What Is Health Insurance: Meaning, Benefits & Types
Health care costs are rising faster than inflation, which is why it's important for everyone to have health insurance that will save not only your emergency fund, but your life in the event of a medical emergency. Or your loved ones are also helping you cope with rising medical bills.
Experts believe that health insurance should be part of your financial planning and should be taken out early if you're young and worried about your safety. Investing in health insurance when you're young can result in better coverage, lower premium rates, no doctor tests, and more. So it offers many advantages
Here's a guide that explains all about health insurance, the factors that affect health insurance, what type of health insurance you can choose, and more.
What is Health Insurance: Importance of Health Insurance
Health insurance is a provision that provides immediate financial help in an emergency. It is an agreement between the insured and the insurance company to cover medical expenses incurred as a result of illness, injury or accident. If you have health insurance, some or all of your medical expenses are covered by the insurance company, the policyholder has to pay a certain amount called the policyholder's premium.
There are two ways a health insurance company can reimburse you for your medical expenses:
Cashless treatment: Here the insured person does not have to pay anything to the hospital association. Because the health insurance company pays the hospital directly.
Payment: Here the policyholder must first pay the medical expenses and then claim compensation from the insurance company.
Why should I have health insurance?
Getting health insurance is something we all avoid until we understand its importance. Before making a purchase, it's very important that you understand the benefits of health insurance, as medical emergencies can strike at any time and leave a big hole in your pocket. For this reason it is advisable to take out health insurance from an early age, where you can enjoy a greater value of the premium and be able to claim the premium for tax purposes.
In short, health insurance must be taken out because:
- This makes it easy for you to get excellent treatment without worrying about high medical costs.
- It offers special coverage for serious illnesses.
- Covers ambulance costs on the road.
- It offers affordable prices for young people.
- It offers a cashless application feature so you can keep track of your medical records instead of worrying about huge medical bills.
- Protect your savings in the event of a medical emergency.
- Offers Section 80D tax benefits.
- After all, it protects you and your family and protects your savings.
types of health insurance
There are mainly two types of health insurance, namely individual or individual insurance and family pool policy. As the name suggests, a single policy only provides coverage and benefits to the main insurer. In the case of a variable family plan, however, there is only one plan that covers the entire family unit, i.e. spouse, dependent children, parents and in-laws or dependent siblings.
You should choose the plan based on your age, family medical history, age of children, medical history, and of course budget. Let's understand each of these plans in detail:
Individual or personal health insurance plans
Individual health insurance is issued in the name of a single insured, which means that the sum insured and the benefits are attributed entirely to the insured and do not cover anyone else. Here, a person takes out health insurance that provides financial assistance in case of medical emergencies.
Floating health insurance plan for families
A family pool policy is a policy which aims to provide an insured sum to an individual and their family members. Rather than having one policy for each family member, family health insurance is a good option as it acts as an umbrella for the whole family. Here the sum insured is shared by all members of the same plan.
However, it is recommended to have a separate plan for elderly parents or in-laws as it is a cheaper option. Also, if a family member has an extensive medical history, it's better to get a separate plan for them than to cover them in the family plan.
What you should consider before deciding on health insurance
Step 1: Find the right insurance company
Here are some factors to consider when choosing the right health insurance plan:
1. The proposed plan is different
Learn about the different types of plans a company offers, as well as USP plans. Some companies offer a range of products to meet your coverage needs. Choose a company with a variety of plans so you can find the right policy for your needs.
2. The hospital network
The hospital network is very important for obtaining benefits in kind. The wider the insurance network, the better. How to find the nearest cashless hospital.
3. Claims settlement rate
The claims payment report shows one thing: the percentage of claims a company paid in a financial year. A high ratio indicates that the company is persistent in paying its debts. One factor that speaks for the insurer.
4. Download according to the claim
Some companies increase the renewal premium if you apply in previous years. This leads to higher premium costs. Therefore, avoid companies that follow this practice.
5. Premium rate
Pricing policy indicates how much a company charges relative to its competitors. You can check the pricing policy by comparing similar plans across different companies.
For example, Aarogya Sanjeevani policy offers consistent coverage characteristics across all insurers. However, your premium depends on the insurer's pricing policy. Compare insurance premiums to find the one that pays the least. Its pricing policy will likely be fair across all of its plans.
