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Health Insurance: Compare and Buy The Best Plan

What is Health Insurance?

Health Insurance insures against expenses arising due to a medical emergency and uncertainty of health such as hospitalisation or critical illness. It prevents a medical emergency from turning into a financial emergency. Health insurance ensures that health care needs are taken care of without depleting one’s savings and compromising one’s future goals. Health insurance is a contract that requires the health insurer to pay some or all of one’s health care costs in exchange of a periodic premium. Additional benefits of health insurance policies include regular health check-ups, cashless treatment across a network of hospitals.

 

Individual Plans Cashless Hospitalization: Medical expenses are sky-rocketing! Get health insurance and cover your medical costs. With cashless hospitalization stay tension-free and cure yourself faster. PolicyBazaar will help you compare and find the best plan.

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There is no debating on the importance of having a medical insurance in a country like India that ranks very low on human life index. Every person must buy a good health plan that covers medical costs, hospitalisation costs, treatment and laboratory test costs and even critical illness. As is rightly said, “Health is wealth”, one must be prepared to manage such a situation in life. Don’t get confused with questions like – Which health policy to buy? Does this cover everything? What are the diseases excluded from this cover? PolicyBazaar is here to resolve all such confusions. Just compare health insurance policies from top health insurers on our website and buy a best health plan. Let us know your basic requirements and we will find the best suited health insurance quotes. You can then compare health insurance policies side by side on parameters like health insurance premium, riders, benefits etc and choose the best fit cover.

List Of Health Insurance Plans

Types of Health Insurance Policies in India

One needs to ensure the security of health of oneself and the family as well. With the increasing cost of healthcare and medical treatments across private hospitals in India, health insurance has become almost mandatory for everyone. Health insurance ensures not only health security but also hassle-free claim reimbursement. In today’s world of advancements, people have different choices even when it comes to buying health insurance. There are various plans readily available in India to cover every aspect of a medical emergency. Some popular types of policies are explained below:

Individual Health Insurance Policies:

This health insurance policy is designed to cover an individual against various illnesses with cashless hospitalization and other add-on features. The entire sum insured is available for only one individual and the premium is determined by the age of individual covered under the policy. It is a policy where each insured member is entitled to the entire amount separately.

Family Floater Health Insurance Policies:

With this health insurance policy, you can cover all your family members against diseases under a single cover. This cover offers a fixed sum insured for the family members that can be availed either by an individual member or as a sum total for treatment of one person. Family floater Mediclaim cover offers a fixed sum insured for the family members that can be availed either by an individual member or as a sum total for treatment of one person. Floater benefit means the sum insured as specified for the proposer under the policy, is available for any or all the members of his/her family for one or more claims during the tenure of the policy. As compared to individual plans, family floater Mediclaim plans come at a marginally incremental premium.

Surgery & Critical Illness Insurance Plans:

This is usually brought as a standalone policy or a rider in case of treatment against serious illnesses like- cancer, kidney failure, heart attack, paralysis etc. As the treatment of such diseases is expensive so the premium is also on a higher side. A critical illness is a serious, possibly terminal disease, strictly defined by the insurer. Most critical illness policies provide for payment of a lump sum benefit if the policyholder is diagnosed, suffering from one of a number of specified terminal conditions.

Pre-Existing Disease Cover:

After a waiting period of 2-4 years, various policies offer a cover against the pre-existing diseases -e.g. - diabetes, hypertension, kidney failure, cancer etc. Pre-existing disease cover includes the diseases or illness that the policyholder had before buying the policy.

Senior Citizen Health Insurance Plans :

This health insurance plan is designed especially for senior citizens, offering protection from health issues during old age. According to IRDA, every insurer must provide cover for people up to the age of 65 years.

Preventive Healthcare:

Undoubtedly health care is expensive and who wants to fall sick; anyways. So, now we have preventive health care that offers to take care of you and not let your fall sick. This includes preventive care treatments like regular checkups, consultation charges and other tests or x-ray fees concessions. The idea is to monitor your health at timely intervals and provide overall health care benefits. Preventive Healthcare is medical care rendered not for a specific complaint but focused on prevention and early-detection of diseases. Some health insurance policies limit coverage for preventive care services, while others encourage such services.

