Compare & Buy Health Insurance Plan

Health insurance in India is a necessity. With increasing lifestyle diseases and medical costs, everyone must buy a health policy to secure themselves and their families. A good health plan covers pre and post-hospitalisation, maternity, ambulance, AYUSH and modern treatment.

Health insurance in India is a necessity. With increasing lifestyle diseases and medical costs, everyone must buy a health policy to secure themselves and their families. A good health plan covers pre and post-hospitalisation, maternity, ambulance, AYUSH and modern treatment.

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Health Insurance In India

Buying a health insurance policy in India will help you to protect yourself financially during a medical emergency that may occur in a year. The best health insurance plan can bear the cost of hospitalization, day care treatment costs, expenses incurred during the surgeries, charges for ambulance, and much more. Not only this, but you will also get tax benefits under section 80D of the Income Tax Law, 1961 on the premium amount that you will pay to the insurer.

Let's talk a little more about what health insurance is.

Best Health Insurance Plans

What Is Health Insurance?

Health Insurance is your financial security blanket for all emergency and planned medical expenses. In India, 50% of healthcare expenses are paid out-of-pocket. Raising awareness and investing in health insurance will help change these statistics nationwide.

An affordable health plan in India covers hospitalization, OPD, room rent, surgery expenses, and many more healthcare expenses for you and your family. However, you must select the right medical insurance for yourself and your family.

traordinary Facts

According to Plum, an average Indian household is one serious medical incident away from slipping into poverty. But, what is the point of sharing this information? Well, data says

  • India is the diabetes capital of the world
  • 1 in 5 adults are pre-diabetic
  • 1 in 4 deaths are caused due to cardiovascular issues
  • 1 in 4 Indians have hypertension, which is a major contributor to cardiac ailments

What Are The Types of Health Insurance Plans?

It is important to understand the health insurance policies available in the market to make an informed decision. You have Individual, family, senior citizen, women, critical illness, and other categories.

Let us take a look at the categories for health insurance in India in detail.

  1. Individual Health Insurance

    Individual health insurance, as the name suggests covers an individual under the health plan. It is among the most common types of medical insurance sold in India. The premiums are generally affordable and depend on various factors such as age, medical history, lifestyle, sum insured selected, location, riders/ add-ons, etc.

    Individual Health Insurance Plans

    Name Of Plan Sum Insured Premiums

    Niva Bupa Aspire
    Up to INR 1 Crore Rs. 834/- Per month


    Star Health Assure
    Up to INR 2 Crores Rs. 960/- Per month


    Care Supreme
    Up to INR 1 Crore Rs. 929/- Per month


    Aditya Birla Activ Health Platinum Enhanced
    Up to INR 2 Crores Rs. 934/- Per month


    ManipalCigna Prime Active
    Up to INR 15 Lakhs Rs. 919/- Per month

    *Premiums are calculated for base SI INR 10 lakhs & for a 30-year-old individual including GST

  2. Family Health Insurance

    Family health insurance policies or family floaters are similar to individual health plans. However, family floater plans have a higher sum insured shared between family members. The best part about investing in a family floater health plan is that you do not need to manage medical insurance for different family members separately.

    Family Health Insurance Plans

    Name Of Plan Sum Insured Premiums

    Star Family Health Optima
    Up to INR 25 L Rs. 2,110 /- Per month


    Niva Bupa Reassure 2.0 Bronze+
    Up to INR 1 Crore Rs. 1,706 /- Per month


    ManipalCigna Prime Protect
    Up to INR 15 L Rs. 1,778 /- Per month


    Care Classic
    Up to INR 75 L Rs. 1,557/- Per month


    Star Comprehensive
    Up to INR 1 Crore Rs. 1,879/- Per month

    *Premiums are calculated for base SI INR 10 lakhs & for 2 Adults (30 yrs male + 28 yrs female) + 1 Child (5 yrs) including GST

  3. Senior Citizen Health Insurance

    Senior citizen health policies are designed for individuals who are over 60 years of age. Senior citizens are prone to health ailments which is why premiums are usually higher than other health insurance plans. Many senior citizen medical policies do not stress on pre-policy medical check-ups and even provide domiciliary care, and annual health check-ups.

    Senior Citizen Health Insurance Plans

    Name Of Plan Sum Insured Premiums

    Care Freedom
    Up to INR 10 L Rs. 2,312/- Per month


    Care Senior
    Up to INR 10 L Rs. 2,598/- Per month


    ManipalCigna Prime Senior Classic
    Up to INR 50 L Rs. 2,246/- Per month


    Niva Bupa Health Companion
    Up to INR 1 Crore Rs. 3,119/- Per month


    Star Senior Citizen Plan
    Up to INR 25 L Rs. 2,489/- Per month

    *Premiums are calculated for base SI INR 10 lakhs & for individuals aged 60 years including GST

  4. Critical Illness Health Insurance

    Investing in critical health policy is your saving grace against serious ailments like cancer, kidney failures, heart attacks, and others. Critical illness health plans offer lump sum amounts when you are diagnosed with the listed critical ailments.

    Critical Illness Health Insurance Plans

    Name Of Plan Sum Insured Premiums

    Care Heart
    Up to INR 10 Lakhs Rs. 14,195 /- Per year


    Star Critical Illness Multipay Policy
    Up to INR 25 L Call Our Insurance Experts At 1800-4200-269


    Niva Bupa CritiCare
    Up to INR 2 Crores Rs. 12, 521/- Per year


    ManipalCigna Lifestyle Protection Critical Care Basic
    Up to INR 25 Crores Rs. 2,915/- Per year


    Aditya Birla Activ Secure Critical Illness
    Up to INR 1 Crore Rs. 5,463/- Per year

    *Premiums are calculated for base SI INR 10 lakhs & for a 30-year-old individual including GST

  5. Health Insurance For Women

    Health insurance policies for women cover delivery expenses, pre-natal and post-natal care, newborn baby medical care expenses, first-year vaccination, and more. Investing in a good maternity plan well before starting a family is advised to avoid waiting period hurdles.

