Health Insurance is a type of insurance that offers coverage to the policy holder for medical expenses in case of a health emergency. A health insurance plan chosen by the insured provides coverage for different expenses including surgical expenses, day-care expenses, and critical illness expenses etc.

What is a Health Insurance Policy?

A health insurance policy is a contract between the insurer and policyholder in which insurance company provides financial coverage for medical expenses incurred by the insured. A health policy provides benefit of reimbursement of medical expenses or cashless treatment mentioned in the health policy.

Importance of Health Insurance Plans

Health emergencies do not come with a prior notice. With sedentary lifestyles more and more people are becoming prone to lifestyle diseases in India. And with the increased demand for quality healthcare services, medical treatment has now become quite expensive, especially in the private hospitals. And without insurance the hospital bills are enough to drain one’s savings.

Health Insurance Plans

Therefore, a health insurance plan becomes an absolute necessity as it offers coverage to the insured family members and the policyholder against the exorbitant hospitalization expenses in case an accident or illness.

Apart from the medical coverage, health Insurance plans also offer tax benefits on premium under section 80D of the Income Tax Act, 1961

We at Policybazaar can help you buy a right health insurance plan that suits your requirement below is the list of health insurance plans with the top Insurers. You can do the comparison and find the best health plan for your family.

Top Health Insurance Plans in India






























Insurance Companies

Health Insurance Plans

Sum Insured (Rs.)

Incurred Claim Ratio

Network Hospitals

Aditya Birla Health Insurance

Active Assure Diamond Plan

Min – 2 Lakh

Max – 2 Crore

59%

6000+

Bajaj Allianz Health Insurance

Health Guard Plan

Min – 1.5 Lakh

Max – 50 Lakh

85%

6500+

Bharti AXA Health Insurance

Smart Health Assure Plan

Min – 3 Lakh

Max – 5 Lakh

89%

4300+

Care Health Insurance (Formerly known as Religare Health Insurance)

Care Health Care Plan

Min – 4 Lakh

Max – 6 Crore

55%

7400+

Chola MS Health Insurance

Chola Healthline Plan

Min – 2 Lakh

Max – 25 Lakh

35%

6500+

Digit Health Insurance

Digit Health Insurance Plan

Min – 2 Lakh

Max – 25 Lakh

11%

5900+

Edelweiss Health Insurance

Edelweiss Health Insurance Plan

Min – 5 Lakh

Max – 1 Crore

115%

2578+

Future Generali Health Insurance

Future Generali Criticare Plan

Min – 5 Lakh

Max – 50 Lakh

73%

5000+

HDFC ERGO General Health Insurance

my:health Suraksha Silver Smart Plan

Min – 3 Lakh

Max – 50 Lakh

62%

10,000+

HDFC Ergo Health Insurance ( formerly known as Apollo Munich Health Insurance)

Health Optima Restore Plan

Min – 3 Lakh

Max – 50 Lakh

63%

10,000+

IFFCO Tokio Health Insurance

Heath Protector Plus Plan

Min – 2 Lakh

Max – 25 Lakh

102%

5000+

Kotak Mahindra Health Insurance

Kotak Health Premier Plan

47%

4800+

Liberty Health Insurance

Health Connect Supra Top-up Plan

Max – 1 Crore

82%

3000+

Max Bupa Health Insurance

Companion Individual Health Plan

Min – 3 Lakh

Max – 1 Crore

54%

4115+

ManipalCigna Health Insurance

ProHealth Plan

Min – 2.5 Lakh

Max – 1 Crore

62%

6500+

National Health Insurance

National Parivar Mediclaim Plus

Up to 50 Lakh

107.64%

6000+

New India Assurance Health Insurance

New India Assurance Senior Citizen Medi claim Policy

Min – 1 Lakh

Max – 15 lakh

103.74%

3000+

Oriental Health Insurance

Individual Mediclaim Health Plan

Min – 1 Lakh

Max – 10 Lakh

108.80%

4300+

Raheja QBE Health Insurance

Health QBE

Min- 1 LakhMax – 50 Lakh

33%

2000+

Royal Sundaram Health Insurance

Lifeline Supreme Plan

Min – 5 lakh

Max – 50 Lakh

61%

5000+

Reliance Health Insurance

Critical Illness Insurance

Min – 5 Lakh

Max – 10 Lakh

14%

4000+

Star Health Insurance

Family Health Optima Insurance Plan

Min – 1 LakhMax – 25 Lakh

63%

9800+

SBI Health Insurance

Arogya Premier Policy

Min – 10 Lakh

Max – 30 Lakh

52%

6000+

Tata AIG Health Insurance

Tata AIG MediCare Plan

Min – 2 lakh

Max – 10 Lakh

78%

3000+

United India Health Insurance

United India UNI Criticare Health Plan

Min – 1 Lakh

Max – 10 Lakh

110.95%

7000+

Universal Sompo Health Insurance

Individual Health Plan

Max – 10 Lakh

92%

5000+

See More Plans

Disclaimer : *Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

Types of Health Insurance Plans

To ensure that the health insurance plan meets your insurance needs, it is important to know the different types of health insurance plans, to decide the right policy.

Mentioned below are the different types of health insurance plans you can choose as per your insurance requirement:


  • Individual Health Insurance Plans

    Individual health insurance plans offer insurance protection with benefits such as cashless hospitalisation, reimbursement, compensation for expenses incurred on pre and post hospitalization expenses, coverage for domiciliary treatment and many more. Individual health plans come with add-on covers as well to enhance the basic health insurance coverage, at a minimal premium.


