Get best Health Insurance Plans from Top Rated Insurers!
What is Health Insurance?
A health insurance plan (also known as a medical insurance policy) covers medical expenditures incurred as a result of an accident, sickness, or accident. Individuals can obtain such coverage in exchange for annual or monthly premium payments for a certain period of time. During this time, if the insured individual gets is diagnosed with any covered illness or gets injured in an accident, the insurance company will cover the costs of treatment.
Highlights of Health Insurance
|Sum Insured||5 Lakh to 1 Cr|
|Day Care Procedures||Covered|
|Pre & Post-hospitalization Expenses||Covered|
|Newborn Baby Expenses||Covered|
|Free Health Check-ups||Available|
|Room Rent||Covered As per Policy|
|Organ Donor Expenses||Covered|
|Save Tax||Upto ₹75k Under Section 80D|
|Happy Customers||50+ Lakhs|
|Claim Process||Online & Offline|
IMPORTANCE OF HEALTH INSURANCE IN INDIA
Health insurance plans has become a requirement for every citizen in India. The primary causes of death in India include ischemic heart disease, COPD and stroke. All of these diseases are life-threatening and require immediate treatment, but because of their high costs, most people cannot afford the treatment. The best health insurance policy in India provides financial protection against unforeseen expenses resulting from medical emergencies and allows you to get the best possible treatment with little to no out-of-pocket expenses.
This is especially important in a country like India, which has witnessed a medical inflation rate of 14% in recent years. With the healthcare expenses going so high, it is only reasonable to get a good health insurance plan in place. The best health insurance policy will not only help you manage your healthcare needs but also give you peace of mind in case something goes wrong. You don’t have to worry about putting yourself into debt just because of an unexpected situation.
Features of Buying Health Insurance Online
Here is a list of some common features of health insurance policies:
- Premiums: Premium is the regular payment that the policyholder needs to make in order to keep the health insurance coverage active for the specified policy term. Insurance premiums depend on the policy type, coverage, insured’s age and many other factors.
- Waiting Terms: Insurance providers do not offer health insurance benefits as soon as the policy is acquired. There is a 30-day initial waiting period where the insured cannot file claims except for accidental claims. Apart from that, there are specified waiting periods for pre-existing diseases and other medical conditions.
- Sub-Limits: Most insurance companies set limits on their coverages. For example, you can get a health insurance plan with INR 5 lakhs of the sum insured, but the policy can set a sub-limit on hospital room rent to 1% of the entire sum insured, i.e., INR 5,000.
- Co-Payments: Co-payment provisions allow the insured person to reduce his or her insurance premium in return for contributing a specified proportion of the sum covered at the time of claim filing. Co-payments can be either voluntary or mandated by the insurance policy.
- No-claim Bonus: No-claim bonus is a monetary benefit that an insurance provider provides to insured individuals if they do not file any claim for a policy year. When you renew health insurance plans, this bonus will be awarded as either a discount on the premium or an increase in the total sum insured.
- Medical check-ups: Most health insurance providers offer medical check-ups as a part of their insurance coverage. Some policies offer free healthcare check-ups as a part of their annual no-claim benefit.
- Exclusions: Just like any other insurance plan, health insurance plans include a list of policy-specific exclusions. These are conditions when the insurance company will not be obligated to settle any health insurance claims with the insured.
- Network hospitals: Network Hospitals are medical facilities which are affiliated with insurance providers and offer cashless treatment to active policyholders of the same company.
Benefits of buying health Insurance Policy
Here are some benefits when shopping for health insurance online:
- Multiple Choices: Hundreds of health insurance policies are accessible online. These insurance plans provide several coverage options for customers with varying needs and budgets. So, in this sea of various online plans, you can always discover your ideal medical insurance coverage.
- Easy to Compare Policies: It is easy to compare health insurance plans online as long as you have them all in a single plan. Premium rates, coverage ranges, network hospitals and available add-ons are some of the important factors that you need to compare policies.