    Health Insurance Plans For Women

    Name Of Plan Sum Insured Premiums

    Future Generali Health PowHer
    Up to INR 1 Crore Call Our Insurance Experts At 1800-4200-269


    Niva Bupa Aspire Gold+
    Up to INR 1 Crore Rs. 834/- Per month


    Star Women Care
    Up to INR 1 Crore Rs. 1,103/- Per month


    Niva Bupa Aspire Titanium+
    Up to INR 1 Crore Rs. 1,114/- Per month


    Star Young Star Gold
    Up to INR 1 Crore Rs. 699/- Per month

    *Premiums are calculated for base SI INR 10 lakhs & for a 30-year-old woman including GST

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Health Insurance For Special Needs

For many, general health insurance is not enough, and requires special medical care. Various private and public health insurance providers have launched affordable special health insurance plans for the disabled.

These medical policies are designed specifically keeping in mind the different healthcare needs of individuals with conditions like Autism, congenital diseases, and more. Special health plans reduce out-of-pocket expenses for various medical expenses. Some popular and affordable policies for special needs are mentioned below:

Health Insurance Plan Eligibility Sum Insured
Star Special Care Min Entry Age: 3 Years
Max Entry Age: 25 Years
INR 3 Lakhs
SBI Divyang Suraksha Plan Min Entry Age: 18 Years
Max Entry Age: 65 Years
INR 4 & 5 Lakhs
Niramaya Health Insurance Scheme No Age Limit INR 1 Lakh

Government Health Schemes

Government health insurance in India are an ideal option for many in India. Families from weaker economic sections of society highly benefit from these schemes. Central and multiple state government medical insurance schemes like Ayushman Bharat Pradhan Mantri Bima Yojana are ideal for senior citizens, and families alike. Other government schemes like Mukhyamantri Amrutam Yojana, Dr YSR Aarogyasri, Bhamashah Swasthya Bima Yojana, and others.

Ayushman Bharat Yojana

Ayushman Bharat Yojana

SI Up to INR 5 L

Ayushman Bharat Yojana is a flagship health insurance in India launched by the government of India. It is an important move by the government to achieve universal health coverage. It is important to note that PM-JAY is the world’s largest health insurance/ assurance scheme fully financed by the government.

Mukhyamantri Amrutam Yojana

Mukhyamantri Amrutam Yojana

SI Up to INR 3 L

A state government policy launched by the state government of Gujarat. It is designed to cover families belonging to the weaker sections of the society. Multiple benefits including, the cost of diagnosis, medicines, hospital fees, and others are covered.

Dr YSR Aarogyasri Trust

Dr YSR Aarogyasri Trust

SI Up to INR 5 L

The Aarogyasri scheme is a medical insurance provided by the government of Andhra Pradesh to families belonging to the weaker sections of society. INR 5 lakhs are provided annually to families that cover cashless services for multiple ailments.

Bhamashah Swasthya Bima Yojana

Bhamashah Swasthya Bima Yojana

SI Up to INR 3 L

Affordable health insurance policy launched by the state government of Rajasthan. The scheme offers treatment benefits of up to Rs. 30,000 for general illnesses and Rs. 3 lakhs for critical diseases.

Want to know more if you are eligible for these public health insurance plans? Click Here

Eligibility Criteria of Mediclaim Insurance Policies

Investing in the best mediclaim policy is an important factor for financial planning. However, to achieve that goal it is important to compare medical policies in the market. Consider the important factors mentioned below.

Your Occupation
  • You should be a citizen of India to buy a health insurance plan in India.
  • Children are covered from the day of their birth till they turn 18 years old are covered under a family floater health policy.
  • Most health insurance in India gives coverage till the age of 85 years. But certain plans give coverage till death.
  • You can get coverage for your extended family members in the family floater health insurance plan.

POV- Eligibility criteria are the general requirements made by your health insurance provider before it issues a health policy to you. Factors like age, employment status, residency status, and more matter.

Key Benefits of Health Insurance

Let us look at the top 10 benefits of health insurance for you and your family:

  1. Hospitalization Expenses Covered

    If you are admitted to a hospital for 24 hours or more, your health policy covers hospitalization expenses like room rent, doctor's consultation fees, diagnostics, pharmacy bills, and more.

  2. Annual Health Check-ups

    All top health insurance companies in India, offer policyholders the facility of annual health check-ups, covered by health insurance.

  3. Maternity and Newborn Cover

    With maternity and newborn medical care benefits, health insurance plans offer holistic medical coverage for both mother and child.

  4. Accident Care

    Accident health policies safeguard your financial health by offering accident cover. Accidents can happen anytime, and one must have a robust health plan to cover medical expenses in such situations. Most bestselling personal accident plans/ riders offer lumpsum payouts, child education grants, nominee benefits, etc.

  5. Emergency Ambulance

    Your health policy offers emergency ambulance coverage when you need to reach your nearest hospital. The coverage varies from policy to policy as some offer unlimited coverage, while others have a sub-limit amount on ambulance coverage.

  6. Better Financial Management

    It helps you manage your finances better and bridges the gap between consistently rising medical care expenses and affordable health insurance premiums.

  7. All-in-One Coverage

    All-in-one coverage for you and your family members with comprehensive health plans offering all-round protection and assistance.