  • Family Health Insurance Plans

    Family health insurance offers insurance coverage to entire family against a single premium. Under this health plan, a defined sum insured is divided among the policy members equally, which can be availed either by one or all members of a family for one or more claims during the tenure of the policy. With a family health plan, almost all the family members can be added under a single health insurance premium.


  • Senior Citizen Health Insurance Plans

    Senior Citizen health insurance plans offer insurance coverage to the age group between 60 and above. The health insurance plan covers hospitalization expenses including in-patient expenses, OPD expenses, Daycare procedures, pre, and post-hospitalisation expenses along with tax deduction benefit u/s 80 D.


  • Critical Illness Insurance Plans

    Critical illness health insurance plans offer a lump sum amount in case the insured is diagnosed with a critical illness such as kidney failure, paralysis, cancer, heart attack, etc. Usually brought as a standalone policy or as a rider, the sum insured is pre-defined, where the insured has to survive a particular survival period after being diagnosed to avail the policy benefits.


  • Maternity Health Insurance Plans

    The maternity health insurance plans offer coverage for maternity expenses incurred during both pre and post-natal care, child delivery (normal or cesarean). Some providers also include expenses incurred on vaccination of newborn babies in a maternity health insurance plan. The list of coverage also includes the transportation fee for ferrying the mom-to-be to the nearest network hospital of her choice.


  • Personal Accident Insurance Cover

    Personal Accident Insurance is a rider cover that offers insurance coverage in case of an accident leading to disability or death. The policy coverage includes hospitalization and bears the medical outlay in the event of an accident. A fixed monetary benefit is offered in case of an unfortunate event leading to loss of income.


  • Group Health Insurance Plans

    More than 80% of employers these days provide health coverage to their employees. The health insurance offered by an employer covers hospitalization expenses of the employee and his/her family including spouse, children or parents. It is a wise decision to opt for the mediclaim offered by your company as you need not pay any premium. This comes under a group health insurance policy and the premium is paid by the employer, based on the group size and the benefits offered.


  • Coronavirus Health Insurance Plans

    Post COVID-19 outbreak, the IRDAI has also launched two Coronavirus specific health insurance plans i.e. Corona Kavach health plan and Corona Rakshak health insurance plan. Corona kavach is a family floater plan while Corona Rakshak is an individual coverage based plan. Both the polices cover COVID-19 hospitalization expenses, including the cost of consumable items like masks, gloves, PPE kits, oximeters, ventilators, etc. that make the major portion of the hospital bills. If someone has a health insurance policy then also any of these coronavirus health insurance policies can be purchased to ensure safety of your loved ones during the ongoing pandemic.


  • Unit Linked Health Insurance Plans

    Unit- Linked Health Insurance Plan (ULHP) is a type of health plan, which has been introduced recently. Unit Linked Health Insurance plans offer a unique combination of health insurance and investment. Apart from giving health protection, ULHPs also contribute to building a corpus that can be used to meet expenditures that are not covered by health insurance plans.

    Among the ULHP health plans available in the Indian market, ICICI Pru’s Health Saver, LIC’s Health Protection Plus, Birla Sunlife’s Saral Health, and India First’s Money Back Health Insurance Plan are a few big names.

Why Do You Need to Buy Health Insurance?

You need a health insurance cover as a financial back up to be able to meet the rising cost of healthcare in India. Medical inflation in India has been 15% over the past few years, and a health insurance policy helps people to be able to pay for expensive medical treatments, hospital bills, in case of an illness or accidental injury.

Unfortunately, only 20% of the total population in India has health insurance coverage. Additionally, only 18 percent of the total population residing in urban areas and 14 percent of the total population residing in rural areas had any form of health insurance coverage. Let’s check why do you need to buy a health insurance plan in India:

  • A health insurance policy can pay for hospitalisation expenses, medication and laboratory test costs, ambulance, doctor fees, etc. Some health plans also cover OPD expenses up to a certain limit.
  • It helps in minimizing your out-of-the-pocket expenses with a cashless medical treatment facility in the network hospitals
  • Nowadays, amid the coronavirus outbreak, it is all the more important to have or buy a medical insurance cover that covers the cost of treatment including the cost of PPE kits, masks, ventilators, ICU charges, etc.
  • Even those who are planning a family can buy a health insurance plan to get maternity and new-born baby cover
  • You can buy Corona kavach and Corona Rakshak health plans if you do not have coronavirus health insurance plans cover and keep all your worries at bay
  • The cost of major surgeries like liver transplantation, open-heart surgery, and day-care treatments like cataract surgery, varicose veins, and the likewise are also paid by the insurer if you have a medical insurance policy
  • A health insurance policy helps you and your family enjoy their peace of mind without worrying about the future hospitalization or a medical emergency, which can otherwise drain a major portion of your savings
  • If you cannot pay much premium and are confused which health insurance you should buy then you can opt for a standard policy i.e. Arogya Sanjeevani health insurance policy, it covers modern treatments and COVID-19 treatment as well

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.

Key Benefits of Health Insurance Plans

Comprehensive health insurance plans come packed with features that can assist a person in managing expenses associated with medical emergencies and also with preventive health care check-ups.

Following are the key benefits of health insurance plans that one can consider:


  • Cashless Medical Treatment

    Every medical insurance company has tie-ups with various nursing homes and hospitals across the country called ’empanelled hospitals’. If you are admitted to one of these, you don’t need to pay anything. You only need to mention your policy number and everything else will be taken care of by the hospital and your insurer.

    These types of health insurance plans are preferred because there is no stress of claim reimbursement and documentation. However, if your expenses go beyond the sub-limits specified by the insurance cover or marked as not covered by the provider, then you will have to settle it directly with the hospital. Another important thing to remember is that cashless mediclaim is not available if one gets hospitalized which is not a part of the hospital network of the insurance company.