Maternity Health Insurance: 

Health insurance companies today provide coverage against maternity and additional expenses, including both pre and post natal care, child delivery (normal or caesarean), which sometimes lead to vaccination of newborn babies. Maternity insurance covers the new-born baby up to the validity of the maternity insurance policy. It also covers ambulance charges for ferrying the mom-to-be to the nearest network hospital of choice.

Personal Accident Cover: 

These personal accident plans are frequently provided as riders to standard health insurance plans, which provide coverage for hospitalization and reimbursement of medical expenses, in the case of an accident. These are issued as fixed benefit policies, where specified sums are paid on occurrence of specified or unforeseen events such as accidents. Such events can result in death or disability of the individual. However, the payout is not related to the expenses incurred.

 

Health Insurance Plans Online

Key Benefits & Features of Health Insurance Policies

The cost of healthcare in the modern days is increasing at a high pace while one’s income does not seem to match up that level. Regular health check-ups are getting out of one’s range of affordability since multiple expenses of thousands are common in such scenarios. A patient looking forward to availing frequent health check-ups is no longer expected, whereas a health insurance policy easily covers all such expenses with assured benefits. A comprehensive health plan comes packed with features. Let us understand these features in detail so that buying a healthy policy becomes easy.

  • Cashless treatment - Every health insurance company or its Third Party Administrator has tie-ups with a network of hospitals and nursing homes called a ‘network hospital’ or ‘empanelled hospital’. If you get admitted in these hospitals, you don’t need to pay anything. Just tell your policy number and rest everything will be taken care by the hospital and the health insurance company. This type of plan is the most preferred because there is no stress of claim reimbursement and arranging documentation. However, expenses beyond limits or sub-limits allowed by the insurance policy or expenses not covered under the policy have to be settled by the insured directly with the hospital. Another important thing to remember is that cashless Mediclaim treatment or cashless facility is not available if one gets treatment in a hospital that is not part of the network.

  • Pre and Post Hospitalization - This feature of health insurance policy takes care of both pre and post hospitalization charges for a period of 30 to 60 days depending on the plan purchased. It takes into account expenses incurred during a certain number of days prior to hospitalisation and post hospitalisation for a specified period from the date of discharge as part of the claim, provided the expenses are related to the disease/sickness.

  • Ambulance charges - The policy holder is free from burden of transportation or ambulance charges as it is paid by the insurer. This is a add-on benefit and you should have opted for it while purchasing.

  • No Claim Bonus - NCB or No Claim Bonus is a benefit provided if the insured does not claim for any treatment in the previous year. Benefit could be in any form, either an increment in the sum assured or a discount in premium. You can avail this benefit on renewal.

  • Medical Check- Up - Health insurance policy entitles the policyholder to receive regular medical check-ups. Free check up is provided by few insurers provided you have a good history of no claim bonus.

  • Tax Benefits - According to India’s tax system if you are paying a premium amount then you are liable to get tax rebate under section 80D of Income Tax Act for a maximum value of Rs.25000 for Indians in the age group of 18 to 50 years and Rs.30000 for senior citizens.

  • Co-Payment - According to this feature you can lower the health insurance premium amount. Medical insurance plans offers co-payment option wherein there is a pre-defined amount of voluntary deductibles mentioned in the policy to be paid by the insured. So in case of a treatment, some amount is paid by the insured and rest by the insurer. It is a cost-sharing requirement under a health insurance policy that provides that the policyholder/insured will bear a specified percentage of the admissible costs. A co-payment does not reduce the sum insured.

  • Health Insurance Portability - Health insurance portability gives freedom to the policyholder to switch from one health insurance company to another without losing continuity benefits with respect to pre-existing diseases, waiting period and other time bound exclusions earned in the previous policies. Health insurance portability is subject to continuous insurance coverage in the previous years. Those covered under employer group health insurance or family floater policies can also make use of health insurance portability to port to an individual health cover. For this, they have to first switch to a plan offered by their existing health insurance company and after a year, they are allowed to switch to an insurer of their choice. Health insurance portability has come as a breather for policyholders who were trying to change their insurance company but were unable to do so earlier. With health insurance portability, they can now try out the policies they prefer with the insurance companies they prefer.