  8. Save Your Tax Deductions

    An excellent financial tool, apart from safeguarding your health it also offers tax benefits under section 80D of the Income Tax Act as per Indian laws.

  9. Shield Against Critical Illnesses

    Expensive treatments like cancer, organ transplants, etc. have the potential to drain your life savings but are now easier to treat with health insurance support.

  10. Cashless Treatments

    Cashless treatments are available nationwide as health insurers and network hospitals settle claims directly.

Benefits Of Health Insurance

Benefits of Buying Health Insurance in India

Buy health insurance online to avail the following benefits:

Compare Multiple Plans at Once

With online platforms like PolicyX, you can select, customize, and compare multiple health plans available in the market online.

Pay Premiums Instantly

Select your preferred medical policy, and pay premiums instantly. Premium payments are quick and easy with online health insurance purchases.

Better For The Planet & Best For You

Buying health insurance online saves paper and we all know what saving paper means, a better planet for all! Not just that, the online buying process simplifies the concept of insurance and allows people to compare health insurance plans to select the best one from the comfort of their home or office, without moving an inch.

Available 24/7

You do not have to worry about talking to insurance agents to purchase a health policy when you can purchase health plans online in a jiffy!

Digital Payment Options

Buy health insurance online with digital modes of payment that allow you to pay for your policy securely and quickly.

Multiple Online Discounts

Buy health insurance online and you will be eligible for multiple discounts as most companies offer online purchase discounts.

Tax Benefits on Health Insurance

While health insurance plans are an excellent way to safeguard your family from unforeseen medical expenses, it is also capable of helping you save taxes. Tax benefits under section 80D are as follows as per the age criteria for different individuals. Insurance holders are eligible to buy the best health insurance plans with the tax deductions mentioned above. You are eligible for the following tax deductions as per the Income Tax Laws in India.

  • Critical Illness Rider
    For
    parents
    Rs. 25,000
    Below 60 Years
  • Critical Illness Rider
    Senior
    Citizen
    Rs. 50,000
    Above 60 Years
  • Critical Illness Rider
    For self
    and spouse
    Rs. 25,000
    Below 60 Years
  • Critical Illness Rider
    For dependent
    children
    Rs. 25,000
    Below 25 Years

Let us understand tax benefits through a real-time scenario:

Raj is a 30-year-old working professional and his father is 70 years old. He purchases an individual health plan for himself and a senior citizen health plan for his father separately. He pays premiums of INR 30,000 and 35,000 respectively for individual and senior citizen health plans.

As per section 80D, Raj can claim tax deductions up to INR 25,000 for his health plan and INR 35,000 for the separate senior citizen health plan taken for his father. Raj can claim a total of INR 60,000 in tax deductions.

Inclusion vs Exclusions

Critical Illness Rider
COVID-19 Cataract OPD Care Ambulance Cover Maternity Cover AYUSH Treatments Daycare Procedures Modern Treatments Accident Cover Medical Tests Diagnostic and Pharmacy Cover Pre and Post-hospitalization Expenses
Injuries due to illegal activities Injuries due to involvement in adventure sports Cosmetic procedures Obesity-related treatments Self-inflicted injuries War, riots-related injuries

Riders In Health Insurance In India

To compare health insurance policies in India, considering riders is important. Health insurance riders are additional coverage options in addition to your base health coverage. The additional cost of health insurance riders depends on factors like age, type of rider, sum insured, and others but is comparatively much lower than investing in another health plan.

Below are some common riders you can avail of with your health policy:

Critical Illness Rider

Critical Illness Rider

With the rise in critical illnesses among people due to lifestyle and environmental factors, having a critical illness rider is a must-have today!

Personal Accident Rider

Personal Accident Rider

It also protects the future of your family by offering a child education fund, loss of income coverage and many more exclusive features.

Hospital Daily Cash

Hospital Daily Cash

Loss of income caused due to hospitalization can be recovered with a daily hospital cash rider. The rider pays you a fixed amount daily as per pre-defined sub-limits.

Maternity Benefit Rider

Maternity Benefit Rider

Expenses during pregnancy and childbirth may be expensive without a health cover, this is when a maternity add-on steps in and helps you manage your health and finances, altogether.

Consumables Cover

Consumables Cover

Consumables rider in medical insurance offers coverage for all non-payable medical expenses. Items used for medical treatments such as cotton, gloves, bandages, thermometers, masks, etc. are paid for under this rider. The cost of consumables often contributes to a significant amount in your total hospital bill increasing the overall out-of-pocket cost.

Waiting Period Waiver

Waiting Period Waiver

Waiver of premium rider in your health insurance policy waives off premiums for the policyholder in case he/she becomes critically ill, or is disabled. The rider works under certain terms and conditions and you might be required to fulfil an additional fee at the time of purchase or renewal to avail of this rider.

Riders In Health Insurance In India

To compare health insurance policies in India, considering riders is important. Health insurance riders are additional coverage options in addition to your base health coverage. The additional cost of health insurance riders depends on factors like age, type of rider, sum insured, and others but is comparatively much lower than investing in another health plan.

Below are some common riders you can avail of with your health policy:

Critical Illness Rider

With the rise in critical illnesses among people due to lifestyle and environmental factors, having a critical illness rider is a must-have today!

Personal Accident Rider

It also protects the future of your family by offering a child education fund, loss of income coverage and many more exclusive features.

Hospital Daily Cash

Loss of income caused due to hospitalization can be recovered with a daily hospital cash rider. The rider pays you a fixed amount daily as per pre-defined sub-limits.

Maternity Benefit Rider

Expenses during pregnancy and childbirth may be expensive without a health cover, this is when a maternity add-on steps in and helps you manage your health and finances, altogether.

