Health Insurance

Health Insurance is a type of insurance, which offers coverage for different medical expenses to the policyholder. Based on the chosen health insurance plan, the policyholder can avail coverage for hospital expenses incurred due to an accident or illness, critical illness expenses, surgical expenses, etc.

It is basically a cover provided by health insurance companies against any kind of expense incurred on medical treatment by the policyholder. The health insurance cover, for an individual or family, becomes active by paying an annual premium, which can be renewed yearly.

Most Insurance companies have a tie-up with a large number of hospitals to ensure cashless treatment and speedy recovery of the patient.

Why Should You Buy Health Insurance Policy?

Sedentary lifestyle has reduced physical activities to the minimum. Health injuries, ailments, critical illness, and accidents are on the rise. In such a scenario Health Insurance Plans serve as a savior for people by providing coverage against the exorbitant hospital bills.

• Due to inflation in healthcare sector, medical costs are rising at a rapid pace. The heavy expenditure on medicines, health tests, doctor visits, laboratory tests, surgeries causes a dent in the individual's pocket
• Health insurance policy prevents investments and savings of the family from getting depleted in medical bills
• Health Insurance in India works as a boon for people with greater liabilities and limited resources
• Buying a health policy keeps an individual/ family relaxed and carefree by ensuring health cover
• Most insurance companies offer cashless treatment through their wide network of hospitals. In other cases, reimbursement is provided to the policyholder in the event of any medical exigency
• Some Health Insurance Plans offer coverage for the costs incurred on the ambulance, medical tests, consultations, hospitalization, and post-hospitalization

Top Health Insurance Plans in India 2020

The below-mentioned health insurance providers are ranked basis their Incurred Claim Ratio (ICR). ICR stands for the ratio between the total premiums earned in a year and the total number of claims paid against it by the insurer. ICR ascertains the performance of the insurers. The higher the ICR, the better the record of claim settlement.

Here’s a rundown on some of the top health insurance plans from the best health insurance companies:

Health Insurance Cover for Coronavirus (COVID-19)

With the outbreak of coronavirus in the country, people have inquired about the COVID-19 coverage under health insurance policies. Reports say that there has been a 40% rise in queries on health insurance.

Here’s a rundown to health insurance cover for Covid-19:

Coronavirus health insurance cover is available right from the day of diagnosis. As coronavirus is a news disease, it does not fall under the pre-existing illness category.

Inclusions of COVID-19 Health Insurance Plan:

Listed below are covered under Coronavirus Health Insurance Policy:

Exclusions of COVID-19 Health Insurance Plan:

Listed below are not covered under the Coronavirus Health Insurance Plan:

• Home Quarantine
• Pre-existing disease
• Non-recognized quarantine centres
• Hospitalization without the recommendation by the doctor
• Pre and postnatal expenses

Types of Health Insurance Plan

The types of medical insurance plans offering health coverage are listed below.

• Individual Health Insurance

  These plans provide health insurance for individual policyholders. The policy premium of individual Health Insurance plans is relatively low and decided on the basis of several factors such as age, previous medical condition, location, etc. 

• Family Health Insurance

  These are plans that offer coverage for the entire family under one medical insurance policy. Most family floater health insurance plans offer coverage for up to 4 members of the family. These include parents and children (up to 2). Some plans extend coverage to up to 15 members of a family under a single Family Floater Health Insurance plan. The sum assured in these plans is applicable to the entire family. The policy comparison of buying a family floater health insurance policy with individual health insurance policies for the family prove family floater to be cheaper.

• Senior Citizen Health Insurance

  These plans are specially designed for people who are over the age of 60 years. Most of the Senior Citizen Health Insurance plans offer discounts on the policy premium. The insurers offering senior citizen health insurance plans are limited and may conduct a health check-up before selling the policy. The plans are relatively expensive when compared with health insurance plans for younger people owing to the vulnerability of the senior citizens to fall ill.

• Critical Illness Insurance

  This plan is specially designed to provide cover against critical illnesses such as heart attack, kidney failure, cancer, organ transplant, etc. Critical illness plans are useful for people with any medical history of critical illness in the family.

• Maternity Insurance

  These insurance plans cover expenses related to pregnancy. This includes expenses during prenatal, postnatal, and delivery stages. Both the newborn child and mother are covered under the Maternity Health Insurance plan. These plans are available as riders that can be bought with an existing health policy. However, some of the health insurance providers have started aternity cover as in-built feature in their plans.

• Group Health Insurance

  These plans are designed for employers or companies to offer health insurance to their employees. The premium of a Group Health Insurance plan is low as they involve less risk, and benefits of the plan remain valid only until the individual is an employee of that company.

• Preventive Healthcare

  These plans offer coverage for expenses borne during the treatment of any disease, illness, or cancer. Screening tests or annual check-ups are some of the services covered under this medical insurance

• Personal Accident Insurance

  This plan covers all medical insurance claims that arise through unforeseen and unexpected accidents. Personal accident Insurance offers compensation for death, disablement, impairment, or injury caused by rail, road, air, or water accidents.

• Unit-linked Health Insurance:

  Introduced recently, this policy comes with the dual benefits of insurance and investment, where a portion of the premium amount is invested in the market and the other is to provide health coverage. This policy comes in handy in covering those expenses that are not covered by a regular health insurance policy.

Inclusions of a Health Insurance Plan

Different plans have different features to suit varied requirements. Even though most health plans can be tailor-made as per the needs of the individual. Some common inclusions found in health plans are listed below.

• The expense incurred during inpatient hospitalization
• Ambulance charges cover
• Any pre-existing ailment or disease cover
• Post-hospitalisation expense cover
• Donor expense, in the event of organ transplantation
• Maternity expense cover
• Pre and Post Hospitalization
• Daycare treatments cover
• Free Health Checkups
• Domiciliary hospitalization cover

Exclusions of a Health Insurance Plan

There are certain treatments, injuries, cases that are not covered under the coverage of a health insurance policy. These Exclusions are as follows.

• Injuries caused as a result of war, suicide attempts, nuclear activity, or terrorism
• Eye or dental surgery
• Rehabilitation, hospitalization in case of common illness
• AIDS or some similar disease or some terminal disease
• Non Allopathic treatment
• Pre-existing illness or any critical illness has a waiting period of 2-4 years to get coverage
• Sex change, replacement of hormones, Plastic, or cosmetic surgery
• No coverage for expenses incurred on newborn/ maternity. Coverage Applicable only of a rider is taken
• Barring an accidental emergency, no reimbursement or coverage id applicable in the waiting period of the plan which is usually 30 days
• Treatment taken by an under-qualified professional or at a non-registered hospital
• Self-inflicted injury like suicide or attempt to suicide

Benefits of Health Insurance in India

Buying a health policy in India comes with several benefits. These benefits are listed below.

• Tax Benefits:

  The premium of health policy is eligible for Tax benefit under Section 80D of the Income Tax Act 1961. This deduction is applicable in two ways:

  For taxpayers below 60 years of age, who have purchased a medical insurance policy for self and senior citizen parent, can claim tax benefit up to Rs 75,000 under Section 80D of the Income Tax Act 1961

  Taxpayers above 60 years of age who have purchased a health insurance policy for self and parents are eligible to claim tax benefits up to Rs 100000 under Section 80D of the Income Tax Act 1961

• Secure Finances through Optimum Health Plan

  The unreasonably high costs involved in medical treatments make it indispensable to own a health plan. Comparing the policy options and buying a health plan for the various expenses involved with medical treatment is the best way to keep the family’s health and finances secured. In the event of not having a health plan can lead to depletion of family savings.

• No Claim Bonus

  This is applicable if the policyholder does not take any policy claim in a given year. In such a scenario, the policyholder gets a no claim bonus which is in the form of a discount in the premium or an increased sum assured in the health policy.

• Cashless Treatment

  Most insurance companies have a tie-up with hospitals and nursing homes. When an insured takes treatment from such a hospital that is a part of the network, also known as impaneled or network hospitals, the expense of the treatment is borne by the insurer directly, with the insured only mentioning his policy number. The insured is free from the hassle of documentation submission and reimbursement.

