Health Insurance Jargons You Must Know

Once you have decided to get the insurance policy, there will likely be various terms and jargon you will come across that you may need to be made aware of. Don't worry; we got you covered! This blog will discuss those terms and serve as a guide for when you buy a health policy for yourself.

 

Important Health Insurance Terms

There are constant reforms and developments in the facilities and services provided by insurance companies. To better understand them, it's important to be clear about a few basic terms. Some of them are listed below:

 

Add-On Covers

You can always upgrade your health policy in accordance with your needs by including add-on covers. Add-on covers can be maternity benefits, coverage of child education, funeral/burial charges and more.

 

Automatic Restoration

You might have heard this term often while discussing the best health insurance policy. If and when your sum insured gets exhausted, the insurance company will refill your amount without charging you an extra premium.

 

Pre-existing Diseases (or Comorbidities)

When you are buying health insurance, it is essential to mention pre-existing diseases. This is beneficial as the health insurance policy will then cover the expenses of the health checkups and treatments that you require.

 

Co-payment

Besides health insurance premiums, the co-payment clause also affects the policy cost. In case co-payment is included in your policy, then it implies that the insurer will cover some percentage of the medical expenses, and you will cover some.

 

Critical Illness

Critical Illnesses insurance are recurring or life-threatening illnesses such as cancer, stroke, paralysis, lung diseases and heart diseases. These are specified in every policy. However, in some policies, you need to take the critical illness coverage additionally.

 

Cashless Treatment

Cashless treatment refers to the provision of cashless coverage of medical expenses. There is a network hospital list with specific hospitals connected to your insurer. You must submit your health insurance card, and the Third Party Administrator (TPA) will coordinate with the insurance company.

 

Reimbursement

If you avail of the services from a hospital not on the network hospital list, which ensures cashless payment, then you will be provided with reimbursement. You must retain the bills, medical reports, treatment reports and all other important documents. After that, you can contact your insurance company and apply for reimbursement.

 

Exclusions and Inclusions

There are various exclusions specified in your policy wordings-both permanent and temporary. They are the expenses like cosmetic procedures that are not covered by the insurer and are not eligible for claims. Similarly, inclusions are clearly mentioned to give you an overview of how the policy will cater to your medical needs.

 

No Claim Bonus

No claim bonus is rewarded if you do not avail the claim in any year. It is the benefit you get from your insurance company. These claims are calculated beforehand, and the company keeps a check of when to provide the same.

 

Premium

Health insurance premium is one of the most basic terminologies you should know. It is the amount which the insured pays periodically to the insurer. Thereafter, in case of a medical emergency, the insurance company is responsible for paying the sum insured to cover your medical expenses.

 

Top-Up Plans

If you like to be better prepared for future healthcare needs, you can always add top-ups to your health plan. Health insurance companies provide super top and top-up plans for your convenience, which can be incorporated while paying the health insurance premium.

 

In today's era of rapid development in the healthcare sector and technology, insurance policies are only getting better and more efficient. So if you are still thinking about getting health insurance, you should go for it. It's a necessity and will ensure your secure future.