Consumables Cover

Consumables rider in medical insurance offers coverage for all non-payable medical expenses. Items used for medical treatments such as cotton, gloves, bandages, thermometers, masks, etc. are paid for under this rider. The cost of consumables often contributes to a significant amount in your total hospital bill increasing the overall out-of-pocket cost.

Waiting Period Waiver

Waiver of premium rider in your health insurance policy waives off premiums for the policyholder in case he/she becomes critically ill, or is disabled. The rider works under certain terms and conditions and you might be required to fulfil an additional fee at the time of purchase or renewal to avail of this rider.

Hospital Cash Rider

Hospital cash rider provides you with a daily cash allowance for a specified period. The amount of cash varies from policy to policy as mentioned in your health insurance policy. However, you must be hospitalized for at least 24 hours to avail of this option.

Health Insurance Premium Calculator

Calculate your insurance policy premiums with PolicyX to compare health insurance plans and make an informed decision. With the PolicyX health insurance calculator you can do so without any charges. Follow these steps to use the PolicyX premium calculator.

  • Step 1

    Visit the official website of PolicyX

  • Step 2

    Select 'Health Insurance' on the website

  • Step 3

    Fill in the details required in the form such as the number of members to be covered, city, age, name, and contact details

  • Step 4

    Click on 'Get Free Quotes' to view all available health insurance plans with premium quotes

  • Step 5

    Compare the list of health insurance plans with premiums as per your requirements

health insurance calculator

Premium Calculator Factors

  • City
  • Age
  • Pre-existing conditions
  • Sum insured, and more.
  • Number of people covered under a policy

Premium Calculator Benefits

  • Accurate premium calculation
  • Economical and hassle-free
  • Helps you compare health insurance plans and buy the best
  • Additional filters like riders, adding family members, etc. can show premium price changes in real-time
  • Customize your health policy as per your need
Who Should Invest In A Health Policy?

Key Factors To Consider Before Buying the Best Health Insurance

Coverage Features

When selecting a health insurance policy you must consider the coverage scope of your policy. Compare the benefits offered by the health policy you want to purchase with others in the market. Hospitalization expenses, OPD covers, sub-limits, accident cover, maternity cover, etc.

Sum Insured Options

What is the maximum health insurance sum provided by your health policy? A minimum coverage of INR 10 Lakhs is advisable looking at the consistent rise in medical expenses in India. Investing in a 1 crore health insurance plan is also beneficial as it offers a wider scope of coverage at affordable premiums.

Co-payment

Look for a co-payment clause in your health insurance policy as it determines your premium costs. Many policies have a mandatory co-payment clause. This means you have to pay a certain percentage of the claim amount. Co-pay in health insurance helps you reduce your overall premiums.

Sub-limits

Many health policies have sub-limits for various features. A sub-limit in health insurance is the upper limit of expenses your health insurer gives at the time of claim. For example, if you have health insurance of INR 3 lakhs, and your daily room rent limit is 1%, your health insurer will pay INR 3,000 per day. You will pay additional room rent charges.

Network Hospitals

Before selecting health insurance, look at the cashless network hospitals list. A health insurer with multiple cashless hospitals in your city will help you in case any emergency medical assistance is required.

Why You Should Invest In Health Insurance At An Early Age?

The medical inflation rate in India is at 14%, leading to a constant increase in the prices of basic medical care. One of the many reasons you must invest in a health insurance policy at a young age is to make it affordable in the future. Other reasons include:

Who Should Invest In A Health Policy?
  • Comprehensive coverage for you and your family members for health emergencies and planned treatments without draining your savings.
  • You can wait out the waiting periods for coverages like maternity which may be your plan. So when the time comes for you to plan a family, you do not have to worry about the waiting periods.
  • Affordable premiums are one major point of attraction to purchase a health insurance plan in your early 20s.
  • You are eligible for tax benefits under section 80D.

Who Should Invest In A Health Policy?

Investing in the best health insurance plan is essential for everyone. However, pay close attention to investing in a health insurance plan if:

  • You are between 25 to 65 years old and are a salaried employee
  • You are planning to start a family
  • You are a newly married couple
  • You have dependent children, parents, or grandparents
  • If you are seeking tax savings tools
Who Should Invest In A Health Policy?

Why Compare Health Insurance Plans Online?

You must have heard this many times, but comparing mediclaim policies online is important. Why? You ask. Well, for starters it narrows down your choices based on the features you require as per your health care needs.

However, we understand that the process can be confusing and often overwhelming. PolicyX is a platform where you can compare health insurance plans and select the best suited for you.

Dr YSR Aarogyasri Trust

Instant Information

You have access to instant and accurate information related to all health insurance plans available in the market. It saves you from unnecessary spam calls from insurance agents.

Dr YSR Aarogyasri Trust

Compare Health Insurance Plans In A Click

You can easily compare all health insurance plans online with the PolicyX calculator. It is economical, and hassle-free. In addition, you can perform multiple functions like paying premiums, opting for additional riders, downloading policy documents, etc.

Dr YSR Aarogyasri Trust

Read Health Insurance Reviews

You can compare and read all the reviews from different people who have been associated with the health insurer. Understand the company's ability to settle claims, and solve insurance-related queries through verified customer reviews.

Dr YSR Aarogyasri Trust

Find Insurance Literature Online

You do not have to contact insurance agents for paperwork like brochures, prospectus, premium charts, etc. Purchasing health insurance online will give you access to all information with a click of a button.

How To Compare Health Insurance?