Best Health Insurance PLans

How to Find the Best Medical Insurance Plans?

There are few factors that you should consider closely to make the right decision and choose the best.

  • Caps and sub-limits - Imposition of sub limits, co-payments or other caps might reduce the premium you pay for the insurance policy but in the long run it would alter the benefits. You should understand and assess this factor vis-à-vis your requirement and paying capacity to get maximum benefit out of a health insurance plan.

  • Claim settlement record - This is an important criterion to assess the credentials of a insurance provider. You should always go with a company with has good claim settlement record. Thus you can ensure that your claims and reimbursements would not be wrongly withheld. Always ask for the company’s claim settlement ratio before purchasing their health plan and save yourself from unnecessary harassment.

  • Scope of coverage - Just don’t buy a plan by comparing health insurance premium. Less amount of premium does not necessarily mean a good plan. On the contrary such a plan might not cover your needs properly. Closely look at what the plan covers. Buy a comprehensive plan. Scope of coverage essentially means the scope of protection provided under a contract of insurance, covering several risks covered by a policy.

  • Renewability - It is important to see how many years the plan proposes to cover you. You should not be left without a proper cover when you need the most, say during your old age. Health insurance Mediclaim policies are usually annual contracts. The automatic re-establishment of in-force status effected by payment of premium is known as renewal. In other words, the issuance of a new policy or the continuation of a current policy that is effective once the old policy’s plan year ends is termed as renewal. At the end of the policy period, the policy has to be renewed by the policyholder. There should be continuous renewal of the policy, because if there is a break, then in the event of a contingency, the insured will lose the benefits of insurance.

  • Cashless Hospital Network - Check if the hospitals around you are covered as a network hospital by the company you are considering to buy from. Cashless hospitalisation is hassle free and seamless. You and your family won’t be required to run around collecting documents and filling reimbursements. The insurer or its Third Party Administrator (TPA) have tie-ups with a network of hospitals and nursing homes called a “network hospital” across the country. The insured can get themselves admitted in these specified network hospitals and take treatment for the disease contracted without payment of cash. However cashless mediclaim settlement is subject to limits and sub-limits which are subject to the sum insured of the policy.

  • Premium Loading - Loading is an additional cost built into the insurance policy to cover losses which are higher than anticipated for an insurance company, arising from insuring a person who is prone to a form of risk. Premium Loading is the amount an insurer needs to cover its expenses and generate profit. We would strongly recommend you to check the terms and conditions pertaining to premium loading. This will save you from paying a high incremental premium post making a claim. This aspect though ignored in the beginning usually becomes a bone of discontentment at a later stage. The best practice would be to verify the premium fluctuation data of the plan for previous 5 years at the very least.

  • Internal Team - Check for the plans from insurers who have a dedicated internal team for handling Mediclaim. This comes in handy while expediting the Mediclaim claim settlement process. Most of the players use a third-party administrator (TPA) to process the claims and do the paperwork. Even though, most of these TPA provide great services, the fact that they are a third party slows down the process. There are certain rules and regulations to be followed when a TPA processes a claim before it is handed over to the insurance company. These affect the turnaround time.

  • Floater (family) Size - Everyone has a different family size so you should always look for the family floater size allowed under the plan before buying it. In case, you are a person in your late 20s and your parents in their 40s, 50s or 60s already have a cover, then it makes sense if you buy an individual cover. Alternatively, if you are married with or without kids and have dependent parents, parents-in-law, siblings, etc. then a family floater is the best policy for you. Checking the premium, family size covered, critical illnesses or other treatment covered will ensure you are able to purchase the plan you need.

