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Health Insurance

Know about Health Insurance

Health insurance is an insurance product that covers medical and surgical expenses of an insured person. These expenses could be related to hospitalisation costs, medicine costs, or doctor consultation fees. Since medical costs are going up, and more people are getting sick because of their lifestyles. If you end up in the hospital without health insurance, it can quickly drain your savings. Buying a health insurance policy can provide you with the required financial assistance in case of hospitalization. This insurance provides coverage against medical expenses that you may incur during the policy period. With a valid mediclaim, you can also receive tax benefits under section 80D of the Income Tax Act, 1961.

Key Features of Health Insurance Plans

Feature Specifications
Sum Insured Rs. 50,000- Rs.3 crore
Room Rent Covered as per policy terms and conditions
Pre and post hospitalization expenses Usually 30-60 days
Day care procedures Covered
Sum Insured Restoration Benefit Available
Maternity and newborn expenses Covered
Pre-existing diseases Covered after the applicable waiting period
OPD Cover Covered
ICU charges Covered
Ambulance charges Covered
Organ donor expenses Covered
Free health check up Covered
Tax Benefits Up to Rs. 1 lakh under section 80D of the Income Tax

What is Health Insurance?

Health insurance is an agreement between the insurer and the policyholder whereby an insurance company agrees to reimburse for medical costs incurred by the policyholder during the tenure of the policy. According to the policy terms, the insured may incur medical expenses if they get ill or meet an unfortunate accident that leads to treatment at the hospital. To avail of the coverage benefits of a health insurance policy, the policyholder must pay a specific amount periodically, called a premium. The premium is determined by the insurance company and must be paid by the policyholders without any fail either monthly, quarterly, half-yearly or annually.

What is Health Insurance?

Why Should You Buy Health Insurance?

In today’s uncertain times and with changing lifestyles, you may never know when a medical emergency will knock on your door. To stay protected against such unpredictabilities, it is very important to stay secure with health insurance. There are several other reasons why you should buy this beneficial health plan, some of which are listed below:

  • Rising Medical Expenses

Over the years, the cost of healthcare in India has witnessed a sharp rise so much so that it becomes difficult to access quality medical assistance. It is the increase in the cost of medicines, hospitalisation, medical examinations, and more that have together led to an overall increase in medical expenses. With this rise in medical expenses, it makes all the more sense to buy a health insurance plan that helps you stay protected against such medical emergencies. Depending on your healthcare needs, buy a suitable plan for yourself and your loved ones.

  • Altering Lifestyle

The current-day modern lifestyle is such that individuals have been exposed to health problems even more. The 9-5 job, eating habits, disrupted sleep cycle, and more have together contributed to an unhealthy lifestyle. Due to the unhealthy lifestyle, a number of health problems such as obesity, asthma, have constantly been rising. Moreover, apart from physical problems, the unhealthy lifestyle has also led to increased mental health problems. Thus, due to all of these reasons, it becomes all the more important to buy a medical insurance policy in India.

  • Tax Benefits

A plan like health insurance not only protects you from medical emergencies but also provides tax benefits. It is the premium that is paid towards such plans that offer tax benefits under the Income Tax Act of 1961. The tax benefits vary from one group to another, for instance, the tax benefits for senior citizens are higher as compared to the others. Policyholders can avail of maximum benefit of Rs. 75,000 against their policy.

  • Network Hospitals

Network hospitals or cashless hospitals are those where policyholders can avail of cashless treatment. The number of network hospitals varies from one health insurance company to another. Thus, it is important that you check the availability of network hospitals while buying the plans. With the availability of network hospitals, it becomes easier to avail of quick and cashless claims.

  • Pre-existing Disease Coverage

Health insurance plans also offer coverage for pre-existing diseases after a specific waiting period. However, if you want to get health insurance coverage for these pre-existing conditions like diabetes, hypertension, and more, you can also buy a plan that offers coverage for pre-existing diseases from the start. You can also check with your insurer regarding the coverage for pre-existing diseases in your mediclaim plan.

  • Pre and Post Hospitalisation Expenses

With a number of health insurance policies available in India, you will also get coverage for pre and post-hospitalisation expenses. Once you are insured with a relevant type of plan, you can enjoy financial coverage for both pre and post hospitalisation.

  • Variety of Health Insurance

There are a variety of health insurance plans available such as individual plans, senior citizen, family health insurance, and many more. With different types of plans availablle, you can pick a desired type of plan based on your requirements and budget.

  • Provides Additional Discounts

On buying medical insurance, you can also get several types of discounts such as wellness discounts, renewal discounts, and more. This means that you can save a lot of money and avail discounts once you have bought health insurance plans.

  • Ensures Peace of Mind

When you know you and your loved ones are protected against any kind of medical emergency, it will ensure a great sense of relief for you. Thus, by buying health insurance plans, you can stay stress-free and focus more and more on getting quality treatment.

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Health Insurance At A Glance

Parametres Specification

Sum Insured

Rs. 50,000 - Rs. 6,00,00,000

Tax Benefits

Available under Section 80D of the Income Tax Act

Maximum tax benefits u/s 80D

Rs. 75,000

Types of Health Insurance

Senior Citizen Plans, Individual Plans, Family Floater Plans, etc

Add-ons

Critical Illness Cover, Maternity Cover, Reduction in Pre-existing Waiting Period, etc

Coverage

Pre and post hospitalisation expenses, Modern Treatment, AYUSH treatment, In-patient treatment, Domicilliary Treatment, Day care procedures etc

Pre-existing Waiting Period

Generally 48 months, however varies depending on the health insurance policy

Claim Process

Cashless or Reimbursement

Health Insurance Checklist

Here is the checklist that you need to follow:

  • Waiting Period

The waiting period refers to the period during which the policyholder will not be able to raise claims. The waiting period varies from one insurer to another, hence you must check it while buying such plans. You should ideally choose a health insurance company that has a lower waiting period.

  • Co-payment

Co-payment refers to the amount you need to pay from your pocket to get the relevant coverage. You should choose a plan that has a lesser or no co-payment so that you don’t have to spend anything from your pocket. However, when you have a higher co-payment, then the premium in such cases will be lower.

  • Grace Period

Select the company that offers more grace period. The grace period refers to the period during which you can still renew your plan irrespective of its expiry. You must thus read the policy details to know about the exact grace period.

  • No Claim Bonus

No Claim Bonus in health insurance refers to the benefit given to the policyholder if you raise no claim in a given year. A No Claim Bonus benefit is given when a policyholder is renewing their plan. So, before buying such plans, you should check the No Claim Bonus.

  • Network Hospitals

Network hospitals are those where you can get cashless treatment. You should choose a company that has tie-ups with more network hospitals. The more the number of network hospitals, the easier it becomes for policyholders to locate a nearby cashless hospital and get quality treatment without worrying about hefty medical expenses.

  • Restore Benefits

Restoration benefits refer to the process in which the exact sum insured gets automatically restored once it has been used or after a claim has been raised. You should ideally choose a health plan that offers greater restoration benefits or 100% restoration benefits.

  • Preventive Health Check-up

Preventive health check-up refers to the benefit given to the policyholder to avail of an annual health check-up for free. While buying such plans, you must check with the insurer whether there is a free annual health check-up available with your plan or not.

  • Sub-limits

There are a number of health insurance plans that come with different sub-limits. However, you should choose a company with no sub-limits on your plan. So make sure to go through the policy wording to know all about the sub-limits in your plan.