  • Coverage of Pre and Post-Hospitalization Expenses

    This feature of a health insurance policy takes care of expenses incurred on both pre and post-hospitalisation. It takes into account the costs incurred during a certain number of days both prior to and post hospitalization as part of the claim, provided the expenditures are related to the covered disease/illness.


  • Ambulance Fee

    Once hospitalized the person is free from the burden of transportation fees as it is borne by the insurer.


  • No Claim Bonus

    NCB (or No Claim Bonus) is a bonus provided to the insured if no claim has been filed for any treatment in the previous policy year. The reward can be offered either as an increment in the sum assured or as a discount on the premium cost. You can avail this advantage on policy renewal.


  • Medical Check-Up Facility

    A medical plan entitles the insured to receive regular medical check-ups. A free check-up facility is provided by some insurers, or you can get it as an add-on benefit.


  • Room Rent Sub-limits in Your Health Insurance Plan

    A health insurance plan may have various sub-limits associated with it; room rent is one of those sub-limits. General Insurance Companies provide you with maximum coverage up to the sum assured. However, they can deliberately trim down their liability by introducing the sub-limit clause in the coverage for hospital room rent.

    Once the insured is hospitalized the sub-limit on room rent coverage is applicable on a per day basis. For instance, if your medical insurance policy covers your daily room rent up to a maximum of Rs. 3,000 and your room cost incurred is Rs. 5,000 per day, then you will have to pay the remaining Rs. 2,000 from your own pocket. Besides, room charges are directly associated with the type of hospital room you are availing, i.e. a single room or on a sharing basis. Everything else is calculated accordingly.

    If the total cost incurred on treatment at the hospital is Rs. 5,00,000, the table shown below illustrates the expenses that are expected to be borne by your insurer and you, respectively.














    Policy Sum Assured (in Rs.) 5,00,000
    Room Rent as per Sub-Limit (in Rs.) 3,000
    Room Rent Per Day (in Rs.) 5000
    Room Availed at the Hospital (in Days) 10

    Actual Hospital Bill (in Rs.) Reimbursed Amount (in Rs.) To be Borne by You (in Rs.)
    Incurred Room Charges (in Rs.) 50,000 30,000 20,000
    Doctor’s Fee (in Rs.) 20,000 12,000 8,000
    Medical Tests’ Cost Incurred (in Rs.) 20,000 12,000 8,000
    Operation/Surgery Cost (in Rs.) 2,00,000 1,20,000 80,000
    Incurred Medicine Cost (in Rs.) 15,000 15,000 0
    Total Expenses Incurred (in Rs.) 3,05,000 1,89,000 1,16,000

    In this case, the total cost borne by you is Rs. 1,16,000 out of the total expenses incurred, i.e. Rs. 5,00,000. Thus, make sure you choose wisely if you want any such sub-limits in your medical insurance policy.


  • Co-Payment

    Medical insurance plans offer a co-payment option that pre-defines the voluntary deductibles, which have to be borne by the insured. So, in the event of a medical exigency, some amount is paid by the insured and the rest, by the provider. According to this feature, you can lower the cost of your health insurance.

    Co-payment is a cost-sharing requirement under a health policy, which states that the organization or the person will bear a certain share (in percentage) of the total admissible cost incurred. However, the co-payment option does not have any effect on the sum assured. It allows you to reduce your premium to a certain extent (subject to the insurer and insurance policy).


  • Tax Benefits of Health Insurance Plans

    Health insurance plans entitle you to receive tax benefits under section 80D of the Income Tax Act, 1961. The premium you pay towards health insurance plans for yourself or your family members, get you a tax rebate, irrespective of whether they are dependent on you or not. The tax deduction offered, with respect to the premium, is subjected to the age of the insured and the maximum tax deduction limit that is available. You can save up to a maximum of Rs. 25, 000 in a financial year if you are below the age of 60 years. If your age is above 60 years, then this cap of maximum tax benefit increases to Rs. 50,000.
    If you are paying the medical insurance premium for your parents and for self, then you are eligible for tax exemption up to Rs. 55, 000 in a year under section 80D, provided your parents are senior citizens.

    *Tax benefit is subject to changes in tax laws


  • Third Party Administrators

    The TPA concept is the brainchild of the Insurance Regulatory and Development Authority of India (IRDA), to assist both the insured and the insurer. While it benefits the insurer by reducing their overheads or administrative costs, fake claims, and claim ratios, the insured, too, enjoys improved and fast insurance services.
    TPAs are important players in the health insurance sector. They have the capacity to handle all or a portion of the claims related to health insurance plans. They have tie-ups with health insurers or self-insuring companies to manage services such as premium collection, enrollment, claim settlement and other administrative services.

    Often, hospitals and health insurers outsource medical insurance-related responsibilities to lower their burden.


  • Pre-Existing Disease Cover

    After 2-4 years of policy inception, various policies begin considering pre-existing diseases, e.g. diabetes, hypertension, etc., for claims. Coverage for pre-existing diseases is offered for specific illness (es) that the insured had before purchasing the policy.


  • Preventive Healthcare

    Undoubtedly, healthcare is very expensive and nobody wants to get hospitalized. So, now we have preventive health care check-ups that take care of you before you fall sick. Preventive care, such as regular health check-ups, concession in X-ray fees, consultation fees, etc., is offered under some health insurance plans. By offering various healthcare provisions, this type of plan benefit aims at keeping you healthy. Preventive care is medical care rendered not for a specific complaint but for prevention and early-detection of ailments.