• Ambulance Fee

  The ambulance fee involves getting the insured to the hospital is also covered under the Health Insurance policy.

  Cover for Pre and Post Hospitalization Expense

  Since the expenses incurred both prior and after hospitalization is part of the treatment, they are included in the list of coverage. The number of days included in the pre and post hospitalization varies with the policy option.

• Medical Checkup

  A large number of health insurance providers offer annual medical check-up free of cost. This feature is subject to a particular claim-free year, where the insured is eligible to earn NCB benefit.

• Cover for Alternate Treatment methods

  Some health insurance plans offer insurance cover for availing medical treatment through alternative treatment methods. These may include Yoga, Homeopathic, or Ayurveda. This feature allows the policyholder the freedom to try alternative treatment methods without worrying about the costs.

• Room Rent

  Most Health Insurance policies offer cover for the room rent which is another huge cost in the medical expenses.

• Coverage for Pre-existing Illness

  Once the policy has run for a few years, the insurer offers the insured cover for pre-existing illness. This simply means that the policy will provide cover for pre-existing illnesses that the insured had prior to purchasing the policy.

• Daily Hospital Allowance in Cash

  This benefit is either a rider or an in-built, depending on the provider. Under this feature, the overhead expense that occurs during hospitalization, like travel, food, etc. are covered under this.

• Day Care Treatments

  These include procedures such as radiotherapy, dialysis, angiography, colonoscopy, appendectomy, chemotherapy, eye surgeries, hydrocele, and lithotripsy among others. Some select medical plans offer coverage for these daycare procedures, which take

• Addition Protection over the Employer Cover

  Though employers offer health insurance, at times it might not suffice the insurance requirements of a person, considering the rising cost of health care services. Hence, an additional health insurance plan comes at one’s rescue, if the hospital expenses go above the limit. 

Best Health Insurance Plans in India 

With innumerable insurance companies existing in the market, each company has its own pool of medical insurance plans, selecting the health plan that suits one individual or family perfectly becomes a taxing task.

In order to simplify the task, a list of the top insurance plans of the country is compiled below. 

• Apollo Munich Optima Restore Plan 

  This plan is popular owing to the numerous benefits it offers to its policyholders. The plan covers people in the age group of 91 days and 65 years and a sum assured ranging between Rs 3lakhs – 50 lakhs. The benefits offered by this plan include a cover for air ambulance, domiciliary treatment, post, and pre-hospitalization, etc. The unique benefit of this plan is the Stay Active Benefit. Under this, the policyholder becomes eligible for certain discounts on the policy premium by staying active and fit. 

  Inclusions

  Policy benefits under Apollo Munich Optima Restore are:

  • Option for Lifetime Renewability
  • Cover for Road ambulance
  • Cover for inpatient hospitalization and daycare procedures
  • A 100% rise in the sum assured after 2 years of no policy claim

  Exclusions

  The policy doesn’t cover the expenses incurred for the following:

  • Cosmetic surgeries and mental disorders
  • Expenses on the treatment of diseases such as HIV/AIDS
  • The expense incurred on treatment that happens within 30 days of the policy purchase
  • Expense on any treatment that is a result of alcohol or tobacco addiction

• Bajaj Allianz Health Guard Plan

  Counted among the best health insurance plans in the country, Bajaj Allianz Health Guard Plan offers coverage against expenses incurred on major health ailments. The plan is an all-inclusive plan covering individuals, families, and pregnancy (along with the newborn baby).     

  Inclusions

  Policy benefits can be categorized into the following:

  • The plan covers pre-hospitalization expenses for a period of 60 days and pre-hospitalization expenses for 90days
  • The expense incurred on road ambulance for up to Rs 20,000 each policy year
  • Covers inpatient hospitalization expenses such as ICI charges, room rent, nursing expenses, and surgery cost
  • Coverage for daycare treatment procedures
  • Maternity expense including childbirth, miscarriage, abortion, or any related process
  • An expense incurred on newborn baby treatment including expenditure incurred on vaccination for up to 90 days from the date of birth

  Exclusions

  Some of the policy exclusions are mentioned below:

  • Any kind of dental treatment or inpatient hospitalization which does not involve any nursing staff or doctor supervision
  • Medical treatment as a result of war, invasion, insurrection, or civil unrest
  • Any medical treatment that has been taken abroad
  • The expense incurred on the treatment of HIV
  • An expense incurred on treatment of for impotency, infertility, erectile dysfunction
  • Treatment on self-injury caused by suicide or an attempt to suicide, alcohol, or drug abuse

• Bharti AXA Smart Health Insurance Plan

  The health insurance plan covers all kinds of emergency hospitalization and medical expenses.

  Inclusions

  Coverage offered under this policy usually include:

  • Daycare treatment covered up to sum assured
  • Coverage for the expense incurred on Ayush treatment
  • The expense incurred on Domiciliary hospitalization up to 10% of the sum assured
  • An expense incurred on critical illness
  • 30 days coverage for the pre-hospitalization expense and 60 days coverage for the post-hospitalization expense

  Exclusions

  The policy doesn’t cover the expenses incurred for the following:

  • The expense incurred on hormonal treatment
  • Cosmetic surgery
  • Dental treatment
  • AIDS/HIV treatment expenses
  • Certain illnesses are not covered until the completion of one year
  • Any pre-existing ailment that is not covered till the completion of the waiting period which is 48 months

• Chola MS Family Healthline Insurance Plan

  This is a comprehensive single health insurance plan that offers coverage for both Ayurvedic and Allopathic treatments. The coverage under this plan includes spouses and children in the same plan.

  Inclusions

  The list of benefits under this policy include:

  • Maternity expenses
  • Sum assured of up to Rs 15lakhs
  • Coverage for the expense incurred on hearing aids, spectacles, OP dental treatment, and contact lens
  • The cost incurred on donor treatment, and organ transplantation

  Exclusions

  The policy doesn’t cover the expenses incurred for the following:

  • The cost incurred on the treatment of pre-existing ailments for up to 2years of the policy term
  • Costs incurred during the first 30 days of the policy term barring accidental cases
  • Some diseases are not included for a period of 1 or 2years (as mentioned in the policy document)

• Edelweiss Health Insurance Plan

  This health plan offers budget-friendly premium plans offering wide and unique coverage. The plan is available in silver, gold, and platinum variants for the policyholder to select as per the requirements.

  Inclusions

  The list of benefits under this policy include:

  • No limit on the cost of ICU
  • Daycare and AYUSH treatments covered
  • Coverage for organ donor costs
  • Coverage for the expense incurred on critical illness and maternity benefit
  • Coverage for the compassionate visit

  Exclusions

  The policy remains null and void in situations such as

  • Suicide or attempt to commit suicide
  • An expense incurred on self-treatment
  • The cost incurred on self-treatment
  • HIV AIDS

• Future Generali Criticare Plan

  This plan offers coverage for 12 critical diseases that are mentioned in the policy document. On diagnosis of any of these ailments, the insurer pays the insured a lump-sum payment of the sum assured. The sum assured for this plan ranges between Rs 1lakhs and Rs 50lakhs.

  Inclusions

  Policy benefits are to be availed for:

  • Covers both children and spouses
  • The policy is subject to a waiting period of 90 days from the policy initiation date
  • Cashless treatment through the network of impaneled hospitals
  • A lump-sum payment to the insured
  • Critical illnesses include kidney failure, cancer, etc.
  • No medical test required up to age 45 years

  Exclusions

  The policy doesn’t cover the expenses incurred for the following:

  • Suicide or attempt to commit suicide
  • Any kind of fertility treatment
  • Treatment cost incurred on HIV AIDS
  • Depression
  • Pre-existing ailments
  • Congenital disease

• Max Bupa Health Companion Individual plan

  The plan is a unique health insurance plan offering many benefits to the policyholder. From allowing entry to the policy from the age of 91 days, the policy provides a sum assured ranging between Rs 2lakhs and Rs 1 crore. Offering a health cover for up to 19 relations, the plan is available at budget-friendly prices.