Best Health Insurance Plans In India

  • Cover 5 L
    Starting at 832/month*
    No room rent limit 100% no claim bonusUnlimited restoration benefits3 years PED waiting period
    View All Features
  • Cover 10 L
    Starting at 739/month*
    No room rent limit Unlimited restoration benefits50% no claim bonus4 Years PED Waiting period
    View All Features
  • Cover 5 L
    Starting at 447/month*
    No room rent limit 33% no claim bonus100% restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 1,312/month*
    No room rent limit 50% no claim bonus100% restoration benefits3 yrs PED waiting period
    View All Features
  • Cover 5 L
    Starting at 448/month*
    Single Private A/C Room 20% no claim bonus100% restoration benefits1 year PED waiting period
    View All Features
  • Cover 5 L
    Starting at 664/month*
    No room rent limit null20% no claim bonus100% restoration benefits2 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 675/month*
    No room rent limit 50% no claim bonusUnlimited restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 690/month*
    Single Private A/C Room 100% restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 546/month*
    Twin sharing room Zero no claim bonus100% restoration benefits2 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 566/month*
    No room rent limit 20% no claim bonus100% restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 1,770/month*
    Zero no claim bonusNo restoration benefits1 year PED waiting period
    View All Features
  • Cover 40 L
    Starting at 62/month*
  • Cover 2 L
    Starting at 146/month*
  • Cover 5 L
    Starting at 806/month*
    Single Private Room 10% no claim bonus100% restoration benefits2 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 476/month*
    60% no claim bonus150% restoration benefits4 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 526/month*
  • Cover 5 L
    Starting at 855/month*
    25% no claim bonus100% restoration benefits4 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 448/month*
    Single Private A/C Room 20% no claim bonus100% restoration benefits1 year PED waiting period
    View All Features
  • Cover 5 L
    Starting at 396/month*
    Room rent upto 2% of SI Room rent upto 1% of SI No room rent limit Single Private Room
    View All Features
  • Cover 5 L
    Starting at 738/month*
    No room rent limit 50% no claim bonus100% restoration benefits3 yrs PED waiting period
    View All Features
Note: Premium is shown for 18yr old individual of Delhi
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Importance of Health Insurance in India

With rising healthcare expenses, access to high-quality medical treatment can drain your finances. Thus, to protect yourself and your loved ones financially against any critical illness every citizen must get insured under a reliable health insurance plan. Here are the top reasons why you should get coverage as early as possible:
  • To Protect Your Savings

    To Protect Your Savings

    Though savings are required to meet unexpected future expenses. But, a single hospitalization can drain your life savings in one go. However, you can overcome the situation by getting secured through comprehensive coverage provided by different insurance providers. Most commonly, the companies provide benefits for in-patient hospitalization expenses, pre and post-hospitalization expenses, day-care treatment, ambulance charges, and much more. Besides all, a variety of plans are available in the market, among which an individual can buy as per their specific requirements.
  • To Deal With Medical Inflation

    To Deal With Medical Inflation

    An unexpected critical illness like Cancer, HIV, Heart disease and more can put anyone under stress because of the increased cost of high-quality treatment. Besides treatment expenses, there are many other costs involved like medicines, diagnosis, ambulance charges, consultation fees of a doctor, and much more. Hence, you can save yourself from this drudgery and stressful situation by purchasing a health insurance plan for yourself and your family at the right time.
  • Lifestyle Changes

    Lifestyle Changes

    As we are moving forward with the new lifestyle, critical illnesses like cancer, kidney failure, stroke, and many more critical illnesses are following us. These are unexpected diseases happening to people above 45 years of age due to sedentary lifestyles, stress, pollution, and more. Thus, purchasing a comprehensive health plan will not only keep you updated about your health through regular check-ups but will also provide financial coverage for the treatments.
  • To Secure the Health of Your Family Members

    To Secure the Health of Your Family Members

    Within a single insurance plan, you can be secured financially against unexpected critical illnesses. There are many policies available that cover you including your spouse, dependent parents, dependent children, or any other dependents. A family-floater policy will reduce the complexity of maintaining separate insurance plans and will keep your entire family protected. Furthermore, purchasing a family-floater plan is the most cost-effective way to get benefits.
  • Timely And High-Quality Medical Treatment

    Timely And High-Quality Medical Treatment

    Reliable security can be advantageous for having a premium-quality treatment without burning your pockets. The process of availing the benefits is as simple as baking bacon. In case of requirements, you just have to visit the nearest network hospital and get the treatment as per the terms and conditions mentioned in the policy. The benefits of insurance can be availed in both cases, which may be a planned hospitalization or an emergency case.

Key Features of Health Insurance

Listed below are the key features of medical insurance that you should know about before buying it for yourself:

  • Sub-Limits on Room Rent

The sub-limits are the maximum amount that an insurance company shall pay in case a claim is raised. Generally, this limit is up to 1% of the sum insured and a maximum of 2% in case of ICU expenses. But there are several health insurance companies that offer plans without any sub-limit on room rent. Hence, it is recommended to go for such health plans.

  • Pre-Existing Diseases

Pre-existing diseases are those from which an individual has already been suffering. In health insurance policies, pre-existing diseases come with a waiting period, so while buying these plans, you need to check the waiting period for pre-existing diseases.

  • Health Insurance Types

Before buying any plan, you need to be clear about the different types available. For instance, if you are buying it for all your family members, then you must buy a family floater health insurance plan.

  • Cashless Treatment

Another major feature is the cashless treatment facility that you can enjoy with your health insurance plans. Cashless treatment means the option wherein the insurance companies tie-ups with network hospitals to provide policyholders with the option of getting cashless treatment. If this feature is not covered, then you will be required to pay the expenses incurred at the hospital, from your own pocket, and the insurance company will reimburse you for the same later.

What is Typically Covered in Health Insurance?

In India, most companies provide coverage for the following:

  • In-patient Hospitalisation

Coverage for inpatient care, including surgeries, treatments, and room charges in a hospital if the patient is hospitalised for more than 24 hours.

  • Pre-existing Illness

Health insurance also provides coverage for pre-existing conditions after a certain waiting period. You should check the waiting period with your insurer.

  • Pre and Post-Hospitalisation

Under pre-hospitalisation expenses, you get coverage for blood tests, urine tests, and more. On the other hand, post-hospitalisation provides coverage for medicines that are prescribed for the well-being after getting discharged from the hospital.

  • Preventive Health Check-ups

Many health plans cover preventive services like vaccinations, screenings, and wellness check-ups. With preventive health check-ups, policyholders get such check-ups done at no additional cost.

  • Ambulance Expenses

Almost all plans provide coverage for ambulance expenses, however, the coverage varies from one insurer to another.

  • Maternity Cover

Under the medical insurance plan, you will also get coverage for expenses related to the birth of a baby.

  • Day-care Procedures

In case a policyholder is seeking treatment for less than 24 hours, then coverage for such daycare procedures is also offered.

  • Home Care

If a policyholder is seeking treatment at home under a medical practitioner, then coverage for that is also offered.

  • AYUSH

Health insurance policies in India also provide coverage for AYUSH treatment such as homeopathy, ayurveda, and more.

  • Mental Healthcare Cover

As per the latest guidelines by IRDAI, it is now a mandate to provide coverage for mental healthcare problems like bipolar, depression, and more.

What is Not Covered Under Health Insurance?

