Navigating the Complex World of Health Insurance in India
In This Article
Navigating the Complex World of Health Insurance in India
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Arjit
Updated on June 22, 2024
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Financial Wellness
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When you hear the term health insurance, what does generally come to your mind? Do you find it complex? Have you tried applying for it but haven’t been able to process it? Or have you never gone close to it because you’re totally confused and doubtful?
You’re not alone. In fact, a majority of people face quite a lot of difficulties and doubt with insurance.
There are some who know the importance of having insurance but are scared of the complexity that comes with it. There are others who are aware of the merits of having health insurance but are afraid of the complex clause that comes in the policy.
And the third group fears the word ‘insurance’ itself, they don’t know about it and heard some old case of insurance claims getting rejected.
Karepedia, with its impeccable health insurance assistance feature, is here to help you navigate this complex world of health insurance without any hassle.
What Should You Know About Health Insurance
There is so much to know and learn about it. From benefits to the factors that can increase the chances of your claims getting rejected.
Quite surprisingly, you won’t easily find any awareness campaigns about health insurance. But not to worry, we have your back.
First we will understand what actually health insurance is? And what are the terms related to it?
As simple as it can be, health insurance is a safer way to invest your money on health. So that in any case of medical emergencies, you can be assured that you and your loved ones are safe and secure in terms of affording treatment.
Now that you are aware of what it is, let us explain it technically. Health insurance is a type of insurance that provides coverage for medical expenses incurred due to accidents, illnesses, or injuries.
You can avail such a policy against monthly or annual premium payments, for a specified tenure or period of time.
The Basics of Insurance Terms
Have you heard about health insurance terms? Are you aware of them?
If not, then please do know that there are three terms for medical insurance. While explaining these terms we will include some examples too to simplify it for you.
Here you go.
Premium: This is the total amount of money you will be paying to the insurance company. This would be the amount that will be covered by the company during your medical emergency. This whole amount can be paid on a monthly, quarterly or yearly basis.
For example- If you buy a health insurance policy of 10 lakhs, it means the insurance company will cover all your emergency medical expenses up to 10 lakhs.
Deductible: This is the amount that you have to pay as a medical expense before the insurance company starts to cover your expenses.
For example- If your medical bill is Rs 30,000, and they have a policy which will cover only Rs 27,000, then you will have to pay Rs 3,000. This deductible amount has to be paid first and then the company will start paying for your medical expenses.
Co-payment: It is a fixed amount of money that you have to pay to the company every time you avail the benefits of the policy. This amount varies according to the policy and for some companies it is even zero.
For example- You may have to pay Rs 200 to the company for just availing the benefits of the policy.
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Decoding the Complexity of Health Insurance
Now, we will try to understand the complexity of health insurance.
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One of the major reasons why people are afraid of health insurance is because the healthcare industry is a complex and ever-evolving sector. And the policies and regulations governing it are subject to change.
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The health insurance sector can be complex and the coverage and benefits of health insurance policies may vary depending on the policy and the insurance provider.
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These evolving policies create chaos among people and that’s why a lot of you may hesitate to buy a health insurance policy.
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In addition, the healthcare industry is characterised by a wide range of stakeholders, including healthcare providers, insurance companies, and government agencies. Each with their own interests and objectives. This can make it challenging for you to navigate the healthcare landscape and understand the various policies and regulations governing it.
Some Simple Tips To Handle Health Insurance
There are a lot of clauses that you should be aware of, whether it is about the specific hospital giving benefits or covering up the specific illness.
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There are certain things that you should consider before or while owning a health insurance policy.
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You should be responsible enough to read all the scheme related documents about the policy, before owning it.
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If they are not clear about it then surely consider having a conversation about the health insurance policy with someone who knows about it. Mykare Health can assist you throughout the entire process.
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Please read all the scheme related documents before owning any health insurance policy.
We hope you now have a fair understanding of the basics of health insurance. If there are any reviews that you would like to give us or a comment to add about this blog, you can contact us through the ‘Contact us’ section. It would be our honour to communicate with you!
Challenges Faced by Many: Many individuals find health insurance complex and daunting, leading to difficulties in understanding and navigating the process.
Health insurance is an investment in your well-being, ensuring financial security during medical emergencies.
Technically, it covers medical expenses resulting from accidents, illnesses, or injuries, with policyholders paying premiums monthly or annually.
Key Insurance Terms - Premium: Total amount paid to the insurance company, determining the coverage for medical emergencies.
Key Insurance Terms - Deductible: Amount paid by the individual before the insurance company covers expenses.
Key Insurance Terms - Co-payment: Fixed amount paid to the company each time the policy benefits are availed.
Fear of health insurance often stems from the complexity of the healthcare industry, which is dynamic and subject to frequent changes.
Policies and regulations vary, leading to confusion among potential policyholders.
Navigating the Healthcare Landscape: The healthcare industry involves multiple stakeholders, including healthcare providers, insurance companies, and government agencies, each with their own interests.
This complexity makes it challenging for individuals to understand various policies and regulations.
Tips for Handling Health Insurance: Consider specific clauses related to hospitals and illnesses when choosing a policy.
Read all scheme-related documents thoroughly before obtaining health insurance.
Seek assistance or have conversations with knowledgeable individuals, like those at Mykare Health, to ensure clarity in understanding policies.