Selecting the best health insurance in India is a challenging job. You must compare the sum insured, affordable premiums, network hospitals , and more. However, to make your job easier we have compiled a list of factors that will further help you to compare health insurance in India.

Comparison Parameters How Will It Help?
Incurred Claims Ratio (ICR) Compare health insurance companies ICR. It is the ratio between the total claim amount paid by the health insurer to the premium amount collected in a financial year.
Network Hospitals Look for network hospitals associated with your health insurance provider to compare health insurance plans.
Riders & Add-ons It is always beneficial to have some extra coverage when it comes to health insurance. Compare your health insurance plans and look for rider/add-on options available.
Waiting Period When comparing health plans in India, look for minimal waiting periods offered by different plans.
Co-payment Look for minimal co-pay/co-pay waiver options in your health insurance when comparing the best health insurance for yourself or your family.
Pre-policy Medical Check-up Does your health insurer demand a pre-policy medical check-up? If so, will it be covered by the health insurer? Compare health plans for pre-policy medical check-up terms.

Health Insurance Myths Vs. Facts

Let's bust some common myths related to health insurance in India:

Myth

I am young, I do not need a health insurance

Fact

Often young individuals think they do not require medical insurance as they do not have any health issues. However, health issues come uninvited. There are many health risks like unfortunate accidents, and seasonal illnesses like malaria, dengue, etc. which can easily stretch your medical bills from INR 50,000 to 1 Lakh. However, it is important to note that buying a health plan in your early 20s will be affordable as compared to buying it in your 30s. Many insurance companies offer benefits like premium locking at a young age, like Niva Bupa (Lock-the-Clock). This keeps your premium constant for years unless you apply for a claim.

How to File a Health Insurance Claim?

With the latest initiative of ‘Cashless Everywhere’ by the government, it is easy to file claims. Earlier policyholders couldn't avail of cashless treatments at non-network hospitals. Now, you can access cashless claims regardless of the hospital you are admitted to.

Cashless Claim

Cashless claims are filed when you avail of medical treatments in a network hospital. Once your treatment is complete, your hospital will settle the medical bills directly with your health insurer. Often, the claim settlement process is hectic and confusing for many. We, at PolicyX, understand such problems. If you face claim settlement issues, connect with our experts at PolicyX for hassle-free claim settlement.

Reimbursement Claim

If you avail medical treatments from a hospital, not listed on the panel of your health insurer, you can file for a reimbursement claim. After the completion of treatment, pay your medical bills, collect all the documents, and file for a reimbursement claim at the TPA desk or on the official website of your health insurer.

Health Card: How to Get a Physical Copy of Your Health Insurance Policy?

On purchasing a health insurance plan, every health insurer shares a policy document or policy card. This document contains your policy number, name, and other important details. This soft copy helps you avail of medical treatments at network and non-network hospitals.

However, if you want to download the physical copy for your health insurance plan look at the steps below:

  • Visit the official website of your health insurance provider
  • Log in with your email ID, name (login credentials)
  • Go to the policy document section and get it printed

You can also ask for a physical copy of your health insurance policy from your insurer at the time of purchase.

Who Should Invest In A Health Policy?

Documents Required for Health Insurance Claim

Documents required for health policy claim settlement are:

  • Valid photo-ID proof
  • Indoor case papers
  • Original bills from pharmacy/chemists
  • Duly completed and signed claim form, in original
  • Post-mortem report, if conducted
  • Medical practitioner's referral letter and prescription
  • First Information Report, final police report, if applicable
  • Any other document as required by the company to assess the claim
  • Original pathological/diagnostic tests reports/radiology reports and payment receipts
  • Original bills, receipts, and discharge cards from the hospital/medical practitioner
Who Should Invest In A Health Policy?

How to Buy Right Health Insurance Plans Online from PolicyX?

With so much information on the internet, selecting the best health plan can be tiring! However, if you go to the right source the process is efficient and hassle-free. PolicyX comes with 11 years of experience, guiding lakhs of Indians to buy the best health plan suiting their requirements. As a buyer, you have easy access to compare and buy health insurance plans available in the market. Customize your health plan as per needs, add riders, and family members, set your sum insured requirements, and voila! Get the best health plan suggestions with accurate premium prices.

Dr YSR Aarogyasri Trust

Online Process

You can purchase health insurance in two ways, either with PolicyX.com or via the concerned health insurer. Below mentioned details will give you a clear picture on what works best for you:

  • Step 1

    Visit the PolicyX health insurance page, and enter your details such as name, age, number of members to be covered, and city.

    Tax
  • Step 2

    Click on 'Get free quotes' and compare health insurance plans as per your needs.

    Tax
  • Step 3

    Select and pay premiums online for the purchased health insurance plan of your choice.

    Tax
  • Step 4

    Our team of insurance experts at PolicyX will provide you with all the assistance required regarding claims and other queries post-purchase of your health insurance plan.

    Tax

Health Insurance Words To Remember

Before you purchase a health insurance plan, make sure to tick all these boxes from the PolicyX checklist of purchasing a health plan.

  • An adequate sum insured must be selected for your health plan
  • Select the appropriate riders, as per your medical history and future needs
  • Select a health insurer with enough network hospitals in your city
  • Select a health insurer with quick and hassle-free claim settlement support
  • Check for any additional charges such as co-payments, and deductibles, mentioned in your health policy clause
  • Check for additional benefits like gym memberships, seminars, healthy lifestyle benefits, and others.
Tax

PolicyX Health Insurance Glossary

Here are some common terminologies used in health insurance when you go and purchase a health insurance policy.

Automatic Restoration

In case the policy sum insured is exhausted, it is restored automatically to cover you for the next hospitalization.