  Inclusions

  Policy benefits under Max Bupa Health Comapnion plan are as mentioned below:

  • Free Look period of 15 days.
  • Option to avail lifetime renewability.
  • Tax benefit under section 80D of the Income Tax Act.
  • Treatment is done with inpatient hospitalization.
  • Pre hospitalization up to 30 days and post-hospitalization of 60days

  Exclusions

  Some of the policy exclusions are mentioned below:

  • An expense incurred on OPD
  • Eye based and laser treatment
  • An expense incurred due to any act of self-harm or for the treatment of HIV/AIDs
  • Accidents arising from warlike situations or war
  • No claim in initial 30 days

• Max Bupa Health Companion Individual Plan

  The plan is ideal for nuclear families and individuals looking for a budget-friendly comprehensive health plan.

  Inclusions

  The policy provides insurance coverage for:

  • Expense incurred on pre-hospitalization for up to 30 days and post-hospitalization expenses for 60 days
  • Coverage for all daycare procedures
  • Coverage for inpatient hospitalization for any of the covered ailments
  • Coverage for AYUSH treatments
  • No claim bonus of increasing the sum insured by 20-100% of the sum assured
  • Emergency ambulance expense, organ transplant cover, and Domiciliary treatment
  • Tax benefit under section 80D of the Income Tax Act
  • Cashless treatment facility, 15 days free look period, lifetime renewal option

  Exclusions

  The list of exclusions includes the following benefits

  • Cosmetic surgery, weight control surgeries, optical services, dental treatment
  • HIV/AIDS
  • Unlawful and dangerous activities, conflicts
  • Maintenance of life by artificial means
  • Circumcision
  • Maternity and other reproductive related expenses, menopause, puberty
  • Medical treatment is taken from abroad
  • Laser treatment or robotic surgery
  • Nonmedical costs

• National Parivar Mediclaim Plus

  The plan offers a sum assured as huge as Rs 50lakhs and covers the entire family including children, self, spouse, parents in law, and parents.

  Inclusions

  The below coverage are offered under this plan:

  • Cashless treatment facility at the network of hospitals
  • Facility for lifelong renewal
  • Budget-friendly insurance cover for both individual and family
  • Coverage for any pre-existing ailment provided after completion of the waiting period
  • Tax benefits on the policy premium

  Exclusions

  The policy doesn’t cover the expenses incurred for the following:

  • Complications due to pregnancy
  • Treatment of genetic disorder, STD, or obesity
  • Cosmetic surgery, hormone replacement treatments
  • Psychiatric and Psychosomatic disorders

• New India Assurance Senior Citizen Mediclaim Policy

  The policy offers several benefits to policyholders. The main policy inclusions and exclusions are mentioned below.

  Inclusions

  • A 10% family discount is applied if the policy includes spouse coverage
  • Coverage for treatment by Unani, Homeopathic, or ayurvedic means provided at a government hospital
  • Coverage to pre-existing ailments after 1.5 years of the policy purchase
  • These include hypertension, diabetes, and some other related diseases
  • Pre and post hospitalization expense cover for 30 and 60 days respectively
  • Ambulance charges cover

  Exclusions

  • An expense incurred on the treatment of HIV and other STD
  • Pregnancy, childbirth, and related complications
  • Cosmetic surgeries

• Oriental Individual Mediclaim Health Insurance Plan

  This health insurance plan covers individuals between the age group of 18 -65 years extendable up to 70 years.

  Inclusions

  The list of inclusions covers the following:

  • Facility for a 100% family discount
  • No medical test till the age of 55 years
  • Lifelong renewability
  • Sum assured for the policy ranges between Rs 1 lakh to Rs 10 lakhs
  • Coverage for expenses incurred on ICU charges, OT charges, X-Ray, diagnostic tests, surgeon fees, chemotherapy, dialysis, lab tests, etc.
  • Options to opt for voluntary co-payment of 10% and 20% on SI above 2 lakhs

  Exclusions

  The insurer doesn’t entertain a claim during the following conditions:

  • Suicide
  • Attempt to suicide
  • Pre-existing illness cover after 4 years
  • No claim in initial 30 days of the policy
  • Injuries due to particpation in dangerious activities
  • Self-harm or its attempt
  • Ailments caused due to drug or alcohol abuse

• Raheja QBE Health Insurance

  The plan is available in several variants and offers coverage to people within the age group of 90 days to 65 years.

  Inclusions:

  Some of the policy inclusions include:

  • In-patient hospitalisation expenses
  • Pre and post-hospitalisation cover
  • Ambulance cover up to a certain limit
  • Organ donor expenses in case of organ transplant
  • Daily allowance for up to 6 days of continuous hospitalisation per claim

  Exclusions

  The list of exclusion includes:

  • Medical treatment availed outside the country
  • Treatment for complications arising from pregnancy
  • An expense incurred on HIV/AIDS
  • An expense incurred on treatment through non-allopathic means

• Royal Sundaram Lifeline Super Plan

  The plan offers wholesome coverage for both families and individuals.

  Inclusions

  The policy coverage is offered for below expenses:

  • Coverage for the expense incurred on inpatient hospitalization
  • Ambulance expense up to Rs 5000
  • Daycare procedures and Domicialiry treatment equal to the sum insured
  • Coverage for the expense incurred on 60 days of pre-hospitalization treatment and 90 days post-hospitalization
  • The benefit of no claim bonus up to 20-100% of the sum assured
  • Coverage for treatments done under AYUSH for up to Rs 30,000.0
  • Vaccinations against animal bit covered for up to Rs 5000
  • Daily Hospital cash of Rs 2000 per day for a period of 30 days
  • Coverage for the expense incurred on taking consulting for a second opinion in case of treatment for any of the mentioned 11 critical ailments

  Exclusions

  • Critical Illness detected within 90 days of getting the policy plan
  • Any ailment detected in the waiting period of 30 days is not covered
  • Expenses incurred on treatment of circumcision
  • Expenses incurred on account of participation in dangerous sports activities
  • Expenses incurred on the treatment of congenital conditions
  • The expense incurred on any cosmetic surgery
  • OPD treatment
  • The expense incurred on any treatment of eyesight
  • The expense incurred on oral and dental treatment
  • The expense incurred on the treatment of drug overdose
  • The expense incurred on artificial life maintenance means
  • The expense incurred on the treatment of HIV/AIDS
  • The expense incurred on the treatment related to obesity, OPD, hereditary conditions, psychiatric and psychosomatic conditions
  • Stem cell treatment
  • The expense incurred on the treatment of speech or sleep disorder
  • The expense incurred on the treatment of any injury caused due to participation in illegal activities

• Reliance Critical Illness Insurance

  The plan offers coverage for some critical illnesses for which the treatment costs are extremely high. Some of the illnesses covered under this plan are Cancer, Third-degree burns, Coma, Organ Transplant, Multiple Sclerosis, Total Blindness, Heart valve Replacement, and renal Diseases.

  Inclusions

  Some of the benefts of this policy are mentioned below:

  • The policy covers 10 critical illnesses where a lump sum payout is offered at the time of diagnosis
  • No medical test is required to avail this plan
  • Some of the major illnesses covered under this policy include Cancer, third degree burns, Aorta Graft Surgery etc.

  Exclusions     

  Claims arising out of the following will not be entertained:

  • Treatments for HIV/AIDS
  • Treatment for mental disorders, dental surgeries, congenital disease
  • Cosmetic surgery
  • Suicide or attempt to suicide
  • Treatment for injuries as a result of criminal activities
  • Treatment for illness as a result of drugs or alcohol consumption

• Star Family Health Optima Plan

  It is a health plan that offers all-round benefit to the policyholder. Star Family Health Optima Plan offers covers to the complete family at a budget-friendly premium. The policyholder can include spouse, self, and dependent children (of the age group 16 days to 25 years) with this plan.  The sum assured offered in this plan ranges from Rs 3lakhs to Rs 25lakhs. Anyone between the age group of 18 -65 years can purchase the plan. This policy scheme has the benefit of lifetime renewability and automatic restoration (3 times during the plan) on complete exhaustion of the sum assured.