- Convenience: It is highly continent to buy health insurance plans online. You can do so from the comfort of your couch or office at any point of the day with no problem.
- Low Paperwork Hassle: Online purchase of health insurance plans requires filing and submitting the required paperwork online. So, it reduces the hassle of paperwork that you would have experienced when looking for offline plans.
- Instant Issuance of Policy: When you purchase health insurance coverage online, your plan is issued almost immediately. However, it is important to note that you still have to wait out the initial 30-day waiting term to enjoy coverage benefits.
Types of Health Insurance Plans We Provide
1). Women’s Health Insurance
Women in India have a unique set of health concerns and risks. The good news is that there are many health insurance options available to meet their needs. These women’s health insurance plans encompass several women health related issues & compensate for the same.
2). Children’s Health Insurance
Children’s Health Insurance in India is a vital topic. As per NFHS, nearly 37 per cent of Indian children aged 0-5 years are underweight, and 42 per cent are stunted. However, children’s health insurance plans encompass several children’s health-related issues & compensate for the same.
3). Health Insurance for Individuals
Many Indians are purchasing individual health insurance plans. These plans offer many benefits, including the ability to choose your own doctor and customise your coverage. Individual health insurance plans are becoming more popular in India as people become more aware of the benefits they offer.
4). Health Insurance for Senior Citizens
Senior citizen health insurance in India has gained immense attention in recent years. With a large population of senior citizens and a limited number of available resources, the Indian government has been working to create a system that provides adequate health coverage for its elderly citizens.
5). Health Insurance for Family
In India, family health insurance is a type of insurance coverage that provides financial protection to a nuclear family in the event of an unforeseen health crisis. The head of the family is typically the policyholder, and the other members of the family are the beneficiaries.
6). Health Insurance for Parents
In India, health insurance for parents is a vital aspect of life. There are many options available for health insurance in India, but it can be difficult to choose the right one. It is of prime importance to carry out a bit of research before purchasing health insurance for your parents in India.
7). Coronavirus Health Insurance
Covid-19 spread like rapid fire in India in 2020. Cases spiked a lot during the mid-period of 2020 & became worse in the early half of 2021. However, many people got the advantage of coronavirus health insurance plans. Coronavirus health insurance plans compensated for the patients’ treatment.
8). Personal Accident Health Insurance
Personal accident health insurance offers compensation in case of any losses to the policyholder in terms of injuries sustained due to an accident while being in the vehicle. It is one of the most highly recommended health insurance policies if you have a bike or a car.
9). Critical Illness Insurance
Critical illness insurance provides compensation in cash in case you’re diagnosed with a pre-specified critical illness or critical ailment. Critical illnesses can have a significant impact on an individual’s financial stability, as they often result in high medical costs and a loss of income.
10). Cancer Insurance
Cancer insurance provides compensation in cash in case you’re diagnosed with cancer or cancer-related ailment. Cancer can have a significant impact on an individual’s financial stability & physical state of being, as it often results in high medical costs, loss of income & suffering.
11). Group Health Insurance
Group health insurance in India is offered by employers. It is a cost-effective way of providing health coverage to employees and their families. Group health insurance plans are available from a number of insurers in India, and they can be customised to suit the needs of an organisation.
What is Covered in a Health Insurance Plan?
We offers a range of benefits and coverage under various health insurance plans. These include:
- In-patient hospitalisation expenses: When a patient gets admitted to a hospital and remains there for more than 24 hours, it is counted as in-patient hospitalisation coverage, and the expenses are covered by the insurance company. However, if the patient is discharged before 24 hours, in-patient cover is not applicable.
- Pre and post-hospitalisation expenses: Pre and post-hospitalisation expenses, as the name suggests, are meant to cover the treatment expenses incurred by a patient before getting admitted and after being discharged from the hospital. One may receive pre-hospitalisation expenses of up to 60 days and post-hospitalisation expenses of up to 90 days, depending on the policy opted.
