Health Insurance
Health insurance is your financial safety net when it comes to medical expenses. It covers the costs of doctor visits, hospital stays, surgeries, treatments, diagnostic tests, and more, ensuring you get the necessary care without worrying about the medical bills. A good health insurance policy not only provides coverage for unexpected health costs but also safeguards your well-being by giving you access to top-tier medical care, advanced treatments, and the latest healthcare innovations. Whether you're looking for the best health insurance plan for yourself or a family medical insurance plan that protects your entire household, having the right coverage ensures you're prepared for the future.
What can it do for you?
- Extensive Coverage for a wide range of healthcare needs, from consultations to surgeries.
- Cashless Treatment at trusted hospitals, reducing the burden of immediate out-of-pocket expenses.
- Protection from Unforeseen Medical Costs, helping you avoid financial setbacks during health emergencies.
Choose plans from a bouquet of products - 140+ policies, 40+ insurers, 8500+ Network Hospitals
Highlights of Health
Insurance Plans
Types of Health Insurance Plans
You can choose plans for individuals, family, senior citizens, parents, and super top-up options. There are also health insurance plans for maternity, critical illness and personal accident. Choose the right health insurance cover to safeguard yourself and your family against medical expenses.
In addition to yourself, these plans cover your spouse, children, and parents, with individual sum assured for each member. Provides medical coverage for a single person, ensuring financial security during health emergencies.
These plans cover the immediate family members with a single sum insured under one policy. Covers the entire family under one health insurance plan, offering cost-effective protection for your loved ones.
These plans cover medical expenses of individuals who are 60 years and above in age. Specially designed for individuals above 60, covering age-related ailments and high medical costs.
These plans help you enhance your existing plan’s sum insured at an affordable price. Acts as an additional safety net in case your medical bills exceed a predefined deductible amount.
If you want coverage against all kinds of maternity- related costs like hospitalization, childbirth, medicines, and pre-and post-natal expenses, maternity insurance is the right support. Covers pregnancy-related expenses, including delivery (C-section and normal), medical tests, and postnatal care, ensuring financial ease during motherhood.
A critical illness insurance policy that protects the insured from life-threatening critical diseases. Provides a lump sum payout for life-threatening illnesses like cancer, heart disease, and kidney failure. This includes cancer, heart attack, renal failure etc.
Personal Accident Insurance covers an insured against severe injury or disability caused by an accident. It also compensates the family of the insured in case of the death of the individual. Also known as Corporate Health Insurance, it provides affordable health coverage for employees, offering access to quality healthcare as part of workplace benefits.
Most Popular Health Insurance Plans
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Pays for medically necessary expenses incurred towards Assisted Reproductive Treatment, where indicated for sub-fertility
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Pays for medically necessary expenses incurred towards Assisted Reproductive Treatment, where indicated for sub-fertility
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Pays for medically necessary expenses incurred towards Assisted Reproductive Treatment, where indicated for sub-fertility
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
100% unlimited reset of Annual Sum insured in a policy year.
Expenses incurred for modern treatments such as immunotherapy, stem cell therapy, robotic surgeries and balloon sinuplasty
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Expenses covered maximum up to 50% of the sum insured
Coverage for expenses for daycare treatments
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
100% unlimited reset of Annual Sum insured in a policy year.
Expenses incurred for modern treatments such as immunotherapy, stem cell therapy, robotic surgeries and balloon sinuplasty
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Expenses covered maximum up to 50% of the sum insured
Coverage for expenses for daycare treatments
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
100% unlimited reset of Annual Sum insured in a policy year.
Expenses incurred for modern treatments such as immunotherapy, stem cell therapy, robotic surgeries and balloon sinuplasty
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Expenses covered maximum up to 50% of the sum insured
Coverage for expenses for daycare treatments
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
100% unlimited reset of Annual Sum insured in a policy year.
Expenses incurred for modern treatments such as immunotherapy, stem cell therapy, robotic surgeries and balloon sinuplasty
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Expenses covered maximum up to 50% of the sum insured
Coverage for expenses for daycare treatments
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
100% unlimited reset of Annual Sum insured in a policy year.
Expenses incurred for modern treatments such as immunotherapy, stem cell therapy, robotic surgeries and balloon sinuplasty
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Expenses covered maximum up to 50% of the sum insured
Coverage for expenses for daycare treatments
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
100% unlimited reset of Annual Sum insured in a policy year.
