | |
| Autism (Asperger’s Syndrome) | |
| Hallucinations (Auditory, Visual) | |
| Assisted reproductive services | Female infertility |
| Male infertility | |
| Artificial insemination | |
| In vitro fertilisation | |
| Back, neck and spine | Osteochondrosis |
| Spondylolysis | |
| Spondylolisthesis | |
| Ankylosing Spondylitis | |
| Spinal stenosis | |
| Collapsed vertebra | |
| Spinal instability | |
| Cervicalgia | |
| Sciatica | |
| Lumbago | |
| Chemotherapy, radiotherapy and immunotherapy for cancer | MBS only |
| Dental surgery | MBS only |
| Dialysis for chronic kidney failure | MBS only |
| Implantation of hearing devices | MBS only |
| Insulin pumps | MBS only |
| Joint reconstructions | MBS only |
| Joint replacements | MBS only |
| Podiatric surgery | MBS only |
| Weight loss surgery | MBS only |
| Plastic and reconstructive surgery | MBS only |