Health Insurance Plans

pays for your hospital bills for diagnostics, surgery etc.

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Health Insurance Cheat Sheet

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If you are looking to buy a Health Insurance Policy there are various terms that you will come across and it is important that you understand them well. Knowing these terms would help you take a better decision in terms of the choice of the policy to go for.

Given below are the important terms that you would typically encounter

1) Sum Insured / Assured -

This is the maximum amount of Mediclaim that an Insurer would reimburse under the health policy. The sum insured amount may be offered on an individual basis or on a floater basis.

2) Cashless Facility -

Insurance companies offering medical insurance have a tie up with major hospitals across the country. Anybody who is insured under a health insurance policy can take treatment without having to pay for the medical bills out of his pocket. The insurance company will arrange to pay to the hospital directly. This is called cashless facility. In order to avail the cashless facility, a patient would have to get pre-authorization from the insurance company.

3) Critical Illness Policy -

This can be brought as a separate policy or as an additional rider under you existing health insurance policy. Under a critical illness policy, or rider, you would receive a lump sum payment if you are diagnosed with a critical illness. Some of the common critical illnesses included in the policy include stroke, cancer, heart attack and paralysis. The objective of a critical illness policy is to meet the indirect liabilities arising out of such critical illness. The policy ceases once the lump sum payment is distributed.

4) Pre-existing Disease -

As the name suggests, it points to a medical condition or disease that you would be carrying before you bought your first health insurance policy.
Most insurance companies do not provide Coverage for pre-existing disease for upto four years when you first purchase your health policy.

5) Family Floater Policy -

A Family Floater is one single policy that would insure all your family members for Hospitalization expenses. Basically, you do not need to buy a separate policy for each family member. This not only saves you cost, but allows you to a higher sum assured. Cumulatively or individually all family members are eligible to receive Reimbursement for medical expenses upto the maximum Sum Assured under the policy.

6) Hospital Daily Cash Benefit policy -

Under this policy, you would be provided a fixed amount daily for each day you remain under hospitalization. The fixed benefit can increase if insured is admitted in an intensive care unit or for a pre-specified illness.

7) Pre and Post Hospitalization Expenses -

Under the terms of the policy, the insurance company will not only reimburse for the medical expense incurred during hospitalization, but also pay for medical expenses incurred upto a certain number of days prior to and post hospitalization. These medical expenses have to be related to the sickness or disease for which the patient underwent hospitalization.