It is rightly said that health is wealth, so a health insurance policy came up because Insuring your health or that of your family, comes with never-ending benefits that last for a lifetime. Investing in proper health insurance comes with lots of benefits until you grow old. Even with all these health insurance benefits; people still have a hard time deciding if they want health insurance and if it is a worthy investment.
If you also find yourself stuck in this dilemma, read on to find out why you should get a health insurance policy right away…
Benefits of Having a Health Insurance
The importance of health insurance policy can not be over emphases because the increasing prevalence of lifestyle diseases such as diabetes, hypertension, stroke and heart attack among the young as well as the elderly people in the world today, is becoming a major cause of concern.
Having no family history of these conditions does not in any way ensure protection from any of the related complications. In today’s fast-paced life, you must be prepared for a medical contingency at all times. This is where a robust health insurance policy can help. One of the major health insurance benefits, in the face of a medical emergency, is that it allows you to take your mind off the stress related to healthcare costs and focus on the treatment immediately.
However, if you or any of your family members are diagnosed with a chronic illness, be assured that a health policy will let you be relaxed about healthcare costs and allow you to concentrate on the treatment process instead.
Also, the insurers facilitate free annual health check-ups for all policyholders so that you are aware of their health condition and can identify a problem at the early stages itself. These are just a few of the many benefits of health insurance policies. Let us look at some more benefits of having an insurance policy.
What is defined as health insurance?
It is a contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium.
What are The Different Types of Health Insurance?
The following are the different types of health insurance Plans. The functions can be further, categorised into two, that is private or public (government)
Health Maintenance Organizations (HMOs)
Exclusive Provider Organizations (EPOs)
Point-Of-Service Plans (POS)
Preferred Provider Organizations (PPOs)
- Health Maintenance Organizations (HMOs):
Generally, HMOs give a local network of participating doctors, hospitals, and other healthcare professionals and facilities that you may be required to choose from. These types of health insurance plans also require you to choose a Primary Care Provider (PCP) from the network. Your PCP is your home base for medical care. They get to know you and help coordinate all your care. They will also need to provide you with a referral. Here, the costs for an HMO plan copays and coinsurance are typically lower than other types of health plans, as long as you stay in-network.
- Exclusive Provider Organizations (EPOs):
The EPOs offer you a network of participating providers to choose from. Most EPO plans do not include coverage for out-of-network care except in the case of an emergency. This means that if you visit a provider or facility outside the plan’s local network, you will likely have to pay the full cost of services yourself.
On this plan, you may or may not be required to choose a Primary Care Provider (PCP). If you want to see a specialist in your network, you do not need a referral from a PCP.
- Point-of-Service (POS):
POS plans combine features of both HMO and PPO plans. Here, the provider network is typically smaller than a PPO plan and the costs for in-network care are typically lower, like an HMO. POS plans also require one to choose a Primary Care Provider (PCP) from within the plan’s network of doctors and other primary care professionals. Your PCP is your home base for care and advice. They get to know you and your health needs and can help coordinate all your care.
However, if you need to see a specialist, you are required to get a referral. However, like a PPO, you can also choose to see specialists that are in-network or out-of-network. If you see a doctor outside the plan’s network, your share of the costs will be higher and you will be responsible for filing any claims yourself.
- Preferred Provider Organizations (PPOs):
PPOs typically offer you a large network of participating providers so you have a lot of doctors, hospitals, and other healthcare professionals and facilities to choose from. You may also choose to see providers from outside of the plan’s network, but you will pay more out-of-pocket.
5 Health Insurance Benefits
There is the saying Change is constant, as such lifestyle Changing habits, like increases in pollution levels, fire outbreaks, war, climate change, pandemics and many other factors have a severe impact on an individual’s health. This may cause various health conditions and medical diseases.
Medical costs associated with the treatment of such diseases are increasing rapidly. In order to safeguard your finances against high medical bills, it is necessary to invest in health insurance plans. Such plans will cover all hospitalization expenses and more, as well as pre-hospitalization and post-hospitalization bills.
The Following are five (5) major Benefits of purchasing a health insurance policy:
- Coverage for Medical Expenses:
obviously, one cannot predict when chronic and emerging medical problems may occur to him/her or the loved ones. If you have a family floater or individual health policies, your insurer would take care of the medical bills while you can concentrate on the treatment process proper.
The benefits of having health insurance are that it gives room to option for cashless or reimbursement expenses with cashless treatment facilities, you do not have to pay anything from your pocket if you opt for sufficient cover. Take the patient to any of the network hospitals with which your insurer has a tie-up, and inform the TPA (third-party administration) and the insurer as the earliest.
The insurer would settle the bill with the hospital directly. Alternatively, you can get treated at any hospital or by any healthcare provider of your choice and file for a reimbursement claim by submitting original invoices and required documents to the insurer. Some Insurers also provide ambulance services up to a certain amount, coverage for online or e-consultations, expenses for harvesting a major organ from a donor, lifetime renewability options, free preventive health check-ups and more. That is another benefit of health insurance policy apart from hospitalisation cost.