Expenses incurred for modern treatments such as immunotherapy, stem cell therapy, robotic surgeries and balloon sinuplasty
5x Unutilised Base Sum Insured carries forward to the next policy year, maximum up to 5 times
of Base Sum Insured
Offers unlimited e-consultations with qualified General Physicians at our network during the Policy Year through any mode of communication
Expenses covered maximum up to 50% of the sum insured
Coverage for expenses for daycare treatments
Gold – 5 to 10 lacs
Platinum - 5 to 25lacs
Air ambulance up to INR 2,50,000 per hospitalization
Road ambulance up to INR 2,000 per hospitalization
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
Unlimited recharging of sum insured, even the claim arises for related illness
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
Unlimited recharging of sum insured, even the claim arises for related illness
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
Unlimited recharging of sum insured, even the claim arises for related illness
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
Unlimited recharging of sum insured, even the claim arises for related illness
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
Unlimited recharging of sum insured, even the claim arises for related illness
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
Unlimited recharging of sum insured, even the claim arises for related illness
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
Unlimited recharging of sum insured, even the claim arises for related illness
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
Multiple sums insured options available, ranging from 3 lakhs to 25 lakhs
10% Renewal Discount is available after 40 years of age. It is available for customers entering at age <36 years
No health check-up up to the age of 55 years (age as on last birthday)
Pre-existing diseases covered from the third year onwards upon two consecutive renewals with the company
Stay active and get up to 30% of your premium as HealthReturnsTM
For guidance on medical, nutritional, fitness, mental counselling session, homeopathy teleconsultation
70% of customers choose our advisor support for better coverage clarity.
Wide range of trusted providers
Expert guidance at every step
Personalized service across India
3 Reasons to Choose Paybima for Your Health Insurance Needs
A Quick Look At Health Insurance
Features |
Details |
|---|---|
Sum Insured Options |
₹1 lakh to ₹2 crore
|
Hospitalization Cover |
Covers medical expenses for illness & accidents
|
Maternity Newborn Cover |
Available with select health plans
|
Pre Post-hospitalization Expenses |
Covered as per policy terms
|
OPD & Teleconsultation |
OPD expenses & online doctor consultations covered in select plans
|
Day Care & Advanced Treatments |
Covers procedures like dialysis, chemotherapy, robotic surgery, etc.
|
Ambulance & Air Ambulance Cover |
Includes road and air ambulance expenses
|
Annual Health Check-ups |
Free preventive check-ups
|
Pre-existing Disease Cover |
Covered after the waiting period |
Tax Benefits |
Save up to ₹1,00,000 under Section 80D
|
Note: Coverage features may vary based on the chosen policy.
Key Benefits of Health Insurance
Whether it's a planned treatment or a medical emergency, a comprehensive health insurance plan ensures you receive quality healthcare without financial strain. With Paybima, you can choose a coverage amount ranging from ₹1 lakh to ₹2 crore, ensuring complete financial security for you and your family
Types Of Health Insurance Riders
When applying for health insurance, the insured can enhance their coverage with riders that offer additional protection for specific conditions. Below are some health insurance riders that can be considered to optimize coverage:
Key Factors to Consider When Selecting a Health Insurance Policy
Some providers provide discounts on insurance premiums or additional coverage for maintaining a healthy lifestyle. Look for health insurance plans that incentivize preventive healthcare through free check-ups, fitness tracking, or telemedicine access.
Increasingly, health insurers are covering OPD consultations, diagnostics, and treatments like Ayurveda and Homeopathy. If you prefer alternative medicine or need frequent doctor visits, ensure these benefits are included.
When selecting the best medical insurance for family or self, consider policies with minimal or no room rent restrictions. This ensures access to quality hospital facilities without unexpected expenses.
Medical costs rise yearly, making a static sum insured insufficient over time. Look for a health policy with automatic sum insured enhancement or top-up options to keep up with healthcare inflation.
Health insurance becomes active only after the initial waiting period. Opt for a plan with the shortest waiting period to ensure quicker coverage for pre-existing conditions and specific treatments.
Some insurers increase premiums over time due to factors like age, pre-existing conditions, or frequent claims. When selecting the best medical insurance plan, check for policies with stable premium structures and minimal loading to avoid unexpected cost escalations in the future.
A high claim settlement ratio indicates the health insurer’s reliability. Choose a provider with a strong track record in claim approvals, fast processing times, and cashless hospitalization benefits for added convenience.
Some health insurance policies offer international treatment coverage. If you travel frequently or prefer overseas medical consultations, check if your plan includes global hospitalization benefits.
When choosing a health insurance policy, the right coverage varies depending on your personal situation. Below is a breakdown of key benefits you should consider.