  Inclusions

  Some of the policy benefits offered under Star Family plan are:

  • All daycare procedures
  • Cover for the Air ambulance charges to the limit specified
  • Expenses incurred in case of Inpatient hospitalization and domiciliary hospitalization (treatment carried out at home)
  • 60 days cover for pre-hospitalization and 90 days cover for post-hospitalization

  Exclusions

  The policy doesn’t cover the expenses incurred for the following:

  • Any kind of dental treatment
  • Expenses incurred from an act of self-harm
  • Sexually Transmitted Diseases
  • Vaccinations (barring post-bite)
  • Injuries from war or a similar situation

• Tata AIG MediPrime Health Insurance Plan

  Another comprehensive health insurance plan that offers coverage against medical expenses arising from hospitalization.

  Inclusions

  To mention a few of the policy benefits are:

  • Coverage for the expense incurred on domiciliary treatment, or organ donor
  • An expense incurred on treatment taken under AYUSH up to the specified limit
  • Coverage for 140 daycare treatments
  • Pre and post hospitalization expense cover for 60 and 90 days respectively
  • Domiciliary treatment cover
  • Accidental; dental treatment cover

  Exclusions

  The policy doesn’t include the expenses incurred for following:

  • Treatment of Venereal diseases
  • An expense incurred on the treatment of HIV/AIDS/STD
  • An expense incurred on Donor Screening
  • Cosmetic Surgeries

Health Insurance Schemes Initiated by the Government of India

Government Health Insurance Plans are backed by the Government of India. These schemes are intended to make medical insurance available to all the people who are economically deprived. Here’s a list of health insurance plans owned by the Indian Government:

• Aam Aadmi Bima Yojana
• Ayushman Bharat Scheme
• Central Government Health Scheme (CHGS)
• Employment State Insurance Scheme (ESIS)
• Pradhan Mantri Suraksha Bima Yojana
• Rashtriya Swasthya Bima Yojana
• Universal Health Insurance Scheme

• Aam Aadmi Bima Yojna (AABY)

  A Government of India Health Insurance scheme, Aam Aadmi Bima Yojna was started in the year 2007 for the rural landless people of the country. The scheme provides health coverage to the primary earning member of the family. Some benefits of this scheme are

  • Rs 30,000.00 cover in case of natural death
  • Rs 75,000.00 payable in the event of total permanent disability or death from an accident resulting in loss of 2 limbs or both eyes
  • Rs 37,500.00 to be paid in the event of partial permanent disability resulting from an accident leading to the loss of one limb or one eye

• Ayushman Bharat Yojana or Pradhan Mantri Jan Arogya Yojana

  The health scheme initiated by the Government aims to cover poor families across the country. Ayushman Bharat Yojna offers a health coverage of Rs 5 lakhs to each family covered under the scheme per year. This amount includes the expense of tertiary care and hospitalization expense. The Government also aims to open wellness centers and health centers for people for easy access to health facilities.

• Central Government Health Scheme (CGHS) 

  This health insurance policy started by the Government of India offers medical coverage for the employees of the Central Government and their dependent family members. The scheme benefits are extended to pensioners too. To be eligible to avail the benefit of the Central Government Health Scheme, the individuals must be residing in a city that is covered through this scheme. The scheme provides coverage for treatments provided through allopathy, Ayurveda, Siddha, Unani, homeopathy, and Yoga.

• Employment State Insurance Scheme (ESIS)

  The scheme was started for factories having more than 10 employees. The Employee State Insurance Scheme offers health coverage to the employees and their dependent family members. The benefits of this policy include Vocational and physical rehabilitation. Some other benefits of the ESIS are

  • 70% of the wages of 91 days as illness benefit
  • 90% of the wages a dependent benefit
  • Rs 10,000.00 for covering funeral expenses
  • 12 weeks of complete wages as maternity benefit
  • Disablement benefit for the insured
  • In case of any temporary disability, 90% of the last wages

• Pradhan Mantri Suraksha Bima Yojna (PMSBY)

  This Government-run health Insurance plan provides coverage against death or disabilities caused due to accidents. The scheme is a one-year plan and needs to be renewed every year. People within the age group of 18 -70 years can benefit from this policy, subject to having AADHAR (main KYC requirement of the scheme) and savings account in any of the banks participating in this scheme.

• Rashtriya Swasthiya Bima Yojana: 

  This Health Insurance Policy was started, in the year 2008, by The Ministry of Labour and Employment of the Government of India. From April 1, 2015, the operations of the scheme were handed over to the Ministry of Health and Family Welfare. The purpose of this scheme was to provide health coverage to people who fell in the BPL category. The insured under this scheme was given cover for the medical expense of up to Rs 30,000.00. This service was made available through the network of impaneled hospitals. This plan covers up to a maximum of 5 members of a family which includes up to three dependent children and parents. The greatest advantage of the Rashtriya Swasthiya Bima Yojna plan is the facility of cashless hospitalization offered through its network of hospitals.

• Universal Health Insurance Scheme (UHIS)

  Under this policy, the government aims to provide health insurance to the people under below poverty line. 4 companies from the Public sector have come together to offer this scheme to the citizens of India. As per the Universal Health Insurance Scheme, the insured individual or his family can claim health cover for up to Rs 30,000 in case of hospitalization. However, if the breadwinner of the family dies in an accident, the family is given a compensation of Rs 25,000. Additionally, the family will be given Rs 50 per day, for 15 days from the date of death of the breadwinner of the family. The scheme targets poor families who are below the Poverty Line.

Factors to Consider when Selecting the Best Insurance Company in India

There are numerous insurance providers in India offering varied Health insurance plans. When purchasing a policy, it becomes vital to compare health insurance companies and select the one that offers an apt health plan. Some factors that help in comparison to health insurance companies are as follows.

Company Reputation: The goodwill and reputation of a company is a crucial factor in deciding the ideal health insurance policy. A company with an established repute and brand in the market is known for its good services, products, etc. An individual looking to buy a policy should consider the company’s reputation in the market.

Stability: The financial stability of the insurer is another factor to be checked when buying an insurance policy. The Credit Rating Information Services of India Private Limited CRISIL recommended AAA-rated companies are a safe bet as AAA rating implies robust financial stability of the company.

Claims Settlement Ratio: When applying for a health insurance policy claim, a speedy, smooth, and hassle-free claim settlement and minimal rejection lead to a high probability of buying the policy. A high claim settlement ratio of a company is an indicator of the favorable performance of the insurer in settling health claims.

Portfolio of Products: As the number of insurance companies existing in the market keeps increasing, and each company launching new insurance products. It becomes vital to select a company that offers a varied range of health insurance products keeping in mind the needs of the customer and whose products keep updating with the changes in the demand.

Customer Service: Customer service plays a crucial role in the insurance sector. A well informed, helpful, and knowledgeable customer support is of prime importance. The insurance companies providing efficient, quick, and reliable solutions to the customer queries woo more customers. Customer support may be through call/ SMS/ email.

Insurance Advisor: The network of insurance advisors ensures a wider reach. They provide a personal service to the customers and advise products as per the needs of the family. The insurer having a wide network of reliable insurance advisors makes the work of policyholder easy and keeps them attached to the company.

Customer Feedback: Positive feedback posted by people who have bought a specific insurance provider’s policy and experienced their service offers a better and true picture of the company’s performance. Checking the complaint resolution mechanism of the insurer through the IRDAI (Insurance Regulatory and Development Authority of India) can further help in deciding about an insurer.

Factors Affecting Health Insurance Premium

Here are the factors affecting health insurance premium:

• Gender and Age
• Medical History
• Type of Health Insurance Policy
• Term of the Policy
• Lifestyle
• No-claim discount

Policy Calculator for Health Insurance Premium

The health insurance premium calculator is a convenient tool available online that helps people find the appropriate premium amount based on the information provided by them.