Some of the exclusions of health insurance are as follows:

  • Cosmetic Procedures

Procedures considered cosmetic and not classified as medical treatment such as elective plastic surgery or cosmetic dentistry, are often not covered.

  • Experimental or Investigational Treatments

Treatments or medications that are still in experimental or investigational stages may not be covered.

  • Alternative and Complementary Therapies

Some plans do not cover alternative therapies like acupuncture, naturopathy, or chiropractic care.

  • Weight Loss Treatments

Coverage for weight loss surgeries or programs may be limited or excluded in some plans.

  • Infertility Treatments

Fertility treatments, such as in vitro fertilization (IVF), may not be covered or may have limited coverage.

  • Abortions

Coverage for elective abortions may not be included in all plans.

  • Certain Prescription Medications

Some medications, especially those considered lifestyle drugs, may not be covered by certain plans.

  • Cosmetic Dentistry

Cosmetic dental procedures like teeth whitening or veneers are often not covered.

  • Vision and Hearing Aids

While some health insurance plans offer optional coverage for these, routine vision and hearing care may be excluded.

  • Routine Foot Care

Non-medically necessary foot care, like routine pedicures or orthopedic shoes, may not be covered.

  • Self-Inflicted Injuries

Injuries resulting from intentional self-harm or illegal activities may not be covered.

  • Non-Prescription Items

Over-the-counter medications and medical supplies are typically not covered.

Health Insurance Coverage

  • What is Covered?
  • What is Not Covered?
  • In-Patient Hospitalisation Expenses

    Expenses incurred due to hospitalization of 24 hours or more, including nursing and boarding expenses, fees of nurse, doctor, or surgeon, cost of blood, oxygen, and much more.
  • Pre-Hospitalisation And Post-Hospitalisation Expenses

    Expenses that come up before and after hospitalization for a set number of days in accordance with the terms and conditions of the insurance policy. These cover costs for tests, physician fees, medical records, and much more.
  • Daycare Procedures

    Treatments in which an individual does not have to be admitted to the hospital for more than 24 hours are considered daycare treatments. Some of them include cataracts, sinusitis, chemotherapy, radiotherapy, and much more.
  • Organ Donor Expenses

    Expenses that occur due to harvesting the organ from the donor and for the transplant surgery as covered under this policy. The hospitalization expenses include room rent, doctor's fees, and other expenses.
  • Domiciliary Hospitalisation Expenses

    This means that treatment is given at home due to a lack of hospital beds, or when the patient cannot be transferred to the hospital due to a medical emergency. It covers therapy that lasts more than three days for any injury or disease.
  • Road Ambulance Expenses

    Transportation expenses for the insured to the nearest hospital in the case of a medical emergency are covered up to a certain level. The ambulance is equipped with everything needed to transport the patients.
  • AYUSH Treatments

    It comprises in-patient treatments provided by the AYUSH medical system, which includes Ayurveda, Yoga, Unani, Siddha, and Homeopathy. The expenses are paid up to a certain amount.
  • Cosmetic Treatments

    Cosmetic treatments are performed to enhance your appearance. Hence, these are not covered under the health plan. Some of the examples include plastic surgeries, face lifts, nose jobs, and much more.
  • HIV/AIDS

    It is a critical condition in which a virus attacks the immune system of an individual. And, most of the insurance companies do not provide coverage for HIV/AIDS in their plans.
  • Self-Inflicted Injuries

    Suicide or any other condition in which an individual harms themselves is not covered under a health plan offered by different insurance companies.
  • Injuries Due to Alcohol or Drug Abuse

    Injuries that occur due to any harmful substances like alcohol or any kind of drugs are not covered under the health plan.
  • Participation in Adventure Sports

    Injuries happened due to the adventure sports activities like mountain climbing, tracking, and many others that are not covered under an insurance policy.
  • Injuries Due to War, Riots

    Mishappenings that occur because of any type of war or riots, nuclear contamination, or any other perils are not included in the health plans.
  • Unproven And Experimental Treatments

    Treatments that are not medically tested and are solely done for the purpose of investigation are not covered under the insurance policies.
  • Rest Cure, Rehabilitation, And Respite Care

    Health plans do not cover expenses related to enforced bedrest and not for treatment.

Health Insurance Eligibility

Eligibility Criteria to Buy Health Insurance

Eligibility Criteria to Buy Health Insurance

The need for health policy is paramount since medical care, particularly in the private sector, is costly and can be difficult to afford. Paying a small annual premium can undoubtedly assist to reduce your worry by preventing a difficult situation during a medical emergency or illness.

You may easily get a good insurance plan online that often pays some or all of the costs associated with hospitalization, ambulance services, and doctor consultation fees. Here are the eligibility criteria-

  • Entry age for adults- 18-65 years (exclusive plans are provided for people above 70 years of age.)
  • Entry age for children-90 days-18 years.

Purchasing a health policy coverage at a young age can save money because the insurers may not need you to take any medical exams.

Eligibility Criteria to Buy Health Insurance

Documents Required to Buy Health Insurance Online

Documents Required to Buy Health Insurance Online

Following mentioned are a few documents that you must be able to show to buy a health policy online:

  • Age proof: Either of the following-Birth Certificate, 10th or 12th mark sheet, Driving License, Passport, Voter’s ID, etc.
  • Identity proof: Either of-Passport, Driving License, Voter ID, PAN Card, Aadhar Card, which proves one’s citizenship.
  • Address proof: Either of-Electricity bill, Ration Card, Telephone Bill, Passport, Driving License with your permanent address clearly mentioned on it.
  • Medical check-up: Some plans require health check-up to ensure that the individual is not suffering from any chronic illness.
Documents Required to Buy Health Insurance Online

Key Factors To Consider Before Buying Health Insurance Plans

Buying medical insurance for yourself or your loved ones may become a challenging task if you are not aware of the different factors. If you fail to keep these factors in mind, there is a high chance that you may end up buying the wrong plan. So, to help you out, we have jotted down some of the tips that will help you in getting the right health insurance quote:

  • Sum Insured

The sum insured refers to the total financial coverage that is given to the policyholder along with their plan. Thus, it should be carefully chosen because it covers you and your loved ones for medical expenses incurred during the policy term. You should consider your income as well as your age when deciding on the sum insured for your medical insurance policy. Make certain that the sum insured is not insufficient and that the premium is not excessively high. You should ideally choose a sum insured that is at least 10x your current salary. With the rising medical expenses, it becomes all the more important to choose the right sum insured.

  • Claim Settlement Ratio

Before comparing the different health insurance quotes, you need to consider the number of claims settled by the medical insurance company. The ratio between the number of claims settled to the number of claims raised in a given year is called the health claim settlement ratio. The entire purpose of buying a health insurance plan is to secure financially against unexpected illnesses which means if the claim settlement process is smooth then it is advantageous for the insured. So, always choose an insurer that has a higher claim settlement ratio.

  • Network Hospitals

Network hospitals are where policyholders can get cashless treatment. Availing treatment at network hospitals is very convenient as they allow cashless treatment to the insured. This is why you should check the number of network hospitals associated with an insurance company. It is recommended to choose a health insurance provider that has a maximum number of network hospitals. Also, make sure to select the one near your place of residence to save time in case of an emergency. With a large number of network hospitals, it will be easier for you to locate a nearby network hospital.