6. Claims settlement is simple
Insurers have revolutionized and simplified the claims process. These concepts attract attention:
- Proactive processing of complaints using artificial intelligence
- WhatsApp notification
- digital document
- Quick approval
- Application-based claims information and tracking, etc.
These facilities speed up the claim process and make it hassle-free. So look for insurers that offer fast settlement of claims.
7. Review
Finally, don't ignore customer reviews and testimonials. Most insurers display customer reviews on their websites. You can check them. Alternatively, you can talk to friends and family about their insurance. Once they've submitted a complaint, read the complaints experience to see which companies are following best practices.
Step 2: Find the right plan
After choosing the right insurance company, the next and most important thing is to choose a plan. Since many insurance companies offer multiple plans, you have many options. But choosing the right policy is important.
Here are some things that will help you do the same:
1. Cover Services
The first thing you need to check is the coverages offered by the different plans. While most plans offer basic insurance benefits, look for plans with special features
First, evaluate your insurance needs and then look for plans that offer them. For example, if you are planning to have a baby in the near future, look for plans that offer maternity protection. Otherwise, skip these plans when your family is complete.
Second, look for other add-on features that can expand your coverage. For example, reimbursement of insured sums, maximum bonuses, value-added benefits, annual health check-ups, etc.
Choose the plan with the most comprehensive coverage. This reduces your costs in the event of damage and gives you greater financial security.
2. Personalization options
Look for plans that allow you to customize coverage features to suit your needs. This is possible through the additional services offered by health insurance companies. Add-ons help you choose additional coverage features based on your needs and allow for customization.
3. Prize Amount
Of course, the price is important. Check the premium calculated with the expected coverage. Compare to get a better idea. Compare premiums between different insurance plans with similar coverage. Check if the premiums are competitive or if the coverage offered is excessive.
Choose a plan with the cheapest premium rate for the same coverage, even if it means choosing a different insurance company.
4. Lower limits
Health insurance covers room rent, ICU room rent, AYUSH insurance, home care, etc. There may be lower limits for various expenses, such as B. This low limit, which limits coverage and may involve out-of-pocket expenses. So opt for a policy with no sub-limits to enjoy the maximum possible insurance protection.
5. Advance payment clause
Health insurance companies may have co-pay obligations for various reasons. A co-payment means that for each claim you have to pay a certain amount of the claim out of your own pocket. For example, a 10% surcharge means you pay 10% of each claim. The general cost sharing rules apply to:
- If the insured person is 61 years of age or older at the time of taking out the insurance
- If you take out a policy in a lower tier city and get treatment in a higher tier city
- For certain medical conditions and/or treatments
Look for health plans without co-payments Even if a deadline is unavoidable, choose a plan with a lower co-pay rate, such as B. senior insurance.
6. Waiting time
A waiting period is a period of time during which certain health insurance benefits are not provided. After the waiting period, your coverage will be approved.
The waiting time applies to different health insurance companies. Moreover:
- The first 30 or 60 days you wait for health insurance coverage. It is also known as the cooling off period where illnesses are not covered. However, accidental injuries are insured from 1 day.
- Some diseases or hernia, fissure, hydrocele, tonsillectomy, cataract, joint replacement, etc. Due to the waiting time for treatment, this waiting time is usually 24 months. In some plans, the period may vary.
- Previous waiting times ranged from 12 to 48 months. This waiting period applies to illnesses or medical conditions that may arise when you take out a new policy. Complications arising from existing medical conditions are not covered during this period.
- The waiting period for maternity can vary from 9 to 48 months.
- Rates OPD, bariatric treatment, etc. Waiting time for coverage.
Waiting time is unavoidable. However, you can come up with a plan with less time. This is especially true if you are looking for maternity insurance or have pre-existing medical conditions and want to be covered as soon as possible.
7. Discounts available
Health insurance companies allow various discounts to attract customers. Some common discounts available include:
- Exception when buying a two or three year policy
- A discount that applies to two or more members individually
- Exception for online purchase policies
- Exception if the premiums are paid in a lump sum instead of in instalments
- Discount for existing customers of the company
- A supplement to maintain a healthy lifestyle
- Reduction of the extension if you have not made any claims in the last insurance year
- Discount when choosing a voluntary franchise
- Discount for treatments in partner hospitals
Look for available discounts. Choose the plan with the highest discount to get the best rewards offer.
