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With healthcare costs soaring, a solid health insurance plan is more than just a safety net
Customers need to understand that for agents and companies, a policy is a product and they are selling it, but for you, it’s a protection cover. (Representative image/AI)
Buying insurance for health can be a complex task, especially when faced with a maze of unfamiliar terms. Whether you’re a first-time buyer or a seasoned policyholder, understanding these key terms is your compass to making informed decisions. In many cases, it is reported that even insurance companies and agents don’t reveal certain terms and conditions to policy buyers amid meeting their sales target.
Customers need to understand that for agents and companies, a health insurance policy is a product and they are selling it, but for you, it’s a protection cover. Hence you must know key clauses and terms before signing any policy from any insurer.
With healthcare costs soaring and medical emergencies lurking around the corner, a solid health insurance plan is more than just a safety net; it’s a shield against financial ruin. In this guide, we’ll unravel the essential terms you need to know to pick the right policy and secure your financial future.
Key Terms to Know:
- Premium: The periodic payment you make to keep your policy active.
- Sum Insured: The maximum amount your insurer will pay for covered medical expenses during a policy year.
- Deductible: The amount you pay out-of-pocket before your insurance kicks in.
- Co-payment: A fixed percentage you pay on medical bills, even after insurance.
- Waiting Period: The initial period when certain conditions or treatments aren’t covered.
- Network Hospitals: Hospitals tied up with your insurer for cashless treatment.
- No-Claim Bonus (NCB): A reward for claim-free years, often a discount or increased sum insured.
- Pre-existing Conditions: Medical conditions existing before policy purchase, which may have coverage restrictions.
- Inclusions and Exclusions: The specific medical expenses and treatments covered or not covered by your policy.
- Add-on Covers/Riders: Optional benefits you can add to your policy for extra coverage, like critical illness or accidental cover.
- Day Care Procedures: Medical procedures that don’t require hospitalization but need medical attention.
- Cashless Claim: A claim process where the insurer directly settles the hospital bill.
- Reimbursement Claim: A claim process where you pay the medical bills upfront and then claim reimbursement from the insurer.
Tips for Choosing a Health Insurance Plan:
- Assess Your Needs: Consider your age, family size, medical history, and lifestyle to determine the right coverage.
- Compare Plans: Use online comparison tools to evaluate different plans based on premium, coverage, network hospitals, and claim settlement process.
- Read the Policy Document Carefully: Understand the terms, conditions, exclusions, and waiting periods.
- Choose a Reputable Insurer: Research the insurer’s claim settlement ratio and customer reviews.
- Consider Add-on Covers: Opt for additional coverage for critical illnesses, accidental injuries, or maternity expenses.
- Regularly Review Your Policy: Update your policy as your needs and circumstances change.
By grasping these terms, you can confidently select a health insurance plan that aligns with your needs and provides adequate financial protection for you and your loved ones.