  • Health Insurance Premium

The purpose of buying a health insurance is to reduce financial stress in case of any medical emergency. You must choose a plan with an affordable premium so that you continue your policy for a longer period without any financial stress at present. However, choosing a medical insurance policy with a low premium is not always advisable as it may not get you enough coverage in case of an emergency. So, while buying an insurance policy like this, it is important to check its premium.

  • Add-on Benefits

There are a number of riders that you can include in your health insurance plan such as maternity riders, hospital cash, critical illness rider, and many more that will help in enhancing the plan benefits. You can choose the add-ons voluntarily by paying an extra premium at the time of policy purchase. However, remember that on including these add-ons to your plan, the premium will vary to a great extent.

  • Waiting Period

The waiting period refers to the period during which you cannot raise health insurance claims. Typically, the waiting period varies from one insurer to another, which is why you must check the waiting period at the time of buying a policy.

  • Inclusions and Exclusions

Just like the inclusions or the coverage offered under your health insurance plan, it is equally important to analyse the exclusions. Exclusions are the conditions for which you cannot make a claim. Hence, when choosing a policy, you must opt for the one with the least number of exclusions. Some common exclusions under health plans are treatment required due to self-harm, treatment required due to participation in adventure sports, any injury due to involvement in adventurous activities, and more. So, be aware of both the inclusions and exclusions while purchasing health plan.

  • Lifetime Renewability

You should always check the renewability feature in your health plan. Ideally, you must buy policy that offers lifetime renewability. When there is a renewability feature, it becomes easier to renew the plan without any inconvenience at additional costs. So, you save both time and money when you purchase health plan with a lifetime renewability option.

Some Myths About Health Insurance

Due to a lack of knowledge and understanding, people in India have a lot of misconceptions when it comes to health plans. It is important to debunk these myths to make the best purchasing choices. Here are some popular misconceptions and the truth about health insurance policies:

Myth 1: Young And Healthy People Do Not Require Health Insurance Coverage

Reality: The most effective time to buy medical insurance is when you are young. This is because you are young and are less vulnerable to critical illnesses. Hence, the chances of getting hospitalised are low and you will be able to get health coverage at an affordable premium. Also, you can serve the waiting period of your health plan at a young age and get quality treatment at an older age without any obstacles.

Myth 2: Only Hospitalisation Charges Are Covered

Reality: It is true that health insurance plans cover you for hospitalisation expenses only when the hospitalisation of at least 24 hours takes place. But it is not true that the plans only cover you for these expenses. In most cases, they also cover you for daycare procedures such as sinusitis, radiotherapy, chemotherapy, etc, which do not require hospitalisation of at least 24 hours. Other expenses covered are OPD expenses, road ambulance expenses, second medical opinion, medical check-up, etc.

Myth 3: People who smoke cannot be covered under any health insurance policy

Reality: You can still buy a health plan even if you are a smoker. However medical insurance companies are concerned about pre-existing conditions, which may even lead to the cancellation of your insurance application form. So, if there is any pre-existing condition due to smoking, then you must disclose the same to your insurer. It will not deny you the policy but may charge you a higher premium because as a smoker, you will be more prone to illnesses.

Myth 4: Health insurance plans are bought to save taxes

Health insurance plans do not only help you save taxes as per the prevalent tax laws but most importantly, cover you for healthcare expenses, which may help you save even more in the long term.

Myth 5: It is not safe to buy medical insurance plans online

Purchasing health plans online through reputable companies such as InsuranceDekho is safe and easy. All you have to do is fill out a quote, compare the insurance plans offered on the screen, shortlist the one you want to buy for yourself and your family, and pay the premium online through a secure payment method. You can choose from a variety of premium payment methods such as credit cards, debit cards, and e-wallets.

Why Should You Buy Health Insurance Online?

In today’s digital era, it makes all sense to buy medical insurance plans online. Wondering why? Listed below are some of the convincing reasons why you should buy it online:

  • Time-Saving

Unlike the traditional ways of buying a health insurance where you had to explain all your requirements to the insurance agents and follow the tedious process, buying online saves your time and lets you buy the health plan conveniently. All you need to do is fill out a few details, after which you will be able to view quote details and accordingly buy the right insurance plan for yourself. This means that you will be able to buy such plans in a matter of a few minutes and save on both time, effort, and energy.

  • Compare Different Plans

The online way of buying a plan has simplified the process of comparing different health insurance quotes. With an online premium calculator, it becomes easy to calculate premiums as well as compare different insurance plans. When you buy these plans online, you just need to enter a few details to do a comparison of the different types of plans available. So, compare the different types and buy a desired plan with InsuranceDekho.

  • No Paperwork Required

When you buy health insurance online, there will be little to no paperwork involved. You just need to submit a few documents online, followed by which you will be able to buy it online.

  • Find a Plan That Suits Your Budget

If a policyholder decides to buy health plans online, then it becomes easier to find a plan that fits your budget. Moreover, there will be no involvement of an agent or intermediary, when you buy it online, resulting in purchasing an affordable plan.

  • Availability of Add-ons

You can also check the number of add-ons you can include in your health insurance policy. It is important to check which company offers which add-ons and accordingly include them in your plan. Some of the add-ons or riders that you can include in your existing plan are hospital cash benefit, maternity rider, no claim bonus protector, critical illness rider, and so many more.

How to Buy Health Insurance Plan Online?

Now getting insured online is not rocket science. Buying an affordable mediclaim policy which meets all your requirements is very simple and quick with InsuranceDekho.

  • Step 1: Enter Personal DetailsStep 1
    Step 1: Enter Personal Details

    Fill up your details like Name, Mobile Number, Email-Id, Gender, City, and other crucial details to see the top insurance plans available as per your requirements.

  • Step 2: Compare Plans OnlineStep 2
    Step 2: Compare Plans Online

    From all the available health insurance quotes, select the plan which meets your budget and requirements in the best manner.

  • Step 3: Complete Online Payment
    Step 3: Complete Online Payment

    Choose the payment mode and pay the premium online through a secured payment gateway to get the policy document at your registered email ID.

Benefits of Comparing Medical Insurance Plans Online

There are several benefits when you compare health insurance quotes online such as the following:

  • Select The Best Plan

On comparing the health plans online, you will be able to able to select the best plan as per your budget and requirements. Moreover, comparing these plans also helps you make an informed choice without the involvement of an agent.

  • Offers Convenience

The comparison of these policies online is more convenient than offline. The process will become too tedious if you have to visit different locations to get quotes and understand the coverage benefits before shortlisting the health insurance plan. Hence, it becomes easier to buy when you compare plans online.

  • 24*7 Availability

You can compare insurance plans anytime at your convenience. Unlike the online process, the offline process has fixed working hours and hence you won’t be able to visit an insurance company’s branch office late at night to compare the plans.

  • Saves Time

When comparing the plans online, you will not be required to spend so much time filling out forms or discussing with agents or executives. All you need to do is fill in a quote and several plans will be displayed on your screen which you can compare easily. This saves you enough time as well as money.

  • Health Insurance Premium Calculator

With the help of a premium calculator available online, it becomes convenient to select the most affordable health insurance for yourself.

  • Right Coverage

While comparing the medical insurance plans offline, you may be restricted in understanding the coverage benefits of a few plans. However, comparing the plans online will allow you to search for the desired coverage by comparing as many insurance plans as you need.

How To Buy Health Insurance Plans With InsuranceDekho?

