Health Insurance
Insurance in India: How it works!
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What is Health Insurance?
Health insurance is a form of cover which can help you control the expenses of health care and other medical-related services. With health insurance, you pay for all or some of your health care expenses to the insurance company. It provides this financial protection so that you have access to any medical treatment that you might need without bearing the cost of the whole expense yourself. Depending upon the specific plan you have, health insurance plans may include a variety of healthcare services, such as visits to doctors, hospitalisation, surgeries, medication, and preventive care.
Types of Health Insurance:-
A. Indemnity Plan
An indemnity health insurance plan, also called fee-for-service plan, offers flexibility for you to be able to choose your doctors and services. You pay medical costs yourself and then submit claims for rebates according to what the policy limits have provided. This plan is flexible, but it requires more paperwork and out-of-pocket costs.
B. Fixed Benefit Plan
A fixed benefit health insurance plan provides certain pre-defined payouts for particular medical events, such as hospitalisation, surgeries, or critical illnesses. The plan pays out a predetermined amount irrespective of the actual medical expenses incurred. It offers simplicity and helps cover specific costs but does not necessarily cover all healthcare expenses.
What Is Covered by Health Insurance?
Health insurance covers almost every health care expense and facility based on the plan selected by you. Generally speaking, health insurance can provide:
Hospitalisation: Costs relating to inpatient admission at a hospital, along with room charges and any other surgery-related costs.
Outpatient Care: Outpatient services, including physicians and clinic fees, diagnostics, or consultancy.
Medications: Any prescription drugs and medication for your treatment.
Emergency Care: Emergency room admission charges and urgent care, which could include ambulance services in most states.
Preventive Care: Vaccinations and blood tests, as well as other preventive checkups related to wellness.
Specialist Services: Specialist charges including consultancy, therapies, treatments, and other prescribed specialisations.
Maternity Care: Prenatal services, childbirth, post-natal care, as well as other related deliveries, such as cesarean deliveries.
Diagnostic Tests: Lab test, X-rays, imagery in diagnostics.
Mental Health: Therapy, counselling, psychiatric care.
Know a few terms concerning Health Insurance
Premium: The amount you pay for the policy, insurance coverage.
Deductible: Your insurance begins after you covered an amount.
Co-pay or Co-payment: How much you pay for an illness.
Network: Approved Listed, accepted doctors, and medical centres.
Claim: Is how you get paid; request when you use this medical care.
Pre-existing conditions: Health problems you have or know of before getting the health insurance.
Exclusion: Any treatment or situation not insured.
Policy Limit: The highest amount of money an insurer would pay on any given claim.