Even though you’ve decided to buy health insurance to protect your finances, the right way to do it makes all the difference. Often, people have their claims delayed or denied for some reason. It could be because they needed to learn about a waiting period or a policy exclusion when they bought the health insurance.

If you just bought your first health insurance policy or are planning to buy one, you might need clarification on all the complicated terms and jargon you find online and in your policy documents.

But instead of waiting until the last minute to figure things out, we can help you get ready by telling you what you need to know before buying health insurance. If you know all these things, you’ll be able to choose the best health insurance plan for you and have less trouble when you need to make a claim.

So, let’s look at some important health insurance terms you should know.

What You Need To Know Before You Buy Health Insurance

To get the most out of your money, you must be familiar with every aspect of your health insurance plan. Here is a rundown of the five most crucial factors to consider when selecting a health insurance plan.

1- Co-Payment

A co-payment is the percentage of the claim amount the policyholder will pay when they file a claim. It means that you and your insurance company will split the medical bills. Your insurance company will pay for most of the bill, but you will have to pay a smaller amount. For example, if your co-pay is 15%, your insurance company will pay 85% of the claim amount, and you will pay the rest.

If you choose a higher co-pay, your total premium will go down, but you’ll have to pay a larger amount when you make a claim. On the other hand, if your co-pay is lower, your premium will go up, but you will pay less when you make a claim.

Some best health insurance policies require a co-payment, while others let policyholders choose the amount of the co-payment they want to make.

2- Coverage Limit

Your sum insured is the most your health insurance company will pay for your medical bills in a year. So, it is the most money you can get back from your health insurance if you file a claim.

You will have to pay the difference if your total medical bills exceed the covered amount. So, it is important to be careful when choosing the SI.

Even though a lower SI can lead to a lower premium, if you choose a higher SI, you will have more money in case of an emergency.

3- Pre-Hospitalization

Most of the time, your medical bills are more than what you need to pay for your hospital stay.

Before you go to the hospital for treatment, you may have to pay for diagnostic tests, investigational procedures, medication, and more. These are called pre-hospitalization costs.

Post-hospitalization expenses are the medical costs. You must pay between 45 and 90 days after you get out of the hospital. Best health insurance could include follow-up tests, continuing treatments, certain medications, etc.

Many health insurance providers have a list of hospitals that they have agreements with. Therefore, people with coverage can get care without paying out of pocket in case of a medical emergency. It saves you time and trouble filling out forms when you are admitted or making a claim. Also, the insurance pays the hospital the insured amount right away.

4- Waiting Period

You need to know about the waiting period to get real benefits. There will be different kinds of waiting periods in your health insurance plan:

  • Initial waiting period: This is the time after you buy the policy. During which you can’t claim anything other than an accident. It can be anywhere from 15 days to three months, depending on the health insurance plan.
  • Pre-existing illness: If you have a pre-existing illness, you may have to wait anywhere from 2 to 5 years before you can start making claims.
  • Waiting period for critical illness: Depending on your type of health insurance plan, certain diseases may also be waiting periods.

5- Claim Settlement Procedure

You should also ensure that your insurance provider provides a hassle-free. Also, a speedy procedure for the settlement of claims. So that the benefits may be distributed to you in the manner you feel appropriate. In addition to the health insurance, you can analyze the claim settlement ratio as a metric that will assist you in comprehending the effectiveness of your insurance provider. It is the ratio of resolved claims to the total number of claims filed.

The insured is better off if the claims process is easy and the claims are paid out quickly. So, these two things are important to think about when picking a policy. Good customer service is another thing to look for. Also, make sure the policy includes free medical check-ups.

Why Is It Important To Buy A Health Insurance Plan?

Recently, unexpected medical costs have increased, especially since the pandemic. Changes in lifestyle, such as eating unhealthy foods, have also made people less resistant to infections and more likely to get sick. On the other hand, costs for medical care and hospital stays are going up.

Because of this, you need the best health insurance plan to pay for costs before and after you go to the hospital. It also lets you make claims without cash, which makes it easier for you to get care.

Now that digital technology has advanced, you can use the health insurance plan online. Also, policies that don’t use paper are cheaper and save time and effort. So, learn more about health insurance, compare plans, and make the best choice online.


If you understand these terms, you should know what to look for when buying health insurance. This way, the next time you buy or renew your best health insurance policy, you will feel free of the complicated terms and jargon!

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