Now that you've found the best company and the most suitable plan, you might think you're done. not this Another aspect to consider is choosing the right sum insured.
Step 3: How to find the right amount of coverage
It's important to get the best insurance for your health plan to adequately cover your medical bills. Insuring a small amount defeats the whole purpose of investing in health insurance and is definitely a no-no.
Choosing the right sum insured is easier than you think. you just have to consider the following:
- Number of policyholders in the policy
- If you or another member has a pre-existing medical condition
- Acquisition costs for hospitalization and treatment
- rising medical inflation
Most insurers will help you calculate the ideal sum insured based on your income, expenses, existing coverage, and policyholders. You can estimate the optimal requirement with a simple formula like this:
बिमाक्रित उर्थ = 50% of your annual income + total cost of hospitalizations in the last 3 years
Let's say your annual income is INR 15,000 and you have received INR 5,000 in hospital bills in the last three years. In this case, the best sum insured is calculated as follows:
15 lakh INR + 5 lakh INR = 50% of 12.5 lakh INR
Step 4: How to pay for the health plan
Low health insurance premium. Also, insurers offer किस्तिर प्रिमियाम where you can pay the premium monthly, ट्रूमासिक or अधा-बर्षव।.क. This makes health plans affordable.
If paying high coinsurance is a concern, you can also opt for a super comprehensive health plan. The supercharge plan helps increase your coverage while keeping your premium low. Suppose you want coverage of Rs 15 lakh but the premiums are out of your reach. In this case, you can choose a comprehensive health plan of 5 lakh or 10 lakh INR and add a super charge plan of 10 lakh or 5 lakh INR.
The add-on super plan will help you enjoy full coverage of 15 lakh INR. However, compared to buying a INR 15 lakh health plan, the total premium is less.
How can I take out health insurance online?
- The easiest way to get health insurance online is a paperless process that can be completed in minutes and without a physical signature.
- According to your needs and requirements, you should get comprehensive information on various health guidelines.
- Check out the best health insurance plans and further compare them based on your needs and requirements to finally choose the best one. Explore them online to learn more about coverage, benefits, and premium rates at a time and place that's right for you.
- After taking out your policy, read the policy document carefully and complete the deposit process.
- Once the documents have been uploaded, it is time for the final payment which can be made by credit card, debit card or net banking. Insurance companies typically take seven to 10 days to complete the entire process and then deliver the policy to you.
Things to avoid when getting health insurance
Hurry to get a policy - do not rush to get health insurance. It is advisable to do thorough research and then select the best health insurance plan for you or your family. Before deciding on health insurance, you can do your research and compare premium prices online.
Choosing undercoverage: When purchasing a health plan, you should consider premium costs. Do not opt for insufficient or limited insurance coverage to save on premium costs. Instead, opt for a comprehensive coverage plan that takes into account family size, your medical history, and your financial situation.
Withdrawal of health data: When you take out health insurance, you provide all necessary information about your health, lifestyle or previous illnesses. Withholding relevant medical history can be extremely damaging as claims can be denied due to undisclosed medical information.
Don't buy separate health insurance: Don't rely solely on your employer's health insurance, as it offers limited coverage. Even if you leave the company, the contract ends immediately. It is very important to have separate health insurance that offers higher coverage and is not affected by your current employment status.
Ignore Policy Document Conditions: Ignore or ignore the conditions of the policy document । Whether it is coverage, premium fee, reinstatement condition, discount, refund, free viewing period, waiting period, co-pay clause or any type of deductible, everything is clearly stated on the insurance document. If you still have any doubts, do not hesitate to contact the responsible health insurance company to clarify your health insurance.
Buy a policy just to save on taxes: Don't buy health insurance to save taxes on the premium you pay. You should be aware of the tax benefits that come with paying health insurance premiums, but the main purpose of buying health insurance is to get enough coverage to financially support you and your family in case of medical and health problems.
Frequently Asked Questions (FAQ)
Need to know what to do?
Waiting time is a very important factor when buying health insurance. This refers to the time the policyholder has to wait to claim the insurance benefit. This varies from health policy to health policy.
Tidak ada komentar untuk "What Is Health Insurance: Meaning, Benefits & Types"
Posting Komentar