People in India are now becoming conscious about their health. In view of this, the health sector is emerging as a market. Health insurance product is also making its place in different types of health products. Today people do not hesitate at all to take a health policy. It has become a means to make themselves financially capable to bear the cost of their own medical expenses as well as avail tax benefits. In this article, we will discuss about the different types of terminologies used in health insurance, which a person buying health insurance needs to know. Let us go through the Health Insurance Terminology in detail.
- Sum Insured :
Sum Insured is the maximum amount that an insurance company is liable to provide as a health insurance benefit in case of hospitalization of the insured. If the cost of your medical treatment exceeds the sum insured chosen by you, then you will have to pay for the cost over and above the sum insured yourself. Hence it is necessary that you should opt for a higher sum assured plans while choosing a health insurance policy.
- Pre – existing Diseases :
If you are already suffering from any kind of disease while buying the health insurance policy, then this disease is considered in the free existing disease category. While buying a health insurance policy, it is necessary that you must disclose all your pre-existing diseases to the insurance company. Otherwise you may have to face problems later.
- Waiting Period :
Waiting period means that if you take an individual health insurance policy then you need to wait for some period of time before the policy starts or the coverage starts. This waiting period may differ from insurer to insurer.
- Sub – limits :
Sub limits refer to the clauses imposed by the insurance company from where you have taken the health insurance policy to limit the expenses that are required to be provided to the insured persons in a particular situation. It is used to reduce the incidence of fraudulent claims. Most insurance companies impose sub-limits on the costs incurred in certain situations such as room rent, common ailments, ambulance charges, doctor fees, etc. The sub-limit is up to a certain percentage of the sum assured as chosen by the individual or up to a certain agreed upon between the company and the insured.
- Co – payment :
Co-payment is the payment amount that is required to be paid by the insured towards a certain percentage of his/her healthcare expenses before receiving payment from the insurance company. You can choose the payment amount at the time of buying or renewing the health insurance policy. You can reduce your premium amount by choosing a higher co-payment amount.
- Deductible :
Deductible refers to the concept of cost sharing between the insured and the insurance company to pay for the health care expenses of the insured. This is a fixed amount that the insured has to pay every time a health insurance claim is made. You may be able to reduce your premium amount by opting for a higher deductible.
- Room Rent Limit :
It refers to the per day room charges in case of hospitalization. On this also some sub-limits are imposed by the insurance company. For this, you can read the terms and conditions of the insurance company carefully.
If a person has more than one health insurance policies then that person can file a claim in all those health insurance policies simultaneously. In this, the claim amount is reimbursed by all the health insurance policies according to a fixed fixed percentage. We know this concept as Coinsurance.
- Free Look Period :
All health insurance companies provide a free look period of 15 days to the customer. Free look period means that during this period, if the insured is not satisfied with the insurance company, he can terminate his policy. This freelook period is of 15 days. You can cancel the policy anytime within this 15 days and no charges are applicable.
- Grace Period :
If your health insurance policy expires, you are given 30 days to renew it. This 30 day period is known as the grace period. If you renew your policy within these 30 days, you will be reinstated in the coverage of the health insurance policy. But if you do not pay the premium during the grace period, then your policy will be terminated.
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