Health Insurance
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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.
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:
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
Health Insurance Calculator
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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:
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
- Reassure 2.0 Platinum+Cover ₹ 5 LStarting at ₹ 832/month*No room rent limit 100% no claim bonusUnlimited restoration benefits3 years PED waiting periodView All Features
- Care SupremeCover ₹ 10 LStarting at ₹ 739/month*No room rent limit Unlimited restoration benefits50% no claim bonus4 Years PED Waiting periodView All Features
- Health Gain PlusCover ₹ 5 LStarting at ₹ 447/month*No room rent limit 33% no claim bonus100% restoration benefits3 years PED waiting periodView All Features
- Optima secureCover ₹ 5 LStarting at ₹ 1,312/month*No room rent limit 50% no claim bonus100% restoration benefits3 yrs PED waiting periodView All Features
- Young Star Individual SilverCover ₹ 5 LStarting at ₹ 448/month*Single Private A/C Room 20% no claim bonus100% restoration benefits1 year PED waiting periodView All Features
Key Features of Health Insurance
Listed below are the key features of medical insurance that you should know about before buying it for yourself:
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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.
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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.
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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.
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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 Eligibility
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.
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.
Key Factors To Consider Before Buying Health Insurance Plans
Knowing how to choose a proper health insurance plan is essential. While the urban population is often exposed to various plans through insurer’s marketing efforts, schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PMJAY) have also helped educate and expand coverage to millions of people in rural India.
- Sum Insured
Sum Insured is the maximum amount or total financial coverage given to you in a single policy year for hospitalisation and medical expenses.
- Claim Settlement Ratio
The ratio between the number of claims settled to the number of claims raised in a given year by your insurance provider is called the health claim settlement ratio.
- Network Hospitals
Network hospitals help you in getting cashless treatment conveniently as these hospitals have tie-ups with your insurer.
- Inclusions and Exclusions
Inclusions are the conditions for which you can make a claim, exclusions are the conditions for which you cannot make a claim.
- Waiting Period
Waiting period refers to the period during which you cannot raise any health insurance claim, (usually, min. 30 days from the day of taking insurance).
- Add-on or Rider Benefits
Add-ons are supplements you can choose voluntarily by paying an extra premium at the time of your policy purchase.
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:
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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.
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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.
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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.
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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.
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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 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 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
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:
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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.
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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.
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Make the Payment
After selecting the best health insurance plan for yourself, select or adjust the sum assured and the term of the policy.
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% |
Partner Health Insurance Companies
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:
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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 |
Government Health Insurance Schemes in India
Health Insurance Riders
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?
- Protection Within 5-minutesInsuranceDekho 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 CustomersWe 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 TeamA 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.