4 min read

A Quick 2 Minute Guide To The Basic Components Of Health Insurance Policies

Health insurance policies can be confusing, especially when you are not familiar with the basic components.

It is vital to have knowledge of the different components of a health insurance policy in order to ensure that you choose a policy that is best suited for you or your company(in case of an employee group health insurance)

Here’s where we can be of help!


  1. Sum Insured- The sum insured is the maximum value for a particular year that the insurance company can pay if you are hospitalized. Any amount exceeding the sum insured will have to be borne by the policyholder. The amount you agree on for sum insured will be the maximum amount you get in case of hospitalization or medical procedures.
  2. Room  Charge- The limit imposed on the coverage of boarding expenses at the hospital or room rent of the hospital is called room rent limit. The limit is either expressed as an absolute amount or as a percentage of the Sum Insured.
  3. ICU Charge - This refers to covering the charges of being admitted in the Intensive Care Unit.
  4. Co-Pay -  Health insurance co-pay refers to an arrangement in which the policyholder will need to pay a portion of the medical expenses on their own and the insurance company will pay the remaining amount. This is usually covered under the portion of co-pay clause of any policy.
  5. Waiting Period- Refers to the time period before a selected list of ailments begin to get covered by your policy. Usually this applies for pre-existing ailments and some ailments may have a waiting period of a year or two.
  6. Pre-Existing Covered- This refers to the question of if the policy will cover the expenses for treatment of pre-existing diseases of the policyholder.

This covers the primary factors a person needs to consider before they make the final policy purchase. You should make sure that you discuss these terms with your insurer along with the different limitations set for each of the above given clauses so as to avoid misunderstandings in the future.

It is better to make an informed decision especially in the case of Health Insurance Policies so that you only need to worry about your health at the time of emergencies!

We at Nova Benefits aim to make understanding Health Insurance Policies an easy process. You can always reach out to our team in case of any help!

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