Often
ignored insurance is the Health Insurance. People do not
realize that there is always a possibility that ine might
fall critically ill and the expenses incurred int that connection
would be alarming. Health is a human right, and its accessibility
and affordability has to be insured. While the rich have
easy access and can afford modern medical care, people in
the rural areas and poorer sections of the society would
be unable to afford the expensive medical care. This is
where Health Insurance comes in, which needs to be seriously
considered by everyone.
More
than the disease it is the cost of treatment that takes
its toll. To get rid of health worries health / medical
insurance is the answer. Health insurance policy not only
covers expenses incurred during hospitalisation but also
during the pre as well as post hospitalisation stages like
money spent for conducting medical tests and buying medicines.
The cover will be to the extent of the sum insured
There
are lots of different kinds of health insurance. Soem plans
cover medical services and prescription medicines, some
cover dental expenses, disability insurance that replaces
income lost due to extended illness or injury, long-term
care, and so on. In India, the Insurance companies have
different packages and one needs to carefully choose a package
that suits them. Some companies even offer packages for
the whole family.
Health
insurance plans are usually sold once, then renewed on an
annual basis. So when a consumer buys health insurance,
the insurer agrees to pay for health expenses as long as
the premiums are paid on time and the account is in good
standing.
Here
are a few common terms that you may want to be familiar
with:
Access.
A
person's ability to obtain affordable medical care on a
timely basis.
Actuaries.
The insurance professionals who perform the mathematical
analysis necessary for setting insurance premium rates.
Ambulatory
care facility (ACF). A medical care center that provides
a wide range of healthcare services, including preventive
care, acute care, surgery, and outpatient care, in a centralized
facility. Also known as a medical clinic or medical center.
Ancillary services. Auxiliary or supplemental services,
such as diagnostic services, home health services, physical
therapy, and occupational therapy, used to support diagnosis
and treatment of a patient's condition.
Annual maximum benefit amount. The maximum dollar
amount set by an MCO that limits the total amount the plan
must pay for all healthcare services provided to a subscriber
in a year.
Claim.
An itemized statement of healthcare services and their costs
provided by a hospital, physician's office, or other provider
facility. Claims are submitted to the insurer or managed
care plan by either the plan member or the provider for
payment of the costs incurred.
Co-insurance
amount: This is the percentage of your medical expenses
you must pay after you reach your deductible. This will
typically range from 10-30%.
Covered
benefits: Types of medical services the insurer will
pay for.
Deductible:
This is the amount you must pay out-of-pocket before the
insurer will pay anything. Deductibles can vary widely,
ranging from $0 to a few thousand dollars.
Exclusions:
Types of medical services the insurer will not pay for.
Its
true: there’s a lot of jargon, and plans are difficult
to evaluate and compare. But it’s important, and worth
your time. Carefully review plan descriptions, and take
your time to understand the coverage of any plan you’re
currently under – or considering purchasing.
Maximum
out-of-pocket amount: This is maximum amount you are
required to pay in a given year, after which the insurer
will pay 100% of the cost of covered medical expenses.
