All the Health Insurance Terms You Need to Know but Were Afraid to Ask

Health is the biggest wealth an individual possesses. In today’s time of uncertainty, it has become more vital than ever to protect your health. Health insurance ensures that, in case of any diagnosis, you are financially protected. It ensures that you do not face a financial burden because of your condition and can avail yourself of the best treatments using your insurance coverage.

When you buy a health insurance policy, there are several terms that you may come across and might hesitate to ask. With a thorough knowledge of these terms, you can make an informed decision and avoid any problems in the future. Here are some terms of health insurance that are important to know:*

• Add-on covers or riders

Riders are add-ons that you add to your basic term insurance plan. They are additional features or coverages that a policyholder gets by paying additional premiums. Critical illness cover, maternity cover, hospital cash benefit, disability cover, and room rent waiver are common riders policyholders opt for. *

• Waiting period

When you buy a health insurance policy, there is a fixed time period for which your coverage benefits are not activated. This is known as the waiting period. It may vary slightly from one insurance company to another and one policy to another. *

• Co-payment

In a health insurance policy, you may come across a copay clause or copayment in the policy document. Copayment is a fixed percentage that the policyholder is required to pay before availing any benefits from their policy. *

• Critical illness

Critical illnesses are those medical conditions that threaten the life of the policyholder. They usually include cancer, kidney failure, cardiovascular conditions, or paralysis. There are critical illness insurance policies or add-on covers that specifically cover these severe ailments. *

* Standard T&C Apply

• Cumulative bonus

When a policyholder does not file a claim in the preceding years, the insurance company rewards them with a cumulative bonus. It is similar to the No-Claim Bonus (NCB) in a motor insurance plan, except there is no markdown in the premium, but an increase in the sum assured of the insurance policy. It is a reward that the insurance company offers to the policyholder for not making any claims. * You can visit the official website of IRDAI for further details.

• Cashless policies

Cashless health insurance is an insurance plan where the policyholder is not required to pay upfront while getting treated in the hospital. In such plans, the bills of the policyholder are settled between the insurance company and the policyholder, with no need for a cash payment from the policyholder. *

• Top-up plans

Top-up plans are additional plans that you can buy along with your base policy or as standalone to enhance the coverage benefits. Individuals, generally, buy top-up plans when the base policy does not cover all their needs. *

• Pre-existing diseases or comorbidities

Pre-existing diseases or comorbidities are underlying conditions that increase the risk factors in terms of a health plan. These usually include hypertension, blood pressure, cardiovascular conditions, kidney problems, and disabilities. Policyholders with health co-morbidities usually pay a higher premium because of the higher risk involved in health. *

• Network hospitals

Every insurance company in the country has a tie-up with certain hospitals, which are known as network hospitals. If a policyholder avails treatment in these hospitals, they do not have to make an upfront payment for the bill. Instead, the insurance company settles it on their behalf. *

* Standard T&C Apply

Insurance is the subject of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.