  • Health Insurance Portability - It is best to choose a health insurance company that offers health insurance portability. Earlier, policyholders had to stick to a policy just to retain the waiting period benefit. Now, health insurance portability allows one to switch from one health insurance company to another without losing waiting period benefits earned in your existing policy. Moreover, with the policy landscape changing so regularly, life insurance companies regularly come up with better policies and it will make sense to opt for health insurance portability. Also, some companies may charge if you prefer to move away from their plans to some other players using the free health insurance portability option provide by the new company. Ensure you do not end up paying for health insurance portability instead of staying with the old insurer. Health insurance portability is a good thing to check when you are finding the best health insurance policy or mediclaim for yourself.

Health Insurance Comparison online

Compare and Find the Best Health Insurance Cover Online

There are so many companies offering medical insurance plans and each of them have a different set of features and benefits that it gets mind-boggling to select one. Sometimes you end up buying a plan that though costs less but has contradictory clauses and you practically get nothing when making a claim. On the other hand you might buy a fancy plan paying a higher premium only to realize at a later stage that you actually didn’t use or never needed those frill items.

PolicyBazaar facilitates comparison of health insurance plans online and ensures you buy the best fitted policy based on favourable health insurance rates. We help you sieve through the in numerous mediclaim policies and get you a few best Health insurance plans based on your needs. You can then compare them side by side and not only save money but also buy a policy that covers your properly. Make an informed choice!

  • What Health Insurance Policies Do Not Cover

    Coverage offered by health insurance policies vary with the insurer; however, certain points are not covered by health insurance, falling under the category called policy exclusions. Following are common health insurance policy exclusions:

    • No coverage or reimbursement offered with the waiting period of the policy, usually initial 30 days.

    • Coverage of critical illnesses and pre-existing diseases is subject to a waiting period of 2 to 3 years.

    • Clear exclusion of expenses incurred for maternity/newborn.

    • Injuries caused by war/terrorism/ nuclear activity/suicide attempt.

    • Terminal illnesses, AIDS, and other diseases of similar nature.

    • Cosmetic/plastic surgery, replacement of hormones, sex change and more.

    • Dental or eye surgery.

    • Non-allopathic diseases’ treatment.

    • Bed rest/hospitalization and rehabilitation, common illnesses etc.

    • Treatment/diagnostic tests, post-care procedures.

    • Treatment in abroad or by an under-qualified medical professional.

    Note: It is recommended to explore each plan under health insurance to ensure the maximum coverage can be availed.

  • Important Points to Remember while buying Health Insurance

    Buying insurance is not a child’s play and when it comes to buying a health insurance policy, you need to be pretty sure about certain points. A few of such key points are listed below:
    • What covers are you offered and who offers the covers?

    • Are add-on features available for later use?

    • Are individual and/or family floater options available?

    • What is the Sum Assured?

    • What are Sum-limits applicable?

    • Is/are there any discount(s) offered?

    • Is there any voluntary/co-payment deductible options?

    • Are policy exclusions mentioned on the documents?

    • What are likely processes of claim – reimbursement, cashless benefit, claim settlement immediately/later?

    • Is there any medical check-up required before policy acceptance?

  • Health Insurance Claim Procedures

    Health insurance comes with additional benefits of cashless treatment and expense reimbursement by the insurer. One can file a claim against an event that is covered by the insurance policy taken. Following are two claim processes:

    Expense Reimbursement:

    Health insurance policies provide insured with the benefit of getting the medical expenses reimbursed by the insurer after paying them off, based on the policy terms documented. The cost of various hospital charges such as bed charges, medicines, lab tests, surgeon's fees etc. are paid back to the insured at the time of making a claim. The insured pays the (hospital) expenses incurred, but gets them reimbursed by the insurance company.

    Cashless Treatment:

    Insurance companies provide policyholders with a wide network of hospital get medical treatment without having to make upfront payments. No payment is required to be done by the insured but the insurer since the clause involves a mutual agreement between both the parties, i.e. the insurer and hospital. In contrast, availing cashless benefit requires TPA approval. The insured can also show the health card at the particular hospital as the proof of insurance cover along with a valid government ID proof. Following are the cases considered:

    Planned Hospitalization:

    In the case of planned hospitalization, the policyholder needs to have the TPA approval in advance along with the other mandatory documents to be submitted. Fill the pre-authorization form at the hospital with a particular section signed by the treating doctors.

