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5 Important Things You Should Know About Health Insurance Policies

Jagrity Sharma Jagrity Sharma 18 July 2019

Understanding Health insurance is not as difficult as it may sound. If you get to know these 5 aspects, then it actually is quite a simple task to choose the best one for you and your family.

Health Insurance Policies

Life can be a rollercoaster ride as it has its ups and downs. Hence, it is best to stay prepared at such times. Health is a common concern among all. The number of diseases have been increasing and it is imperative that each person acquires a health insurance policy. Evidently enough, the rise in these things also leads to immense escalation in the cost of treatment and hospitalization. It can therefore, be confusing when one has to choose the right mediclaim policy.

A Health Insurance plan financially supports or protects the policyholder during phases of ill-health. Health insurance plans are built in a manner that safeguards you from medical expenses. The insured receives tax exemption, according to Section 80D of the Income Tax Act, 1961 for premiums paid towards a health insurance plan.

Mediclaim policies are a part of health insurance, however, they differ in their coverage. A Health Insurance plan is an extensive type of financial coverage, whereas a Mediclaim Policy offers particular financial coverage against health-related expenditures.

5 Important things you show know about Health Insurance Policies

  • Choosing the Sum Insured: Before selecting a health insurance plan, you need to critically analyse your needs and requirements. Based on your financial priorities, you will know whether you can afford a comprehensive coverage or disease specific coverage. Selecting the right insurance plan may be tough. Hence, below is a list of points for you to consider while choosing the sum insured of a health insurance plan.

    • Lifestyle: Your occupation, salary, food habits, city, etc. are all elements of a way of life or lifestyle. All these factors assist you in determining the sum insured you will require in your policy.

    • Life-stage: Life-stage basically refers to whether you are single, married, with kids, without kids, student or working. On the basis of this, you must choose your sum insured amount.

    • Health history: When selecting a health insurance policy, you should keep in mind if you have been recently hospitalised, if you have any ailments, hereditary illnesses and past history. Read the illness and treatments that are covered in a health insurance policy carefully and select a sum insured you think you may require in future.

    • Buy Health Insurance online: Gone are the days when you had run behind agents to get your work done. Now, you can simply purchase the health insurance you desire online in a few minutes. There are broker and aggregator websites which enable you to compare various health insurance policies. You can compare various plans from different insurance companies online instantly. It avoids the hassle of paperwork and saves a lot of your time as you can also renew the policy and pay the premium online.

    • Reimbursement for treatment at non-network hospitals: Each insurance company has certain hospitals under them that offer cashless hospitalization. You may not always get treated in a network hospital, but rather in a trusted hospital that is a choice of your own.

If you get hospitalized or treated at a non-network hospital, then on the basis of the policy that you have chosen, you will be reimbursed for expenditures. For this, you will need to provide medical bills. Contact your insurance company as soon as possible, preferably within 24 hours of getting hospitalized, and provide the following details:

  • Health insurance policy or ID card number
  • Type of illness
  • Name and address of the hospital, contact number, etc.
  • Doctors assessment
  • Prescriptions
  • Medical bills
  • Medical reports
  • Diagnostic tests

    • Hospitalization: You must know the difference between network hospitalization and non-network hospitalisation. A network hospital is the hospital that is in an agreement with the particular insurance company. It signs an agreement for offering cashless hospitalization or treatment for the policy holder of that insurance company. Non-network hospitalization are hospitals that do not get into an agreement with the insurance company and do not provide cashless hospitalization or treatment.
  • Significance of a health insurance: Having health insurance is a necessity, irrespective of your age. You may be young and healthy, but you never know when unfortunate events may occur and you may need financial help and coverage. A health insurance financially protects you against accidents, unforeseen situations that may affect one’s health. It is better to be prepared as a health insurance plan provides coverage for various treatments and hospitalization.

Things to keep in mind while buying a health insurance policy

  • Buy when young: There is an age limit for every health insurance or mediclaim policy. The maximum age limit is considered to be 65 years, following which you will not be able to get a health insurance policy. It is wise to start when you are young and reap the benefits in times of need for medical purposes.

  • Comprehensive coverage: Many health insurance companies have co-payments. However, full coverage of the service or treatment is not promised. Thus, you will have to pay a certain percentage of the medical costs or claim amount. Although cheap, such health insurance plans are less likely to be recommended, as it is not easy to gather such money in emergencies like these.

  • Sub-limits: Choose a health insurance plan with minimum or no sub-limits because sub-limits have a particular limit on the room rent, fees, doctor charges, diagnostic charges, etc. In case of a medical emergency, if you happen to be admitted to a premier hospital, the sub-limits may prove to be a problem.

  • Insurance company: It is very important to choose the right insurer. You must check the company’s incurred claim ratio before selecting a health insurance plan. A good incurred claim ratio would prove its efficiency in settling claims. Thus, you can then be sure of your decision.

  • Cashless network hospital: You should opt for treatment at a cashless network. It is a smart choice and works best for the insured. It has a swift procedure and avoids the hassle of lengthy documentation. It accelerates fast reimbursement. Therefore, search for the hospitals from the insurance company’s network that provides cashless claim settlement.


Medical situations and emergencies may arise at any given point of time. Hence, it is best to acquire health insurance or Mediclaim policies and be prepared for such circumstances. Keep yourself updated about health insurance and mediclaim insurance policies, so that you can make the right decision for yourself and your family members.

Recommended:Best Health Insurance Policies for 2017 – 2018

Jagrity Sharma
Written by Jagrity Sharma
A bibliophile who hates alliterations, but loves cream, comics and content immensely! On another note, a content marketer who leverages the power of words to explain...almost anything!