The following are some of the steps to buy health insurance from InsuranceDekho:

  • Fill Your Details

Visit the official website of InsuranceDekho and browse to ‘Health Insurance’. Enter your personal details such as name, age, gender, and more. Moreover, you can talk to the experts as per your convenience through WhatsApp. Click on the “View Plans” Button to see available plans. Select the family members you want to insure like your father, mother, son, and others.

  • Compare Different Quotes

Once you enter the above details, different health insurance quotes will get displayed to you. Compare the available plans and select the plan that suits you and your requirements perfectly.

  • Make the Payment

After selecting the best health insurance plan for yourself, select or adjust the sum assured and the term of the policy.

Looking for Health Insurance? Book a FREE consultation with Our Health Experts

Documents Required for Health Insurance

Listed below are some of the documents required to buy health insurance plans:

  • Aadhaar card
  • Driving license
  • PAN card
  • Voter ID card
  • Pre-existing medical condition report
  • Copy of previous medical insurance policy
  • A duly-filled application form
  • Copy of salary slips

Best Health Insurance Companies in India

Here is a list of the top health insurance providers based on the claim settlement ratios (CSR):

Rank Health Insurance Company Claim Settlement Ratio FY22  
1 HDFC ERGO General Insurance Co. Ltd. 100.00%
2 Niva Bupa Health Insurance Co. Ltd. 90.70%
3 Care Health Insurance Co. Ltd. 95.22%
4 Aditya Birla Health Insurance Co. Ltd. 96%
5 Star Health & Allied Insurance Co. Ltd. 89.90%
6 ICICI Lombard General Insurance Co. Ltd. 99.70%
7 Reliance General Insurance Co. Ltd. 100.00%
8 ManipalCigna Health Insurance Co. Ltd. 93.00%
9 Go Digit General Insurance Co. Ltd.  93%
10 Cholamandalam MS General Insurance Co. Ltd. 94.00%
11 SBI General Insurance Co. Ltd. 66.08%
12 Royal Sundaram General Insurance Co. Ltd. 92.00%
13 Future Generali India Insurance Co. Ltd. 94.00%
14 Liberty General Insurance Co. Ltd. 97.00%
15 Zuno General Insurance Co. Ltd. 94.00%
16 Magma HDI General Insurance Co. Ltd. 90.00%
17 The New India Assurance Co. Ltd. 92.68%
18 Bajaj Allianz General Insurance Co. Ltd. 92.24%
19 Kotak Mahindra General Insurance Co. Ltd. 97.00%
View All

Health Insurance Premium Calculator

With the help of medical insurance premium calculator, you can easily estimate the value of your health plan or medical insurance policy. The online tool will calculate the premium on your health plan without any hassle. Moreover, it is a free tool through which you can compare a variety of available plans to choose the most suitable for yourself as per your requirements and budget.

The premium is calculated after considering various factors such as BMI, age, lifestyle, income, gender, no. of members to be covered under the plan, and many others. Hence, to avoid any discrepancy in calculating the premium, it is advised to provide the correct details.

Following are the steps to be followed in order to use medical insurance premium calculator online:

  • Visit the official website of InsuranceDekho and click on ‘Health’
  • Enter your personal details such as name, age, gender, city, mobile number, no. of members to be covered, and much more and then click on ‘Check Premium’
  • You will be able then to see the most suitable health plans with their premiums displayed on the screen
  • Among a variety of options, you can select the most suitable plan as per the premium and coverage benefits that are offered by different companies

Factors That Affects Health Insurance Premium

The amount that is paid towards getting health insurance coverage is called the premium. The premium of a particular health policy for an individual is determined by a number of variables such as those listed below:

  • Age

Companies that provide medical insurance generally adhere to the rule that older the customer, the higher the premiums. This is due to the fact that as people age, their susceptibility to illness increases, increasing the likelihood that they will file a health policy claim. As a result, premiums increase with age and vice versa.

  • Pre-medical History/Past Medical History

In case you have a history of any kind of medical condition, then the health insurance company will charge you higher because of the fact that you have a higher chance of getting hospitalised. But you will be charged a comparatively lesser premium if you do not have any past medical problems. However, it is always a better idea to reveal your existing medical conditions to the insurer right at the time of buying the policy.

  • Type of Health Insurance

The type of health insurance plan you are buying also largely affects the premium. For instance, the premium of family plans is higher as compared to individual plans because the former provides coverage for the entire family under one single plan.

  • Lifestyle Habits

Lifestyle habits such as excessive smoking or drinking deteriorate your health and make you more prone to illnesses. If you lead this lifestyle, your health may be at risk, increasing your likelihood of filing a claim. You will pay a greater premium for health plan as a result compared to someone who does not smoke or drink frequently.

  • Policy Term

Policy term is another crucial factor that decides the premium for a health insurance policy. You can choose from different policy terms such as 1 year, 2 years, or 3 years, according to its terms and conditions. The higher the policy term you opt for, the higher premium you will be required to pay, due to the higher coverage offered.

  • Add-On Covers

For comprehensive coverage, you can add add-on covers to your health insurance policy. You will need to pay an additional premium for this when you buy your insurance. The greater the number of add-on covers you buy, the higher the premium you will be required to pay for it. However, it is important to note that on including add-ons, you will be entitled to get greater coverage.

  • Co-Payment

Premiums for medical insurance plans that come with a co-payment clause are generally low, due to the cost-sharing involved. Therefore, if you choose a health insurance policy with a co-payment option, then you will be required to pay a lesser premium and vice versa.

  • Body Mass Index

You run a higher chance of developing health problems if your body mass index is higher than average. Your premium will be expensive as a result. However, if it is normal, you will be liable to pay a lower premium.

  • Occupation

Individuals who are involved in high-risk professions such as mining are liable to pay higher medical insurance premiums. This is simply because such individuals pose greater health risks.

Tips to Reduce Health Insurance Premiums

Worried about hefty health insurance premiums? Don’t worry, here are some of the useful ways in which you can save on health insurance premiums:

  • Buy Your Health Insurance Early: Premiums for health insurance are often based on age and health status. When you buy health insurance at a younger age, you are generally healthier, and insurance companies consider you to be at lower risk for developing health issues. As a result, your premiums are likely to be lower compared to someone who buys insurance at an older age when health risks tend to increase. This is evident from a case where an individual who is 30 years of age is likely to pay higher premiums as compared to one who is 50 years old.
  • Choose Adequate Coverage: It is very important that you choose the right kind of coverage with your health insurance plan. For instance, if you are a young individual, then it makes sense to buy an individual health insurance plan. However, if you have a family and dependant parents, then it is best to buy a family health insurance plan as compared to any other plans.
  • Compare the Health Insurance Plans: Before buying any health insurance plan, you must first compare it with the different plans available so that you do not end up buying an expensive health insurance plan. On comparing the different health insurance plans available, you will not just be able to buy a plan that suits your budget but also get the right plan for yourself and your family.
  • Buy Top-up Plans: You might think that buying a top-up plan will be a costly affair. However, this is not the case, as with top-up health insurance plans, you will be able to boost your health insurance coverage. So, buy top-up plans and be prepared for medical emergencies.
  • Choose Only Relevant Add-ons: Health insurance comes with a number of add-ons such as maternity rider, hospital cash rider, critical illness rider, and so many more. However, on adding these add-ons to your health insurance plan, the health insurance premium is likely to go up. So, it is very important that you wisely choose the relevant add-ons.
  • Lead a Healthy Lifestyle: There is no surprise that health insurance premiums are higher for those who lead an unhealthy lifestyle. This means that individuals who often drink and smoke or lead an unhealthy lifestyle will ultimately end up paying extra health insurance premiums. So, it is better to lead a healthy lifestyle and save on health insurance premiums.