    Emergency Hospitalization:

    Show the health card issued by the insurer at the hospital along with the pre-authorization form filled appropriately. Get the TPA approval for emergency hospitalization. If failed to get the TPA approval, get the expenses reimbursed later instead. The policyholder might have to show the itemized bill, proof of medical expenses, discharge bill etc for claim reimbursement as the proof of the treatment availed at the particular hospital.

  • Documents Required for Health Insurance Claim Reimbursement

    In the event of hospitalization, the policyholder needs to have TPA approval for claim reimbursement, which needs certain documents to be submitted as mentioned below:

    • Discharge card issued by the hospital.

    • In-patient hospitalization bills signed by insured for authenticity.

    • Doctors’ prescriptions and medical store bills.

    • Claim-form with insured’ signature on it.

    • Valid investigation report.

    • Consumables and disposables prescribed by the doctors with complete details.

    • Bills of doctors’ consultation.

    • Copy of Insurance policy from previous year and current year/copy of ID Card of TPA.

    • Any other document(s) asked by TPA.

  • Health Insurance Eligibility Criteria

    Health insurance is mandatory for almost everyone, especially for those who have dependents for families since they certainly do not want them to have financial strains. Buying a health insurance ensures that health is secured and medical expenses are covered across a wide network of hospitals in India. One can opt for health insurance with extended coverage on following two bases:

    • Individual

    • Family Floater

    The following criteria must be fulfilled without failure:

    • Entry age for Adults: 18 to 65 years (70 and above, based on the plan and insurer)

    • Entry age for Children: 90 days to 18 years.

    • Policy renewability: Lifelong and subject to medical clearance

  • Top Health Insurance Companies in India

    Apollo Munich Health Insurance

    A joint venture between Apollo Hospitals Group, India’s premier private hospitals company and Munich Health, the health insurance arm of Munich Re, the German reinsurance major, Apollo Munich Insurance is a focused insurance services provider in India providing a range of health insurance plans. The health insurance company merges the corporate healthcare competencies of Apollo Hospitals Group with the global healthcare insurance and reinsurance expertise of Munich Health.

     

    The company has won numerous accolades over the years and has recently been honoured with awards like the Infosec Maestros Awards - 100 Top CISO 2015 for the second time in a row and Health Insurance Provider Award by Money Today (of India Today Group) and Financial Planning Corporation (India) Pvt. Ltd. (FPCIL) in 2015.

     

    Apollo Munich Insurance focuses on being a trusted leader in the health insurance space with its innovative solutions. Their mission is to regularly introduce pioneering health insurance and wellness solutions that meet customer needs. The company also intends to build an organisation on the principles of transparency, trust and integrity that can constantly deliver on various commitments to all stakeholders.

    Bajaj Allianz Health Insurance

    A joint venture of Bajaj Finserv Limited, a comprehensive financial services company based out of India and Allianz SE, the global financial services major based out of Munich, Germany, Bajaj Allianz General Insurance Company focuses on the general insurance space in the country, including health insurance. The joint venture seeks to leverage successfully Bajaj Finserv's in-depth understanding of the local Indian market and its extensive distribution network across the country with the vast global experience of the Allianz Group. Bajaj Finserv Limited holds a 74% stake in the general insurance company while Allianz holds the remainder.

     

    The company has been one of the outperformers in the space as testified by it receiving the iAAA rating from ICRA for the 10th year in a row. The rating highlights the company's highest claims paying ability and its strong position in the general insurance industry. Most recently, the company was conferred the Economic Times; Best Corporate Brand Award as an outcome of the newspaper's Best Brands Survey for 2016. Bajaj Allianz General Insurance was also acknowledged as the Most Admired Health Insurance Company of 2015 by Pharma Leaders Power Brands Awards. In addition, Indian Market Research Bureau (IMRB) ranked it second among the top health insurance brands in the country on the basis of customer loyalty based on a syndicated survey.