Does Your Health Insurance Policy Cover Coronavirus (COVID-19) Treatment?

Yes, your existing health insurance policy covers the cost of COVID-19 treatment. India is one of the worst’s hit nations with cases constantly on a rise, which put the medical insurance policyholders are in a state of dilemma. The insured people are in a quest, will their standard  health insurance policy cover coronavirus (COVID-19)?

During this pandemic all the insurers are likely to provide coronavirus cover to people who already have a health insurance policy. As it is a new illness and not a pre-existing condition, the coverage cannot be denied as per the IRDAI guidelines. It might not cover the cost of consumable items like PPE kits, oximeters, ventilators, masks, which are a crucial part of the treatment. However, you can check with your insurer for the same.

Those who do not have medical insurance cover or want to enhance the existing scope of coverage can consider buying specific COVID mediclaim policies.  Several health insurers and general insurers have already launched health insurance plans for coronavirus that cover the expense of treatment of coronavirus.

After the IRDAI guidelines, two special standard health insurance products, namely Corona Kavach policy and Corona Rakshak policy were launched and are being purchased by a lot of people already. Lets’ check out how these two COVID insurance products and how they are different from basic health plans.

Corona Kavach Policy

It is an indemnity based health insurance product that covers coronavirus hospitalization (minimum 24 hours), home treatment, and AYUSH treatment cost up to Rs 5 Lakh. The cost of masks, gloves, ventilators, oxygen cylinders, PPE kits, is also recompensed.

Also, the benefits provided under Corona Kavach policy shall remain the same across all the insurance providers.








Eligibility Specification
Entry Age 18-65 years
Coverage Type Individual/Family Floater
Sum Insured ( Rs) 50,000-500,000
Discount on Premium 5% for health workers and doctors

Corona Rakshak Policy

Corona Rakshak policy is a benefit based product that provides lump sum payment for hospitalization (minimum 72 hours) upon diagnosis of Coronavirus during the policy term. The minimum policy term is 3.5 months and maximum is 9.5 months.








Eligibility Specification
Entry Age 18-65 years
Coverage Type Individual
Sum Insured ( Rs) 50,000-2,50,000
Discount on Premium 5% for health workers and doctors

Coronavirus Claim Settlement

Since, COVID-19 has been declared as a pandemic therefore, there has been a lot of confusion regarding claim settlement. The claim is settled just like it’s settled for other insurance plans. In this policy the insured needs to furnish the passport (if he/she has) to file a claim, as the insurer needs to check their travel history.

Now, let us understand the following situations wherein claims for the treatment of coronavirus can get rejected:

  • In case, if an individual is affected with coronavirus and then intending to buy health insurance policy most likely it will not be covered under the newly bought health insurance policy.
  • The policyholder will not get a claim filed if the treatment of coronavirus falls within the waiting period of the health insurance policy.
  • If an individual is diagnosed with coronavirus within the waiting period of the health insurance policy it will not get covered.

Any claim will not be settled if an individual gets infected with coronavirus from any of the family members who recently travelled to COVID-19 affected countries where the travel has been restricted by the country.

Health Insurance Inclusions

The coverage offered by a health insurance policy is subject to the type of policy and the insurance provider. An ideal policy is customizable and suites your requirements in the best way possible.

Following are some common health insurance plans inclusions:

  • In-patient hospitalization expenses
    • Donor expenses, in case of organ transplantation
    • During injuries requiring overnight hospitalization

  • Pre-existing illnesses or diseases
  • Pre and post hospitalization
  • Ambulance charges
  • Maternity or newborn
  • Health check-ups
  • Daycare procedures
  • Treatment availed at home or domiciliary hospitalization

Health Insurance Exclusions

Coverage offered by health insurance policies varies with the insurer; however, certain points are not covered by health policies and fall under the category of policy exclusions.

Following are common health insurance plans exclusions:

  • Unless an accidental emergency, no coverage or reimbursement offered with the waiting period of the policy, usually initial 30 days.
  • Coverage of critical illnesses and pre-existing diseases is subject to a waiting period of 2 to 4 years
  • Clear exclusion of expenses incurred for maternity/newborn unless a maternity rider has been added on
  • Injuries caused by war/terrorism/ nuclear activity/suicide attempt
  • Terminal illnesses, AIDS, and other diseases of similar nature
  • Cosmetic/plastic surgery, replacement of hormones, sex change and more.
  • Dental or eye surgery
  • Non-allopathic treatment
  • Bed rest/hospitalization and rehabilitation, common illnesses, etc.
  • Treatment/diagnostic tests, post-care procedures
  • Treatment abroad or by an under-qualified medical professional

Note: It is recommended to explore each plan to ensure maximum coverage

Factors to Consider Before Buying Health Insurance Plans

There are a few factors that you should consider closely to make the right decision:

  • Caps and Sub-limits

    Caps and sub-limits are the thresholds set on various policy-covered expenses. If a health policy has impositions of co-payments, sub-limits, and other caps, this would mean that there will be a policy-stated coverage offered for various expenses. At times, the co-pay clause and caps help in reducing the premium of the plan. These, however, would alter the benefits in the long run. To make the most of your health insurance policy you must understand these factors before you pay for a health insurance plan.

  • Claim settlement Record

    This is an important criterion to assess the credentials of an insurer. You should always go with a company with a good claim settlement record. Thus, you can ensure that your medical insurance claims would not be wrongly withheld. Always ask for the company’s claim settlement ratio before purchasing their health insurance plans and save yourself from unnecessary harassment in the future.

