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Health Insurance

What Can Your Health Insurance Plan Do For You


health-insurance-part-of-financial-planning

Health insurance coverage usually covers the cost of an insured individual's medical and surgical expenses. It pays for provider services, medications, hospital care, and special equipment when one is sick. The actual costs and care varies based on health care needs and coverage.

How Does Health Insurance Work?


In health insurance terminology, any clinic, hospital, doctor, laboratory, healthcare practitioner, or pharmacy that treats an individual is known as the "provider." The "insured" is the owner of the health insurance policy or the person with the health insurance coverage. Depending on the type of health insurance coverage, either the insured pays the costs out of his pocket and is then reimbursed, or the insurer makes payments directly to the provider by opting for a 'cashless treatment'.

There are two main types of health insurance:

  • Private health insurance:
    According to The Centers for Disease Control and Prevention (CDC), The healthcare system relies heavily on private health insurance.
  • Public or government health insurance:
    In this type of insurance, the state subsidizes healthcare in exchange for a premium.

FAMILY HEALTH INSURANCE

A family health insurance plan covers more than one member of family for a fixed sum assured in exchange for single annual premium. This type of policy provides coverage to two or more members of a family at the same time. These policies are also known as floater policy.

Such a plan generally covers a family including Self, spouse along with up to 4 children, while some insurance companies allow inclusion of parents in the existing health insurance policy. Few companies also allow inclusion of in-laws (extended family members) in the existing family floater plans with addition premium.

BEST INSURANCE PLANS

One has to do lot of research before being able to find the right and best health insurance plan. A thorough comparison of health insurance plans offered by multiple companies is needed. Also each family or individual may have unique health insurance requirements. So, it is advisable and beneficial to compare best companies for their best plan as required.

Here are some of the important factors to keep in mind before buying a family floater health insurance plan:

  • Premium:
    Insurance premium is generally the most important thing to evaluate while buying an insurance policy. A family floater plan provides health insurance to the whole family at a lower cost compared to individual Mediclaims.
  • Co-Pay clause:
    Co-payment means the policyholder will bear a specified percentage of the claim amount. For instance, in an 80%-20% clause, the policyholder will bear 20% of the cost and the remaining amount (80%) can be claimed.
  • Sub-limits:
    Health insurance companies may specify limits for certain illnesses or treatments.
  • Waiting period for Pre-existing diseases:
    One needs to check if the existing diseases are covered by the policy. In some policies all the existing diseases may be covered and in some, the policy holder has to wait for few months or sometimes years before making a claim.
  • Alternative Treatments:
    Some policies also cover non-allopathic or alternative treatments such as homeopathic, ayurvedic amongst others.
  • Maximum Renewal age:
    This criterion states up to what age the policy can be renewed.
  • No claim bonus:
    These are incentives provided by the company in case of a claim-free year. It varies from company to company.

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