Guide to understanding the terminologies used in Health Insurance

The recent pandemic and unexpected health complications have brought about awareness. They have made people realise the importance of preparing for medical emergencies. As a result, there is an increased acceptance of Health Insurance. Despite being momentary, it is still a start. If you are one of them, get ready to face medical emergencies with preparedness. While the process of obtaining the policy is easy, you might get confused by the terminology.

Like other industries, the Insurance sector uses specific terms to describe its clauses. This is for convenience and easy understanding within the Insurance space. However, as an outsider, you might feel clueless. Although the jargons seem complicated, they are the means to understanding the Insurance terms. Hence, you must study them thoroughly before proceeding. Here is an explanation of some essential terminologies to help you with the same:


The essential Medicals Insurance Plans are helpful, but they are not ideal for all medical needs. Sometimes, you need extra protection. This is where add-ons come in handy. Most insurers offer additional services that are a great way to enhance your base Healthcare Plan. They include Wellness Programs, World-Wide Coverage, Reloading Sum Insured, etc. They are added benefits that come with an additional premium cost.


This is the process where you put the Insurance Policy to use. You file a payment request when there is a medical emergency. There is a streamlined procedure for this. The first step involves intimating the insurer and giving essential details. After this, the policy provider verifies your request and pay the medical bills.


When you opt for Health Insurance Plans, you have the choice to opt for a deductible. It is a cost-sharing arrangement that is either a fixed percentage or an amount of the claim amount. Under this, you pay the fixed portion of the amount along with the insurer during a medical emergency. The part you pay depends on the type: Voluntary or Compulsory. In the former, you choose the amount, and the latter gets levied by the policy provider.

Inclusions and exclusions

Insurance policies come with a base coverage. This lets you know what the plan entails. But to give you a clear idea, insurers also provide explicit details about inclusions and exclusions. Under the former, you understand the policy features. These typically include in-patient hospitalisation, pre-hospitalisation, day-care treatment, preventive care, and other expenses.

In contrast, exclusions are limitations. These comprise the waiting period and treatments not covered under the policy. Make sure to check them thoroughly to make an informed decision while buying the Health Insurance Policy.

Grace period

You must renew the Healthcare Insurance every year to maintain its continuity. Failing to do so results in lapsed Plan. But sometimes, you might forget the due date. In such instances, you get a specified period of 15 days immediately after the expiry for premium payment. You must renew the policy within this duration to continue enjoying its benefits. It is a second chance at saving the existing Health Insurance Plans India.

Networked hospitals

Medical emergencies bring with them a stressful ordeal. In this time, settling bills and then filing claims becomes challenging. To reduce this hassle, Insurance companies provide a convenient service. It is called networked hospitals. Under this, the hospital bills get settled directly. Hence, you need not pay them upfront. Policy providers have tie-ups with various hospitals for this purpose. Ensure to check this on their website for availing of the service.