Health insurance or health insurance, also called medical insurance or simply mediclaim, covers the cost of a person’s treatment and surgery expenses. The individual pays a fixed amount (premium) every year for the health cover.
It is not easy for most of the people to get health insurance, because according to their income, they find it very expensive and hence they choose to live without health insurance. When you compare this monthly cost with the out-of-pocket cost at the time of illness, you must be wondering whether you really need health insurance or not.
Many people in their 20th decade of life feel that they do not need health insurance as we are completely healthy. When you are healthy and rarely go to the doctor, it may seem like a good idea to ignore health insurance altogether and justify living without it.
Instead of worrying about the insurance premium and co-payment, you pay directly for the service. However, this is a flawed argument. Everyone should always have some form of health insurance with them. The reason is that medical services are very expensive. If you face an emergency situation without insurance, you are left with no option but to put yourself under debt.
This article explains in detail what is health insurance, types, benefits and why health insurance is necessary for you. Along with this, it has also been told that how to get a better health policy, what to keep in mind while taking health insurance and if you do not want to take private health insurance then which government health insurance can benefit from.
What is Health Insurance?
A health insurance or health insurance policy is a contract or contract between an insurance company and the policy holder with the intention of protecting against costly and unforeseen health costs. Although policy holders pay monthly premiums, co-payments, co-insurance (co-insurance) and deductibles (the portion to be paid by the policy holder), it is expected that this total The total out-of-pocket payment is much higher than the cost
Health insurance can be availed through a government agency or private business. To determine the total cost of insurance, an insurance provider estimates a population’s collective medical expenses, then divides that risk among a group of policyholder customers.
In concept, insurance providers assume that an individual has a large There may be unforeseen expenses, while others do not incur any expenditure. Cool cost then. Is distributed among a group of individuals to make health insurance more affordable for the benefit of all and to grow the business
Clinic, hospital, doctor, laboratory, healthcare, treating one person in health insurance policy terminology A practitioner or pharmacy is called a “provider”. An “insured” is a person who has taken out a health insurance policy or health insurance coverage
Depending on the type of health insurance coverage, either the insured pays out-of-pocket expenses at the time of treatment and is then reimbursed by the insurance provider. or the insurance provider pays the treatment expenses of the insured directly to the service provider.
Health Insurance types
There are many types of health insurance plans. The health insurance sector is witnessing a revolutionary change in the range of insurance plans offered to the customers by private insurance providers. These plans are being designed keeping in mind the genuine and diverse requirement of the customers. So don’t be surprised if you see a care plan for diabetes or a plan specially designed for heart disease patients in the market.
There are mainly two types of health insurance
Private health insurance
There are two types of health insurance policies offered by private companies, first, hospital policies that cover your hospitalization expenses. Whereas second, general treatment policies (sometimes also known as ancillary or extras) cover some of your supportive treatments, for example dental health, physiotherapy, etc. Most providers offer a combination of the two policies that provide a cover for both hospital and general treatment services, or you can buy separate policies. myUpchar Bima Plus is also a private health insurance, under which you can cover yourself and your family.
Public or government health insurance
In this type of insurance, the central government or the state government pays a part of your insurance premium on its own or subsidizes it to the insurance provider so that you get insurance cover at a much cheaper rate. There are many such schemes being run by the government which have been described in the last part of this article.
Why take health insurance
Getting health insurance is very important for many reasons. Uninsured people get less medical care and less timely, lack of insurance becomes a financial burden for them and their families as their health deteriorates
In addition, the benefits of expanding coverage are additional exceeds the cost of the services. Hospitals Free treatment or care improves access to service but does not completely replace health insurance, as many of the costs you have to pay out-of-pocket
Health insurance, designed to ensure that if you require medical treatment in the future, you will not need to worry about waiting lists from government hospitals or paying for the cost of treatment
If you are treated privately, health insurance covers your Will pay all bills. This helps you get your diagnosis and treatment done as quickly as possible, as well as help you get admitted to a private hospital as soon as you need it
With health insurance, you have a list provided by the insurance company. There will be an option to choose from Private Hospital. Most of the hospitals offer a private en-suite room, TV and choice of food under this, which you as a normal patient might not take.
Health insurance benefits
No one wants to get sick or get hurt, but no one knows who may need medical care at what time. Health insurance covers these costs and provides many other significant benefits
One of the benefits of taking private health insurance is that all health insurance plans cover the same set of essential health benefits, even ex – Existing health condition can also be covered. In addition to coverage for visits to the doctor, lab tests, hospitalization, surgery and emergency care, some of the following benefits may also be available:
• Private health insurance is an important and cost-effective way of providing protection against unforeseen health issues and providing the health care service of your choice, the doctor of choice. Personal health insurance gives you more importance
• Even if you do not have a family or personal history of a serious illness, you cannot be sure that you will not need medical services or specialists in the future
• People who have There is private health insurance, they have peace of mind, because they know they have covers available to get the best available medical treatments if the need arises
• Along with the above many benefits of private health insurance, it also gives us While government hospitals avoid long waiting lists for treatment, private hospitals cover everything from your treatment room to your doctor’s or surgeon’s fees.
How to get a good health insurance
If you are buying cover for the first time or upgrading your plan, you may have to wait for a certain waiting period before claiming benefits. During the waiting period, you may receive no benefits for some treatments or you may receive less benefits for that time
There are many things you should consider while opting for health insurance. Following are some recommended steps to follow during the selection process –
• Review the important terms of health insurance. Understanding the health insurance language helps in understanding the benefits each plan actually offers
• Make a list of the family needs of health insurance that your family will need in the future. For example, prevention or major medical coverage, dental, eye and medicine coverage, etc. Once the list is complete, this check list is used to review and compare health insurance providers, plan options, and coverage
• Also find out if your parent’s employer offers an insurance policy ? If so, when is the nomination due and what are the options? Are the parents associated with any club, special interest group or organization that provides health insurance? Are they eligible and approved for any government insurance scheme? Do they want to get service from a private provider?
• Collect information about available health insurance providers. Determine which type of coverage best suits the needs of the family.
• Request your agent or consultant to suggest you one or two attractive policy options
• Compare the policy provisions on your checklist of family health insurance needs
• Also decide whether the cost of insurance is enough for your family’s financial needs. Whether the means are available or not
• After this you can apply for the plan of your choice.
Government Health Insurance scheme
Here are some cost effective government sponsored health care schemes that you can avail, if you belong to a certain income group.
• Rashtriya Swasthya Bima Yojana (RSBY)
RSBY (Rashtriya Swasthya Bima Yojana) has been launched by the Ministry of Labor and Employment, Government of India to provide health insurance coverage for families living below the poverty line (BPL)
• Employment State Insurance Scheme (ESIS)
The scheme is applicable to non-seasonal factories operating with 10 or more employees and in some states other than private educational and medical institutions, certain establishments (shops, hotels, restaurants, cinemas, newspapers, etc.) also applies to those who employ 20 or more people.
• Central Government Health Scheme (CGHS)
This scheme is for Central Government employees, pensioners and their dependents, who live in the cities covered by CGHS. Any employee can get a CGHS card issued from the office of the Additional Director of the city
• Aam Aadmi Bima Yojana (AABY)
Aam Aadmi Bima Yojana, a social security scheme for rural landless families which was launched on October 2, 2007 Went . The head of the family or an earning member in the family of such household is covered under this scheme.
• Universal Health Insurance Scheme (UHIS)
Four public sector general insurance companies are implementing Universal Health Insurance Scheme to improve the quality of health care available to poor families.