It is essential that the individual using the tool provides correct information to get actual amounts. 

Factors Influencing the Health Insurance Premium

The premium amount of a Health Plan varies from one plan to another and from person to person. There are several factors that affect the policy premium of a health plan. These are

• Age and Gender

Both of these factors influence the premium amount. The premium amount for a plan increases with rising age. As many diseases are related to old age, the premium of health insurance plans is higher with increased age. Secondly, in the case of females, the policy premium is relatively low owing to their less susceptibility to a heart attack or stroke. 

• Previous Medical History

Most insurers conduct a medical test after a certain age when issuing a health policy. Some critical factors in this include the medical condition of the individual, family history of diseases, etc. For this reason, the policy premium of smokers is higher than non-smokers. 

• Policy Term

As general consideration policies taken for a longer tenure are at a discounted rate than a shorter one. For instance, a 2-year policy is cheaper than a 1-year policy with the same features.

• Lifestyle

An individual's lifestyle which includes alcohol, smoking, sedentary lifestyle, etc are considered and leads to a higher premium. 

• No Claim Discount

If an individual does not make any policy claim during a given year, the next year's premium becomes eligible for a no claim bonus discount that may range from 5-50 %. 

Health Plan Claim Process

The claim process for any insurance policy is a crucial factor to consider when it comes to buying a health plan. A smooth claim process ensures the insured, a smooth and carefree treatment in case of an emergency. The claim process in a Health Insurance Policy can be categorized as follows.

1. Cashless Claim process
2. Reimbursement Claim process

1. Cashless Claim process

For a cashless claim process, the insured must be treated in any of the impaneled hospitals. The insured can avail the cashless treatment and hospitalization by displaying his health insurance policy, or the card provided by the insurer as proof of the health insurance facility. The illness must, however, be covered in the health plan. Under a cashless claim facility, the medical bills of the insured’s treatment are sent to the insurer by the impaneled Hospital. The insurer on receiving the expense bill settles the bill after careful examination and evaluation of the medical expense bill.

In a cashless claim process, the treatments are either Unplanned or Planned. Unplanned claims are usually for Emergency Treatments.

• Claims Process for a Planned Treatment at any of the Cashless Network:

In order to file a claim for a planned treatment taken at an impaneled hospital, the insured must intimate the insurer about the treatment to be availed. It is usually recommended to inform the insurer a minimum of 72 hours before getting the medical treatment. Along with the intimation, the insured must submit a cashless claim form at the office of the insurer by Post, email, or fax. Once the claim form is received, the insurer would inform the insured and the hospital about the eligibility and cover provided by the policy. Once the treatment is completed, the medical bills are paid by the insurer to the hospital directly.

• Claims Process for an Unplanned or Emergency Treatment at the Cashless Network:

In the case of a medical emergency, the insured can visit the nearest impaneled hospital to receive medical treatment. The policy card with the insured helps in availing the cashless hospitalization facility at the office of the. Here the hospital fills the cashless claim request form and submits it at the insurer’s office. The insurer sends an authorization letter to the Hospital confirming the policy coverage and paying the bills later on receipt of the medical bills from the hospital.

2. Reimbursement Claim Process

This claim is applicable when the insured visits a non-impaneled hospital for treatment. Here cashless claim facility does not apply and the insured has to pay all the medical bills, costs, and other expenses involved in the treatment and claim reimbursement after that. For the reimbursement claim, the insured has to submit all relevant documents and original medical bills to the Insurer. The insurance company evaluates all the medical bills and reimburses the insured as per the scope of the policy the

The following documents are generally required when applying for a claim.

• Duly filled claim form
• Medical form or certificate signed by the doctor doing the treatment
• Original discharge summary or card received from the Hospital
• All original medical bills and the corresponding receipts
• Prescription and cash memos received from the hospital or pharmacy
• Investigation report
• A Medico-Legal Certificate (MLC) or FIR in case of an accident

Health Insurance Policy Renewal

It is essential to renew the medical plans every year to keep one's family and self, protected from unexpected and sudden medical expenses. The health insurance companies now-a-days provide simple, smooth, and online means to renew the medical policy on their websites. The insurer needs to access the policy details by entering the policy number, etc. and make the payment using any of the online payment modes available-net banking, credit card, debit card, etc.

The renewed policy details are sent at the registered email id of the policyholder.

Below are some factors worth considering at the time of policy renewal.

• Modifying the Members Getting Benefit from the Policy

  The policyholder can make changes in the members covered under the policy. The policyholder can add new members. If unfortunately, a member has expired, that member can be removed/deleted from the policy coverage. 

• Raise the Amount of Sum Insured

  The policyholder can utilize the renewal to increase the amount of sum assured. The insurer, in this case, may ask for a medical test and a no claim history. Also, any increment in the sum assured will lead to a new waiting period that would be applicable to the raised amount. 

• Add Some Top-Up Plan

  In the event of the sum insured of an insured being equal to the maximum limit possible under that scheme, the insured cannot raise the sum insured. However, at the time of policy renewal, the insured can look for additional top-up plans with the existing insurer or a different one. 

• Share Details About Some New Medical Condition

  At the time of policy renewal, the health insurance policy is renewed for another year on the same terms and conditions. If however, there have been any changes in the health of the insured in the past year that may impact the policy claim later due to non-disclosure, it is recommended to mention any changes in health conditions to the insurer at the time of health plan renewal. 

• Read all the Terms and Conditions 

  The policy providers can make amendments in their policy features, terms, and conditions from time to time. As per IRDA, the insurer has to take the approval of the policyholder for any changes in the terms and conditions. If the insured does not accept any of the modifications made, the policyholder can port the policy to another insurer or migrate to a new plan with the same insurer.

• Safely Preserve the Receipt

  The renewal receipt of the health insurance policy is a critical policy document and must be kept safely. The details of the policy receipt must be shared with the other family/policy members to be handy at the time of need. 

• Making Some Other Member as the Policyholder

  It is possible to change the policyholder at the time of renewal. An individual can make his parents the policyholder and avail tax benefit for paying premiums under section 80D of the Income-tax Act 1961.

• Renewal Time Period

  To enjoy the benefits of a policy renewal it is essential that the renewal is done before the policy expiry. The grace period in most policies is usually between 15-30 days. Once the policy lapse the medical cover will no longer be valid. Other benefits such as no claim bonus, critical illness cover, and tax exemptions will no longer be valid.

List of Health Insurance Companies in India

Let us discuss some of the health insurance companies in detail:

• Aditya Birla Health Insurance

  Aditya Birla health insurance plans customizable and are designed to meet the various insurance needs of the people. The insurer offers a range of comprehensive plans with a sum assured limit up to Rs. 2 Crores. Health insurance plans from Aditya Birla can be availed as individual, family, critical illness, and group health insurance plans. With its presence in 650 cities across the country, the insurer has more than 17,000 advisors to carry forward its business.

  Health Insurance Plans by Aditya Birla Capital

  • Activ Health Platinum
  • Activ Secure
  • Activ Care
  • Active Assure Diamond
  • Group Active Health/Secure

• Bajaj Allianz Health Insurance

  Bajaj Allianz General Insurance Company has been providing quality insurance solutions in the general insurance segment since its inception.  The provider is a joint collaboration between Bajaj Finserv Limited, a comprehensive financial services company based out of India and Allianz SE, the global financial services majorly based out of Munich, Germany. The provider received iAAA rating by ICRA for the 10th year continuously. As of now the provider claims to have a profit rate of Rs 780 crore and revenue of Rs 11,097 crore with a 17% growth rate.

