Health insurance is a necessary survival tool in day and and society. A good insurance policy allows an individual to pay fixed sums of money and pays all the cost incurred if the individual damages or loses something.
Features of Health Insurance
A health insurance policy enables a person to take cashless treatments at various hospitals and covers pre and post-hospitalization up to 60 days. Various other plans can also augment the basic health insurance plan. They include Critical Illness coverage and Personal Accident Coverage. The prices of these additional plans are infinitesimal. We can consider the example of personal accident cover, which provides cover for all sorts of disabilities. Additional waiting periods, as well as check-ups, are not needed. The pandemic that has gripped the entire world, COVID, is also covered under most medical plans.
What Are the Advantages of Health Insurance?
A whole range of requirements can be met by choosing from a varied range of health insurance plans. E.g. Motor insurance policy covers all the damages done to a motor vehicle resulting in financial loss. Let us look at various benefits of health insurance plans:
- All the medical expenses incurred by a person that includes post and pre-hospitalization charges, are covered in the medical insurance.
- All pre-existing diseases are covered by medical insurance. This facility is only provided after a waiting period.
- All the claim reimbursement charges are also covered. These charges are incurred in case of sudden expenses during hospitalization.
- All these expenses are covered under tax laws and are subject to change.
- A tax rebate is allowed to individuals claiming health insurance policies under Section 80D of the IT Act 1961. The range of tax exemption varies from Rs. 25000 to Rs. 75000
- Another new feature has been added to the medical insurance known as OPD plans. In most non-OPD plans, a minimum hospitalization of 24 hours is required to claim any benefits. The Standalone OPD plans do not have any such requisite.
Types of Health Insurance
Before delving into further details about medical insurance and the costs involved, let us look into various classes of medical insurance offered by insurance providers.
- Preferred Provider Organizations (PPOs) – These kinds of arrangements provide a huge pool of doctors, health care professionals, hospitals, and other facilities. Professionals from outside the pool can also be chosen but only after making some extra payment. Specialists can be concerned using this plan without choosing Primary Care Providers.
- Exclusive Provider Organizations (EPOs) – This type of arrangement provides a huge range of doctors and specialists to choose from. Any specialist other than those in the network can also be consulted by incurring charges. No choice of PCP is needed in this plan.
- Health Maintenance Organizations (HMOs) – A whole network of doctors, hospitals, facilities, and health care professionals are provided in this arrangement. Within this framework, an individual is required to choose a PCP like the base unit, which will cater to all sorts of customer requirements. As long as the person is a part of the network, the cost of insurance for this arrangement is less than others.
- Point-of-Service Plans (POS) – POS combines all the benefits of PPO and HMO plans. That is, an individual can choose the PCP and also avail of low-cost benefits.
- Additionally, make it a point to bundle homeowners, auto and personal when available.
Why Are the Suitable Types Of Health Insurance For An Individual?
It is very important to understand one’s health needs to analyze and avail suitable health insurance.
- People who are not affected by any chronic diseases and ailments can choose a policy with higher deductibles and a lower amount of premium.
- People who need constant medical care should choose a higher deductible policy and a high amount of premium.
Important Points to Remember While Choosing The Right Medical Insurance
Some points must be kept in mind while choosing the best health insurance:
- Insurance Amount sum insured
- Amount of premium to be paid to avail the benefits of the plan
- Waiting periods and sub-limits
- Any clauses of co-payment
- List of hospitals that are covered and the ratio of claim settlements by the company
How Much Does Health Insurance Cost A Month: A Look At Important Factors
Individuals employed mostly get their insurance benefits from their employers who already secure them by providing them insurance plans and benefits. But for those people whose employers do not offer such benefits or who are unemployed, private health insurance schemes can be availed.
After choosing the best health insurance plan suitable for an individual, it is important to decide the deductible. The deductible is the amount an individual must pay before he/she can avail the health insurance plan starts paying. Some studies revealed that paying for an individual plan has become more economical than employer-sponsored plans. When a person avails of an individual health insurance plan, the average premium averages around 450 dollars per month. Similarly, family insurance cost averages out to be 1400 dollars per month. The plans are also divided into Silver, Gold and, Bronze; insurance amount and deductibles vary.
If these insurances are bought through the marketplace of health insurance, they can turn out to burn a smaller hole in an individual’s pocket. In this way, a person can benefit from the tax credits. This helps in reducing the amount paid, be it the deductible or the premium. In addition, there is the concept of out-of-the-pocket limit. This amount is the maximum amount that an individual has to pay for all the insurance services in a single financial year. The deductibles, co-payments, and coinsurance are a part of the maximum financial limits. The paramount limit for this is approximately 8000 dollars for individual insurance and approximately 16000 for group insurance.
Therefore, good health insurance is responsible for making sure that all the medical expenses and out of the pocket expenses are dealt with. This means that such expenses can be cut back up to the amount insured.