Health Insurance Explained (2025): Coverage, Terms, Waiting Periods & How to Choose
A clear guide to health insurance: what it covers, how to pick sum insured, key terms like waiting periods and co-pay, and how to avoid common mistakes. Updated for 2025.
Health insurance basics
Health insurance helps pay for hospital and medical expenses. It reduces the risk of large, unexpected bills that can disrupt your savings or force you into debt.
Medical costs can rise quickly—especially in emergencies. A good health policy focuses on adequate coverage,clear benefits, and reliable claims experience.
What Health Insurance Usually Covers
- Hospitalization (room rent limits may apply)
- Pre- and post-hospitalization expenses (policy-defined window)
- Day-care procedures (many listed treatments)
- Ambulance (often capped)
Not everything is covered
Pre-existing conditions may have waiting periods; some conditions can be excluded. Always read the policy wording.
How to Choose the Right Sum Insured
Consider your city and family size
Bigger cities typically have higher hospitalization costs. Family floater needs a higher sum insured than an individual plan.
Plan for inflation
Medical inflation can be high. Consider a base cover + a top-up/super top-up if needed (based on availability).
Tip
Don’t choose the lowest premium blindly. A slightly higher premium can provide much better room-rent rules and fewer sub-limits.
Important Terms to Understand
- Waiting period: Time before certain conditions are covered.
- Co-pay: You pay a fixed % of the bill (common in senior plans).
- Network hospital: Cashless treatment is easier in-network.
- Sub-limits: Caps on room rent or specific procedures.
Next Steps
- Decide sum insured based on city + family size
- Compare benefits (room rent, waiting periods, co-pay, sub-limits)
- Prefer clear policy wording and strong customer support