Understanding the Health Insurance Plan- Detailed


It is rightly said that “necessity is the mother of invention”. This also applies to health insurance. The worsening of the lifestyles and the rising costs of healthcare in India has paved the way for health insurance services. This need was further reinforced by the fact that, unlike the West, social security systems do not exist in India. Governments have taken all steps to extract citizenship from all possible points, but they have done nothing at all in terms of health care and social security.

In the current scenario, health insurance is often carried out. Some people spend their work and some people buy individually. Almost all health plans use some sort of network, but when it comes to what the insurance company pays, it sounds mysterious. We all know that the plan will receive money for medical bills, but can completely refuse or pay for a part.

You should learn more about your health insurance, since this can be complicated in many ways. Do not understand health plans cannot be a measurement problem for people generally fit and healthy. If someone who is dealing with a serious medical condition, take the time to get an accurate idea of ​​how the plan works. No one is as interested in the precision as your claims are treated as you are, you should at least understand basic elements about your health insurance and know how to make to pay your medical bills. If you do not know how your plan works, this can cause serious confusion and cost you a lot of money.Understanding the Health Insurance Plan- Detailed

Understanding the Health Insurance Plan- Detailed

If you are aware of your thoughtful service, this is really very good for you. Because at least you have an idea of ​​what benefits you will get from your health insurance. Here you will find a list of the services covered by the plan, hospital stays for inpatient and outpatient treatment, medical services, diagnostic procedures and laboratory tests. You can also set certain limits for certain types of coverage.

Understanding other basic rules of your plan is additional knowledge for you. If you understand things like deductible, co-insurance, co-payments, disbursements, exclusions, etc. is worth it for you.

Viewing the exclusion part is very important. You can find the list of articles, which are expressly excluded from the cover. In principle, the health insurance does not grant any special conditions or circumstances.

Importance of Health Insurance

In the current scenario, medical costs cannot be granted and they will continue to rise rapidly. In short, we can say that the medical costs have already exceeded the budget. Health insurance is great, saves money and covers unexpected disasters. It covers the costs of hospital stay, etc.

People buy health insurance for several reasons. Take a look at various reasons and consider the reason why you should apply for health insurance. The following common reasons are explained:

Protect Against the Risk of Medical Bills

The most common reason is to protect against the risk of medical bills for health care. Without health insurance, you may not be able to afford the high cost of medical services.

Hospital Stay

The establishment of a free hospital stay is carried out in hospitals all over the country. In this case, the insurance company will accept your medical bills of all kinds.

Usual Medical Services

Health insurance pays you for the usual medical services that you use during the insurance year.

Family Safety

If you have other relatives, you must apply for a family medical insurance. In this whole family you will cover the single amount of the premium.

Tax Benefit

As a tax benefit, it is more valuable. You do not have to pay taxes on your health insurance benefits.

Are You Buying The Right Health Insurance Plan?

Therefore, it is the responsibility of the citizen to ensure. But it is not so easy to get the right health insurance. There are more than two dozen general insurance companies that offer different types of health insurance plans in India. Many times, people end up buying health insurance plans that are irrelevant and do not help if necessary.

Therefore, it is important that you understand the nuances of Medicare and then make a decision. Here is a short list for you.

Why is it so Important?

The main purpose of the health insurance plans is to cover hospital stay and critical illness. Most plans cover this. However, there are many plans that do not cover certain types of diseases. For example, you can find several Mediclaim plans that do not cover blood pressure and problems related to diabetes.

The extent of coverage can also be different. For example, all plans do not cover hospital costs for hospital stays. In some, the coverage period can be as great as 45 days and in some of the period could be as little as a week.

It is your responsibility to review these problems. If you are going to rely on the insurance agent, it will cost you for later appointments. Agents are interested in selling and commissions. They can show their concern and tend to offer you the best plans, but the reality can be quite different. So, take care of these aspects.

The development of the health insurance sector in India has motivated the insurance companies to submit comprehensive plans. A wide range of riders are also available. So, if you buy a standard policy, you can provide riders who can provide coverage against many other risks, such as permanent disability benefits, diabetes coverage and so on.

Do They Cover Pre-Existing Conditions?

Most Mediclaim plans in India do not cover pre-existing conditions, unless otherwise stated. Do not accept this. If you are looking for coverage for an existing medical condition, clarify it. You can compare the health insurance plans online or consult the customer service center about the possibility of online chatting or calling.

There are plans that cover the prevailing conditions under certain conditions. In general, there is a predetermined period of time in which already existing conditions are covered. The costs of these plans are, of course, higher than the standards.

Can Family Members Be Covered By A Single Plan?

If possible, you can simply opt for a family floating plan and ensure that your family members are covered by a plan. There are thousands of advantages of these plans. The premium is somewhat higher, but much less if you plan different health insurance plans for multiple family members. The collective costs for multiple plans are much higher. Familiar floating plans at the other end are profitable. The most common question about familial floating plans is what happens when a member is deprived of the cover limit and another member becomes ill. There are solutions for these conditions. You can cover the cover limit during the insurance period. Of course, you must pay an additional premium to get an extended coverage.

Can You Switch From One Health Insurance To Another?

Mobility is not limited to the telecommunications sector alone. The Insurance Regulatory and Development Authority India (IRDAI) have made portability in the health insurance sector possible. If for any reason you want to change your health insurance, you can submit an amendment. Health insurance is offered by the general insurance companies so far and cannot deny your application for portability. They can try to hold you back, but in the end it is your privilege to make the final decision. If you experience a problem with your health insurance plan, you can submit a complaint to the IRDAI Online Consumer Claim clearance system. This is incredibly effective and you can expect an action within 15 to 45 days. However, IRDAI has taken hard steps to protect consumer rights, and it is possible that your complaints are solved by the insurance company itself in the first phase and there is no need to be IRDAI in this case.


The importance of health insurance cannot be measured. Certainly, it can be very difficult to get money for health insurance. Today, many health insurance providers are on the market to offer health plans with attractive rates and discounts. But, be careful with the coverage limit, it can be shortened by the price.


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