How to Choose the Perfect Medical Coverage for Your Health Insurance Policy


Medically reviewed by

Bajaj Finserv Health

Aarogya Care

4 min read

Key Takeaways

  • Understanding medical coverage in a healthcare plan is crucial for all
  • A medical insurance cover helps tackle unexpected or planned medical needs
  • Know the various nuances of a healthcare cover before you finalize a policy

Getting expansive medical coverage for you and your family is simply good sense considering the fact that health expenses are skyrocketing. To tackle health-related emergencies and meet rising medical inflation, it is necessary to be proactive and choose the ideal health insurance cover.

Health insurance coverage, also known as medical insurance coverage, helps you manage medical expenses by covering costs of certain tests, procedures and treatments. The scope of cover depends on the policy that you choose. The cost of any service not included in your health benefit plan coverage needs to be borne by you [1]. So, choosing it wisely will help you gain more in the long term.

Read on to get an in-depth understanding of what medical coverage typically includes based on the plan you go with.

Additional readTop 5 Reasons Why Investing in Health Insurance is Beneficial

Covers pre-and post-hospitalization expenses 

It is essential to know the medical insurance cover of the plan you are choosing as it affects what you get out of it. So, check if your insurance provider covers expenses for various treatment and medical procedures. In case of hospitalization, check if the room rent is also included in the plan or you have to pay for them out of pocket. A health insurance policy needs to cover your medical costs not just during a hospital stay, but also before and after that [2].

Pre-hospitalization expenses include medical checkups, blood tests, and X-rays. Any health test done post your stay in hospital is also taken care of by your insurance policy. However, these costs may be covered for a fixed number of days as specified in the policy document. While pre-hospitalization expenses are cover up to 30 days, post-hospitalization expenses are covered up to 60 days with conditions applied in most cases [3].

Also check if your cover includes cashless claims. The cashless facility allows you to manage hospital expenses as you need not pay for the medical treatment. All these expenses, up to the limit of your policy, are settled by your health insurance provider. So, make sure you check your provider’s network of affiliated hospitals for a seamless experience.

Provides coverage for pre-existing diseases 

Remember than any pre-existing diseases such as diabetes, blood pressure or thyroid that you have mentioned in the policy document may also be a part of your health insurance cover 

The only catch here is that you need to complete the waiting period to enjoy benefits of the plan. In case of hospitalization due to an unexpected medical emergency, this waiting period is not considered. In most cases, insurance providers prescribe a waiting period from 2 to 4 years after which you can claim hospitalization expenses.

what is included in health insurance

Includes day-care procedures and ambulance services 

In cases where you need to undergo a medical procedure like arthroscopy, which doesn’t necessarily require hospital admission beyond 24 hours, a comprehensive healthcare plan can come to your aid. Other common procedures under a medical insurance cover include dialysis and eye surgery. Make sure these are mentioned in your policy documents. If there is any emergency that requires you to use am ambulance, your healthcare plan should cover these costs as well. However, there is a limit to use these charges, which is fixed by each provider.

Accommodates ICU and emergency room charges during hospitalization 

Your healthcare policy may also cover costs for any treatment you undergo during your hospital stay. The plan covers for a medical procedure to be completed in operation theatre. If there is a need to be shifted to ICU, the room charges shall be borne by your insurance provider as well. The maximum amount you can claim is mentioned clearly in your policy document. So, pay attention to it and choose the sum assured with care.

Allows for lab tests at regular intervals

Some healthcare plans do allow you make claims for annual health checkup costs along with routine doctor visits. Apart from these, if you have to undergo any lab tests on a regular basis, check if these expenses may also be covered in your policy.

Additional read7 Important Factors to Consider Before Choosing Health Insurance Plans

Now that you have a better understanding of what is included in a healthcare cover, you can choose the right plan for yourself. Take a step forward by considering the Aarogya Care plans on Bajaj Finserv Health. These plans offer features like cashless claims, lab test benefits of up to Rs. 17,000, reimbursement of up to Rs.12,000 for doctor consultations, medical coverage of up to Rs.10 lakh and a claims ratio that far exceeds competitors! Invest in a healthcare plan today and take proactive steps to secure your health and that of your family too.

Published on 13 Sep 2021Last updated on 20 Jun 2022

Please note that this article is solely meant for informational purposes and Bajaj Finserv Health Limited (“BFHL”) does not shoulder any responsibility of the views/advice/information expressed/given by the writer/reviewer/originator. This article should not be considered as a substitute for any medical advice, diagnosis or treatment. Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. The above article has been reviewed by a qualified doctor and BFHL is not responsible for any damages for any information or services provided by any third party.


Health Videos

Mobile Frame
Download our app

Download the Bajaj Health App

Stay Up-to-date with Health Trends. Read latest blogs on health and wellness. Know More!

Get the link to download the app

Google PlayApp store