  Health Insurance Plans by Bajaj Allianz Insurance Company

  • Health Guard Family Floater Plane
  • Hospital Cash Daily Allowance Plan
  • Tax Gain Health Plan
  • Health Care Supreme Plan
  • Critical Illness Policy
  • Silver Health Plan
  • Health Ensure Plan
  • Silver Plan for Senior Citizens
  • Star Package Health Plan
  • Healthcare Supreme
  • Arogya Sanjeevani

• Care Health Insurance (formerly known as Religare Health Insurance)

  This is an all-inclusive plan that offers cover for medical expenses incurred on any illness, injury, or accident. The policyholder has the option to select the sum insured between Rs 4lakhs - Rs 6crore. Several add on benefits are available with this policy by paying the extra amount with the premium. These include everyday daycare, no claims bonus super, personal accident cover, unlimited automatic recharge, smart select, air ambulance, international second opinion, and global coverage. Care Health Insurance (formerly known as Religare Health Insurance) is available in 5 different variants which are Care 3 (Super Saver), Care 4 (Elite), Care 5 (Elite Plus), Care 6 (Global), and Care 7 (Global Plus).

  Inclusions in the policy are:

  • All daycare treatments
  • Hospitalization expenses for inpatient treatment up to a maximum of sum insured
  • Expense on pre-hospitalization covered for 30 days and 60 days in case of post-hospitalization
  • Global cashless cover across the network of hospitals
  • Domiciliary hospitalization expenses covered up to a specified limit
  • Ambulance cover, air ambulance, daily hospital costs, organ donor treatment
  • Tax benefits on the policy premium

  Exclusions in the policy are:

  • Congenital ailments/diseases
  • Expenditure for treatment of AIDS
  • Expenses incurred due to tobacco or alcohol addiction
  • Expenses which are a result of war, riots, strike, etc.
  • Expenses incurred as a result of injury due to self-harm
  • Pregnancy or infertility related illness treatment

• Cholamandalam MS Health Insurance

  Cholamandalam MS General Insurance Company Limited, established in 2001, was a joined venture of Murugappa Group, a multi-business conglomerate, and the Japan-based Mitsui Sumitomo Insurance Group to address the general insurance market in India. With 105 branches in the country, the insurer provides individual and corporate insurance solutions with 9000+ agents.

  Health Insurance Plans by Cholamandalam MS Insurance Company

  • Chola Swasth Parivar Insurance
  • Chola Top-up Healthline
  • Chola Hospital Cash Healthline
  • Chola Super Top-up Insurance
  • Chola Healthline
  • Chola Tax Plus Healthline
  • Chola MS Critical Healthline
  • Chola Classic Health Individual
  • Individual Healthline Insurance
  • Hospital Cash Plan
  • Chola Classic Health Family Floater
  • Chola Accident Protection
  • Chola Family Healthline

• Digit Health Insurance

  Known as digital-friendly health insurer in the Indian insurance market, Digit health insurance is one of the sought-after insurance products. The polices are designed to cater to the various insurance needs including individual, family, senior citizen, where the insured can avail cashless benefit at over 5900 network hospitals.

  Health Insurance Plans by Digit General Insurance Company

  • Health Insurance
  • Corporate Health Insurance

• Edelweiss Health Insurance

  Edelweiss medical insurance plans offer coverage to Individuals, Families, and Groups. Available in 3 variants- Silver, Gold, and Platinum, one can avail coverage up to a maximum of Rs 1 cr. Edelweiss health insurance offers coverage for critical illness under Gild and Platinum plan option.

  Health Insurance Plans by Edelweiss General Insurance Company

  • Edelweiss Health Insurance
  • Edelweiss Group Health Insurance

• Future Generali Health Insurance

  With a PAN India presence of 137 branches, Future Generali Insurance Company is a joint collaboration of Indian Conglomerate Future Group, and the Generali Group. The insurer takes pride of providing customized insurance solutions catering the different individual needs.

  Health Insurance Plans by Future Generali Insurance Company

  • Future Health Suraksha - Individual Plan
  • Future Health Suraksha - Family Plan
  • Future Hospicash - Hospital Cash
  • Comprehensive Plan - Health Total
  • Accident Suraksha - Personal Accident
  • Future Criticare - Critical Illness
  • Future Vector Care
  • Future Advantage Top up
  • Future Health Surplus - Top-Up
  • Surakshit Loan Bima               

• IFFCO Tokio Health Insurance

  When it comes to offering health insurance solutions, IFFCO Tokio Health Insurance can be a true choice. The insurer has been serving the industry since 2000, with maximum customer satisfaction with transparency. IFFCO Tokio offers a hassle-free claim settlement with a CSR of 92% and promises to offer cashless treatment over 5000 network hospitals across India.

  Health Insurance Plans by IFFCO Tokio General Insurance Company

  • Family Health Protector Policy
  • Critical Illness Health Insurance
  • Individual Medishield Policy
  • Swasthya Kavach Policy
  • Individual Health Protector Policy
  • Personal Accident Insurance Policy

• Kotak Mahindra Health Insurance

  Famous as a subsidiary of one of the leading India private banks Kotak Mahindra, Kotak Mahindra General Insurance offers health insurance at an affordable rate of insurance. Apart from the basic coverage, the insured can opt for various add-ons. The insurer also offers discounts on various products, which can be availed online easily. With 4000 network hospitals within the country, health insurance from Kotak Mahindra offers benefits such as cashless hospitalisation, day care procedure, in-patient treatment cover, domiciliary cover etc.

  Health Insurance Plans by Kotak Mahindra Insurance Company

  • Kotak Secure Shield
  • Kotak Health Super Top-up
  • Accident Care Health Plan
  • Kotak Health Premier

• Liberty Health Insurance

  The insurance company was established in the year 2013 and since then has been offering diversified insurance products to cater to the various needs of the people. Health insurance provided by the insurer can be availed an individual and family floater, where the insured can avail cashless facilities at over 5000 network hospitals. For its excellent services, the insurer is awarded with Employer of Choice by the Excellence Awards.

  Health Insurance Plans by Liberty General Insurance Company

  • Health Connect Policy
  • Health Connect Supra
  • Secure Health Connect
  • Individual Personal Accident

• Max Bupa Health Insurance

  Max Bupa Health Insurance has its global presence in more than 190 countries. The claims are settled directly without an intervene of a Third-party Administrator. To ensure ease of insurance claim for its customers, the insurer offers cashless claim pre-authorization in 30-minutes.

  Health Insurance Plans by Max Bupa General Insurance Company

  • GoActive Family Floater Health Insurance
  • Heartbeat Family Floater Health Plan
  • Max Bupa Health Recharge Plan
  • Criticare Health Insurance Plan

• New India Assurance Health Insurance

  Founded in the year 1919 and having its head-office in Mumbai, New India Assurance General Insurance Company has a reputation in the market. In addition to other insurance products offered by the insurer, health insurance can be a good pick for one looking for securing the finances in times of an eventuality. New India health insurance doesn’t require a medical test to avail the policy, while a comprehensive coverage can be expected at an affordable premium. Currently, the insurer has its presence in 28 different countries globally.

  Health Insurance Plans by New India Assurance

  • Enhanced good Health
  • New India Assurance Mediclaim Policy
  • Two Year Good Health Mediclaim
  • New India Global Mediclaim Policy
  • Standard Group Janata Mediclaim
  • ICAI Family Floater
  • Overseas Mediclaim
  • New India Flexi Group Mediclaim

• Oriental Health Insurance

  With its global presence in, Nepal, Kuwait and Dubai, Oriental Insurance Company is well-famous for its insurance products. Health insurance from Oriental offers comprehensive coverage for mitigating those additional expenses arising out of a health emergency. The insurance provider also offers insurance products for petrochemical and chemical industries.

  Health Insurance Plans by the Oriental Insurance Company

  • Happy Family Floater Plan
  • Oriental PNB Health Plan
  • Individual Mediclaim Health Insurance
  • OBC Oriental Medicliam
  • Personal Accident Insurance
  • Janata Personal Accident Plan
  • Overseas Mediclaim
  • Super Health Top-up

• Reliance Health Insurance

  With around 139 branch offices across India, Reliance is a renowned health insurer in India. The insurer is more accessible through its digital platform to make the insurance process convenient for its customers. Health insurance from Reliance has its presence in India and abroad with a vast customer database.  Reliance health insurance can be availed as individual and family floater.

