How to afford healthcare expenses and lower insurance plan premiums amidst the rising costs of medications

With the changing lifestyles and pollution levels, individuals are facing a variety of health issues and diseases. Moreover, as drug manufacturers keep revising the costs of their medications and formularies, and exclude many medications from coverage during yearly revisions, it becomes important for an individual to carefully choose the right insurance plan that can help them in meeting the rising healthcare costs. Insurance plans allow individuals to receive the best healthcare without worrying about expenses as these plans offer them protection against the rising costs of treatments. It covers hospitalization expenses, daycare procedures and domiciliary costs.

Many insurance providers provide cashless treatment facility in which the patient does not have to make any out-of-pocket payments as the hospital expenses are settled between the plan provider and the healthcare facility. Some plans also cover pre and post-hospitalization charges upto a period of 60 days, depending upon the plan. No claim bonus (NCB) is paid to the insured in case no claim was filed in the previous year.

  • A variety of health insurance plans are available such as:
  • Individual health insurance plan
  • Family health insurance plan
  • Surgery and clinical illness insurance plan
  • Personal accident plan
  • Maternity health insurance plan
  • Senior citizen health insurance plan, and
  • Unit linked health plan

Each of these plans has their own benefits, eligibility criteria and other riders. Before purchasing a plan, one should consider some points such as sum assured, inclusion and exclusion of medications, capping on room rent, minimum entry age and renewability, and other benefits, such as whether the plan has any provision for lump sum payments or pensions in case one becomes incapable of earning due to accident or some other diseases.

There are two main types of health insurance claims processes:

Cashless claim process:  The individual will provide the details of their insurance to the healthcare facility as they begin to receive treatment. The hospital forwards bills to the insurance company upon the discharging of the patient. The insurance company audits the treatment costs and settles outstanding payments due to the healthcare provider.

Reimbursement claim process: The insured person pays for the treatment and hospitalization costs incurred and makes a reimbursement claim to the insurance company after receiving the treatment. The person will have to submit the original bills to the insurance company. The claim will be audited by the insurance plan provider and payment is done for the approved expenses.

Many organizations cover their employees with a group insurance plan. However, these insurances are not custom made and an individual would be left uncovered in case of the job change or job loss. To keep yourself covered, you should purchase a health cover individually.

Lowering the costs of your health insurance premiums

Often the cost of health insurance premiums increases with age as the elderly are perceived to have more frequent health-related issues. So, if you want to lower the costs of your health insurance plans, you should get yourself covered at a younger age. Moreover, by opting for co-payment, you will be able to lower the cost of your health insurance premium. Co-payment is a pre-decided sum of money that the insured person has to pay from their pocket at the time of claim. The higher the co-payment amount you are willing to pay, the lower will be your insurance premium. Moreover, before picking up any policy, go through its terms and conditions, especially about what is covered and what is not. Often pre-existing conditions are not covered, and the companies that provide coverage for pre-existing conditions do so after specific years of a buying a policy. So, read carefully between the lines of product details.

For more information on choosing a health insurance plan, lowering your premium costs, and other details related to your health insurances, you should refer to some trusted source, such as PrudentRx Program, which is designed by the industry experts and provides the most updated and accurate information on all matters related to health insurance.

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