     

    Bajaj Allianz General Insurance also recently awarded a Certificate of Appreciation by Rajasthan High Court, and Punjab and Haryana High Court for excellence in the field of claim servicing for motor third party claims. Other awards in 2015 included The Silicon Valley Business Award 2015 under the categories of Best Financial App and Best Overall App for Insurance Wallet product. In addition, it won the Claims Award Asia 2015 for the third year running, under the categories of Insurer Claims Team of the Year for Claim Settlement during the Jammu and Kashmir floods, and Claims Innovation of the Year for launching pioneering claim settlement practices for health insurance claims.

     

    Bajaj Allianz General Insurance intends to be the first choice in insurance for Indians. It has a mission to be a responsible and customer focused market leader that understands and meets the insurance needs of the market through affordable, value for money products.

    Bharti AXA Health Insurance

    A joint venture of Bharti Enterprises, one of Indian's leading business groups, and AXA, the France-based international insurance solutions company, Bharti AXA General Insurance is a provider of various general insurance solutions in addition to health insurance. Bharti Enterprises owns the majority 74% stake while AXA holds the remainder in the company. Bharti AXA General Insurance started operations in August 2008 and is headquartered in Bangalore and has 59 branches across India.

     

    The company has received numerous awards for innovation and performance over the years, among other categories. In 2014, it received the Asia Insurance Industry award for its initiative to reach the under penetrated smaller towns and cities where the physical branch network was limited. In addition, it received the honour of being the best insurance company in the private general insurance sector from the World HRD Congress at the 2014 BFSI Awards.

     

    Bharti AXA General Insurance focuses on serving all its stakeholders including its customers, business partners, employees, shareholders and the overall society. It uses its fundamental values of professionalism, integrity, team work, innovation and pragmatism to realign industry standards through empathetic service that helps drive customers towards its comprehensive and innovative insurance solutions.

    Cholamandalam MS Health Insurance

    Cholamandalam MS General Insurance Company Limited, established in 2001, was set up by the India-based Murugappa Group, a multi-business conglomerate, and the Japan-based Mitsui Sumitomo Insurance Group as a joint venture to address the general insurance market in India. The company provides both individual and corporate insurance solutions through its 105 branches and 9000 plus agents in the country.

     

    Also known as Chola MS, the company was awarded the best insurance company across Asia as ‘Health Insurer Claims Team’ at the 2013 Claims Asia Awards. It also received the ‘Innovation Leader Award’ for 2012 from Fintelekt and was adjudged the best insurance company for ‘In time Claims Settlement for the year 2011-12’ in the Rashtriya Swasthya Bima Yojana (RSBY) scheme operated under the aegis of the Ministry of Labour and Employment, Government of India.

     

    Cholamandalam MS has a singular focus on value creation and hopes to become the most respected general insurance company in India. It uses a T3 strategy of Trust, Transparency and Technology to deliver innovative risk-free health insurance solutions for all its customers.

    CignaTTK Health Insurance

    Established as a joint venture between TTK Group, the Indian conglomerate and Cigna Corporation, the US based international health insurance solutions company, CignaTTK Health Insurance Company Limited focuses on providing health related insurance solutions to the Indian market. The health insurance company was launched in February 2014 and has ramped up its operations to create a pan India presence across 15 cities within a short while. The company is headquartered in Mumbai.

     

    The company was recently awarded the Economic Times’ ‘Best Promising Brands 2015’ award. CignaTTK has also shown its focus on good health and wellness and has served as the official health insurance partner for the popular Delhi and Mumbai marathons.

     

    CignaTTK Health Insurance Company’s mission is to improve the health, well being and sense of security of the people. Its service philosophy is to make customer experiences easy and reliable so that customers always receive personalised and empathetic services.

    Future Generali Health Insurance

    A joint venture of the Indian conglomerate Future Group, and the Generali Group, one of the world’s largest international insurance companies, Future Generali India Insurance Company has a pan India presence through its 137 branches. The company provides a range of insurance solutions and intends to exploit the expansive network and local experience of the Future Group and the in-depth insurance expertise of Generali Group.