- Alternative treatment: Some insurers also take up the costs for alternative treatments such as (Naturopathy and Homeopathy). Other benefit facilities include cashless facilities for daycare treatments, treatment at home under a doctor’s advice, and pre and post-hospitalisation expenses up to a certain period.
- Maternity benefits and alternative treatments: Several insurers cover maternity expenses in their health insurance policy plans. This is particularly beneficial for young couples who are planning or expecting a child.
2. Cashless Claim Service:
With cashless claim services, you can get treated at any of the best hospitals across the country without paying anything out of your pocket. You just have to get admitted at any one of the network hospitals with which your insurer has a tie-up. Once you inform the TPA (third-party administrator) and the insurer about getting admitted immediately, they will communicate with the hospital staff and settle the bill directly. To get a cashless claim, your treatment cost should be within the coverage amount.
3. Portability Benefits:
Portability of health insurance means you can change your insurance policy from one insurance company to another, or one plans to another without losing the benefits that you have accumulated. Your new insurer should be able to give you the credit relating to the waiting period for pre-existing conditions that you received from your previous insurer. Your new insurer has to insure you for at least up to the sum insured under the old policy. A required condition is that you must port the policy only during the renewal so that the new insurance period will be with a new insurer.
4. Hospitalisation Daily Allowance:
Some health insurance companies provide daily hospital cash benefits or daily allowance provisions every day in case of hospitalisation and you can use them as per your requirement or for compensating the loss of income during the period of emergency hospitalisation. Some of these types of expenses are called inadmissible expenses such as surgical accessories, X-Ray charges, and expenses.
5. Financial Security against Rising Medical Costs:
Staying healthy is extremely important but several factors such as physical inactivity, extreme workload, unhealthy personal habits, and poor diet can have an adverse effect on the health of most people. The outcome could be multiple health challenges and excessive costs of medical treatment.
A health insurance policy can be a solution to dealing with rising medical costs. It provides financial security by covering the costs related to treatment, hospitalisation, free health check-up, and pre and post-hospitalisation expenses. Also, you can get tax relief on the premium ones.
How You Can Get Less Premium Health Insurance Cover:
With rising prices of necessities, it would become difficult for you to spend a lot of money on policy premiums. The following tips would help you stay covered at a quality premium with lesser cost to reduce your expenses on health insurance:
- Purchase health insurance when young:
It will be good if you purchase health insurance when you are young as your premium will be much lower compared to what you have to pay when you are older.
- Invest in Good health Insurance at a low cost:
Initially, keep your premiums low and gradually increase them over the years. This way, you can have a much more affordable policy.
- Co-pay and deductibles:
Option for a co-pay and voluntary deductibles so that your premium goes down. Co-pay and voluntary deductibles give you the option to pay for part of the expenses when you make a claim.
- Go for different options:
If you have an existing group health coverage from your employer, choose the additional policies carefully so that you do not spend a lot unnecessarily on premiums.
- Buy long-term health policies:
The premium for long-term insurance policies is usually lower than the traditional plans with one-year terms. You can buy long-term health insurance plans with 2-3 years tenure as they would lower your premium payment by a substantial amount.
- Top-up plans:
Top-up plans are good for availing of higher coverage without paying a huge amount of premium. Top-up plans help to split your cover and raise higher claims.
- Family floaters:
In some cases, you will find family floater plans to be cheaper than the total premium that you have to pay for different individual plans. So, you can reduce your premium by purchasing a family floater policy.
- Compare plans:
Compare and purchase policies online to get attractive offers and discounts on your insurance policy. This way, you can reduce the premium paid towards your health policy to some extent. You will also be able to maximise your benefits.
- Purchase health insurance policies for your parents before they turn 60+ years:
The premium of most health insurance policies increases as the age of the insured person crosses 60 years. So, it would be best if you cover your parents before they become senior citizens.
Note: Consider the following factors while selecting the best health insurance coverage for you and your family:
- Maximum coverage:
Look out for a health insurance policy that provides maximum coverage, daycare and domiciliary treatments. Certain treatments such as cataract surgery require hospitalisation for less than 24 hours. Again, for bone fractures, treatments can be done from home instead of in a hospital.
Certain policies may have attractive features related to healthcare, provide extensive coverage and but with a limit on the enrolment age. Before enrolling in any health insurance policy, first, Check the eligibility criteria for various health insurance plans and select policies with maximum renewal age and lifetime coverage.
- Waiting period:
It is a minimum period between the issuance of the policy and the availing of the benefits. You may find policies without a waiting period. Others have a waiting period ranging from 30 days to six months or one year or more. Select policies with short waiting periods.
A health insurance policy, no matter how extensive, would have a limit up to which it can cover. Hence, it is important that, before purchasing a policy, go through the exclusions carefully to avoid confusion in future. Buy policies with the minimum number of exclusions.
It is very important that you do not go for policies based on low premiums only. Generally, low-priced policies have limited coverage or other limitations. Choose a policy with maximum coverage at an affordable premium.
On all notes when it comes to private health insurance, there is no one-size-fits-all solution. The best way to decide which company’s health insurance policy may be the right fit for you and your budget is by considering their hospital fees, type of plans available, customer reviews, and your budget.
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