Parameters of the Health Insurance System

 1) Renewal Age Size: 

The maximum renewal age is the age at which a person can be offered insurance cover. This parameter is very important in determining because the need for health insurance becomes more acute as the years go by, so you should look for a plan that offers time to renew the longest policy.

2) Bottom limits: 

Sub-limits are the limits set on the various parts of the cost involved in coverage. It sets a maximum limit for which insurers will cover certain costs incurred during treatment. Eg. some insurance companies place a high limit on the rent of a room to be reimbursed. So in such cases if the costs incurred by you exceed the insurance limit, there is a residual amount that you need to pay. There will be other limitations such as consulting a doctor,

3) High cover price: 

This is the maximum amount a person is entitled to cover. Each insurance company has its own policy of a guaranteed amount offered. The choice of cover depends on our needs and premium payment capacity. The amount is guaranteed from 2 lakhs to 50 lakhs depending on the insurance.

4) Pre- and post-hospital expenses:

 This means the cost of medical examinations, medications, scans etc. It occurs within the allotted time before and after hospitalization. Depending on the insurance coverage can be up to 30 days before hospitalization and 180 days after hospitalization.

5) Existing Diseases: 

Some insurance companies cover existing diseases after a certain waiting period for further renewal. Eg. the diabetic policymaker will be considered for his or her age and the plan will be selected after a wait period of 3 or 4 years. We should choose an insurance plan with a shorter waiting period.

6) Treatment options for day care:

 There are certain diseases or medications covered even though they do not require hospitalization for 24 hours which is a mandatory clause. This may be due to technological changes that have led to a shorter treatment period. Eg Cataract Surgery.

7) Ambulance Fees:

 In the event that the policyholder needs hospitalization, insurance companies reimburse the cost of ambulance travel. Each company has a fixed amount allocated for ambulance costs.

8) Medical Examination: 

Companies have a list of pre-defined medical tests that a person must perform if a person is over the age of 45 or a proven amount of interrogation exceeds a certain number. The need for testing varies. And these tests are fully paid for by the insurer.

9) No claim bonus: 

If the policyholder does not want to last year it is entitled to receive an 'unwanted bonus' with a premium reduction or a guaranteed increase in the amount of the current premium.

10) Tax Benefit: 

The amount paid as a premium is entitled to a tax deduction under section 80 (C).

11) Non-allopathic therapies: 

Some insurance companies offer medical coverage under ayurved, alternative and homeopathy.

12) Cosmetic and other surgery:

 In most cases insurance does not cover cover surgery, dentures or any weight loss treatment or surgery.

13) Network Hospitals: 

These are hospitals affiliated with insurance companies to provide free medical care. On the basis of the health card issued to TPA (Third Party Manager) you have the right to receive free medical treatment.

14) Home Treatment:

 In most cases the patient needs home treatment and cannot be referred to a hospital. In such cases, many insurance companies offer reimbursement for medical expenses incurred.

15) Joint payment:

 This means that there is a division of costs paid between the policyholder and the insurance company. If a company describes a co-pay option as 10% for all applications you will need to pay 10% of the cost and the insurance will pay 90%.

16) Loading of Claims: 

Each premium following the year in which the claim is made is loaded with other charges. These fees depend on the percentage of cover covered. Premium uploads can be very high in some cases so you should always look for additional premium costs defined by companies.

17) Exclusions: 

There are certain diseases that insurers do not consider at all. Such discharge is a permanent discharge such as AIDS, mental disorders, substance abuse etc.