What is Health Insurance – Features You Must Know


Health Insurance plans are a necessity for all. It helps you get compensation for the hefty medical bills. Read on to know about health insurance and its features.

Today, as medical treatment costs are increasing every day, a lot of people are finding it hard to get quality treatment. Most people rely on their savings to cover the treatment cost. But, you can keep your years of hard-earned savings safe and yet avail the best medical facilities if you have a health insurance policy in your financial portfolio.

A health insurance policy not only pays for the hospitalisation costs, but it also covers the pre-hospitalisation and post-hospitalisation expenses. Not to mention, it helps you get tax benefits; the premium paid for the health insurance policy is eligible for a tax deduction.

Although many people are aware of the importance of health insurance, not many people know the health cover features and have no clue how to purchase the best plan to suit their needs. So, to help you get the right cover, we list down the features of health insurance plans that you must look for:

Coverage for pre-existing diseases

As the name suggests, pre-existing conditions are those that you suffer from before you purchase a health insurance policy. Therefore the insurers do not cover them from the day of buying the policy. Most insurance companies have strict terms and conditions for covering pre-existing diseases. One such condition is the waiting period, which may vary from six months to four years based on the condition you suffer from.

The waiting period implies that the insurance is not liable to pay for the hospitalisation expenses to treat the pre-existing conditions. So, when you compare and buy a health insurance policy, you must pay close attention to the waiting period and choose the one that has the least number of waiting period.

Co-payment Clause

Every time you file a claim for hospitalisation expenses, it is a liability for the insurance. To reduce the liability, the insurers introduced a co-payment clause for all health insurance policy buyers. Under this clause, you agree to pay a certain percentage of the total claim amount from your pocket while the insurer pays the rest.

For example, if you purchase a health insurance plan with a co-payment clause of 20%, when you file a claim for say Rs. 1 lakhs, the insurance company will be liable to pay Rs. 80,000 while you must pay the remaining Rs. 20,000.

So, when you compare the health insurance plans, it is better to look for an insurer with no or the least co-payment clause.

 Network Hospitals

Today, all reputed insurance companies in India have tie-up with several hospitals around India called ‘network hospitals.’ If you get admitted to any of these articles, you can get a cashless claim facility. With the cashless claim, you need not pay a single Rupee from your pocket. After getting a discharge, you must fill the cashless claim form and submit necessary bills and receipts at the hospital. The insurer will directly settle the bill with the hospital.

When you compare health insurance plans, look for an insurer with a wide network of hospitals, especially in your locality, so that it is easier for you to get treatment during an emergency. Typically, the insurance companies mention the list of network hospitals in the policy document. You can even check the same on the insurer’s website.


When they buy a health insurance policy, most people feel relaxed knowing that they have covered their family against all hospitalisation expenses in the future. But, not many people realise that their policy has exclusions too, which means the insurer is not liable to compensate for certain medical conditions. So, before you finalise any health insurance plan, you must be aware of the exclusions and select the plan that has the least number of exclusions.

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