  Health Insurance Plans by Reliance General Insurance Company

  • Reliance Health Wise Plan
  • Reliance Health Gain Plan
  • Reliance Wellness Plan
  • Reliance Health Gain Instalment Plan
  • Reliance Critical Illness
  • Reliance Personal Accident Plan

• Raheja QBE Health Insurance

  QBE Insurance belongs to the Rajan Raheja Group. Health insurance from Raheja offers extensive and exclusive coverage in times of need. The insure provides cashless facility, hassle-free claim settlement, online renewal of policy along with the other policy benefits.

  Health Insurance Plans by Raheja QBE General Insurance Company

  • Cancer Insurance
  • Health QBE
  • Individual Personal Accident
  • Group Personal Accident Insurance
  • Hospital Daily Cash-Group
  • Pravasi Bhartiya Bima Yojna
  • Arogya Sanjeevani

• Royal Sundaram Health Insurance

  Royal Sundaram GI Co. offers cashless hospitalization facilities in nearly 5000 network hospitals in India itself. Some of the alluring features of Royal Sundaram health insurance are lifelong renewability option, option to double the sum insured in 5 claim-free years and 100% reload of sum insured.

  Health Insurance Plans by Royal Sundaram Insurance Company

  • Family Plus Health Insurance
  • Elite Lifeline Health Plan
  • Supreme Lifeline Health Plan
  • Classic Lifeline Health Plan

• Star Health Insurance

  Star Health and Allied Insurance Co Ltd. is the first standalone health insurer founded in the year 2006. At its initial stage, the insurer focused on health insurance, personal accident plan and overseas mediclaim policy, and expanded its wings slowly and steadily thereafter. Today the insurer is counted among the most sought-after insurance providers in India. The company is known for its vast network list of 9800+hospitals PAN India. It was awarded by Economic Times with the best BFSI Brand Award in 2019.

  Health Insurance Plans by Star Health Insurance Company

  • Senior Citizen Red Carpet
  • Star Comprehensive Family Plan
  • Super Surplus Insurance Plan
  • Family Health Optima
  • Medi-classic Insurance
  • Star Health Gain
  • Diabetes Safe Insurance
  • Star Cardiac Care
  • Star Cancer Care Gold
  • Star Care Micro
  • Star Criticare Plus
  • Star Family Delite
  • Star Special Care
  • Star Micro Rural & Farmers Care
  • Star Hospital Cash Policy
  • Star Outpatient Care Policy
  • Young Star Insurance
  • Star Novel Coronavirus
  • Arogya Sanjeevani Policy

• SBI Health Insurance

  Founded as a joint venture between State Bank of India (SBI) and Insurance Australia Group, SBI Health Insurance offers suitable insurance solutions of every genre. Health insurance from SBI General Insurance can be availed for both individuals and groups. Over these years, the company has proved its potential by sharing a vast customer base. Health insurance offered by the insurer provides huge sum insured at an affordable rate, ranging from Rs 50,000 to Rs. 5,00,000.

  Health Insurance Plans by SBI General Insurance Company

  • Arogya Premier Policy
  • Arogya Plus Policy
  • Arogya Top up Policy
  • Retail Health Insurance Policy
  • Critical Illness Insurance Policy
  • Hospital Daily Cash Insurance Policy
  • Group Health Insurance
  • Loan Insurance Policy
  • Arogya Sanjeevani Policy

• Tata AIG Health Insurance

  Tata AIG General Insurance is collaboration between TATA Group and the American International, which celebrates its 18-yers of service in 2019. With more than 4000 network hospitals across India, the insurer facilitates its customers with cashless benefit. Moreover, TATA AIG is quite popular for its seamless claim settlement process.

  Health Insurance Plans by TATA AIG General Insurance Company

  • TATA AIG MediCare
  • TATA AIG MediCare Premier
  • TATA AIG Medicare Protect
  • TATA AIG Wellsurance Executive
  • TATA AIG MediSenior
  • TATA AIGWellsurance Women
  • MediPlus
  • TATA AIG Wellsurance Family
  • Critical Illness Plan

• Universal Sompo Health Insurance

  Founded in the year 2007, Universal Sompo General Insurance Company is a joint collaboration between Dabur Investment Corporation, Indian Overseas Bank, Karnataka Bank, Allahabad, and Sompo Japan. Health insurance plans offered by Universal Sompo are affordable and customizable in the manner to meet the insurance needs of the people. Moreover, cashless treatment is available in more than 5000 network hospitals across India. The policies can be availed for individual, family, senior citizens, groups, NGOs and likewise.

  Health Insurance Plans by Universal Sompo

  • Super Healthcare Insurance
  • Arogya Sanjeevani Insurance
  • Individual Health Insurance
  • Group Health Insurance Policy
  • Individual Accident Policy
  • Janta Personal Accident Insurance
  • Group Personal Accident
  • Aapat Suraksha Bima Policy
  • Loan Secure Insurance Policy
  • Hospital Cash Insurance Policy
  • Saral Suraksha Bima (Micro Insurance Policy)
  • Sampoorna Surkasha Bima (Micro Insurance Policy)
  • Senior Citizen Health Insurance Policy
  • Pravasi Bhartiya Bima Yojana
  • Surva Vidyarthi Bima Yojana
  • Swarna Gramin Bima Yojana - Individual
  • Swarna Gramin Bima Yojana - Group
  • Critical Illness Insurance Policy

How to Buy A Health Insurance Policy?

Buying a health plan is possible through both offline and online modes.

In the offline mode of purchasing a health plan, the buyer must visit the insurer’s branch office, refer to the various plans available, select the plan that meets their requirement, provide all relevant documentation and fill the form, and make payment to purchase the policy.

In the online mode, the prospective buyer can make policy comparisons online and select the appropriate plan to be purchased. This involves a simple process of visiting the website of the insurer whose policy is to be purchased, filling all the mandatory details, attaching any documents that are required and making the necessary payments

Documents Required to Purchase Health Insurance

The documents required to purchase a Health Insurance policy are as follows

• Age Proof

  The policyholder needs to submit certain documents that serve as age proof of self and dependent family members who are covered in the plan. These include

  • Birth certificate
  • Pan Card
  • Passport
  • Driving Licence
  • Aadhaar Card
  • Voter Card
  • Marks Sheet for 10^th or 12^th
• Identity Proof

  The following documents are considered valid to be submitted as proof of Identity.

  • Aadhaar Card
  • Pan card
  • Driving Licence
  • Voters Id Card
  • Passport
• Address Proof

  A document as a proof of residence is another mandatory document to be submitted while purchasing a policy.  Some documents that are valid to be submitted as address proof are mentioned below:

  • Passport
  • Driving Licence
  • Aadhar Card
  • Electricity Bill
  • Telephone Bill
  • Voters Id card
• Photographs

  In some cases, the insurers might ask for some additional documents too while selling the policy.

Eligibility to Buy a Health Insurance Plan

The basic eligibility criteria to buy a health policy in India are the same for all insurance providers with a slight variation in some cases.

• The minimum entry age to buy a medical policy lies between 18-21 years, as mentioned by the specific insurance provider
• The maximum entry age at which an individual can buy a health insurance policy is between 60 -100 years of age with the facility to extend the renewal to whole life
• Parents, children, and spouse can become the dependents of the policyholder in a health plan. In case of children, the entry age begins from 91 days of age up to 18 years or 25 years, as per the norms of the insurer
• Renewing a health plan is generally allowed by all insurance providers. However, after a certain age, in some cases 45 years of age, the insurer may need a medical examination before renewing the policy or selling a new individual health insurance plan. Moreover, some policy come with lifelong renewability as well.

Factors to Check While Buying a Health Insurance Policy

In order to ensure the right health cover, one should consider the below factors:

• Know the Family Requirement

  It is vital to analyze the health insurance needs of one’s family before buying a health policy. This ensures that the health plan that is bought meets the needs of the family. 

