So here are some important terms related to Health Insurance-
• Health Insurance Policy-
A health insurance policy is a legal contract between you and the insurance provider. It outlines the terms of coverage, including what medical expenses are covered, exclusions, the sum insured, duration of the policy, and conditions under which claims can be made. It acts as a financial safety net during medical emergencies.
• Deductible in Health Insurance-
A deductible is the fixed amount you must pay out of your own pocket before the insurer pays. For example, if your policy has a ₹10,000 deductible and your hospital bill is ₹50,000, the insurer will pay ₹40,000 while you pay the first ₹10,000. Higher deductibles usually reduce the premium cost.
• Cashless Treatment-
Cashless treatment means you don’t have to pay upfront for medical expenses at a network hospital. The insurer settles the bill directly with the hospital, subject to policy limits and terms. You only need to show your health card and get pre-authorization from the insurer at the hospital.
• Reimbursement in Health Insurance-
In a reimbursement claim, you first pay the hospital bills yourself and then submit the necessary documents to your insurer to get the money back.
• Health Insurance Claim-
A health insurance claim is the formal request you make to your insurance company asking them to cover your medical expenses as per the policy. Claims can be cashless or reimbursement as discussed above.
• Waiting Period in Health Insurance-
A waiting period is the initial duration after purchasing a policy during which certain conditions are not covered.