How does Health Insurance work in Hospitals?

Every one of us would agree to the fact that health is wealth. It is indeed a challenge, if not entirely impossible, to lead a normal and healthy lifestyle under today’s stressful conditions.

Frequent variations in health due to various factors can lead to anxious moments. This is where a proper Insurance cover can go a long way in reducing those anxious moments, especially if hospitalization is required. 

What exactly do we mean by Health Insurance and what are the various options available in hospitals when it comes to health insurance plans in Bangalore? Let’s take a closer look.

 

What is Health Insurance?

Health insurance is a policy document that covers a certain percentage of medical expenses, especially involving hospitalization. These can include short or long-term hospitalizations that may require surgery, serious illness, disability, or death due to an accident or near-fatal injuries. 

 

How does it work?

Health insurance coverage in hospitals is usually based on the illness type and the type of insurance plan you have opted for. 

 

A plan can be categorized under:

  • Individual Plans: 

  • This type of a health insurance plan is created keeping an individual in mind.

  • It offers a blanket cover against all medical expenses, meeting the ACA or Affordable Care Act for essential care.

  • Family/Extended Family: 

  • Aimed towards generating a health security cover for a joint family/extended family

  • It covers the individual sum insured for each member of the family along with the floating sum insured which can be claimed by any member of the family, in need.

  • Fixed Benefit: 

  • This benefit offers a range of health insurance schemes accommodated in one program as it covers critical illness and personal accident cover 

Key Components of Health Insurance Plans

       The key components include:

  • Premium

Payment made to the insurance provider to maintain your health coverage plan.

  • Deductibles

This is an amount you pay to the hospital out of your pocket before insurance comes into the picture.

  • Coverage limit

The maximum amount that the policyholder is eligible to be covered.

        Health Insurance plans vary based on the category of hospital you have approached for treatment. This can be either a network hospital or a non-network hospital. In a network hospital, the policyholder can get admitted to any hospital that is listed under a particular insurance provider company. The insurance company pays the hospital directly. In the case of a non-network hospital as the policyholder has to settle the amount to the hospital personally before discharge and then claim it from the insurance company.

         How to claim?

         Processes followed for Health insurance claims in hospitals include the following:

  • The insurance provider is informed by the respective hospital regarding the details of the treatment including duration and cost.

  • After the treatment, either the hospital or the policyholder submits the claim to the insurance provider.

  • The claim is assessed and the insurance provider will either reimburse the amount to the policyholder or pay the hospital directly before the patient gets discharged. 

          Health insurance is important for safeguarding financial well-being during availing treatment for a serious health crisis. United Hospital has an exclusive insurance desk with experienced professionals to guide you through each and every step so that you go through your claims process without any hassle.

Posted on : 16/10/2024      Views : 79

How does Health Insurance work in Hospitals?

Every one of us would agree to the fact that health is wealth. It is indeed a challenge, if not entirely impossible, to lead a normal and healthy lifestyle under today’s stressful conditions.

Frequent variations in health due to various factors can lead to anxious moments. This is where a proper Insurance cover can go a long way in reducing those anxious moments, especially if hospitalization is required. 

What exactly do we mean by Health Insurance and what are the various options available in hospitals when it comes to health insurance plans in Bangalore? Let’s take a closer look.

 

What is Health Insurance?

Health insurance is a policy document that covers a certain percentage of medical expenses, especially involving hospitalization. These can include short or long-term hospitalizations that may require surgery, serious illness, disability, or death due to an accident or near-fatal injuries. 

 

How does it work?

Health insurance coverage in hospitals is usually based on the illness type and the type of insurance plan you have opted for. 

 

A plan can be categorized under:

  • Individual Plans: 

  • This type of a health insurance plan is created keeping an individual in mind.

  • It offers a blanket cover against all medical expenses, meeting the ACA or Affordable Care Act for essential care.

  • Family/Extended Family: 

  • Aimed towards generating a health security cover for a joint family/extended family

  • It covers the individual sum insured for each member of the family along with the floating sum insured which can be claimed by any member of the family, in need.

  • Fixed Benefit: 

  • This benefit offers a range of health insurance schemes accommodated in one program as it covers critical illness and personal accident cover 

Key Components of Health Insurance Plans

       The key components include:

  • Premium

Payment made to the insurance provider to maintain your health coverage plan.

  • Deductibles

This is an amount you pay to the hospital out of your pocket before insurance comes into the picture.

  • Coverage limit

The maximum amount that the policyholder is eligible to be covered.

        Health Insurance plans vary based on the category of hospital you have approached for treatment. This can be either a network hospital or a non-network hospital. In a network hospital, the policyholder can get admitted to any hospital that is listed under a particular insurance provider company. The insurance company pays the hospital directly. In the case of a non-network hospital as the policyholder has to settle the amount to the hospital personally before discharge and then claim it from the insurance company.

         How to claim?

         Processes followed for Health insurance claims in hospitals include the following:

  • The insurance provider is informed by the respective hospital regarding the details of the treatment including duration and cost.

  • After the treatment, either the hospital or the policyholder submits the claim to the insurance provider.

  • The claim is assessed and the insurance provider will either reimburse the amount to the policyholder or pay the hospital directly before the patient gets discharged. 

          Health insurance is important for safeguarding financial well-being during availing treatment for a serious health crisis. United Hospital has an exclusive insurance desk with experienced professionals to guide you through each and every step so that you go through your claims process without any hassle.



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