Financial decisions are easier to understand when the basic concepts are clear. This article is designed as an educational introduction and should be read together with current product, legal and regulatory information where applicable.
What Is Health Insurance?
Health insurance is a financial protection product that may cover eligible healthcare expenses according to the terms, conditions, limits and exclusions of a policy.
Depending on the policy, coverage may include hospitalisation and other specified medical expenses. Always read the policy wording rather than relying only on a summary or advertisement.
What Is Sum Insured?
The sum insured is the maximum amount of coverage available under a policy for covered claims, subject to the policy terms.
Choosing an appropriate level of coverage depends on factors such as location, family size, healthcare costs, age and the policy features available.
What Is a Health Insurance Premium?
A premium is the amount paid to keep the insurance policy active, subject to the insurer's terms.
Premiums can vary based on factors such as age, coverage, policy features, location, medical history and other underwriting considerations.
What Are Waiting Periods?
Some health insurance policies have waiting periods during which certain conditions or treatments may not be covered.
Waiting periods can differ by policy and condition, so check the policy documents carefully before purchasing.
What Is Cashless Hospitalisation?
Cashless treatment may allow an eligible policyholder to receive treatment at a network hospital without paying the entire eligible bill upfront, subject to insurer and hospital processes and policy terms.
Cashless does not mean every expense is automatically covered. Deductibles, exclusions, limits and non-covered expenses may still apply.
Important Terms to Understand
A deductible is an amount you may have to bear before the insurer pays eligible expenses, depending on the policy.
Co-payment means the policyholder bears a specified percentage of an eligible claim.
Room-rent limits, sub-limits, exclusions and waiting periods can affect the amount actually payable by the insurer.
Common Health Insurance Mistakes
Buying a policy based only on the lowest premium.
Not checking exclusions and waiting periods.
Ignoring the hospital network and claim process.
Not disclosing relevant information accurately when applying.
Assuming every medical expense will automatically be reimbursed.
Health Insurance: Key Takeaways
Understand what the policy covers and excludes.
Check the sum insured and applicable limits.
Review waiting periods and claim conditions.
Understand deductibles and co-payment.
Read the policy wording before making a decision.
Frequently Asked Questions
What is health insurance?
Health insurance is a policy that may cover eligible healthcare expenses according to its terms and conditions.
What is sum insured?
It is the maximum coverage amount available for covered claims, subject to policy terms.
What is a waiting period?
It is a specified period during which certain listed conditions or treatments may not be covered.
Does cashless mean everything is free?
No. Cashless processing does not remove exclusions, deductibles, co-payments, limits or other non-covered expenses.