Last Updated on February 21, 2023 by admin
The skyrocketing costs of healthcare facilities could make our lives an unpleasant experience. It created the demand to make a health insurance policy, a vital component of our financial armony.
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However, picking the right policy is as important as deciding the correct treatment protocol for your health. Like many other people, you are aware of the importance of a health insurance policy that secures you and your family.
But, do you know all the aspects of health insurance like waiting period, policy exclusion, no claim bonus, critical illness, top-up health insurance etc.? So let’s discuss the basics you need to know about the health insurance policy to identify the best policy to secure your and your family’s health.
What is health insurance?
It is a type of insurance that provides coverage against medical emergencies arising from an illness, injury or accident. The health insurance policy extends its coverage to hospitalisation costs, medicines and doctor’s consultation fees. Age of the insured, sum insured, and health habits are the three major deciding factors of health insurance policies. You can purchase a health insurance plan for a specific period by paying a monthly or yearly premium.
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Different terms used in health insurance you should know
These are the few terms listed below that are used in health insurance you must know before buying a health insurance plan. So that you know all the specifications in a better way.
Inclusion:
Inclusions are the conditions or diseases covered under the policy. Every insurance company has a list of inclusion, so if you are looking for coverage against specific needs, you must check if that is a part of the inclusion list or not.
Exclusion:
Exclusions are the conditions or diseases that are not part of the health insurance policy.
Add-ons & Riders:
Add-ons and riders are the additional benefits that are not included in your base plan. They are optional and can be bought according to the need of the insured person. Maternity cover, critical illness cover, daily hospital cash, personal accident cover, room rent waiver etc., are some examples of add-ons and riders.
Waiting period:
Most health insurance policies come with a waiting period of 30 days. The waiting period for hospitalisation arises due to the particular illness and disease.
Pre-existing diseases:
These are the conditions and illnesses you and your family have before purchasing the policy. Generally, health insurance companies do not provide coverage for pre-existing diseases without a minimum waiting period of 2-4 years.
Network hospitals:
Your insurance company will have tie-ups to give you the benefits of cashless claims. When you go to the network hospital for treatment, it settles all the expenses directly from the hospital.
No Claim bonus:
It is also known as NCB. NCB is a reward added to your sum insured for every claim-free year.
Co-Pay:
Co-Pay is a part of the claim amount you pay from your pocket. The percentage of the Co-Pay amount is mentioned in the policy document. But these days, many renowned companies do not ask for Co-Pay as arranging money could be very stressful during a medical emergency.
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What are the benefits of a health insurance policy
- It pays and indemnifies the insured person’s hospital bills and medical expenses as mentioned in the policy documents.
- If you seek treatment from a network hospital through a cashless claim, You do not have to pay anything from your pocket.
- If you want to go to the hospital of your choice, you can claim the amount with the help of medicines and hospital bills.
- Now, most health insurance companies provide coverage against the treatment done under AYUSH (Unani, Ayurveda, naturopathy, Yoga, Homeopathy).
- Generally, health insurance plans cover 30 days of pre-hospitalization and 60 days of post-hospitalization expenses.
- Previously insurance providers covered the medical condition, which needed at least 24 hours of hospitalisation, but nowadays, many health insurance companies offer OPD treatment plans that do not require hospitalisation.
Different types of health insurance plans
Individual health insurance:
Individual insurance policy is meant for an individual only. So if you are planning to buy for the whole family, you must purchase a separate insurance plan for each family member. The plan is suitable for a single person who is not eligible for a family floater health insurance.
Family floater health insurance:
The family floater health insurance plan covers the whole family, as the name suggests. You can pay a single premium as it’s a single policy covering each family member. The family floater could be ideal for small families with 2 adults and 0-3 children.
Group health insurance:
Nowadays, most companies offer group health insurance to their employees. The insurance companies provide the plan at affordable premiums, which are fulfilled by the employer.
Critical illness insurance:
In most health insurance policies, critical illnesses such as cancer and kidney diseases are not covered under the primary health insurance plan. However, critical illness insurance provides coverage against all critical illnesses for a low-cost premium.
Maternity insurance:
Maternity insurance plan covers normal as well as C-section deliveries. It covers the fetus’s termination due to complications and pre-natal and post-natal expenses, including the newborn baby. This insurance plan comes with a waiting period of 2-4 years.
Senior citizen health insurance:
Many health insurance companies offer policies that meet the need of older people who are older than 60 years. It covers the illness which older people are more prone to have.
Arogya Sanjeevani health insurance:
it is the latest and standard health insurance policy that provides more comprehensive coverage at affordable premiums. Arogya Sanjeevani health insurance is designed to provide maximum benefit at the lowest possible cost. The plan is ideal for people with limited healthcare needs and first-time buyers who do not have extensive knowledge about the bits and pieces of health insurance policies.
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What points should be considered while buying a health insurance policy?
- You must check for the sum insured is sufficient for you or not.
- Compare the various benefits offered such as ambulance charge, the room rent cap, Daycare treatment, critical illness, list of inclusions etc.
- You should compare and check the premium you are paying against the sum insured and the benefits offered by the insurance company.
- Make sure you prefer hospitals on the insurer’s network list. It will help you to avail the cashless claim facility.
- Make sure the claim settlement process is quick and easy, and customer support should be prompt.
- Consider the company’s goodwill, the number of years it has been in business, its ability to pay its short-term and long-term liabilities and the number of policies issued in a year.
- Make sure that buying and renewing your policy must be done smoothly. Make sure they are flexible in making changes to the existing policy.
- Before purchasing a health insurance policy, make sure you read all the terms and conditions, the exclusions of the policy and other conditions they have in the policy documents to avoid any dispute in the future.
After reading this article, you have pretty much knowledge of everything you must know before purchasing a health insurance policy. Make sure you understand each terminology beforehand to avoid any uncertain situation at the time of emergency need.
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