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Healthcare Insurance - How it Works, Advantages & Disadvantages

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Health Insurance

These days, health insurance is an absolute necessity. Health insurance is a type of insurance that covers the medical, surgical, prescription drugs, and sometimes dental expenses of the insured person. Health insurance may apply to a limited medical services range and will give for full or partial payment of the costs of specific services. Here we’ll discuss about the healthcare insurance works and its advantage-disadvantages.

Health insurance helps protect you against high health care costs. This lets you pay for visits to the clinic, hospital stays, prescription drugs, and essential preventive services. 

Health insurance is generally provided in workplace compensation packages in countries with no universal healthcare coverage, such as the United States.

Treatment rates in emergency departments differ significantly depending on what form of health insurance a person has.

In 1947 after from the independence of India, the health care system revolved around policies and plans programs of government. To Indians, the life insurance scheme dating back to 1818 was the first of its kind. Life insurance’s success in India was due to low life expectancy and close-knit family structures.

The report found that only 44% of the 1.3 billion people in India have a health insurance policy as of 2017. This means that 56% of the country’s 1.3 billion people do not have health insurance.

Health insurance is costly. Every year, health-care costs are rising. Without health insurance, most people will find it hard to pay for their health care bills. Health insurance works by shielding the assets from high medical care costs. 

You can select from a range of health insurance options with different coverage rates to match your needs and budget.

Health insurance works in the same way your car or home insurance works. You or your employer pick a package and decide to pay some amount, or fee, each month. In return, your health care insurer plan promises to pay some percentage of the medical expenses that you cover.

Depending on your age and salary, the insurance provider will decide the amount you'll pay for your Health Insurance policy. It will assess your health through a comprehensive test. This will set an annual fee, and the guaranteed amount will be accepted, depending on these factors. Any claims made beyond the amount assured shall be remedied on the basis of certain circumstances, Examples include deductibles and co-payments.

Once you have invested in health insurance to secure your savings, it is vital to understand the claim process in both cashless hospitalization and reimbursement cases to get the hassle-free settlement. Some steps of the health insurance claim process:

Cashless hospitalization Claim Process

Contact the help desk at the hospital.

Show the ID card of the insured, for identification.

The hospital will verify the identity of the insured and will submit the pre-authorization form to the health insurance provider of the insured.

The insurance provider will review submitted forms and process the claim as per the terms and conditions of the health insurance policy.

When all formalities are done, the claim is settled as per the terms and conditions.

Submit the Police Report or FIR if a personal accident is covered under the plan

Post-mortem report

Death certificate 

Submit the medical documents issued by the hospital

Immediately intimate via writing or call along with the particulars required

Duly submit our claim form 

Submit Police Report or FIR if a personal accident is covered under the plan 

Submit the medical certificate issued by the hospital

Show the health insurance card provided by us to get cashless benefit at our network hospitals 

Submit the form of discharge

Submit the report issued by a medical examiner

Provide the medical documents issued by the hospital/doctor

Post-mortem report

Death certificate

Submit the medical documents issued by the hospital/doctor

Keeps you financially protected: The biggest benefit of purchasing health insurance is that it prevents erosion of your long-term savings. You might be saving and investing for goals such as buying a property or child's education, but you or someone in your family suffering from a medical emergency can require you to liquidate your assets.

Transportation Charges: Health Insurance also covers the charges which are paid to ambulance towards the transportation of insured.

Free health checkup: one more benefits of health insurance is it offer free health checkup to the insurer periodically.

Pre and post hospitalization cost coverage: health Insurance also covers pre- and post-hospitalization costs up to 60 days, depending on paid insurance plans.

Hospitalization: One of the biggest benefits of health insurance is cashless claims. Most top insurers nowadays have an extensive list of network hospitals all over the country. In case if you are suffering from a health problem and get admitted to one of the network hospitals, you’ll mostly be able to take advantage of cashless hospitalization.

Health Insurance