Health Insurance is a contract between an individual and an insurance company, or in some cases, a government agency. The insurance company agrees to cover some or all of the insured person’s healthcare costs. Meanwhile, the insured person pays a monthly premium. This contract is typically a one-year agreement. During this period, the insured person is responsible for paying specific expenses. These expenses can be related to illness, injury, pregnancy, or preventative care.
Health Insurance provides essential financial protection if you experience an accident or illness. For instance, it can help cover the costs of doctors’ services, medications, hospital care, and special equipment needed when someone is sick or injured. These benefits are typically provided in exchange for a monthly premium. Additionally, health insurance can help cover the cost of a stay at a rehabilitation hospital or even a portion of home health care. Moreover, it can help keep a consumer’s costs down even when they are not sick, for example, by helping pay for routine checkups. Most health insurance plans also cover many preventive services at no additional cost, such as immunizations and cancer screening and counseling.
There are different types of Health Insurance plans. Some common types include:
In the U.S., managed care insurance plans require policyholders to receive their care from a network of designated healthcare providers. If patients seek care outside this network, they must pay a higher percentage of the cost. In some cases, the insurer may even refuse payment outright for services obtained out of network. Most managed care plans, such as health maintenance organizations (HMOs) and point-of-service plans (POS), require patients to choose a primary care physician. This physician oversees the patient’s care, makes recommendations about treatment, and provides referrals for medical specialists.
An individual health insurance policy is issued under the name of a single policyholder. This means that the sum insured coverage and the benefits of the policy are dedicated solely to the insured individual and do not cover anyone else. In this case, the individual purchases the policy to manage their own health, which in turn provides financial assistance in case of a medical emergency.
Family floater health insurance is a single policy designed to provide coverage to an individual and their family members. This type of plan offers a combined sum insured that is shared among all covered family members. For instance, if a family floater plan has a coverage amount of INR 8 lakhs, the entire family can utilize this amount within the policy year. However, it’s important to note that if one family member exhausts a significant portion of the coverage, it reduces the available coverage for the remaining members.
