Health Insurance Terms Explained

By Sanesh Mathew | December 20, 2016

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With the rise in medical costs and a plethora of lifestyle diseases going around, Health Insurance has become a necessity rather than just an option. Not only do medical emergencies come unannounced, but they end up draining you financially and emotionally. Therefore, it is wise to buy yourself a Health Insurance policy early in life. Besides buying it early means a lower price, full benefits, and better financial sense.

Additional Reading: Benefits Of Buying Health Insurance Early

Though people have realised the necessity of a Health Insurance policy, they still find most of the terms and conditions quite confusing to comprehend. We believe that understanding these terms and conditions is vital before buying any Insurance, especially if you want to make a well-informed decision. This is exactly why we have hand-picked a few common Health Insurance terms and explained them to help you understand better.

Portability – As an insurance policyholder, portability is the right given to you to switch to another insurer, should you so choose. It lets you transfer the benefits you’ve accumulated to the new policy. It is also applicable if you’re shifting from your current plan to another plan offered by the same insurer. So, you can shift between insurers or plans without losing the credits gained for pre-existing disorders and time-bound exclusions. However, remember that this is possible only if you have maintained your previous Health Insurance policy without any breaks.

Additional Reading: What Is Health Insurance Portability

Pre-existing Disease – A pre-existing disease refers to any medical condition or illness for which you have either shown signs or symptoms, were diagnosed, or were under medical treatment before you purchase the Health Insurance.

Insurers are often reluctant to provide Health Insurance to those with pre-existing illness. However, things are changing. Now, your Health Insurance will cover pre-existing diseases, albeit after a certain period of time. But, make sure that you disclose any pre-existing condition to your insurer before you purchase your health insurance. If you don’t, then your insurer can reject your claim later.

Additional Reading: Misconceptions about Health Insurance

Grace Period – This refers to the period of 15 days after the premium due date. You are required to make the premium payment during this period if you want to renew your policy without losing any of the benefits gained. However, you won’t be getting any coverage for the period between your premium due date and the late payment date. If you fail to pay the premium within the grace period, your Health Insurance policy will lapse. So, you have to keep renewing your policy as and when the premium is due.

Additional Reading: Tips To Plan Health Insurance Premiums Considering Inflation

Free Look Period – So, you have received the policy document and read through it. But you aren’t happy with the coverage or do not agree with the policy’s terms and conditions. You want to return the policy. What do you do? Simple! You return it.

Most insurers provide new policy takers with the option of returning the policy within 15 days, provided you don’t make any claims during this period. This is called the Free Look Period. Your 15-day return period kick-starts from the date you receive the policy document and not the policy issuance date.

Additional Reading: All About Free Look Period In Health Insurance

Co-Payment – This is a cost-sharing requirement in a health insurance policy wherein the policyholder agrees to pay a specified percentage of the hospital expense while the rest is covered by the insurer. In case of co-payments, the premium charged by the insurer is usually lower. However, the insured sum remains the same. Keep in mind that this feature may not be a part of all Health Insurance plans.

Additional Reading: 6 Ways To Elude Health Insurance Scams

Deductible – A deductible is a cost-sharing requirement in a Health Insurance policy, which is similar to the co-payment. However, in this case, you are liable for a specified amount (fixed) as compared to sharing a percentage of the hospital bill (which was the case with co-payment). The insurer decides whether the deductible is applicable yearly, per life, or per event. Even if there is a deductible, your insured sum remains the same (no reduction).

Maternity Expense – Some Health Insurance plans also cover maternity expenses. However, they usually come with a waiting period of up to 48 months. The coverage includes expenses for delivery or lawful pregnancy termination, and the pre and post-natal expenses related to the delivery or termination of pregnancy.

Additional Reading: All About Maternity Cover

That should make things a lot clearer for you. So, the next time you head out to buy a Health Insurance policy, you should be well-equipped to make an informed decision. If you want to know more about Health Insurance then check out these FAQs.

All information including news articles and blogs published on this website are strictly for general information purpose only. BankBazaar does not provide any warranty about the authenticity and accuracy of such information. BankBazaar will not be held responsible for any loss and/or damage that arises or is incurred by use of such information. Rates and offers as may be applicable at the time of applying for a product may vary from that mentioned above. Please visit www.bankbazaar.com for the latest rates/offers.
Category: Health Insurance Insurance

About Sanesh Mathew

A talkative sleepyhead, Sanesh, enjoys watching horror movies, listening to music, reading all things related to personal finance and wandering aimlessly (walking meditation, he calls it!). He refers to himself as a 'simple human being with a rather chaotic mind'.

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