Add-on Covers

Additional coverage features that you can add to your base policy with slightly higher premiums. Common add-ons are personal accident cover, critical illness cover, etc.

Age Limit

The age limits specified by health insurers for customers to apply for purchasing or renewing a health insurance plan.

AYUSH Treatment

Alternative treatments like Ayurveda, Unani, Siddha, and Homeopathy are covered by most health insurance plans.

Annual Health Check-Up

Yearly health check-ups are covered by your health insurance plan.

Beneficiary

The policyholder or the nominee who receives the health insurance benefits is called a beneficiary. This is especially required when purchasing a personal accident plan.

Cumulative Bonus

The bonus received by a policyholder on completing the policy tenure without raising a claim. A cumulative bonus is received at the time of policy renewal.

Deductibles

The amount of money a policyholder pays out of pocket before the health insurance can cover their medical expenses. It is pre-decided by the policyholder and helps reduce the overall premium price.

Consult for Personalized Insurance Advice

Contact With Advisor

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Health Insurance News

02 Jan

Odisha to Launch Integrated Health Card in February

 

The Odisha government is set to launch an integrated health card in February 2025, combining the benefits of the central Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) and the state's Gopabandhu Jan Arogya Yojana (G-JAY). This single card will provide seamless access to healthcare services under both schemes, simplifying the process for beneficiaries and enhancing healthcare accessibility. 

31 Dec

IRDAI pushes Companies to Expand Health Coverage

 

The Insurance Regulatory and Development Authority of India (IRDAI) encourages insurance companies to expand health coverage to include individuals of all ages and those with pre-existing conditions. This move aims to make healthcare more accessible and affordable for a larger population. "Most citizens shy away from health insurance because they find the terms and conditions confusing, especially when it comes to pre-existing ailments as well as waiting periods. With these new guidelines, the regulator endeavours to ensure standardisation to make life simple for the citizens when it comes to understanding health insurance. The new regulation intends to make health insurance even more inclusive, especially for senior citizens, individuals with disabilities and people with chronic ailments," said Tapan Singhel MD & CEO of Bajaj Allianz General Insurance. 

27 Dec

Ayushman Vay Vandana: High Senior Citizen Coverage in Madhya Pradesh and Kerala

 

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is India's flagship public health insurance scheme, providing free healthcare coverage to millions of underprivileged families. Ayushman Vay Vandana is a special component of AB PM-JAY specifically designed for senior citizens aged 70 years and above. It provides an additional top-up health insurance cover of up to Rs 5 lakh per year to those already covered under the main AB PM-JAY scheme. High Coverage in Madhya Pradesh and Kerala, these two states have reportedly demonstrated higher levels of insurance coverage for senior citizens under Ayushman Vay Vandana compared to other states.

26 Dec

Healthcare premiums are rising at an alarming rate.

 

Since the COVID pandemic, the cost of healthcare is continuously rising. Last year, India witnessed a healthcare cost inflation of 14% while the general inflation rate was in the single digits. The further rising healthcare costs may push the health insurance premiums.

23 Dec

GST Council defers the decision on the tax rate for life and health insurance premiums.

 

In the GST Council meeting held on December 21, 2024, the decision regarding GST on life and health insurance premiums has been deferred. The reason for delaying the decision is that the ministers need some more time to decide on the matter.

Health Insurance: FAQ's

1. How can I select the best health insurance plan?

To select the best health insurance plans, consider factors fulfilling your healthcare needs. Sum insured of your health plan, number of members to be covered, riders/ add-ons, co-payment, etc.

To learn more, consider key factors before buying health insurance plans.

2. Which is the best medical insurance policy in India?

It is best to compare health insurance plans before making a purchase decision, using an online comparison website like PolicyX. Compare the top 10 health insurance companies in India and find your best match according to medical needs and requirements.

3. What are the discounts available in Policx in a health insurance policy?

Purchasing health insurance online gives you multiple discount options such as long-term policy discounts, good health discounts, and more. To know more about such discounts, connect with our insurance experts for a 30-minute personalized session with PX Prime.

4. What is the right age to buy health insurance?

It is best to consider purchasing a health insurance plan in your early 20s. Premiums are lower in your early 20s and will only increase as you age. One of the many advantages of buying health insurance early is that all the waiting periods are served on time, leaving you to enjoy the benefits when needed.

5. Is a medical test mandatory to buy a health insurance policy?

A pre-policy medical test is not required to buy medical insurance. However, it varies from insurer to insurer as some health insurance providers ask policyholders above a certain age to get a pre-policy medical check-up.

6. What does cashless hospitalization mean in a health insurance policy?

Cashless hospitalization means you do not have to pay out-of-pocket. Your health insurance plan has tie-ups with hospitals across India to provide you with cashless treatments. Once you are treated, the hospital bills will be taken care of by your health insurer if you are hospitalized for more than 24 hours.

7. At what age can I include my children in my health insurance plan?

Depending on the health insurance plan, you can add your children to the health coverage. While some health plans cover newborns immediately after 90 days, others might cover children from 5 years. Read your health plan policy details carefully.

8. What does a free look period in health insurance do?

Freelook period in health insurance refers to the period during which you can terminate your health policy if you are not satisfied with your purchase. Free look periods can vary between 15 to 30 days depending on your health insurer.

9. What is the sum insured in health insurance?

The sum insured in your health insurance plan refers to the coverage amount provided by your health insurance provider. The amount provided covers you for all medical treatments during the policy tenure selected by you. The sum insured of your medical insurance can range between 1 Lakh to 1 Crore or more.

10. What are pre-existing diseases or conditions mentioned in a health insurance plan?

Pre-existing diseases refer to health conditions that a policyholder is diagnosed with before purchasing a health insurance plan. Most health insurance plans cover pre-existing diseases after a waiting period of 2 to 4 years.

