Understanding Medical Insurance

Medical insurance is an essential aspect of one’s life. In today’s world, the cost of healthcare has skyrocketed, and without proper insurance coverage, it can become difficult to manage these expenses. While some individuals get medical insurance through their employers, others opt to buy it on their own.

What is Medical Insurance?

Medical insurance is a type of insurance coverage that pays your medical bills and expenses when you get ill or injured. This type of insurance provides financial assistance to cover the costs of medical care, such as hospitalization expenses, prescription drugs, surgeries, and doctor’s visits. The medical insurance plan you choose and its coverage options determine the extent of financial protection you receive.

Types of Medical Insurance

There are various types of medical insurance plans, each with different coverage options. The most common types include:

How Does Medical Insurance Work?

When an individual purchases a medical insurance policy, he/she pays a certain amount of premium for the policy. The premium cost varies based on the coverage options and the type of insurance plan. Once purchased, when the individual falls sick or gets injured, he/she can visit a hospital, clinic, or medical practitioner who accepts his/her insurance plan.

The medical care provider sends a bill to the insurance company, which then validates the bill and approves payment. The payment is sent to the health care provider directly, and the remaining balance (if any) is paid by the individual.

What Does Medical Insurance Cover?

The coverage options vary depending on the type of medical insurance plan you have. However, most health insurance plans cover the following:

Hospitalization Expenses

This includes room rent, board and lodging expenses, nursing expenses, and ICU expenses during your hospital stay. Some insurance policies may also cover the cost of the operation theater, surgical appliances, and medicines.

Critical Illness Cover

Some medical insurance policies provide coverage for critical illnesses such as cancer, kidney failure, heart disease, etc. In case the individual diagnosed with any of the critical illnesses, he/she will receive a lump sum payment to cover the treatment expenses.

Day Care Procedures

Medical insurance policies also cover day care procedures, which are medical procedures that do not require hospitalization. This includes procedures such as chemotherapy, dialysis, etc.

Pre and Post Hospitalization Expenses

Medical insurance policies also cover the pre and post-hospitalization expenses. The pre-hospitalization expenses include medical bills incurred before hospitalization, such as diagnostic tests, doctor’s fees, etc. The post-hospitalization expenses include medical bills incurred after hospitalization, such as follow-up diagnosis, tests, etc.

FAQ

1. What is the premium for medical insurance?

The premium for medical insurance varies based on the coverage options and the type of insurance plan. Individual medical insurance plans are generally more expensive than group medical insurance plans. The premium cost also depends on factors such as age, medical history, etc.

2. Can I change my medical insurance policy at any time?

Yes, you can change your medical insurance policy at any time. However, it is advisable to do so during the policy renewal period to avoid any penalties and loss of benefits.

3. Can I use my medical insurance policy when traveling outside my country?

It depends on the insurance plan you have. Some insurance policies provide international coverage, while others do not. It is essential to check your insurance policy to understand the coverage limitations.

4. Can I claim medical insurance for treatment received before purchasing the policy?

No, you cannot claim medical insurance for treatment incurred before purchasing the policy. Medical insurance coverage only applies to medical bills incurred after purchasing the policy.

5. Can I choose my healthcare provider?

It depends on the medical insurance plan you have. Some insurance policies allow you to choose your healthcare provider, while others have a network of healthcare providers that you must choose from. It is essential to read the insurance policy terms and conditions to understand the healthcare provider options.