How To File A Health Insurance Claim?

Claim under a health insurance policy can be made in two ways - in a cashless manner and in a reimbursement manner. A cashless claim is when you receive treatment at a network hospital of the insurance provider who is servicing your policy. If the claim request is accepted, the insurance company directly settles the bills at the hospital. Whereas in reimbursement claims, you are required to pay for the hospital bill from your own pocket first, and make a claim request with the insurance company later. The insurance company will process your claim and reimburse you for the same after accepting the claim. You can make a health insurance claim by following the simple steps given below:

  • Step 1: Visit the network hospital or the hospital of your choice and inform the insurance company about the hospitalisation.
  • Step 2: Fill the pre-authorization form at the hospital’s TPA (third-party administrator) desk.
  • Step 3: You will receive an approval letter by the claim management team.
  • Step 4: Respond to the query raised by the claim management team, if any.
  • Step 5: Avail the required medical treatment.
  • Step 6: The insurance company will directly settle the bills at the network hospital as per the terms and conditions mentioned in your policy.

Documents Required For Health Insurance Claim Reimbursement

The documentation needed in the case of a reimbursement claim are as follows:

• Valid identity proof
• Duly signed and completed original claim form
• Doctor’s prescription recommending hospitalisation
• Original pharmacy bills
• Original prescription for medicines, consultation, and diagnostic tests
• Indoor case papers
• Ambulance receipt
• First Information Report (FIR), if applicable
• Policy details with the insured person(s) name, policy number, illness, and address
• Any other document if required by the insurer

Listed below are additional documents required in case of a cashless medical insurance claim:

• Pre-authorization form
• Valid identity proof along with a photograph
• Documents like voter ID card, driving license, PAN card, and Aadhar card

Types of Health Insurance Plans

  • Family Health Insurance

    Family Health Insurance

  • Senior Citizen Health Insurance

    Senior Citizen Health Insurance

  • Individual Health Insurance

    Individual Health Insurance

  • Personal Accident Health Insurance

    Personal Accident Health Insurance

  • Health Insurance for Parents

    Health Insurance for Parents

  • Maternity Health Insurance

    Maternity Health Insurance

  • Children Health Insurance

    Children Health Insurance

  • Newborn Baby Health Insurance

    Newborn Baby Health Insurance

  • Self-Employed Health Insurance

    Self-Employed Health Insurance

  • Women Health Insurance

    Women Health Insurance

  • Group Health Insurance

    Group Health Insurance

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Tax Benefits of Health Insurance

Under Section 80D of the Income Tax Act, 1961, every Hindu undivided family can claim tax benefits. You can avail of tax benefits on the premium paid for yourself and your family members including spouse, dependent children, or parents.

The deduction from the total income can also be availed on the premium paid for top-up health insurance plans as well as critical illness health insurance plans, apart from regular insurance plans.

Refer to the table below to comprehend the amount of deduction now offered to a single taxpayer in various circumstances.

Situations

Premium Paid

Deduction under Section 80D of the Income Tax Act

Self, Family, Children

Parents

When the policyholder and parents are aged below 60 years

Rs. 25,000

Rs. 25,000

Rs. 50,000

When the policyholder and family members are aged below 60 years with parents aged above 60 years

Rs. 25,000

Rs. 50,000

Rs. 75,000

When the policyholder, family members, and parents are more than 60 years of age

Rs. 50,000

Rs. 50,000

Rs. 1,00,000

Members of the HUF (Hindu Undivided Family)

Rs. 25,000

Rs. 25,000

Rs. 25,000

Non-Resident Individuals (NRIs)

Rs. 25,000

Rs. 25,000

Rs. 25,000

Health Insurance Riders

Health insurance riders are supplemental coverages that let you tailor your plan and increase its coverage to meet your needs.
  • Critical Illness Cover

    With this add-on, you will be eligible for a lump-sum payment if you are diagnosed with a serious and long-term sickness such as cancer, stroke, kidney failure, and many others. You can utilise the money to compensate for any income loss caused by a catastrophic illness. Some insurance companies offer critical illness coverage as part of a standalone policy, while others offer it as an add-on cover for up to 50 severe illnesses.
  • Maternity Cover

    If you are planning to have a baby, then maternity cover riders would be of great advantage. Both a mother and child need premium quality treatment during this lovable phase of life. So, to cover the financial strain that may occur due to childbirth medical treatment, you can take advantage of maternity riders. Moreover, some insurers also provide childcare expenses. These plans generally come with a waiting period of 2 to 4 years.
  • Hospital Cash

    The add-on cover of hospital cash provide you cover for all the non-medical expenses that are incurred during the hospitalization and are not covered under the health plan. The policyholder gets a daily cash allowance as per the limit specified in the policy document, for a specific tenure of the policy. The coverage amount for daily cash benefits may vary from insurer to insurer but, usually, it ranges between Rs. 500 to Rs. 5000 per day.
  • Room Rent Waiver

    The type of room you choose, while you are hospitalised, has a significant impact on your hospital expenditures. A normal health insurance plan includes a restriction on the room's per-day charges. This means that any additional expenditures paid as a result of changing from standard accommodation to a deluxe room must be borne by the insured. However, with the room rent waiver add-on, you can choose any room of your choice at no extra cost.
  • OPD Cover

    Outpatient department commonly known as OPD is that area of a hospital, wherein patients can simply visit and consult the doctor. In this type of coverage, the patient has to pay the doctors fee instead of getting admitted as a daycare patient in the hospital. Generally, OPD expenses are not covered as an add-on in health insurance. But, it can cover the cost of medicines, consultation fees, and much more.
  • Personal Accident Cover

    Considering the rising number of road accidents in India, a personal accident add-on cover is a great option as it provides financial protection in case an insurer meets an accident. This includes the coverage in case of permanent total disability, permanent partial disability, total disability, or death. If you are planning to add-on this rider, then you can additionally buy it with your standard health plan by paying an extra premium at the time of purchase.
  • International Second Opinion Cover

    With the help of this add-on cover, you can consult international doctors before availing of a specific treatment. You can use this rider in case the insured is not satisfied with their treatment. Hence, adding on this rider will be empowering for the insured as they can review the treatment advice and recommendations, offered for a particular illness. Moreover, it will help you in getting additional insights into your illness and treatment.
  • Air Ambulance Cover

    This add-on cover helps in transferring the patients to the hospitals through air domestically and internationally, as per the terms and conditions specified by an insurance company. With the help of this add-on, an insured will be able to avail of the benefits of reaching timely at the hospital in case of an emergency.
  • Reduction in Pre-Existing Diseases Waiting Period

    Health insurance plans usually come with a waiting period for pre-existing diseases of 48 months. But with an add-on cover of reduction in the pre-existing waiting period, you can reduce your waiting period from 48 months to 24 months. However, terms and conditions related to reductions may vary from insurer to insurer. Simply by paying an extra premium you can avail of this feature.

Waiting Period In Health Insurance

Even after purchasing a health plan, insured is not entitled to receive the entire value for some conditions that are mentioned in your policy due to a waiting period in health insurance. Hence, this means that insured person will only be eligible to get health insurance coverage benefits for pre-existing diseases after completing a specific time-period, which is determined from the beginning of the policy.