  • Scope of Coverage

    Don’t buy a health insurance plan by just comparing health insurance premiums. Less cost does not necessarily mean a good medical insurance plan. On the contrary, such a health plan might not consider your coverage needs properly. Closely look at what the plan includes. Buying a comprehensive plan is a better option comes to your rescue when you need it the most.

  • Renewability

    It is important to see how many years the plan proposes to protect you. Mediclaim policies are usually annual contracts. Once the policy term ends, in order to continue the insurance coverage, the insured has to pay the insurance premium. This recurring process is called health insurance renewal. The policy should be renewed continuously, because if there is a break, then, the person will lose the benefits of medical insurance.

  • Cashless Hospital Network

    Check if a hospital around you is included by the medical insurance company you are considering to buy the plan from. You and your family won’t be required to run around collecting documents and filling reimbursements. The provider or its Third Party Administrator should have a tie-up with a range of network hospitals. The insured can get admitted to any of these nursing homes/network hospitals without paying anything from the pocket. However, cashless claim settlement is subjected to limits and sub-limits, which, in turn, are subjected to the sum assured of the medical insurance policy.

  • Premium Loading

    Premium Loading refers to the increase in standard premium applicable when the medical insurance company perceives a person to be more at risk (of claiming the insurance) in comparison to others. It is strongly recommended that you check the terms and conditions pertaining to premium loading. This will save you from paying an extra premium after making a medical insurance claim. This aspect, though ignored in the beginning, usually becomes a bone of discontentment later.

  • Internal Claim Settlement Team

    Check the health insurance plans from insurers that have a dedicated internal claim settlement team. This expedites the claim settlement process. Most of the medical insurance players use a third-party administrator to process the claims and do the paperwork. Even though most of these Administrators provide great services, the fact that they are a third-party slows down the process. There are certain rules and regulations to be followed when an administrator processes a medical insurance claim before it is handed over to the medical insurance company, which in-turn affects the turnaround time.

  • Members Included

    Everyone has a different family size, so you should always look for the family size allowed under the medical insurance plan before purchasing it. If you are in your late 20s and your parents already have a health insurance cover, then purchasing insurance only for yourself does make sense. Alternatively, if you are married with or without kids and have dependent parents, parents-in-law, siblings, etc., then a family health insurance plan is best for you. Checking the premium cost, family size covered, critical illnesses or other benefits will ensure that you are able to purchase the plan you need.

  • Health Insurance Portability

    It is wise to choose a health insurance company that offers health insurance portability. Earlier, policyholders had to stick to a policy just to retain the advantage. Now, you are allowed to switch from one insurance company to another without losing the waiting period advantages earned in your current policy. Moreover, with the insurance landscape changing so regularly, insurance providers regularly come up with better policies and it may make sense to opt for health insurance policy portability.

    Although health insurance portability is free, some companies may charge you a certain fee if you are to port out of their plans to those of some other players. Therefore, make sure you do not pay any charges for medical insurance portability. Health insurance portability is a good thing to check when you are finding the best health policy or mediclaim.

  • Restore Benefit

    With the ‘restore benefit’ facility in your health care plan, you can restore your basic sum assured in case you have already spent the same or the multiplier advantage during your policy tenure. Mostly, the benefit cannot be obtained on the same ailment if you have exhausted the existing sum limit.
    Restoration assistance proves to be helpful for a family floater health plan, where if the entire sum assured is used in the treatment of only a single family member, the other members are not left uncovered. In such a case, the other family members can avail policy coverage for the illness other than the one for which the expenses have already been compensated by the insurer.
    Well, while finalizing your health insurance plan, you should consider other important factors such as waiting period, sub-limit, claim settlement procedures, etc. You can replace restore benefit with a super top-up plan at an affordable price. Moreover, top-up health insurance plans are more comprehensive since they come with few or no restrictions.

  • Top up Health Insurance Plans

    With the rise of medical inflation, it is prudent to increase the medical insurance coverage amount. But, not all can afford it due to the high cost of the premium. This is where a top-up medical insurance plan comes into the picture. A top up health plan reduces the deductibles cost i.e. the portion of a claim you pay willingly for the damages before the insurer compensates the rest or up to the sum assured. With a top up medical policy, you don’t pay until a hospital breaks its defined limit. A top up plan is considered far cheaper than a standalone medical insurance policy.
    For instance, if the medical bill is Rs. 6 lakhs with a deductible of Rs. 2 lakhs, you are required to pay only the latter amount and the remaining 4 lakhs will be paid by the insurer. But, you can utilize your health policy to pay the liable amount. Again, the blending of a top-up plan with a medical cover is helpful as the premium you pay is much more affordable than an individual health plan. For example, if you pay 6,500 as a premium for Rs. 5 lakh regular cover, a top up coverage of Rs. 15 lakh will entail an additional premium of 5,000, which is anyhow cheaper than a separate policy.

  • Waiting Period

    As per the medical insurance norms, every insured must serve a defined waiting period to get coverage for any pre-existing illness. It is usually a 30-day period from the day your health insurance plan is initiated. If any claim falls during the waiting period, the insurer has the right to reject the claim for any hospitalisation, except in the case of an emergency. A hospitalisation that arises out of an accident can be registered as a claim and the insurer will compensate for the hospitalisation cost. However, the insured is not required to serve the waiting period for subsequent years.

Which Health Insurance Policy Should You Buy?