Segment |
What to Look For |
|---|---|
Individuals |
Look for comprehensive coverage that includes hospitalization, critical illness, preventive check-ups, and mental health benefits. Ensure the policy offers flexibility and low premiums.
|
Couples |
Consider policies with maternity benefits, infertility treatments, and family planning coverage. Also, look for coverage for both pre-existing conditions and routine health expenses. Prioritize insurers with a wide network of hospitals. Depending on your family setup and healthcare needs, choose between a family floater plan or individual coverage.
|
Women |
Look for policies that offer maternity benefits, newborn care, gynecological treatments, and cancer coverage. Ensure that preventive screenings, mental health services, and emergency care are included for holistic protection. Also, consider plans with coverage for specific female health conditions, such as breast cancer or gynecological surgeries, for added peace of mind
|
Senior Citizens |
Choose plans with a higher sum insured and enhanced coverage for age-related diseases like diabetes, hypertension, and cardiovascular conditions. Look for plans that offer day care treatments, free annual check-ups, and Recovery Benefits, which provide financial assistance for household expenses in case of extended hospitalization.
|
Families with Children |
Ensure the plan covers pediatric care, vaccinations, and emergency treatments. Opt for a family floater plan that provides comprehensive healthcare access for all members at affordable premiums, with added benefits for preventive care.
|
Eligibility Criteria for Health Insurance Plans
Criteria |
Specifications |
|---|---|
Minimum Age for Adults |
18 years and older
|
Maximum Age for Adults |
Usually up to 65 years, some plans extend coverage up to 80 years for senior citizens
|
Entry Age for Children |
90 days to 25 years
|
Minimum Age for Senior Citizens |
60 years and older, depending on the health insurance provider
|
Medical Check-Up |
Required for applicants above 45/50 years, or for those with pre-existing conditions
|
Pre-existing Diseases Waiting Period |
2-4 years, depending on the insurer and the condition
|
Lifestyle Habits Disclosure |
Smoking, alcohol consumption, and obesity may impact premiums or eligibility
|
Family Coverage |
Available for spouses, children (up to 25 years), and dependent parents (age limits may vary
|
Sum Insured Limits for Children |
Some plans offer limited coverage for children below 18 years or separate coverage for them
|
Residence Requirement |
Some insurers require applicants to be Indian residents or provide proof of residency for foreigners
|
Renewal Age |
Many insurers offer lifetime renewability, but specific plans may have a maximum renewal age limit (e.g., 75 years)
|
Why You Should Compare Health Insurance Plans Online
Before you apply for health insurance, it’s essential to compare different plans to find the best coverage at the right price. Online comparisons help you evaluate features, benefits, and costs to choose the best medical insurance for family and self that meets your healthcare needs.
Benefits of Comparing Health Insurance Plans Online
Debunking Common Myths About Health Insurance in India
Many people in India hold misconceptions about health insurance that can lead to inadequate coverage or financial setbacks. Understanding the facts about health insurance plans ensures that you choose the best health insurance policy for your needs.
Factors That Affect Health Insurance Premium
Understanding what influences your health insurance policy premium can help you choose the best health insurance plan that fits your needs. Here are the key factors that determine your premium:
How to File a Health Insurance Claim?
Understanding the claim process ensures you can avail yourself of benefits under your health insurance plan without hassle. There are two kinds of health insurance claims, namely cashless claims and reimbursement claims.
Health insurance providers issue a digitally verified health insurance policy, which is legally valid. However, if you require a physical copy of your medical insurance, there are multiple ways to obtain it:
- Download and Print: Check your registered email for the policy document sent by your insurer, download it, and print it.
- Customer Support Request: Contact your insurer’s customer service to request a hard copy of your health insurance plan.
- Insurer’s Website: Log in to your insurer’s official portal, download your health policy, and print it.
Documents Required While Registering a Health Insurance Claim
Filing a claim under your health insurance policy requires submitting specific documents to ensure a smooth process. Whether you are making a cashless claim or a reimbursement claim, having the right paperwork is essential.
Ask Anything as We Have Answers to Everything in Health Insurance
We recommend coverage of ₹10 lakhs per insured member, which means coverage of ₹40 lakhs for a family of four. However, with a slightly extra amount, one can go for ₹1 crore coverage, which gives complete peace of mind.
Buy health insurance not only for parents but for in-laws is possible. Just be aware of their pre-existing conditions, if any, for the policy proposal purpose.
Yes, almost all insurers allow adding a spouse in case of marriage or a child born during the policy period.
One must buy health insurance as young as possible. Here’s why:
- Buy policy since policyholder are fit and fine
- Complete the waiting periods at a young age
- The premiums are very less
Yes, all the above can be included in one health insurance policy. In-laws can also be included in place of parents. However, considering the age of parents and their pre-existing health conditions, they should take one policy for them and a separate one for themselves, spouse, and children to get the best premium options.
