Thread by @MoneyWell_

Health Insurance 101

Having a health insurance does not change your life, instead it prevents your lifestyle from being changed ❗

Read this thread so that you can choose the best health insurance plan.

Here's everything you need to know about 'Health Insurance' 👇

1/ First, What is Health Insurance?

A health insurance policy extends coverage against medical expenses incurred owing to accidents, illness or injury. An individual can avail such a policy against monthly or annual premium payments, for a specified tenure.

2/ Why is it important?

With the constant increasing prices of healthcare in the world, and with the ever rising instances of diseases, health insurance today is a necessity.

The Average healthcare expense in US is about $11,000 / person. Such kind of expenses does hit you hard

3/ Buying a health insurance policy for yourself & your family is important because medical care is expensive, especially in the private sector. Hospitalisation can burn a hole in your pocket & derail your finances.

4/ Now that you've on board that health insurance is a must.

Let us know the benefits of having a health insurance : 👇

5/ ✅ Cashless Treatment - If you are insured, you can get cashless treatments as your insurance company would work in collaboration with various hospital networks.

✅ Pre and post hospitalization cost coverage : Insurance policy also covers pre & post hospitalization charges.

6/ ✅ Transportation Charges: Insurance policy also covers the amount paid to ambulance towards the transportation of insured.

✅ Room Rent: Insurance policy also covers room expenses depending on the premium being paid by the insured.

7/ ✅ Tax Benefit: Premium paid on Health insurance is tax deductible. Every country does provide tax benefit on premium paid for health insurance.

8/ But hey @MoneyWell_, how to select the right insurance policy, you ask?

You must know that It’s difficult to select the best insurance policies as all insurance company provides a similar type of insurance plan.

9/ What are the types of Health insurance?

1️⃣ Individual Health Insurance: This policy covers the health expenses and hospitalization expenses of individual who has taken the policy. Premium under this policy is determined as per the age of insured.

10/2️⃣ Floater Plan: Under this policy, an individual can include all the family members against multiple diseases under a single cover. Family health plan offers a fixed sum assured for the family members, which can be availed by all members of the family or by any one individual

Under Floater plan, you'll have to pay one premium amount for all the family members. The main benefit of this plan is that its premium will be low as you're insuring all the family members. But, if you have an elder with a disease in your family then the premium will get higher.

12/ 🔖 Hence, it's recommended that have an individual plan for the elder and floater plan for the rest family members.

This way you'll pay less premium.

13/ What should be an ideal cover?

An ideal cover depends on various factors : your lifestyle, in case you're doing some hazardous job, etc.

In my opinion,
An ideal cover for kids can range between $5k-6k (Approx INR 4 lakh)

And, $7k-8k (Approx INR 5 lakh) for healthy adults

14/ Things you must know -

1️⃣ Room rent - The biggest scam while taking a health insurance is 'Room rent policy'.
There are two kinds of policies -
1. With limit on room rent (Has Low Premium) Say : Upto INR 5000
2. No limit on room rent ( Has Higher Premium)

15/ Most people choose the limited room rent because premium is cheap.
Assume you've taken a health insurance with INR 5 lakh cover.
The room rent limit is calculated as a % of your insurance cover. It's usually 1%. So, Limit on room rent is INR 5000 (1% of 5 lakh)...Got it?

16/ Now, Say : you're admitted to a hospital due to an accident/Surgery. The room you've chosen is for INR 10,000. The insurance company won't give you 10,000. They'll only give 50% of it - INR 5000. That's not it. The room rent deduction is connected with other hospital charges.

17/ Incase of a Surgery for INR 250000, you'll only get INR 125000 (50%) from the insurance company. Most of the hospital expenses are linked to your room rent. If you get 50% claim on your room rent, then the same thing will happen for other things like PPE, Medicine, etc.