Types Of Waiting Period In Health Insurance:

  • Initial Waiting Period

Initial period, that is also known as cooling period, is that in which the policyholder has to wait for a certain number of days before receiving any claim benefits under the plan. Most of the health insurance plans come with a waiting period of minimum 1-month and maximum 90 days.

  • Pre-Existing Diseases (PED) Waiting Period

It is a pre-existing disease waiting period that the insured acknowledges at the time of policy purchase. According to the Insurance Regulatory and Development Authority of India (IRDAI), a pre-existing disease is defined as any condition, accident, ailment, or disease detected within 48 months of the policy acquisition. Pre-existing illnesses include thyroid, hypertension, and diabetes. Pre-existing conditions are usually subject to a 1-4 year waiting period in most health insurance coverage.

  • Waiting Period for Specific Diseases

There are some conditions, including hernias, tumours, ENT disorders, cancer, strokes, and cardiac problems, that come with a specific waiting period. This period for specific diseases vary from insurer to insurer and can found in the policy provision of each company.

  • Maternity Waiting Period

If you are planning to start your family very soon, then you can add maternity coverage to your standard health policy. With this plan, your pregnancy expenses and a newborn baby care cost will be covered. However, a policyholder can avail of benefits only after the waiting period of 2 years to 4 years.

The purpose of a waiting period is to prevent people from claiming benefits under a policy for the wrong reasons. People without health plans have purchased plans after being given a specific diagnosis, often without disclosing the diagnosis to the insurance company. The concept of a waiting period is also included in health policies to stop unethical behaviour like this.



Health Insurance Renewal

Every health insurance plan has its own policy term and thus comes with an expiry date. The policy term thus varies from insurer to insurer and it is important to check the policy term before buying it. However, every health insurance company has its own renewal period to get it plan renewed. In case policyholders are not able to make the renewal during the renewal period, the insurance company offers a grace period which also differs from one insurer to another. If the policyholder still fails to renew their health insurance, then the policy will get lapsed. Listed below are the steps by which you can easily renew your health insurance plan:

  • Review Your Health Insurance Plan

First and foremost, you need to assess the different health insurance quotes available. This will help you understand what coverage is offered and whether it meets your needs or not.

  • Visit the Insurer’s Website for Plan Details

You can also visit the insurer's website to learn more about the plans and accordingly decide whether to renew the existing plan or not.

  • Make the Payment

Finally, pay the renewal fees to renew your plan. You can choose among the following payment options such as credit/debit card, NEFT, net banking, e-wallets, UPI, and more to complete your payment.

Why Choose InsuranceDekho For Buying Health Insurance?

We serve as a one-stop platform for all insurance needs. Affordable plans, easy renewals, policy tracking, and much more features are simplified to provide the best customer experience.
  • Protection Within 5-minutes
    Protection Within 5-minutes
    InsuranceDekho offers a quick and easy way of buying a health plan. At the portal, you can compare and select the best insurance plan for yourself and your dear ones, available at a cost-effective price, within 5-minutes. Simply, you can enter a few details and can get insured in a transparent and hassle-free way.
  • 5.5 Lakh+ Happy Customers
    5.5 Lakh+ Happy Customers
    We aspire to establish trust in our customers by making the process of purchasing health plans online as smooth and easy as possible. Over the years, InsuranceDekho has built trust in more than 5.5 lakh insurance buyers by providing a great user experience.
  • Dedicated Support Team
    Dedicated Support Team
    A professional team at InsuraceDekho is available seven days a week to address any complaints and clear your doubts that you may have about health insurance. To make your process easier, you can contact us if you have any questions about how to get an insurance policy, file a claim, or renew your plan.
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FAQs About Health Insurance Policy

  • General
  • Premium
  • Renewal
  • Plan Coverage
  • Claim Settlement
  • Critical Illness
  • 1

    What is a health insurance plan?

    Health insurance policy is an agreement whereby an insurance company agrees to undertake a guarantee to compensate the insured for medical expenses in case of a medical emergency. A health insurance policy protects the insured for several surgical expenses, critical illnesses, and daycare expenses, for a policy term, for up to the sum insured limit. 

     

     

  • 2

    Can I purchase more than 1 health insurance plan? How are the claims settled in this case?

    Yes. You can be covered under more than one health insurance plan. In this case, the claims are settled as per the contribution clause, when the claim is higher than the sum insured for one health insurance policy. 

  • 3

    Why should I buy a health insurance plan?

    A health insurance policy not only protects the insured financially for future, but also offers relief in the present. Lifestyle habits such as drinking, smoking, or sedentary lifestyle invite health  issues, which can be minor or serious, may be expensive to treat. To stay financially protected in such times, you need a reliable health insurance plan that covers you at all times. Apart from this, buying a health insurance policy also reduces your overall tax liability by allowing you tax deductions on the premium paid, under Section 80D of the Income Tax Act, 1961.

     

     

  • 4

    Can I cancel my health insurance policy? If yes, will I get a refund for the same?

    Yes. You can cancel your health insurance policy. Every health insurance company provides you a free look period to understand the policy terms and conditions. During this period, if you find any objectionable clause in your health insurance policy, then you can cancel the policy and ask for a refund. Note that you will receive the refund only if no claim has been made during the policy term. The amount of refund will be calculated after taking into consideration the expenses incurred on medical check-ups, stamp duty, and proportionate risk premium, i.e. the number of days you have been covered for risks under the policy. To know more about a premium refunds, it is recommended to go through the policy document.   

     

     

  • 5

    What Is The Right Age To Buy A Health Insurance Policy?

    The ideal age to buy a health insurance plan is when you are still young. This is because when you are young, the chances of acquiring a disease is less and you are in a better position physically as well. This even reduces your chances of health insurance denial.

     

  • 1

    How is health insurance premium determined?

    Different health insurance plans have different premiums. The insurance companies determine premiums after considering various factors that are explained below: 

    1. Type of Insurance Plan: Your health insurance premium is based on the type of plan you choose. If you choose a critical illness insurance plan, then the premium will be high. If you choose an individual health insurance policy, then the premium will be different from that of a family floater plan. To know the difference in health insurance premiums, you can use InsuranceDekho’s health insurance premium calculator.  

    2. Age of the Insured: With age, you become more prone to health issues and are more likely to make health insurance claims. Therefore, you are required to pay higher premiums if you buy health insurance plans in later stages of life. This is why it is recommended to buy health insurance policy when young. 

    3. Policy Term: Most health insurance plans come for a period of 1 year, 2 years, or 3 years. Greater the policy term you choose, the greater will be your coverage, and hence higher will be your health insurance premium, and vice versa. 

    4. Lifestyle Habits: If you drink alcohol or smoke regularly, then you may be denied health insurance completely. However, there are some insurance companies that cover you for the same, for which they charge high premiums. This is because, with these lifestyle habits, you are more prone to health issues.   

    5. Family Medical History: Before deciding your health insurance premium, the insurance company will ask about your family medical history. This is because if someone in your family has a certain disease that you are also vulnerable to, then the insurance company will charge you a higher premium due to increased risk.  

    6. Sum Insured: Health insurance plans come with different sum insured options that you can choose from as per your budget and requirement. The higher the sum insured, the higher the medical coverage and hence higher the health insurance premium. But it is not recommended to compromise on the sum insured to save on premiums. This is because it will not cover you adequately in the time of need.  

     

  • 2

    What Is a cumulative bonus in a health insurance plan?

