Health insurance gives us the opportunity to pay health centers better for us and our families. In addition, you can also enjoy tax benefits. Today, health insurance specialist, Mahavir Chopra takes us through the A-Z of health insurance.

Understand the concept of health insurance:
Health insurance in India, popularly known as Mediclaim is no more insurance to cover expenses related to hospital necessary due to illness or injury. A standard Mediclaim cover the costs of hospital wide, including:

- Investigate the costs of hospital care before medical tests, doctors' fees,

- Includes the cost of ambulance

- All costs, while in the hospital, which is included in the room, editing fees, diagnostic tests, etc.

- Costs incurred after a hospitalization for a full recovery, for example, followed by physician visits, diagnostic tests, medications associated with hospitalization.

Health Insurance Benefits Plan:
Due to the attention of inflation, the quality, more expensive hospitalization. Great hospitalizations that cost lakhs of rupees can seriously burn a hole in tremendous savings, or worse, the burden of which has a huge debt. Health plans will help to spread the risk around the corner. people and reduce the costs per person.

How does a health insurance works?
Health insurance is generally an annual insurance, renewable annually. Insurance hospitalization for sick leave and injury, and with certain exceptions, waiting times, which is specifically mentioned in policy formulation. You can apply for the right health insurance in two ways - without cash or a refund.

Click here to apply Health Insurance in Delhi

Without money - every insurance company with a network of hospitals that have a direct billing agreement. In these cases, insurance companies pay directly the amount of eligible claims in the hospital. When the insured is admitted to a hospital network, he / she or a family member to his / her would only have to present his / her billing office, cashless payment cards for hospitals, which will be the admission process without money cash for the patient, subject to approval by the insurance company. In such cases, the insured must pay only not covered by health insurance.

Refund - If you happen to be admitted to a hospital that is not in the network of your insurance, you have to make all payments on your own to the hospital, and then send the original documents with the form claim to the insurance company for reimbursement.

Tips while buying the right insurance plans
- One needs to understand that there is no perfect plan. Understand your needs well, plan for the long term, and go for the closest suitable plan. Don't wait for that perfect plan with everything covered to arrive and risk delaying your coverage.

- Remember, you are buying an insurance for your old age. With healthcare inflation at 20%, do not go for a small sum insured of Rs. 1 lakh, if you can afford more. A premium of around 25% of your monthly salary is surely affordable.

- Demand the policy wordings (where all terms and conditions of the policy are mentioned) of the product you are going to buy. Before you sign the dotted line.

- Do not solely depend on health insurance from your employer. Employer sponsored coverage is changing every year according to claims experience and budgets of your employer. You may suddenly find yourself or your family with very low or no coverage. It is becoming more and more difficult to get insurance for people above 45 years or people who have an ailment or health condition like diabetes/thyroid/hypertension etc.

- Check the maximum renewal ceasing age of the policy. This is the age when your policy will discontinue. Today, there are policies available which can be renewed for lifetime. Go for lifetime renewable policies.

- Ensure you spend time in finalizing a good health insurance advisor, who would provide you unbiased advice across all leading insurance cos., as well as assist you for renewals and claims in the long term.

Top 5 FAQs on health insurance
1. What is Family Floater?
Family Floater is a very cost effective product, that covers an entire family under one policy and one fixed cover. This fixed cover is shared with the family members, i.e. if Vermas, a family of three buys a Family Floater Mediclaim of 3 lakhs, the full family covered can make claims of upto Rs. 3 lakh in a year, subject to other terms and conditions in the policy. In most policies Self, Spouse, and Kids are covered in a family floater policy. On the other hand, Individual Mediclaim is a product where each member is covered under a separate coverage. Taking individual policies turns out to be more expensive than Family floater. If you are a young couple, Family floater would be a better choice.

2. What is Pre-existing Diseases?
Pre-existing Ailments or Diseases are Symptoms, Diagnosed Ailments, or any existing or past health condition which exist at the time of applying for Mediclaim Policy. When you apply for a Mediclaim, please ensure you provide a detailed medical background about your family. Ailments which already exist, are generally covered by Mediclaim after 4 years. In a recent trend, most Insurance companies now have started putting permanent exclusions for Pre-existing diseases in the policy.

3. Is Maternity Covered in health isnurance?
No, Maternity and expenses related to Maternity are not covered under Standard Mediclaim. There are some policies which provide Maternity cover after an initial waiting period of 2 to 4 years.

4. What is TPA?
TPA is 24X7 outsourced agency of the Insurance Company, which keeps records of the policies issued by the Insurance Company, including people covered, benefits and exclusions. The TPA maintains the network of hospitals for the Insurance Company and provides the Cashless Card to the Insured Persons. TPAs process all claims including Cashless and Reimbursement claims on behalf of the Insurance Company.

5. Will Cashless Card provide Emergency Service?
No, Cashless Card is not like a Credit card which can be swiped at the Hospital and you don't have to make any payments. The authorization of Cashless between the Insurance Company/TPA and the Hospital normally takes 5-8 hours, and hence cannot be depended on for Emergencies. In emergency cases, Hospitals may demand a deposit to admit the Insured patient. Always have a Credit Card with a good balance handy for such exigencies.

Source: [TOI]