Page 49 - The Insurance Times September 2024

PRESS RELEASE

How Health Insurance Works: Key

Terms and Concepts

L et's suppose you wake up one morning feeling a healthcare coverage. Here are 11 concepts and terms

related to best health insurance policy that you should be
little under the weather. You decide to see a
doctor and go to your neighbourhood clinic. The
aware of:
doctor examines you, prescribes necessary
medicine, and suggests specific tests. You leave the clinic 1. Premium: The amount customer pays annually to the
insurance company to avail the benefits of your health
feeling relieved knowing that your health is well taken care coverage. This premium can be converted into easy
of. However, have you ever questioned how you pay for such monthly instalments as well.
premium healthcare?
2. Deductible: The amount customer agrees to pay out
of his pocket in case of a claim. Customers opt for
That's where health insurance comes in, like a guardian deductibles to reduce the premium they need to pay
angel overseeing your well-being. Having said that, upfront to get coverage
understanding the key terms and concepts in the large and
convoluted world of healthcare is critical for navigating the 3. Copayment: Insurance companies offer a co-payment
facility to make it more affordable for customers to buy
maze of plans and coverage.
health insurance. Co-pay is an arrangement whereby
This blog will examine all you need to know about healthcare customers agrees to pay a percentage of medical
insurance. So, let's get started! expenses out of pocket while the remaining is paid by
the insurer.
What is Health Insurance? 4. In-network: In-network providers are healthcare
experts and facilities with which your insurance
Health insurance acts as a safety net, saving you from
unforeseeable medical care fees. It is a contract between company has a contract. Customers can avail cashless
you and an insurance provider that helps pay the price of claim services in these hospitals
healthcare benefits such as doctor visits, hospital stays, 5. Out-of-network: Healthcare practitioners and skills
prescription medications, and medical treatments. You get without an agreement with your insurance company are
access to a comprehensive range of healthcare benefits by considered out-of-network. If customer takes treatment
paying a regular premium, ensuring that you can afford the in such facilities, then he has to opt for reimbursement
treatment you require when you need it the most. claim.

6. Pre-Authorisation: Prior authorisation is another name
Top 11 Terms and Concepts Related to for preauthorisation, which refers to getting your
Healthcare Insurance insurance provider's approval before going for a
particular medical procedure or treatment. This is also
With its plethora of jargons and concepts, navigating the
called cashless approval.
world of healthcare insurance may be daunting. On the
other hand, understanding these fundamental features is 7. Pre-Existing Condition: An illness or disease you had
critical for making educated selections regarding your before buying a health plan.

44 September 2024 The Insurance Times