18/ Then what's the use of health insurance, when you'll have to pay the other 50% from your pocket. It's almost like you're getting penalised from the insurance company because your room rent was higher #Scam

Now, if you are thinking : why not take a policy that has high room rent limit (Say:INR 10,000). In that case, you'll have to take a policy with INR 10 Lakh cover (High premium), so that you'll get 10,000 limit.
✅ So, find a policy with No rent limit & No link with other expense

20/ 2️⃣ Sub limit - Now, you've purchased a policy with INR 5 lakh cover. But, there can be a limit on maximum amount of cover for a specific disease. Like : Maximum INR 2 lakh is allowed for health surgery & so on.
✅So, find a policy which has no such limit on diseases.

21/ 3️⃣ Co Pay - It means that some amount of hospital bill will be covered by the insurance company & rest will be payed by you. But, the real reason we take a health insurance is because we don't have to pay a single rupee, isn't it?
✅So, find a policy which doesn't have Co Pay

22/ 4️⃣ Top Up v/s Super-Top Up

This will be a bit confusing for many people as it's a lengthy subject.
Hence, to sum up in one Sentence -
✅ Always take a policy with Super Top up option & not Top up option.

23/ 5️⃣ Pre & Post Hospitalization -
Most insurance policies also cover Pre & Post Hospitalisation costs such as regular therapy, medicines,etc.
Most policies provide Pre hospitalisation for 60 days & Post hospitalisation for 180 days.
✅So, find a policy with Pre & Post feature.

24/ 6️⃣ DayCare Coverage
Is it necessary that you'll get your claim only if you're admitted to the hospital? No, it's not. What if your treatment is completed the same day with you not being admitted? Many insurance Companies also offer this feature.
✅ Find a policy with day care

25/ 7️⃣ Waiting Period

What if you've purchased a policy today & after 5 days you've met with an accident. Will they pass your claim? No, they won't. Because mostly all policies have a waiting period of 30 days. You can only apply for claim once the waiting period is over.

26/ 8️⃣ Waiting period for Pre-existing diseases -

What if you've purchased a policy and have a pre-existing disease & you get hospitalized. Will they pass your claim? No, they won't. Because there is a waiting period for such claims. Generally you can claim after 3 to 4 years.

27/ 9️⃣ No claim bonus

What if tell you that the insurance companies provide a bonus to the people who have paid premium for a year, but remain fit & haven't used the health insurance. Yes, that's right. The bonus is either your base cover gets increased or premium is reduced.

28/ 🔟 Ambulance charges

✅ Make sure that the policy also includes ambulance charges.

29/ 1️⃣1️⃣ Cashless hospitals -

Make sure that your insurance company have a tie up with various hospitals for a cashless treatment, so that you don't have to pay any upfront payment.

30/ 1️⃣2️⃣ Free health checkup -

Many insurance companies also provide free full body health checkup once a year. So, don't forget to avail the benefit.

31/ Make sure that you keep the results in a safe place for proof, so that in future the insurance company does not reject your claim as they think that you've got the disease before purchasing the policy. Show them that you were fit when the policy was purchased.

32/ Watch out for the following requirements while purchasing a policy
👇

✅Choose - Floater / Individual
✅From whom - Private / Government ✅Decide your Base Cover*Super Top Up
✅Room Rent
✅Sub-limit on diseases
✅Co-Pay
✅Pre & Post hospitalisation
✅Day Care
✅Waiting period
✅No claim bonus
✅Cashless hospitals
✅Ambulance charges
✅Free Checkups

34/ Bonus Tip -

1️⃣ Don't hide your alcohol/cigarette problems from the insurance company. They can reject your claim in future.

2️⃣ Different cities have different premiums. So, don't put a wrong address just to pay low premium. Always give your original address where you live.

Ufff...A long thread, right.

If you're still with me, thank you very much!

So that was 'Health Insurance 101. hope you liked it.
For more educational threads on money, finance, and economics, do follow the page @MoneyWell_