Guide to Know How Health Insurance Plan Work

Medical insurance addresses the medical and surgical expenses of the insured individual. Depending on the insurance terms, the insured person may either pay upfront and get reimbursed or have the insurance company directly cover the costs.

How Does Health Policy Work?

Here’s how health plans work, simplified into key points:

  • Application and Premiums: When you apply for medical insurance, you’ll receive premium quotes based on factors like your age, medical history, desired coverage amount, and plan type.
  • Medical Tests (If Required): Depending on your circumstances, you may need to undergo medical tests before the insurer approves your coverage.
  • Policy Issuance: Once the terms and conditions are agreed upon, you’ll be issued a policy outlining your coverage.
  • Waiting Periods: Most policies have waiting periods. The initial waiting period is typically a few weeks to a month, during which non-emergency claims cannot be made.
  • Receiving Medical Care: If you require medical treatment after the waiting period, there are two scenarios:
  • Network Hospital: If you seek treatment at a network hospital, inform your insurer, and they will directly settle the payments with the hospital. You may be responsible for additional uncovered expenses and any voluntary co-pay.
  • Non-Network Hospital: If you receive medication at a non-network hospital, you’ll initially pay for the expenses and then submit a reimbursement claim to your insurer.
  • Financial Protection: Regardless of where you receive treatment, medical insurance ensures you receive necessary care without a significant financial burden.

Types of Health Insurance

Everyone is unique, with distinct needs that a one-size-fits-all health plan product can’t adequately meet. This is why various health plans are designed to cater to individual requirements. Let’s explore these different options.

  • Individual Health Insurance
  • Family Floater Health Insurance
  • Senior Citizens Health Insurance
  • Critical Illness Insurance
  • Group Health Insurance

Need for Health Insurance

Medical costs, including Medicare, are on a relentless upward trajectory, surpassing the inflation rates of everyday expenses like food and clothing. While the cost of living essentials typically rises in single digits, healthcare expenses frequently surge by double digits.

For individuals with limited savings, securing funds for unexpected medical emergencies becomes challenging. This challenge is especially formidable for seniors, as many health issues manifest in later stages of life.

Investing in the best mediclaim insurance in India is one effective strategy to prepare for healthcare emergencies. Medical plans offer substantial flexibility in covering various diseases and ailments. For example, some policies encompass up to 30 critical illnesses and over 80 surgical procedures. These insurance plans benefit specific surgeries or illnesses, regardless of the medical expenses incurred. Moreover, the policy remains effective even after benefit payments for select conditions.

Insurance providers like Niva Bupa guarantee a more secure future in terms of health and finances with their plans. It is also a crucial asset for individuals responsible for their family’s financial well-being.


Understanding how health plans work is not just a matter of financial prudence; it’s a cornerstone of securing your well-being and that of your loved ones. As medical costs continue to rise and unexpected health emergencies become a reality for us all, the knowledge and protection offered by medical insurance are invaluable. It provides the reassurance of a safety net, the promise of financial stability, and the confidence to face life’s uncertainties with resilience. So, invest in your health, your future, and the peace that medical insurance  can bring.


  • Nieka Ranises

    Nieka Ranises is an automotive journalist with a passion for covering the latest developments in the car and bike world. She leverages her love for vehicles and in-depth industry knowledge to provide readers with insightful reviews, news, perspectives and practical guidance to help them find their perfect rides.

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