• Selecting the Optimum Coverage Amount 

  The amount of cover can be decided keeping the health conditions of the family members in mind. The ideal thing to do when buying a health insurance policy is to select a plan that provides maximum coverage, especially if the family members are susceptible to illness. 

• The Extent of Illnesses Covered

  It is advisable to select a policy that offers coverage against critical illnesses. The Health policy that offers coverage for a maximum number of critical illnesses must be selected over others. Since the expense incurred for the treatment of any critical illness is huge, this factor must be carefully analyzed. 

• Higher Sum Assured

  With skyrocketing costs of medical treatment, doctor consultation, and other hospitalization, it is essential to compare health insurance plans and buy a health plan that offers the highest sum assured. A higher sum assured would mean that that individual and his/her family is covered for a large amount. 

• Higher Renewal Age

  The real benefit of health insurance plans begins with advancing age when health starts falling. It is therefore recommended to select a policy plan with a high renewal age limit. Plans that have a renewal age limit of 70 or 75 years must be preferred over others. 

• Higher Claim Settlement Ratio

  Insurers that have a high claim settlement ratio must be selected over others as the preferred choice. A high Claim Settlement Ratio refers to the higher probability of the claims getting approved and settled in case of an unfortunate incident. 

• Network Hospital Coverage 

  All insurance companies have a tie-up with a network of hospitals. The insurer that has an extensive list of hospitals must be considered while buying a health plan. 

• Lower Co-pay Amount

  The co-pay amount in the selected health insurance policy, especially in case of senior citizen plans, must be nil or minimum. Co-pay refers to the amount that has to be borne by the policyholder at the time of a claim settlement. Most companies have a co-pay percentage in the range of of 10-30%. 

• Scope Of Coverage

  It is always recommended to select a health plan that covers a wide range of services. Getting mislead by a lower premium must be avoided as it might lead to low benefits at the time of policy claim. 

• Portability Option in Health Insurance Plans

  Health insurance Portability allows the policyholder to switch the health plan from one company to another. This way the policyholder can switch to a new plan within the same company or to a new company with a new plan that offers benefits without compromising on the accrued benefits with the existing plan such as NCB, waiting period etc. 

• Benefit of Restore

  It refers to the facility provided by the insurer wherein the sum assured in a health plan is restored during the policy term after getting exhausted for medical treatment. This facility is especially useful in a family floater when the sum assured gets used in the reimbursement of a single member's medical treatment expenses. The restored sum assured can however not be used for the reimbursement of the same illness by any family member. 

• Waiting Period 

  It refers to the period after the insurance plan is initiated, which the policyholder must serve to get the policy coverage. In most cases, this period is 30 days. Any claim that is presented during this period can be rejected by the Insurer. Apart from the initial waiting period, there are pre-existing illness waiting period, maternity waiting period, waiting period for specific illnesses etc. 

• Premium Loading

  If the insurance provider, at any time, feels the policyholder is likely to have a higher probability of claiming insurance, it can raise the standard premium applicable. This process of Premium Loading must be carefully checked while buying an insurance policy to avoid paying any extra premium. 

Tips to Avoid While Buying a Health Insurance Plan 

When selecting a health insurance policy, there are several factors that must be considered. Similarly, there are some points that must be completely avoided when buying a health insurance policy. 

• Buying a policy with Inadequate Cover

  It is commonly found that while buying a health insurance policy, people prefer buying a policy that has a lower premium rate and hence low coverage. Though buying a policy within the budget is essential, it is critical to not be too cautious in buying a health cover and rather buy a plan with the appropriate coverage.

• Ignoring the Fine Print on the Policy

  It is mandatory and crucial to read the fine print and terms and conditions of the policy carefully before selecting the policy plan. It is the finely written details that mention the policy exclusions which prove critical at the time of policy claim.

• Policy and Insurer Comparison

  When buying a health plan it is mandatory to analyze and examine all the plans of an insurer and the plans offered by other insurers. It is recommended to buy a policy that meets all the requirements and needs rather than buying a policy in haste.

• Presenting False medical Records

  The most crucial factor when buying a health insurance policy is to mention the true and actual medical health at that time. The lure of a lower premium rate lures people to lie about their health and in some cases existing medical conditions which in most cases leads to claim rejection at a later stage.

• Cashless Hospital

  In many cases, individuals buying a health plan miss checking the cashless facility offered by insurers. The cashless facility offered by an insurer is the most beneficial facility that proves useful to the individual in the time of any health claim.

• Selecting Multiple Riders

  Although riders prove beneficial when buying a health plan, selecting a rider just for the sake of buying a rider without checking its benefits must be avoided. As rider comes with an additional premium, it should be the one that is necessary and supports the basic insurance cover.

Why Compare Health Insurance Plans?

It is of utmost importance that one does compare health insurance plans online to get the best out of the rest. With a plethora of health insurance policies offered by various insurance companies, it gets confusing to land on the right plan. Here comes health insurance comparison into the picture to help someone bring out of this situation. With the online comparison of health insurance plans, one can compare the policies based on their offerings, features, premium and avail the right option. Moreover, online comparison helps in getting the accurate information on the insurer and plans, saves time and money, checking the reputation of the insurer and getting the right health insurance plan at the most affordable rate.

How to Compare Health Insurance Plans in India?

It is no wonder that sometimes, a policy seeker may end up paying for a health cover that is insufficient or has contradictory clauses. That’s why a comparison of plans is necessary. Here’re some of the factors to keep in mind while comparing health insurance plans:

• Choose the Right Sum Insured:

  One should compare the plans keeping the sum insured amount and rate of inflation in mind. Also, it is best to go for the maximum sum insured amount at the best possible premium rate.

• Factors that Affects Health Insurance Premium:

  While comparing, also keep the determining factors of health insurance in mind such as life history, smoking habit, lifestyle, medical history etc.

• Provide Accurate Information:

  The comparison tool provides insurance quotes based on the information provided by the individual. So it should be accurate in order to get the right information.

• The Credibility of the Health Insurance Provider: 

  It is one of the most important aspects while comparing and buying a health insurance policy. Having said that, insurers’ claim settlement ratio is the most important aspect to look for. The higher the claim settlement ratio, the better it is for the insurance buyers.

What are the Benefits of Comparing Online Health Insurance Plans?

It is recommended to Compare online the health plans existing in the market before zeroing in on the one that suits one's needs and requirements. Comparing plans brings out the features of the plans and makes it convenient to select the ideal plan to avoid any inconvenience at the time of policy claim.

Some benefits of comparing online the Health plans are:

• Access to Correct and Reliable information:

  Comparing health plans online provides complete and accurate details about the plans, its features, benefits, etc. An online comparison leaves no scope of getting mislead by an insurance agent who is likely to provide unreliable and distorted information. 

• Saves Time:

  Online comparison saves time and people can directly purchase the selected policy plan without spending time visiting offices, meeting agents, or comparing plans. Individuals planning to buy the policy can simply visit the company website and purchase the plan. 

• Convenient and Economical

  Access to all relevant and reliable information at the click of a mouse makes it simple and convenient to select the plan that meets their budget and family requirements. In addition, purchasing a policy online proves quite cheap and budget-friendly as the agent fee or brokerage charges are not levied. 

• Information of Insurer

  The online comparison provides all critical information about the insurer also such as its claim settlement ratio, etc. 

Comparison between a Health Insurance Policy and Mediclaim

A Health Insurance policy provides a wider area of coverage than a Mediclaim policy. While Mediclaim covers only the expense incurred on hospitalization, health insurance covers both pre and post hospitalization expenses, ambulance fees, pharmacy bills, etc.

Comparison Between Health Insurance and Critical Illness insurance

Comparison Between Individual Health Insurance and Family Health Insurance

Health Insurance Network Hospitals:

A group of hospitals that are associated with a particular insurer are called network hospitals. The best thing about network hospitals is that life insured can avail the cashless facility at a network hospital that isn’t the same as that of the non-network hospital.

Health Insurance FAQ’s