11. Can I purchase more than one health insurance policy?

Yes, you can have coverage of more than one health insurance plan if required. You can purchase different health policies for your various needs. For example, if you have an individual health plan, purchase a top-up or super top-up for enhanced coverage.

12. I am covered by my company group health insurance plan; do I need to buy a separate health insurance plan?

Yes, purchasing a separate individual or family floater health insurance plan is important despite having a group health insurance policy. Most companies, do not offer a health cover beyond 3 to 5 Lakhs, which is not enough given the consistently rising healthcare expenses. A minimum of 10 Lakhs health insurance plan should be purchased separately to cover healthcare expenses.

13. How can I add my family members to my existing medical policy?

You can add your family members at the time of renewal or when purchasing a health insurance plan.

14. What are the documents required for purchasing a health insurance policy?

You do not need any specific documents when purchasing a health insurance policy. However, you will need documents such as ID proof, address proof, and others if required.

15. Can foreigners buy a health insurance policy while living in India?

Yes, health insurance plans can be bought by foreign nationals living in India. However, the benefits of your health insurance policy will only be applicable in India.

16. Can I increase the sum insured under my existing health insurance plan?

Yes, you can increase your sum insured limit under your existing health insurance plan at the time of renewal of your medical insurance. However, added premiums will be charged on increasing the sum insured limit.

17. What are the pre and post-hospitalization expenses in health insurance?

Pre-hospitalization expenses refer to all the expenses charged before the policyholder is admitted to the hospital. Pre and post-hospitalization expenses include follow-up tests like ultrasounds, x-rays, etc. Whereas, post-hospitalisation included all the expenses incurred after getting discharged from the hospital like any tests, medication, follow-up treatments, etc. Health insurance plans usually cover pre and post-hospitalization expenses for 60 to 90 days.

18. What are the diseases not covered by health insurance?

There are certain exceptions when it comes to illnesses covered by health insurance plans. Listed illnesses such as HIV/AIDS, sexually transmitted ailments, and cosmetic procedures are generally not covered by medical insurance.

19. Will my health insurance policy cover healthcare expenses related to COVID-19?

Yes, your health insurance policy will cover you against medical expenses incurred due to COVID-19 as mandated by IRDAI.

20. How much health insurance coverage do I need?

The most common advice when purchasing a health policy is to buy a cover of at least INR 10 lakhs to have adequate coverage against rising medical expenses. However, there are multiple factors to consider such as age, city of residence, medical history, family size, and more.

21. Is ₹5 lakh health insurance enough in a tier-1 city?

India has a medical inflation of 14%, the highest in Southeast Asia which means the medical care expenses are consistently rising in India. A health insurance policy with INR 5 lakh coverage may not be enough to cover your hospital bills in a tier 1 city.

22. Do health insurance plans cover expenses for X-rays, ultrasounds, or MRIs?

Yes, your health insurance plan will cover expenses for diagnostic tests like ultrasound, MRI, and X-rays if you are admitted for more than 24 hours. However, certain health insurance plans also cover these expenses under OPD care regardless of 24-hour hospital admission.

23. Are pre-existing diseases covered under a health insurance policy?

Yes, a health insurance policy covers pre-existing diseases. However, you have to serve a waiting period varying between 2 to 4 years. The waiting period terms and conditions depend on your health insurance policy.

24. Will I be covered for robotic surgery & modern treatments?

Yes! Most health insurance plans in India cover modern treatments. These procedures cover robotic surgery and many other advanced treatments up to a specific sub-limit defined in the policy schedule.

25. What is the cost of health insurance plans in India?

The cost of health insurance in India depends on multiple factors such as your age, city of residence, sum insured opted, family or individual coverage, optional riders, and more. Calculate and compare the best health insurance plans in India with the PolicyX premium calculator.

26. What is the benefit of a Cumulative Bonus in a health insurance plan?

A cumulative bonus is an additional financial benefit given to you, if you do not file for a health claim during your policy tenure. The cumulative bonus could either be an increase in sum insured, or reduced premiums, or both at the time of renewal.

27. Can I cancel my health insurance policy and get my money back?

Yes, you can cancel your health insurance policy and get your money back. However, it depends on when you cancel, and if you have made any health insurance claims.

28. How does smoking affect health insurance premiums?

If you are a regular smoker, it will increase your health insurance plan premiums. Smokers are at a higher risk of health issues related to heart, lungs, and throat which makes them a liability on health insurance providers.

29. Under what conditions is my policy premium likely to increase at renewal?

Your health insurance policy premiums are subject to increase due to various reasons. It could include additional coverage for family members, additional riders, medical conditions, and more.

30. What happens if I forget to pay my health insurance premiums?

If you forget to pay your health insurance premiums, your policy will lapse and you will lose all its benefits. This also means that all the waiting periods served will have to be served on buying a health insurance policy again.

31. What are the modes available for the payment of premiums on PolicyX?

To pay premiums for your health insurance plan, there are various modes of payments available like UPI, Credit card/Debit card, which can be paid monthly, quarterly, bi-annually, or annually depending on your health plan.

32. What are the discounts available in Policybazaar in a health insurance policy?

The various discounts available in health plans are good health discounts, long-term policy discounts, non-smoker discounts, and more.

33. What is the right age to buy health insurance?

There is no right age to buy a health insurance plan, it is advised to purchase health insurance as early as possible due to various reasons. Early 20s are the best time to purchase health insurance as you have minimal responsibilities, and premiums are low.