- Day-care treatment cover: Those treatments or surgeries done in a hospital that does not require hospitalisation of more than 24 hours is considered day-care treatment. Cataract surgeries, dialysis, and chemotherapy are a few examples of daycare treatment.
- Domiciliary hospitalisation cover: When a patient receives doctor-prescribed hospital-like treatment at home due to the inability to shift to the hospital, the expenses are covered as domiciliary hospitalisation cover. Health insurance providers offer domiciliary cover if home treatment exceeds 3 days.
- Ambulance cover: The charges of an ambulance is also covered under a health insurance plan. Typically, an amount up to a specified limit is paid out per hospitalisation in a policy period. Air ambulance charges of up to 10% of the basic sum insured are also covered by several health insurance plans.
- Organ donor expenses: In case there is a need for an organ donor, such expenses are also covered.
- Alternative treatment cover (only for specific policies): Alternative treatments come under AYUSH treatments. It refers to Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy (AYUSH). So, the cost of AYUSH Treatment is covered by various health plans for specific policies.
- Outpatient treatment cover (only for specific policies): The treatments done in OPD (Out- Patient Department) like diagnostic tests, doctor’s consultation, etc. which do not require hospitalisation, are covered under outpatient treatment cover. It is available only for specific policies.
- Maternity cover (only for specific policies): Available under specific policies as add-ons, the insured receives coverage for maternity expenses.
- Critical Illness cover ( only for specific policies): Life-threatening diseases are considered critical illnesses. Such illnesses may require frequent hospital visits and a longer duration of hospitalisation. Depending on the policy you choose, you may receive critical illness coverage, which covers medical bills, consultation charges, treatment costs, etc.
- Hospital daily cash benefit (only for specific policies): A fixed amount of daily cash is provided to the insured when hospitalised for more than 24 hours. The amount is fixed at the time of purchasing the policy and remains unchanged. It helps in covering inadmissible charges of hospitalisation like gloves, masks, etc.
- Mental illness cover (only for specific policies): When a patient receives treatment for any mental illness. The expenses are covered. It is available for specific policies only.
Note: These are generic inclusions of health insurance plans and may vary from policy to policy. Please refer to your health insurance provider for an exhaustive list of inclusions.
What is Not Covered in a Health Insurance Plan?
Not everything can be included in a health insurance policy. The terms that are not covered include
- Claims during the waiting period of 30 days: Most health insurance plans have a waiting period of 30 days, and during this waiting period, you cannot raise a claim unless hospitalisation is required due to an accidental injury.
- Claims for pre-existing illnesses during their waiting period: If your health insurance plan covers pre-existing illnesses of the insured, you cannot raise a claim during the waiting period, which can be up to 48 months. On the other hand, if pre-existing illnesses are not covered, no claim shall be raised for the same.
- Cosmetic surgery costs: Expenses incurred due to cosmetic surgeries are not covered under health insurance plans unless required after an accidental injury.
- Pregnancy complications: If there occur treatment expenses due to complications in pregnancy/childbirth, the health insurance plan may not cover the expenses.
- Treatments for infertility and sterility: Treatments received for infertility and sterility are not covered under a health insurance plan.
- Treatments or medications received without prescription: If you take treatments or medications on your own without a doctor’s prescription, the expenses will remain uncovered.
- Claims arising due to intoxication: If the insured requires medical treatment due to intoxication or drug abuse, the cost of treatment remains uncovered.
- Self-harm: Any treatment received against any sort of self-harm is not covered under a health plan.
- Claims arising due to law breach: If the insured participates in any unlawful or illegal activity and suffers physical injury, such treatment expenses are not covered.
- Claims arising due to exposure to nuclear radiation or war: Any medical treatment received for physical injury/illness due to exposure to war or nuclear radiation is not covered.
