Health Insurance Guide: A to Z Health Insurance Rules You Should Know

A to Z Glossary of Terms Commonly Used in Health Insurance Policy

When it comes to reading the health insurance glossary thoroughly, it is possible that the average person does not understand it – sometimes completely or not at all! This blog aims to introduce you to the basics used in all health insurance plans to help you make informed decisions whenever you consider them.

Yours health insurance process it is your permanent guide to future health protection for you and your family. So it is very important that you read it carefully at least once to know what is in this book and how it can help you.

However, since most people like you and I do not know much about the technology used in health insurance plans, it can be difficult to understand the document properly. Note that it is not necessary for you to understand the meaning of every term mentioned in your insurance policy. However, it always helps to know what the word stands for or means to stay informed.

That is why we are writing in this blog the details of the most commonly used terms in health insurance. This has been edited from AZ for your convenience. Keep reading to find out what each of them means.

AZ Health Insurance Glossary of Terms Everyone Should Know

  1. Additional Cover: A widely used term in almost all health insurance policies, supplemental cover refers to an additional feature that is optional for the policyholder to choose/purchase separately from the basic plan. It provides additional support beyond what is provided in the basic plan and therefore has to be purchased at an additional cost.
  2. Beneficiary: This means a nominee nominated by the policy owner who would be entitled to receive cash benefits on behalf of the latter, in case of death during the term of the policy.
  3. Critical Care Insurance: Supplements provided in your plan for health problems such as cancer, stroke, heart disease, etc. Insurance can be purchased to cover the medical expenses incurred in the treatment of chronic diseases of the plan.
  4. Domiciliary Clinic: This means that the owner cannot receive treatment in a hospital and can receive treatment at home under the guidance of medical professionals.
  5. Exceptions: This indicates various diseases or illnesses no provided under your health insurance plan. It is very important that you read everything that is mentioned in your policy document before you start shopping to avoid any confusion during the insurance policy.
  6. Free View Time: This is a small service provided by the insurer to the insured, allowing them to cancel the health insurance policy that was purchased without penalty, Note that it is usually a short period (time without penalty), maybe up to 15 days. .
  7. Health Insurance Group: This is a type of health insurance policy that can be purchased for a group of people together. This is especially true if there is a group of employees working for the same company. The employee brings the salary of the plan and provides benefits to the employees to return their work to the company.
  8. Hospital: This means staying in the hospital on admission for at least 24 hours. It can be used if you plan to stay in the hospital or be admitted unexpectedly in an emergency.
  9. IRDAI: It is a common abbreviation used by the Insurance Regulatory and Development Authority of India. It is the apex body of the insurance industry that governs and regulates the operations of all insurance companies.
  10. Expiration: Lapse is when the benefit provided by the insurer under the health insurance policy expires after the term of the policy, or is terminated by the insurance company due to failure of premium payment on the part of the insurance.
  11. Maternity Insurance: This is given to the insurer to cover all expenses incurred during the birth of the child. Both normal births and C-Sections are covered by maternity insurance along with expenses related to prenatal and postnatal care.
  12. Network Hospitals: The insurance provider can provide you with a list of online hospitals at the time of purchasing the policy that includes the names of the hospitals that have a contract with the insurance company. These hospitals provide free medical care (care without spending money at the hospital) to the insured as they are affiliated with the insurance.
  13. OPD: OPD is the popular abbreviation for Out Patient Department and you will find the term OPD service mentioned in your health insurance policy most of the time. They only refer to treatment that is available at a hospital or a local hospital without the need for hospital admission.
  14. Pre-existing Diseases: This refers to any health or illness that the owner may have at the time of purchasing the insurance policy. Ideally, the insurance company should be informed of this before proceeding with the purchase of insurance.
  15. Restorative Benefits: This is a special benefit offered to the insured in which the insurance company agrees to top up or refund the amount of the insured’s policy if the premium is exhausted or lapsed. This can happen during the treatment of a serious illness that costs a lot of money. At the end of the amount insured in this case, the insured can replenish the amount to be used at another time for other insurance services.
  16. Senior Citizens Plans: There is a health insurance policy designed for the elderly in this country. The Senior Citizen Plan covers people between the ages of 60 and 70. Some of the health benefits provided under the plan include AYUSH coverage (for other treatments like Ayurveda, homeopathy, naturopathy, etc.), reimbursement of psychiatric treatment, and maintenance fees. house.
  17. Additional Cover: These are plans that can be purchased over and above the standard health insurance policy. The additional cover helps to reimburse health care expenses after the expiry of the insurance coverage provided under the regular policy.
  18. Waiting Time: This means the amount of time the owner must wait before filing a claim with the insurance company. The only exception is in the event of an accident where no waiting period rule applies. This period is usually 30 days; however, it can be 4 years if the insured has a pre-existing condition.


This list may not contain the details of health insurance and medical terms as there are several other terms that we could not cover here. However, we hope this gives you a better idea of ​​the most commonly used terms in health insurance letters. To find the best health insurance company in India, always do your research and check customer reviews online.

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