Don’t Buy Health Insurance without Understanding these Terms

When you are purchasing a health insurance plan, your policy documents contain crucial details about the policy coverage and requirements. It is important for all policy buyers to read through the paperwork and understand the financial protection and coverage provided. However, some of the terminology used in health insurance plans might be confusing, and failure to understand the same might lead to insufficient coverage or other complications.

So, we’ve put together some of the key terminologies in health insurance that you should understand before choosing the best plan for you and your family.

Don’t Buy Health Insurance without Understanding these Terms

Here are some of the key terms in health insurance plans that you should know before you purchase the appropriate insurance plan.

Critical Illness: Serious life-threatening illnesses and medical problems like cancer, kidney failure, and cardiovascular diseases are referred to as critical illnesses or critical medical conditions. These illnesses are covered by specific medical insurance plans. You can also get them covered by an additional cover or a rider.

Cashless Claims: These are insurance claims made through a health plan for medical services received in one of the network hospitals, covered by a specific insurer.

Deductibles: In health insurance, deductibles might lower your policy premium, provided you make a higher payment when filing for an insurance claim. So, unless you are prepared to cover the expense of treatment, make sure to check the policy documents for a deductible clause and select one without it.

Exclusions: Exclusions are limitations in the policy for which your health insurance provider will not provide coverage or deny your claims when filed.

Inclusions: The features and benefits of the policy that the insurer will pay for are referred to as coverage benefits or inclusions. It covers hospitalisation costs, ambulance fees, surgery, hospital room costs, anaesthesia, medication costs, and costs associated with treatments.

Network Hospitals: Health insurance providers have a set number of hospitals known as network hospitals. In these facilities, you can receive medical care without having to worry about paying the bill because the insurer will pay the amount in full, up to the coverage limit.

Pre-Existing Conditions: In terms of health insurance, conditions including COPD, hypertension, diabetes, kidney troubles, cardiovascular problems, and other underlying disorders are regarded as important risk factors. So, patients with such pre-existing medical disorders are deemed to be at a higher risk of filing a claim and are consequently covered at a higher premium.

Premium: The sum that you must pay the health insurance provider in exchange for the acquired coverage is referred to as the premium. The premium varies depending on the type of insurance, the amount insured, the policyholder’s age, and a number of other variables.

Sum Insured: The word “sum insured” refers to the policy coverage amount. An amount up to the insured sum, which can range from Rs. 2 lakhs to Rs. 5 crores, is compensated by the insurer.

Waiting Period: A waiting period is the set amount of time before which you cannot use the benefits of a medical insurance policy. Insurance claims from health plans are not accepted during the waiting period. Various health conditions and coverage have different waiting periods.

We hope these terminologies are helpful in choosing the best health insurance plan and enable you to decide for yourself and your family in an informed manner.