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Must Know Terms Used in Health Insurance

Updated On Aug 09, 2022

When it comes to an individual health insurance policy, the primary challenge that people face is to know the sea of terminology and acronyms. Still, most of the terms in health insurance policies are tough to understand. With the right comprehension of your insurance details, you will save yourself from making serious mistakes. And failure can result in compromising the amount insured during the hospitalisation.  

Common Health Insurance Terms You Must Be Aware Of

Below we have curated a list of health insurance-related terms you must know -

  1. Comorbidities

Health comorbidities such as hypertension, COPD, cardiovascular issues, kidney problems, diabetes, and various underlying diseases are said to be important risk factors, especially in terms of health insurance. A patient having pre-existing medical diseases given is considered at a higher risk and thus will be charged a higher premium.

  1. Deductibles

If the deductible amount is more, then the premium will be less. A deductible is a cost-sharing condition under a health insurance plan that is the fixed amount or percentage of a claim amount. Under the provision, your insurance company won’t be liable for paying a percentage or fixed amount of your covered expenses. It’s the policyholder’s liability to pay the contracted deductible sum to the hospital.

  1. Premium

A premium is paid by you to the insurance firm for getting the privilege to have an insurance policy. Many people pay theirs monthly, but your payments will be due for payment once in a quarter or a year.

  1. Critical Illness

Life-threatening medical diseases or critical illnesses mainly refer to any life-threatening medical disease such as kidney failure, cancer, and cardiovascular diseases. There’re special medical insurance policies that will cover such illnesses. But, you can get an add-on cover or rider.

  1. Co-payment

Under the health insurance policy, co-payment is the cost-sharing tool. In some cases, a policyholder agrees to pay a certain percentage of their hospital bill, according to the conditions mentioned in the policy, this is called a co-payment. To do so, an insurer charges a very low premium. It is very important to see that the amount insured in these cases stays the same and will not get reduced. Such a feature is likely to be checked in the senior citizen health plan.

  1. Network Hospitals

Most health insurance companies have a tie-up with certain hospitals which are known as their network hospitals. They are the chain of hospitals where a policyholder can avail their treatment without paying the bills; an insurer settles their bill directly to their coverage limit. And your insurer will directly bear its cost.

  1. Cashless Treatment

Getting cashless treatment means when a policyholder is admitted to a provided network of hospitals and gets medical treatment without paying any money. But, they need to get authorisation before from an insurer regarding their treatment plan. When the treatment is completed, the hospital may send that bill to an insurer and get it reimbursed.

  1. Waiting Period

In the medical insurance plan, there’s a fixed time frame before which you can’t avail any coverage benefits. During this waiting period, the insurance claims aren’t admitted. Also, the waiting period for the different health coverage and conditions varies.

  1. No Claim Bonus

No Claim bonus is a kind of benefit extended by an insurance provider to the policyholders for each non-claim year. When you have this benefit, a policyholder may avail of the higher amount assured at the same premium in a consecutive year.

  1. Pre-Existing Condition

Pre-existing condition means any disability, disease, and condition that you already have before enrolling with the insurance firm. If you’re on any ‘short-term’ insurance plan or want to renew your current health insurance each 3 to 6 months –check your benefits, your health insurance company can deny you for the pre-existing condition.

  1. Add-on Cover

Rider covers or add-on covers are additional covers that are bought with the health insurance plan. They are bought primarily to enhance your coverage offered under the regular plan. Some common rider covers include critical illness cover, personal accident cover, air ambulance cover, restoration of the amount insured, and more.


The above-mentioned health insurance terms can prove very helpful especially when you are looking to purchase a health insurance plan. Buying the right health insurance plan online has become quite a simple and trouble-free way to select the health policy that suits your requirements perfectly. Take a close look at various health insurance plans available online and select a plan that is a perfect fit for you.

Also Read: 

Steps To Become A Health Insurance Agent

Is Health Insurance Worth It


This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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