12 Health Insurance Terms You Must Know

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12 Health Insurance Terms You Must Know

It is crucial to get a health cover in the times we are living in as it offers a vital cushion for our finances during unforeseen circumstances. The first step to choosing the best health insurance policy is to read and understand the policy features. Often, we come across insurance jargons, which may be complex to understand. You would agree that having the right knowledge and understanding of insurance terms is essential to make the best decisions.

Health Insurance Terms You Must Know

So, we list below and explain the frequently used health insurance terms. 

1. Dependents

There are health insurance plans that offer coverage for a person and his or her family members such as a spouse and/or unmarried children and financially dependent parents. These individuals who are eligible for coverage in a policy are referred to as dependents.

2. Exclusions

They refer to medical conditions or scenarios where the insured is not eligible for getting coverage under the health policy.

3. Free Look Period

It refers to a specified time period, from the date of receipt of the policy document, during which a policyholder can review a health policy and is allowed to cancel and return the policy. The premium will be refunded after certain deductions.

4. Grace Period

It is the time period of 30 days that follow immediately after the policy period end date. The insured has to pay the renewal premium before this period expires to enjoy the coverage without losing out on the benefits.

5. Indemnity

Indemnity based health insurance plans are those wherein the insurance companies offer coverage for the actual expenses incurred by a policyholder, subject to the policy terms and conditions. They are different from fixed benefit plans wherein the insurer pays a fixed amount as a lump sum when the insured person raises a claim.

6. Insured Person

Insured refers to an individual or group of individuals covered under a health insurance plan. 

7. Insurer

Insurer refers to the insurance company that provides insurance coverage for the specified medical expenses that are incurred by a policyholder. 

8. Network Provider

In health insurance, a network provider refers to a hospital or any health care provider which has been empanelled with the insurance company to provide cashless medical treatment facility or services/medical care at a discount.

9. Policy Period/Tenure

It is the time period from the inception of a health insurance policy to the expiry date, during which the insured person is eligible to get the coverage.

10. Pre-existing Disease

Pre-existing disease is a disease, illness, or injury or related condition(s) for which medical advice was received/ or was diagnosed by a medical practitioner within 48 months before the effective date of the policy issued by the insurer or its reinstatement.

11. Waiting Period

It is the period during which insured persons must wait before they can get a claim on the incurred medical expenses except in cases like an accident. Usually, there is an initial waiting period of 30 days, a waiting period of 48 months for pre-existing diseases and 24 months for specified ailments/ treatments.

12. Underwriting

In health insurance, underwriting is the process by which a health insurance company assesses the risks of the proposed to be insured and decides the health insurance premium the person has to pay. 

Get the best protection for your health and finances by opting for a health insurance policy from Care Health Insurance. Visit the company’s official website where you can choose a plan based on your requirements. The online facility of paying the premium and checking claim status reduces the hassle for you.

>> Also Read: Fixed Benefit Health Plans Versus Indemnity Plans

Disclaimer: Plan features, benefits, coverage, and underwriting of claims are subject to policy terms and conditions. Please refer to the brochure, sales prospectus, and policy documents carefully.

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