Your Requirement What You Should Get
Coverage for hospitalisation expenses including surgical bills Medical insurance offering cashless facility and claim reimbursement
A fixed amount daily while you are hospitalised Hospital Cash Plan
If diagnosed/hospitalized with a critical illness or if the illness leading to loss of income Critical Illness Plan
When an accidental disability leading to loss of income Personal Accident Insurance
Coverage for expenses in the event of caesarean and normal delivery Maternity Insurance
Insurance coverage for the entire family in a single plan Family Floater Health Plan
Coverage for senior citizens Senior Citizen health Insurance

Health Insurance Eligibility Criteria

The eligibility criteria for health insurance depends on the age of the customer, pre-existing illnesses, current medical conditions, etc. For this reason a medical test is also conducted by the health insurance companies to find out if the applicant is going through some health diseases or not.  In most of the mediclaim policies the following eligibility criterion needs to be met:

Age Criteria– Entry age for Adults: 18 to 65 years (70 and above, based on the plan and insurer). Entry age for Children: 90 days to 18 years and in some plans it is up to 25 years as well.

Pre-medical Screening– In most cases it is required for applicants above the age of 45 years, but it may vary depending on the insurer and the type of medical insurance plan. Most of the senior citizen health plans require premedical tests to check if the applicant meets the eligibility criteria for insurance cover or not. The criterion for individual and family floater health plans may vary as per the policy terms and conditions.

Pre-existing Diseases- When buying a health insurance policy you need to disclose about the health diseases that you have or any pre-exiting illness that you or your family members have. Do not keep it as a secret as it may cause problems at the time of claim settlement. It can even lead to rejection of you claims.

Most of the health insurers ask the applicant if they are going through any medical conditions like blood pressure, diabetes, cardiovascular diseases, kidney problems, and any other diseases. If you are a smoker or an alcoholic then also you need to disclose it to the insurer. Based on this the insurance company will decide if you are eligible to get medical cover or not.

If one insurer doesn’t offer then you can also check with another or a buy a specific health plan as per your medical conditions. Check the policy wordings for terms and conditions to have a better understating about the eligibility criteria.

Why Compare Health Insurance Plans?

It is vital that you compare health insurance quotes online in order to choose the best one to meet your healthcare needs. It can get confusing to select the best health insurance plan as so many insurers offer different health insurance products with varied features.

It is no wonder that sometimes, people end up with a plan that might cost less, but has contradictory clauses, and they practically get nothing when a claim is filed. On the other hand, you end up buying a health insurance plan with a higher cost just to find out later that it has features that you did not use or might never need.

Amid the increasing cost of treatment, a Health insurance policy prevents a medical emergency from turning into a financial emergency. It makes sure that one’s healthcare needs are taken care of without depleting his/her savings or compromising on one’s future goals.

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.


How to Compare Health Insurance Plans?

With more than 25 insurance companies’ and more than 200 health insurance products in the Indian health insurance market, comparing health insurance plans and finding the best quote is not an easy task. Listed below some of the tips to help you make an informed decision:

      • Select the Appropriate Sum Assured

        The healthcare inflation in the country is skyrocketing and is increasing at the rate of 17% to 20% annually. To cover this inflation, it is important to look for the maximum available sum insured at the best possible rate of premium.

      • Provide Complete & Correct Details

        Provide accurate information regarding your health in the proposal form, as any sort of inaccurate or mismatched information can make the insurer reject your claim form.

      • Keep in Mind the Factors That Influence the Premium

        A few factors that influence the premium of a health insurance plan include the proposer’s life history, family health history, lifestyle, smoking habits, etc. These factors are taken into account before the premium amount is determined.

      • Check the Credibility of the Health Insurance Company

        Do go through the history of the health insurance company you are planning to buy the medical insurance plan from. It is recommended that you select the health insurance company on the basis of the following parameters:

        • ICR: Incurred Claim Ratio or ICR, is one of the most important parameters to check while comparing health insurance companies in India. When taking into account the ICR of a health insurance company, look for the average ICR of all the health insurance companies online on Policy bazaar and go for the one that is closest to this average for a period of few years.

Incurred Claim Ratio

    • Customer Experience: You should always take heed to the mass opinion. Look for customer reviews online. If a large number of customers of an insurance company are unhappy, it may be because their customer support or after-sales service isn’t up to the mark.
    • Find out the Claim Process: Though the health insurance claim process is pretty generic over providers, knowing the nitty-gritty of the process can help save a lot of hassle at the eleventh hour.

Benefits of Comparing Health Insurance Plans Online

Due to tight and hectic schedules these days, it has become quite impossible to visit different offices or branches of different health insurers in order to compare various medical insurance policies.

Thankfully, Policybazaar understands the dilemma of the customers and hence, has offered a platform where you can compare different health insurance quotes online.

Enlisted below are some of the major advantages of buying a health insurance plan online:

    • Access to Accurate Information:

      It offers easy access to every medical insurance policy available in the market. It also saves the buyers from dealing with the agents who are known to provide unreliable and biased information most of the time..

    • Time Efficient and Convenient:

      By comparing health insurance plans online, the users are able to save their time as they don’t have to keep meeting with the agents to compare and choose the best plans. Additionally, several tasks, such as paying premiums, renewing the health insurance plans, etc., are also easier via online mode.

    • Pocket-Friendly:

      If a customer buys a health plan via an online channel, he/she will be able to compare the premium and opt for the one that fits in the budget. Also, no brokerage or agent fees are levied and hence, the buyer ends up saving a significant amount of money.

    • Availability of Provider/Plan Reviews:

      Doing so will help you get an overall idea of an insurer’s reputation, enabling you to make an informed decision.

Arogya Sanjeevani Policy: A Health Insurance for All

Arogya Sanjeevani is a standard health insurance policy that is provided by every health insurance company in India. Arogya Sanjeevani policy covers basic health insurance needs and is a good option for those who not have medical insurance cover, especially in smaller towns.