Note: These are generic exclusions of health insurance plans and may vary from policy to policy. Please refer to your health insurance provider for a complete exclusion list of your plan.
How to File A Health Insurance Claim
In order to file a health insurance claim, you just need to follow the right steps. Depending on the hospital in which you seek admission, you can go for either a cashless treatment or a reimbursement claim.
Here is detailed information on how you can file a health insurance claim:
1). Reimbursement Claim
A reimbursement claim is raised when you pay the admissible medical expenses from your pocket. If the patient/insured is hospitalised or receives treatment from a non-network hospital, cashless treatment cannot be availed. Hence, once the patient gets discharged, a reimbursement claim can be raised either offline or online. Make sure that in case of planned hospitalisation, you inform the insurance company 3 – 4 days in advance, so that the pre-authorisation can be done. In case of emergency hospitalisation, the insurer should be informed in the first 24 hours. The steps involved are:
- Visit a hospital of your choice for the treatment
- Pay the hospital bills on your own pocket
- Once discharged from the hospital, collect all the bills and the relevant documents
- Fill and submit a reimbursement claim form to your health insurance provider
- Attach all the bills and the necessary documents
- Once cleared, you will receive the admissible charges in your linked bank account.
2). Cashless Claim
In case you receive medical treatment from a network hospital (the impanelled/partner hospitals of the insurance provider), you become eligible to avail of cashless treatment. You need not make any payment for the admissible expenses. In case of planned hospitalisation, you need to inform the insurance company 2 – 3 days in advance and get the pre-authorisation formalities completed. If it has been an emergency hospitalisation, the insurer can be intimated within 24 hours of admission to the hospital. The steps involved are:
- Visit any of the network hospitals of your health insurance provider
- At the hospital, submit your cashless card/ policy papers
- Fill out the cashless treatment form with all the correct details
- Provide the necessary documents like photo ID, policy number, etc.
- Upon verification, cashless treatment will begin and you will not have to pay for admissible charges.
Who is Eligible to Buy a Medical Insurance Policy?
The eligibility criteria differ from one health insurance policy to another. So, when you are choosing a health insurance provider and the policy, it is essential to check the eligibility details of the particular health plan. Some eligibility criteria include:
- Age of the insured: The age limit of purchasing a health insurance plan may differ from one health plan to another. Most of the plan offers an entry age of 60, while some plans may allow entry to senior citizens as well.
- Risk exposure of the insured: Some individuals are at higher risk of disease than others. For instance, people with a family history of diabetes are at a higher risk of developing high blood sugar levels. So, the premium for such individuals may be higher or the terms of the plan may differ.
- Pre-existing medical conditions of the insured: Depending on the health insurance plan chosen, your pre-existing illnesses may or may not be covered. If you are suffering from a pre-existing illness, you may look for a health plan that covers it with minimum waiting.
How to Calculate Health Insurance Premiums?
Health insurance premium rates depend on various factors, some of them are:
(Step 1). Check Policy type
Premium rates of some health insurance policies are generally higher than others. For example, a health insurance plan which covers multiple critical illnesses along with regular healthcare benefits is more expensive than regular Mediclaim policies.
(Step 2). Check Age
Insurance companies give lower premiums to persons who seek health insurance at a young age, mostly because the likelihood of falling ill and requiring healthcare grows as they get older.
(Step 3). Check Number of insured
As the number of insured increases, the rate of premium is also increased. However, if the policy is purchased on a family floater basis, the premium rate is decreased as the total sum insured covers the whole family as a whole irrespective of the number of individuals covered.
(Step 4). Check Pre-existing medical conditions
People with pre-existing conditions are considered to be a riskier group than people who are healthy. This means that they are charged higher premiums, and must wait a set waiting period before they can file claims for their existing medical conditions.
(Step 5). Check Exposure to Risk
Some people like those who work on construction sites or who participate in adventurous sports create a higher risk for insurance companies, which is again reflected in higher premiums for the policyholders.
