Everything You Should Know About Health Insurance Policies

“Rahul Singh was admitted to a private hospital for COVID-19 treatment. After returning from his business trip to Delhi, he was diagnosed with the virus. Since Rahul was a diabetic, he had to spend more days at the hospital for treatment as the doctors wanted to keep him under observation to ensure he didn’t get affected by any co-morbidities. As he was being treated at a private hospital, the cost of treatment was also higher. But because he had a health insurance policy that covered his hospitalization expenses, he did not feel the pinch of those costs. If he did not buy a health insurance policy, Rahul would have been challenged to manage the expenses.

The COVID-19 pandemic has taught the importance of health insurance in India and also provided a valuable lesson to everyone, which is the need to be vigilant about one’s health. As a result, there is a rise in the interest shown by people to purchase health insurance and to know how health insurance works in India to shield themselves from the rising healthcare costs. Furthermore, to deal with emergency health situations that arise due to lifestyle changes, it is essential to have reliable security in the form of an insurance plan that can cover your medical expenses.

A health insurance policy is an agreement between the insurance provider and the individual who buys the policy (you), according to which the insurance company agrees to pay the medical expenses for the insured, subject to certain terms and conditions previously agreed upon by both parties. In either case, the insurance company shall clear the bills directly with the hospital or reimburse you the cost. All of these services are offered to the person who purchased the policy, subject to the payment of a specific amount, referred to as the premium.

If you are looking to know more about health insurance, the following information shall help you understand its features, types, claim process, etc. In short, this will serve you as an insurance guide and assist in you choosing the best health cover for you and your family.

Types of Health Insurance

Due to the development of the internet and people getting comfortable with buying as per their necessities and convenience online, it’s now possible to purchase health insurance online too. While doing so, you can come across many different types of health plans available on the market. They are:

• Individual Health plan: This is a type of policy that is available to an individual to help cover the cost of healthcare. It only covers one person, and the cost of this policy is determined by the person’s age and medical history, pre-existing health conditions, and the sum insured chosen by the individual.
• Family floater plans. If you’re searching for a single policy that covers the entire family, then family floater plans are your best option since they can provide coverage for yourself, your spouse, children, and your parents. Some plans cover extended families, such as grandparents as well as other family members too.
• Group Health insurance: The policy that companies typically offer for their employees. A group health plan provides health insurance coverage for the employee and their family, for which the premium is directly debited from their salary, protecting them from treatment costs during any illness.
• Critical health insurance: is a special plan designed to offer coverage for some of the most critical illnesses like heart disease, cancer, kidney problems, and other health issues that are specifically listed.
• Health insurance for senior citizens: Senior citizens (aged 65 or older) are the beneficiaries of this policy coverage. The cost of health insurance increases with age, and hence senior citizens are at high risk of diseases. Therefore, their pre-existing medical conditions, medical history, and prior treatments are considered while calculating their premiums.

Advantages of a Good Health Insurance Policy

While searching for the best health insurance plan, it’s essential to understand the benefits of having a health plan.

• Protects the policyholder from the rising cost of medical treatment.
• Offers the best financial protection during medical emergencies by covering the cost of treatment, including pre and post hospitalization, medication, the cost of lab tests and critical illness, etc.,
• Provides cashless hospitalization facility to undergo treatment without having to pay from your pocket. Also, it offers a reimbursement process in case of undergoing treatment at a non-network hospital.
• It gives access to the best medical care at top hospitals for critical illnesses, which wouldn’t be possible under normal circumstances.
• Get tax benefits on the premium amount paid towards the health insurance policy.

Know What is Insurance Claims

If you have a health insurance policy, understanding its claim process for health insurance is a must since you wouldn’t want to run from one pillar to another to get your hospital bills approved for a claim. They are two types of health insurance claims:

• Cashless claims: As the name suggests, there is no requirement to pay for medical treatment at the time of getting admitted to the hospital. The policyholder can avail treatment at any of the hospitals in the network with the insurance company through the cashless card that the insurer issues. On producing it at the insurance desk at the hospital, the costs for hospitalization and treatment are directly paid by the insurance company after necessary approval by the hospital.
• Reimbursement claim: It means the medical expenses should be first paid by the individual, which the insurance company will later reimburse after discharge from the hospital. This is mostly practiced in hospitals that are not part of the insurer’s network. The policyholder is required to pay the hospital for the treatment and then file a reimbursement claim with the TPA or the insurer along with all the required bills and medical documentation. After the verification of the provided documents, the reimbursement claim is approved.

There are many health insurance providers in India, and you have a wide variety of choices to buy a policy that’s right for your needs. Moreover, with internet penetration reaching heights, it is now possible for you to get the health insurance policy information, compare it with a competitor, and then make an informed decision – from the comfort of your house. So why wait to buy a health insurance policy for yourself?”