As mandated by the IRDAI, Arogya Sanjeevani policy provides coverage from Rs. 1 lakh to Rs. 5 lakhs, with a waiting period of just 30 days. However, the waiting period for specific diseases ranges from 24 months to 48 months, which depends on the illness as well.


  • Benefits of Buying Arogya Sanjeevani Policy:

    • The policyholder under Arogya Sanjeevani get coverage for Coronavirus related hospitalization expenses
    • It reduces the complications that arise while selecting from several health plans with varied inclusions, exclusions, and sum assured. Therefore, it is easier for common people to buy a health cover without any difficulty to understand the policy terms and conditions
    • Cashless hospitalization, NCB, and lifelong renewal facility is provided
    • Moreover, it is easily portable from one insurer to another


  • Features of Arogya Sanjeevani Policy:

    • Arogya Sanjeevani health plans cover anyone between the age group of 5 months and 65 years
    • The minimum sum assured is Rs. 1 lakh and the maximum sum assured is Rs. 5 lakhs, therefore it makes a perfect health plan for people in rural areas and those who cannot afford to pay a higher premium
    • The policy cover hospitalization expenses, all daycare procedures, ICU expenses, Ayush treatment, Ambulance charges, Cataract treatment etc.
    • A co-pay of 5% is applicable regardless of the age of the policyholder

How to Port a Health Insurance Policy?

You do not have to stick to your current insurer any longer if you do not want to since IRDA now allows you to change your current insurer without losing any of the existing benefits. Previously, if you changed your insurer, then you had to compromise on the benefits, viz. coverage for any pre-existing disease offered by your existing medical insurance policy.
According to the new rules, IRDA allows you to switch from one insurer to another while the new insurer will have to consider the credits you gained from your previous insurer, where credits refer to the waiting period under pre-existing conditions. The same applies if you switch from one plan to another with the same insurance company.

What you can do

  • Switch from one health insurance company to another
  • Any family floater or individual policy can be switched from/to.
  • Avail insurance cover by your new insurer up to the sum assured by the previous policy.
  • Both the insurers should mutually complete the formalities as per the IRDA timeline.

Criteria to meet

  • A policy can be switched only at the time of renewal.
  • With the new policy, the terms and conditions, including the premium are at the discretion of the new insurer.
  • Submit a formal shifting request to your current insurer at least 45 days before the due date of the renewal.
  • Make sure you specify the name of the new insurer you are willing to switch to.
  • There should not be any break between policy renewals.

Some Myths about Health Insurance

Before relying on the information it is imperative to check the facts and then buy a health insurance policy. Mentioned below are some popular myths that most people believe about medical policies:

  • I am Healthy, and I Don’t Need Medical Insurance

    Despite taking good care of your health, there are numerous unforeseen circumstances like seasonal illnesses, dengue, malaria, or an accident that can hit anyone anytime. Nowadays, hospitalization expenses are not easy to pay off. Even 2-days of hospitalization expenses would cost you somewhere between INR 60,000 to INR 1 lakh and even more (depending on the type of illness).

  • My Health Insurance will Cover all the Medical Expenses

    As per the IRDAI regulations, all the health insurance plans come with a set of exclusions/limitations. It is required that you check all the policy details and the coverage that is mentioned in the plan. The insurer will only compensate for the expenses that are covered in the policy and up to the specified limit.

  • Declaration of Pre-existing Diseases

    It is essential to declare all the pre-existing diseases in the proposal form. One must mention pre-existing diseases clearly before buying a health insurance policy. Inadequate information can lead to rejection of the claim and can cost more than the expected amount.

  • Smokers are not Eligible to Buy a Health Insurance Plan

    As per the survey, nearly 49% of the applicants who consume alcohol are perplexed to buy a health insurance policy. But there are health insurance companies that offer medical insurance coverage to them as well. But taking into consideration the risks, alcohol consumers, and smokers would need to undergo a stringent pre-medical examination procedure and pay a higher premium to get health insurance coverage.

  • Medical Insurance will only Cover Hospitalization Expenses

    Though most of the health insurance plans cover medical expenses for hospitalization more than 24-hours, there are plans that have a capping on the duration of hospitalization as well. But most of the insurers these days cover daycare procedure as well, where it is not required to be hospitalized for 24-hours. It includes cataract surgery, varicose veins surgery and similar medical procedures.

  • I am Covered Under a Group or Corporate Health Insurance Plan!

    Most people rely on the health insurance plan that is provided by their employer. It is important to know that a group health insurance policy comes with a set of limitations. It will not offer coverage to your family members in most of the cases, the sum assured will not be sufficient, it will not cover critical illnesses. Also, getting health insurance coverage after retirement or losing a job can prove to be an expensive affair.

How to Calculate Health Insurance Premium

In order to keep the policy in force, regular payment of a fixed premium is essential. Did you ever think about how this premium is calculated? There are certain factors that affect health insurance premium such as the medical background of your family, your personal medical history and so on.

Based on that, you might want to calculate your premium to figure out how much you would have to pay for the policy. It can be done through a health insurance premium calculator. Premium calculator is an online tool that calculates the premium to be paid as per the information provided by you. At Policybazaar.com, you can calculate your health insurance premium easily.

Factors Affecting Health Insurance Premium

With the advancement in medical facilities, health care costs have also increased. The main benefit of health insurance is that it takes care of the healthcare expenses. It offers financial security to you and your family in the event of an unanticipated serious illness or accidental injuries that could drain all your savings. And here is how the cost of your insurance premium is determined:

  • Medical History

    Your medical history is one of the major determinants of the health insurance premium. Almost all the ‘ health insurers in India make pre-medical tests mandatory (after a certain age) before buying a health insurance policy.