Importance of Buying a Health Insurance Plan at an Early Age?
- Most health insurance providers offer premium rates depending on the insured’s age. Young people or those in their twenties, who seek health insurance at a young age are given lower premiums because the likelihood of them falling ill, and requiring medical care, is small. Because of this fact, young people aren’t charged as much for the same health insurance plan as, say, someone in their late forties.
- Apart from that, buying a health insurance plan early helps you to save money in the long run Accidents do happen without notice, and having enough medical coverage can guarantee that you are insured in the event of an emergency while also allowing you to place your hard-earned cash in long-term investment schemes. Of course, health insurance will also save you taxes. The current limit of tax deduction under section 80D on the total premium paid per year is INR 25,000 for policyholders under the age of 60.
DOCUMENTS REQUIRED TO BUY/CLAIM/RENEWAL PROCESS
For Buy Health insurance Plan
When you buy a health insurance plan, 80% of your hospitalisation expenses are taken care of by the health insurance company. You can either avail of cashless treatment at network hospitals or even pay your expenses first and then claim reimbursement from the insurance company.
- Proof of age: Birth certificate, matriculation marksheet, passport, etc.
- Identity Proof: Passport, driving license, voter ID, or Aadhar card
- Proof of Address: Utility bills like electricity bill, telephone bill, water bill, etc. or passport, driving license, etc. A thorough medical checkup
For Claim Process
When you purchase a health insurance policy, 80% of your hospitalisation treatment bills are paid by the health insurance organisation. However, in terms of the claim process you have to either get admitted to a network hospital & get cashless treatment or wait for reimbursement.
- A duly filled claim form. You can get the form online/offline from your insurance provider
- Passport size photograph
- Bills and receipts of hospital expenses
- Doctor’s prescriptions recommending the treatment taken
- Any other documents as asked by your insurance provider like physician’s letter, payment proof.
- A pre-authorised claim form – For Cashless Claim
- Identity proof along with photographs of the insured like Aadhar/ PAN card, etc. – For Cashless Claim
For Renewal Process
There are usually two ways when it comes to the renewal process of your policy. You can either visit the insurer’s official website & complete the renewal formalities or do the same by visiting the nearest branch of the insurance company.
- A duly filled renewal form
- Identity proof Aadhar/ PAN card/ Passport
- Medical reports (if required)
- Details and policy papers of existing/ previous policy.
For Renewal Process
A health insurance plan is a perfect choice for everyone – from students who are just starting out on their careers to professional experts who are in their late forties to fifties. Though the medical insurance that you get from an employer could be sufficient for you to live a healthy life and carry out your daily tasks, having your own insurance is still better. Whether the injuries and illnesses come from natural or man-made reasons, you will be greatly benefited from getting yourself an insurance policy. So, if you haven’t already, start shopping for the best health insurance in India.
Frequently Asked Questions
The best way to get the highest coverage with medical insurance without splurging is through additional riders. You can add riders as per your needs and enhance your policy coverage.
The minimum age to purchase a health insurance plan is 18 years.
Your policy will lapse or get terminated if you fail to pay your premiums.
There is no limit on how many medical insurance plans you can purchase.
Cashless treatment under health plans ensures that you do not have to pay anything when you get admitted to one of the network hospitals of your health insurance provider.
No, medical insurance is quite affordable. For instance, under a basic health plan with a sum insured of Rs. 5 lakh, you might have to pay a premium of Rs. 5,000 – Rs. 10,000 per year. The premium depends on your age, type of policy, and other factors.
Yes, you can add family members like your spouse, children, parents or parents-in-law under a family floater which offers cover for the entire family.
Every policy comes with a waiting period after which your cover gets activated. The waiting period for most health policies is 30 days but we suggest checking with your insurance provider on the same.
Every policy comes with a waiting period after which your cover gets activated. The waiting period for most health policies is 30 days but we suggest checking with your insurance provider on the same.