    A cumulative bonus in health insurance refers to the financial benefit which you receive as a reward for not making any health insurance claims in a policy year.

  • 3

    How does smoking affect health insurance premium?

    Smokers have to be prepared to make the payment for higher premium cost for their medical insurance policy as health risks increases for smokers and insurance companies charge a higher amount to combat the medical crisis.

  • 4

    Under what conditions are my policy premium likely to increase at renewal?

    Here are different situations that increase the premium during the renewal:

    • Healthcare Inflation – Inflation in healthcare is soaring at a rate of 12% to 18% which comprise the costs of medicines, hospital admission costs, medical advancements, etc. It leads your insurance companies to increase your sum insured every year which increase your premium too during policy renewal.
    • Age of Policyholder – Increase in age can also impact your health insurance premium while renewing the health insurance policy, especially for those touching 60 just before renewal.
    • Change in Coverage – If you change your health insurance policy coverage during the renewal process either by adding some add-on covers to your plan or by changing your insurer altogether, it may increase your premium.
  • 5

    What if I forgot to pay my health insurance premium?

    If you could not make the payment for the health insurance premium on time, then your policy can be cancelled. After paying the first premium, you will be given a grace period if you do not make the payment for the premium on time. You can renew your health insurance plan by paying the premium within 15 to 30 days of the grace period, which can vary from insurer to insurer, but, if you miss this opportunity too, then it could risk you losing your coverage.

  • 1

    How can I renew my health insurance policy?

    It is imperative to renew your health insurance policy to avail continued coverage, and save on accumulated benefits such as waiting period benefits and No Claim Bonus (NCB). You can easily renew your health insurance policy by following the simple steps given below: 

    Step 1: Visit the website of the insurance company and navigate to the ‘Health Insurance Renewal’ page.
    Step 2: Enter the required details such as health insurance policy number and the registered mobile number.
    Step 3: Check the policy details displayed and renewal premium. 
    Step 4: Pay the required health insurance premium via Credit card/Debit card or Net Banking. 

     

  • 2

    What to do if my health insurance policy renewal date is missed?

    Even if you missed the expiry date of the health insurance policy and failed to pay for its premium on time and renew it, you can still do it within a grace period of up to 7 days to 15 days, where may vary from insurer to insurer. Failure to make your payment, even after the grace period, then your policy will lapse.

  • 3

    Why should you avoid policy renewal during the grace period?

    If you could not renew your health insurance plan within the expiry date, you can renew it within the grace period but at this time your policy will not be active and anything that happened to you will not be covered. Hence, you should avoid taking your renewal to the grace period.

  • 4

    Do I get a discount on the renewal of the policy with the same health insurance company?

    The provision of discounts on the renewal of the health insurance policy varies from one insurance company to another ranging from 5% to 20%. You can get the discount with the renewal of policy from the same in different forms such as a discount for staying with the plan for a longer tenure, discount for family members on adding more members in the plan during renewal, discount for women is also provided by some insurance companies, and discount for no claim bonus.

  • 5

    Can a health insurance policy expire if it is not renewed on time?

    Yes, your health insurance plan can get expired if it is not renewed before its expiry date as well as within the grace period.

  • 1

    What if my health insurance policy lapses when I am hospitalised?

    There can be two situations. First, where you get hospitalised before the policy expiry date and notify the insurance company before the policy lapses, and the policy lapses when you are still in the hospital. In the second situation, you may be hospitalised during the grace period, the policy lapses then, and you inform the insurance company about the same during the grace period. In both cases, the insurance company will compensate for the coverage availed, as per the terms and conditions stated in the policy document. 

  • 2

    Can I avail coverage benefits if I get hospitalised for less than 24 hours?

    Yes. Most health insurance plans cover you for medical treatments that do not require hospitalisation of at least 24 hours. These are known as daycare procedures. Daycare treatments are performed under local or general anaesthesia in a clinic, hospital, or daycare center. Some daycare treatments that health insurance plans cover you for are chemotherapy, eye surgery, sinusitis, dialysis, angiography, etc.  

  • 3

    Do health insurance plans cover diagnostic charges like X-rays, Ultrasound or MRI?

    Yes, most health insurance plans give compensation for various types of diagnostic tests comprise X-rays, MRIs, blood tests, etc., if the policyholder stays in the hospital for at least 24 hours.

  • 4

    Do health insurance covers robotic surgery and modern treatments?

    According to the health regulations issued by the Insurance Regulatory and Development Authority of India (IRDAI) in 2019, all insurance companies are required to insure robotic treatments. Therefore, all insurance companies provide it with some sub-limits and policy conditions.

  • 5

    What Are The Diseases Covered Under Health Insurance Policy?

    The diseases covered under health insurance plans differ from one insurance company to another. Some of the common diseases that most of the health insurance plan covers include cancer, accident related injury, cataract surgery, dengue, COVID-19, diabetes, amongst others.

  • 1

    What happens to my health insurance plan after a health claim is filed?

    After a health insurance claim is filed and settled by the insurance company, then the policy coverage tends to be reduced by an amount that has already been released during the settlement. For Instance, if your buy a plan with Rs. 5 lakh policy coverage and make a claim of Rs. 2 lakh, then you can avail of the health insurance of Rs. 3 lakh in the remaining policy year.

  • 2

    What if the insurance company refuses to settle my claim and I want to file a complaint?

    If your insurance company refuses to settle your health insurance claim you can raise your complaint under the Insurance Ombudsman scheme if your insurer rejected the claim, has not resolved your concern to your satisfaction, paid no heed to it for 30 days, etc. After this, IRDAI can take your issue with the insurance company and ensure a re-examination of your complaint or resolution.

  • 3

    Does every network hospital provide a cashless claim facility?

    The insurance companies list some hospitals in their network to offer the cashless facility to their health insurance policyholders, hence, all the hospitals in the network of an insurer provide the cashless facility. However, non-network hospitals do not offer cashless treatment and if you go to them for any type of treatment, then you will have to pay the bill on your own and can request reimbursement later.

  • 4

    What is the procedure for reimbursement settlement?

    The health insurance reimbursement claim can be made if policyholders opt for a hospital that is not in the network of the insurance company. In such a case, a cashless facility is not applicable and you will have to pay for all your medical bills and then raise a reimbursement claim for it. To make the reimbursement claim, you will have to submit the required and relevant documents such as original medical bills to your insurer. The insurance company will evaluate your documents and pay you accordingly.

  • 5

    If I do not make a claim within a policy period, can I get a refund of my money?

    Yes, if you have purchased a health insurance plan, it comes with a provision as per which you can return the policy within a specific period, which is known as Free-look Period, if you have made no claim. However, you will not get any refund of money after passing that period, even if you have not made any claim.

  • 1

    Does a normal health insurance policy cover critical illness?

    Not all health insurance policies have inbuilt critical illness cover but there are some regular health insurance policies that provide coverage for critical illness. Usually a regular health insurance policy does not cover critical illness but you always choose to purchase a critical illness add-on cover for your health insurance policy which will provide coverage for critical illness.

     

  • 2

    Is it worth purchasing a Critical Illness Insurance policy?

    With rising health issues and expensive treatment critical illness insurance policy becomes a necessity. Critical illness insurance policy provides coverage for specific life threatening diseases that require funds and regular visits to the hospitals for the treatment. Treatment for such life threatening diseases can be very expensive and this is where a critical illness insurance policy comes in handy.