    While, some insurance companies don’t make medical screening mandatory but do consider your current medical conditions, lifestyle-related health risks and medical background of your family.

    That is why medical insurance premium for smokers is higher than other people.

  • Gender and Age

    Age is another important determinant of the medical insurance premium. The premium varies based on the age of the insured person.

    That is why it is recommended to buy a policy at a young age because the cost of the premium is low for young applicants.

    Elderly people are vulnerable to cardiovascular diseases, and other critical illnesses such as cancer, kidney problems, etc. For this reason, senior citizen medical insurance premium is usually on a higher side.

    Also, the cost of the premium for women’s health insurance is lower in comparison to the male candidates due to lower risk of stroke, heart attack, etc.

  • Policy Term

    The premium for a 2-year health insurance plan will be higher than a 1-year plan. However, almost all insurance companies offer a discount on long-term medical insurance plans.

  • Type of Health Insurance Plan

    The type of health insurance policy you select also affects the cost of the premium. The higher the risks involved the higher will be the premium and vice-versa.
    With the help of an online health insurance premium calculator, you can compare the premium for different health insurance plans.

  • No-Claim-Discount

    If you have not made any claim during your policy term, then you can earn NCB or No-claim-bonus ranging from 5 to 50 percent. It is also one of the most important factors that are taken into consideration while calculating the cost of the premium.

  • Lifestyle

    If you drink or smoke regularly, chances are high that you will be charged more premium amount. In that case, the insurer can also reject your medical insurance policy request.

Health Insurance Claim Procedures

Health insurance plans come with additional benefits of cashless treatment and expense reimbursement by the insurer. One can file a claim against an event that is covered by the insurance policy. Following are two claim processes:

  • Expense Reimbursement

    Health insurance plans provide the insured with the benefit of getting their medical expenses reimbursed by the insurer. The cost of various hospital charges such as bed charges, medicines, lab tests, surgeon’s fees, etc. are paid back to the insured if the claim for reimbursement is filed. The insured pays the (hospital) expenses but gets reimbursed by the insurance company.

  • Cashless Treatment

    Insurance companies provide policyholders with a wide range of network hospitals to get medical treatment without having to make upfront payments. No payment is required to be done by the insured since the clause involves a mutual agreement between both the parties, i.e. the insurer and the network hospital. Availing cashless benefit requires TPA approval.

    The insured can also show the insurer-issued health card at the particular hospital as proof of medical insurance cover along with a valid government ID. Following cases are considered for cashless treatment:

  • Planned Hospitalization

    In case of planned hospitalization, in order to avail health insurance benefit the insured needs to have TPA approval in advance along with other mandatory documents. Fill the pre-authorization form at the network hospital signed by the treating doctor(s).

  • Emergency Hospitalization

    Show the health card issued by the insurer at the hospital along with the appropriately-filled pre-authorization form to get TPA approval for emergency hospitalization. If you fail to get TPA approval, you would need to file for reimbursement later. The insured might have to show the itemized bill, proof of medical expenses, discharge bill, etc., as the proof of the treatment availed to avail claim reimbursement.

Documents Required for Health Insurance Claim Reimbursement

In the event of hospitalization, the policyholder needs to submit certain documents as mentioned below:

  • Discharge card issued by the hospital/network hospital
  • In-patient hospitalization bills signed by insured for authenticity
  • Doctors’ prescriptions and medical store bills
  • Claim-form with insured’s signature on it
  • Valid investigation report
  • Consumables and disposables prescribed by the doctors with complete details
  • Bills of doctors’ consultation
  • Copies of the Insurance policy from the previous year and the current year/copy of ID Card of TPA
  • Any other document(s) asked by the TPA

Buy Top Health Insurance Plans Online from Policybazaar

Buying health insurance can be easy if you approach the right channel. Having said this, Policybazaar.com can be a good platform for choosing the right insurance policy. Policybazaar has made the process of comparing & buying a health insurance policy easier in comparison to earlier days. One has easy access to the complete details of almost all the health insurance plans available in the Indian insurance market at a competitive price.

Policybazaar helps you sieve through numerous mediclaim and health insurance plans and zero down on the one that measures up to your needs. Moreover, the post-sale services are extended to the customers online as well even at the time of medical insurance claim.

Steps to Buy Health Insurance Plan Online from Policybazaar

To get insured from the comfort of your home, you can buy health insurance online from Policybazaar. No medicals are required and the steps to buy medical insurance are listed below:

Step 1– Select Male/Female and enter your full name

Step 2– Enter your correct phone number, and click on view plans and select your age

Step 3– Click on continue and your city where you are living in and the pin code

Step 4– Click on Yes or No if you take any medications

Step 5– Select the best health insurance plan from the options that are displayed. Choose ‘Get Free Advice’ if you want suggestions or help

Step 6– Select and compare the different health insurance plans on Policybazaar. You can choose the personalized plans options as well

Step 7– Once the plan is selected you can pay the premium or speak to our customer care representative to take your through different options

Step 8– Make an informed decision and pay the premium. Once all the steps are completed, the policy will be emailed on your registered email-id

List of Government Health Insurance Schemes in India

The government health insurance scheme refers to the health insurance programmes that are backed by the Indian Government. The motive of launching government health schemes is to make health insurance accessible to the economically deprived section of the society.

List of Health Insurance Companies in India

In order to help you with the best and convenient buying experience, we have compiled a list of General Insurance Companies in India providing health insurance in India. This list is prepared based on the Incurred Claim Ratio (ICR) and the overall health insurance policy benefits that they are offering:

Let’s discuss these Health Insurance Providers in detail.

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.

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Updated: 30 October 2020



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