Frequently Asked Questions

Why one should buy health insurance policy?

With the surging cost of medical treatment, it becomes quite unmanageable to pay exorbitant medical bills. Therefore, buying health insurance policy not only ensures quality healthcare but saves a person from paying hefty medical bills.

What are the benefits and services one can receive in health insurance policy?

Depending upon the type of coverage, benefits and facilities keep on varying. Usually, medical expenses occurred on the account of illness, accidents, etc are covered under all policies. Similarly, cost of hospitalization and prescription drugs, doctor visits, surgery expenses, etc are covered in all health insurance policies.

How insurance premium amount is determined?

Amount is determined on the basis of health insurance plan under which an insured is enrolled. Other factors like age group, medical conditions, personal habits, etc play crucial role in determining insurance premium. For example, higher age group demands high premium.

What are the exclusions and limitations covered under health insurance policy?

There are a host of exclusions and limitations associated with health insurance policy. Some of the common exclusions include pre-existing conditions, mental illness, attempted suicide, dental and optical coverage, reimbursement via Workers' compensation insurance program, etc. Health insurance policies also exclude coverage from medical conditions such as drug and alcohol pertaining problems, cosmetic or elective surgery and services, etc.

What is the difference between coinsurance and co-payment?

Co-payment is a fixed amount which a policyholder has to pay for availing any particular sort of medical service. For example, under many plans $20 is a co-payment amount for doctor's visit. On the other hand, co-insurance is an amount, not fixed, which are paid by policyholder for availing medical services. Co-insurance amount is not fixed but expressed in the terms of percentage. For example, if any policy has a clause of paying 20% co-insurance for hospital visits, then it implies that a policyholder has to pay 20% amount of the total cost as an expense of hospital visits.

What do you mean by deductible?

Deductible is a fixed amount which an insured has to pay before the insurer starts making him payments for the covered medical services.

What are the different kinds of health insurance plans offered to people?

Indemnity and managed care are two types of plans offered to people. Indemnity plans are also refer as traditional plans and managed care plans are divided into three categories namely HMO, PPO and POS. All healthcare plans differ with each other with respect to benefits, insurance premium amount, expenses covered, etc.