They can definitely buy health insurance for their parents but please keep in mind that all the pre-existing conditions must be declared with the insurer in the proposal form for successful approval and subsequent policy generation.
A regular health insurance policy covers in-patient hospitalisation expenses, which include room rent, doctor fees, diagnostic tests, and medicines. It also pays for any expenses towards doctor consultations, diagnostic tests, etc. which are undertaken pre- and post-hospitalization.
- Initial waiting period - Usually 30 days from the start date of the policy. Only claims related to accidents are admissible in the first 30 days.
- Specific disease waiting period - Usually 2 years from the start date of the policy. Claims related to slow-growing diseases (ex. Hernia, cataract etc,) are paid only after continuing the policy for 2 years.
- Pre-existing disease waiting period - Usually 4 years from the start date of the policy. Claims related to any pre-existing condition such as heart disease/diabetes etc. are paid only after 4 years of continuing with the policy
Critical illness plans pay a lump sum amount on detection of a major critical illness, such as Cancer, First Heart Attack. They cover for loss of income, whereas a regular plan pays for hospitalization costs.
A general list of exclusions from a health insurance policy is as follows:
- Infertility
- Injuries/illnesses that result from illegal activities
- Injuries suffered as a result of engaging in adventure sports
- Addiction treatments
- Dental treatments (unless the dental injury results from an accident)
- Genetic disease/Congenital conditions
- Cosmetic treatments
- Treatment for self-harm
- Alternative therapies
Some health insurers may provide coverage for the above exclusions basis their plans and additional benefits (riders) as the list varies from insurer to insurer.
We suggest they should because coverage in most corporate health policies is,
- Limited to only ₹2-3 lakhs, which is quite inadequate given the high costs of treatment
- Stops immediately in case of a job switch, job loss, or retirement
- Is subject to change as per employer’s discretion
Therefore, one must always have a personal health insurance policy to take care of any medical expenses at any time.
Super top-up is a very low-cost plan that provides additional coverage, over and above the base health insurance plan.
For Example: If they have a base policy of ₹5 lacs, they can buy a Super top-up of ₹95 lakhs at a very minimal cost to make their overall health cover of ₹1 crore.
Policy copy is issued instantly in case there are no adverse medical conditions to declare. In case any medical conditions are declared, it takes 3-4 days, after the submission of past medical records.
Health insurance premiums are adjusted as per the rising medical costs. Few insurers increase the premium in a block of 5 years, while others increase marginally each year. Hence it is always advisable to go for a multi-year policy to get discounts and save more.
Yes. Insurance companies reward the customers with a 'No Claim Bonus' for not making any claim. This means the coverage increases at no extra cost. This can vary from 10% to 50% depending on the plan.
Yes. It’s highly recommended to disclose all past and current health conditions or any lifestyle habits such as smoking or drinking at the time of purchasing the policy. This ensures smooth claims processing.
Tax deduction u/s 80 D of the Income Tax Act is applicable for the premium paid towards health insurance as per the limit below:
For Self and Family (All members below 60 years), the maximum amount that can be saved under section 80D is ₹25,000
For Self and Family + Parents (All members below 60 years), the maximum amount that can be saved under section 80D is ₹50,000 (₹25,000+₹25,000)
For Self and Family (all members below 60 years) with Senior Citizen Parents, the maximum amount that can be saved under section 80D is ₹75,000 (₹25,000 + ₹50,000)
An insurer can decline a claim due to the following reasons:
- Non-disclosure: if a person did not completely disclose any past or present medical condition or lifestyle habit, such as smoking or drinking
- Claim Made in Waiting period: The person files a claim even though the waiting period is not over for the particular disease
- Policy in Grace Period: If a person hasn’t renewed the policy before the expiry date, the policy enters a grace period, where the insurer isn’t liable to pay claims
Insured can use up to the Sum Insured in a policy year. However, few policies provide the benefit of Automatic Restoration of Sum Insured. This means if sum insured is exhausted, the insurance company will restore the sum insured at no extra cost. Lot of insurance companies now provide Unlimited Auto Restoration of Sum Insured.
Yes, individuals can have health insurance from multiple insurance providers. At the time of claim, they can choose to pay from one policy or multiple policies.
NRIs are eligible to purchase a health insurance plan in India and just need proof of residence, IT returns, and other related documents for making the purchase. Please note that most of the health insurance policies come with a clause of ‘geographical restrictions’, which indicates that the policy will not cover any expense of the insured outside India. Eg: If USA residents are seeking medical supervision, the insurance company in India will not cover for the expenses incurred.