34. Is a medical test mandatory to buy a health insurance policy?

Most health insurance plans do not require you to undergo a pre-policy medical check-up. However, some health plans require you to take a pre-policy health check-up after you cross a certain age.

35. What does cashless hospitalization mean in a health insurance policy?

Cashless hospitalization in health insurance provides you with medical treatments at network hospitals without having to worry about hospital bills. Your health insurance plan provider will settle the hospital bill directly with the hospital you avail treatments from. Find the best cashless hospitalization health plans with PolicyX.

36. At what age can I include my children in my health insurance plan?

Depending on the health insurance plan you purchase your children will be covered as per the terms and conditions. Many health insurance plans cover newborns from day 1 while some may cover children from 5 or 6 years of age. Read the terms and conditions carefully before making a decision.

37. What is a free look period in health insurance?

A free-look period allows you to cancel your health insurance policy and get the premium back that you must have paid while buying the policy. In a recent development, IRDAI announced the extension of the free-look period from 15 to 30 days to protect the interest of buyers.

38. What is the sum insured in health insurance?

The Sum Insured of health insurance is the maximum amount of financial coverage provided by your health insurance provider.

39. What are pre-existing diseases or conditions?

Pre-existing conditions are the ailments an individual has before buying a health insurance cover. Some common examples of pre-existing diseases include High BP, diabetes, obesity, heart ailments, etc. Depending on the terms and conditions of your health insurance plan you may be covered for the PEDs after a specific waiting period.

40. Can a person have more than one health insurance policy?

Yes, one individual can invest in multiple health insurance policies. For example, if you are covered by a health insurance plan provided to you by your employer, you can purchase a separate individual health insurance as well.

41. I have my employer's group policy; do I need to buy a separate health insurance plan?

Most group health insurance plans offer INR 3 to 5 Lakhs coverage which is not enough for an individual. It is suggested to have a health cover of at least INR 10 lakhs to have adequate coverage.

42. How to add my family members to my existing medical policy?

You can easily add family members to your health insurance policy at the time of renewal or while purchasing your health plan. Some health insurance plans offer mid-policy addition of newborn children. You must read the terms and conditions of your health policy carefully.

43. What are the documents required for purchasing a health insurance policy?

There are no requirements for any documents while purchasing a health insurance plan. However, you must have documents like Hospital bills, Discharge copy, Reports and diagnostics, Identity proof, Address proof, and others as demanded by your health insurance provider.

44. Can my friend buy a health insurance policy if he/she is not an Indian national but is living in India?

Yes, foreign nationals can purchase a health insurance policy in India but they must remember that their coverage benefits will only be applicable within the country.

45. What if I already have a health insurance policy but just want to increase my sum insured?

You can easily increase the limit of your health insurance plan at the time of renewal. Talk to your health insurance provider, and inform them about your changing requirements. As per the sum insured amount required, your premiums will be re-calculated.

46. What are pre and post-hospitalization expenses in health insurance?

The pre-hospitalization expenses mean all the expenses incurred before the actual hospitalization. Tests, diagnostics, doctor visits, and more are all a part of Pre-hospitalization expenses.

Post-hospitalization expenses are the expenses incurred after the patient is discharged from the hospital. It includes doctor visits, follow-up tests, pharmacy bills, etc. Usually, health insurance plans in India cover 30 to 60 days of pre and post-hospitalization expenses.

47. Which diseases are not covered by health insurance?

There are certain exclusions involved with all health insurance plans in India. These exclusions are the conditions that are not covered by your health plan like HIV/AIDS, Obesity treatments, Cosmetic procedures, hospitalization or injuries because of drug abuse, or alcoholism, etc.

48. Does my health insurance policy cover healthcare expenses related to COVID-19?

Yes, all health insurance plans cover COVID-19-related medical care expenses as per the mandate given by IRDAI.

49. How much health insurance coverage do I need?

As per experts in the insurance industry, health coverage of INR 10 lakhs is considered adequate in order to cover your medical care expenses.

50. Is Rs.5 lakh health insurance enough?

No, INR 5 lakhs as health cover is not enough for anyone living in India. India has the highest medical inflation at 14% among all south-east Asian countries which means medical care is expensive and is only rising further. A minimum of INR 10 lakhs is considered adequate health cover.

51. Do health insurance plans cover diagnostic charges like X-rays, ultrasound or MRI?

Yes, all these expenses are covered under OPD care provided by your health insurance plan. Read the policy documents carefully in order to figure out if your health plan covers OPD expenses or not.

52. Will I get coverage for pre-existing diseases?

Yes, you will get coverage for pre-existing diseases after a specific waiting period of 2 to 4 years. However, many health insurance companies offer a waiver of the waiting period as an add-on coverage.

53. Does health insurance cover robotic surgery & modern treatments?

Yes, with modern treatments and advanced medical procedures, most health insurance plans in India offer coverage for the same. However, there may be sub-limits attached to the procedures.

54. What is the cost of Health Insurance in India?

Health insurance coverage in India premiums depend on the amount of sum insured selected by the policyholder, along with other factors such as tenure of policy, and add-ons. On average INR 15 lakh health cover for a 30-year-old individual can cost you approx. INR 5,000 annually depending on the health plan selected.

55. How to port health insurance policy?

You can port your health insurance policy by filling out the portability form and sending it to your current health insurer at least 45 days before your renewal is due.

56. What is the medical insurance policy number?

A policy number is a unique number provided to you when you purchase a health plan from an insurance provider.

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Simran Kaur Vij

Written By: Simran Kaur Vij

Simran is an insurance expert with more than 4 years of experience in the industry. An expert with previous experience in BFSI, Ed-tech, and insurance, she proactively helps her readers stay on par with all the latest Insurance industry developments.