5 Basic Medical Insurance Components

5 Basic Key Components To Look For While Buying Your Health Insurance!

24th March 2022 8min read 198 views

Everybody knows they need health insurance. But understanding how to purchase healthcare insurance is a whole other matter. Many youngsters today want to buy health insurance online. Sadly, they get confused by the jargon or terms. They do not always understand what kind of policy they need. Instead, they rely on online reviews or look at the cost before picking a policy. To help you make this decision, here’s a look at the main components of every good health insurance policy:

1. In-Patient Hospital Coverage

Your health insurance policy should help cover the cost of a stay in the hospital. If you have to stay for more than 24 hours, your insurance plan should cover it. While shopping for policies, find one that does not limit your in-patient claim amount. So, if required, you should be able to file a claim for 100% of the sum assured after a valid hospitalisation. Some policies put a limit on how much you can claim, so make sure you do your research.

2. Pre- and Post-Hospitalisation Expenses

You may face some health issues right before or after a hospitalisation. Your health insurance plan should cover related costs in the 30 days leading up to a covered hospitalisation. If you continue to face issues after getting discharged, your insurance policy should take care of it. Many health insurance companies pay for health issues related to your hospitalisation for 60 days from your discharge. Some plans will limit what kind of claims you can file. Typically, they must be directly related to the hospitalisation and covered treatments.

3. Daycare Treatments

Scientists and doctors continue to make advances in medicine. Today, you can get various medical procedures without getting admitted to the hospital. For example, cataract surgery only takes a few hours. Health insurance plans today offer coverage for these daycare treatments as well. Look for policies that do not restrict the amount you can claim for a daycare procedure.

4. Room Rent Allowance

If you need to get hospitalised, just paying for the room could drain your finances. Your plan will have something known as a room rent allowance. It’s the maximum amount the insurance company will pay per day for the room you occupy. For example, a shared room in a hospital may have an occupancy charge of INR 1,000 per day. Your room rent allowance might be INR 1,200, so it will cover the cost. If you opt for a private room, the fee could go up to INR 1,800 per day. If this happens, you’ll have to pay the balance of INR 600 per day from your pocket. Depending on where you live and your preferred hospital, you should opt for a policy that offers a room rent allowance that will cover the potential costs of a hospital stay.

5. Sub-Limits for Treatments

Most health insurance companies provide a sub-limit for various procedures. For example, you might be allowed to claim up to 80% of your total sum assured for a particular treatment, like cataract surgery. These sub-limits help the insurance company buffer their costs. They also help you if you face multiple hospitalisations in a year, as you won’t exhaust your sum assured amount in one go. Depending on your health and medical background, you should find a policy with sub-limits that work for you.


These five key components form the basis of your health insurance policy. Before buying an insurance plan, read through all the terms and conditions and check the limits. Compare the policies offered by various companies like Edelweiss Health Insurance. Finally, pick the plan that makes the most sense for you.


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