     

    Its solutions include both life insurance and general insurance, with the latter providing solutions for motor insurance, travel insurance, home insurance besides a host of health insurance plans. The company has also moved into the rural and commercial insurance space and provides a range of products that take care of the specific needs of these sectors.

    HDFC Ergo Health Insurance

    A 74:26 joint venture between HDFC Limited, India’s premier housing finance institution, and ERGO International AG, the primary insurance entity of global reinsurance and insurance major, Munich Re Group, HDFC ERGO General Insurance Company provides a range of solutions for the general insurance market in India. The company has been expanding its network across the country at a rapid pace and currently has 109 branches across 89 cities. The company has an employee base of over 1900 people.

     

    HDFC ERGO General Insurance has been awarded the ‘iAAA’ rating by ICRA that indicates its highest claim paying ability. The company has also received the CMS Outstanding Affiliate World-Class Service Award for 2015 from Chubb Multinational Solutions in addition to ICAI Award for Excellence in Financial Reporting in the Annual Report for the financial year 2014-15 under the insurance sector category.

  • Other Top Health Insurance Companies in India

    • ICICI Lombard Health Insurance

    • IFFCO-Tokio Health Insurance

    • L&T Health Insurance

    • Liberty Videocon Health Insurance

    • Max Bupa Health General Insurance

    • National Health Insurance Company

    • New India Assurance Health Insurance

    • Oriental Health Insurance

    • Raheja QBE Health Insurance

    • Reliance Health Insurance

    • Religare Health Insurance Company

    • Royal Sundaram health Insurance

    • SBI General Health Insurance

    • Star Health and Allied Insurance Company

    • Tata AIG Health Insurance

    • United India Health Insurance

    • Universal Sompo Health Insurance

Best Health Insurance Plans

Insurer Nerwork Hospitals  Plan Name Sum Insured Options  Features Available Features excluded
Apollo Munich Health Insurance 3880 Easy Health Floater Exclusive 3lacs, 4lacs, 5lacs, 7.5lacs, 10lacs, 15lacs, 20lacs, 25lacs, 50lacs
  • Health Check Up
  • Ambulance Charges
  • Maternity Cover
  • OPD Coverage
  • Restore Benefits
Easy Health Floater Premium 4lacs, 5lacs, 7.5lacs, 10lacs, 15lacs, 20lacs, 25lacs, 50lacs
  • Health Check Up
  • Organ Donor
  • Maternity Cover
  • Restore Benefits
  • OPD Coverage
Easy Health Floater Standard 2lacs, 3lacs, 4lacs, 5lacs
  • Health Check Up
  • Ambulance Charges
  • Daily Cash
  • Maternity Cover
  • Restore Benefits
Optima Restore 3lacs, 5lacs, 10lacs, 15lacs, 20lacs, 25lacs, 50lacs
  • Restore Benefits
  • Organ Donor
  • Domicillary Hospitalization
  • Maternity Cover
Bharti AXA Health Insurance 1609 Smart Health Basic 2lacs, 5lacs
  • Ambulance Charges
  • Domicillary Hospitalization
  • OPD Coverage
  • Restore Benefits
Smart Health Optimum 5lacs
  • Ambulance Charges
  • Domicillary Hospitalization
  • Health Check Up
  • Restore Benefits
Smart Health Premium 3lacs
  • Ambulance Charges
  • Domicillary Hospitalization
  • Health Check Up
  • Restore Benefits
Cigna TTK Health Insurance 5023 ProHealth Plus SB 15lacs, 30lacs, 50lacs
  • Health Check Up
  • Restore Benefits
  • Maternity Cover
  • Alternative Benefit
  • Dental Cover
  • Daily Cash
ProHealth Preferred SB 4.5lacs, 5.5lacs, 7.5lacs, 10lacs
  • Restore Benefits
  • Ambulance Charges
  • Maternity Cover
  • Alternative Benefit
  • Convalescence Benefit
ProHealth Protect PLAN 2 Sub Plan 10lacs
  • Health Check Up
  • Ambulance Charges
  • Maternity Cover
  • Restore Benefits
  • Eye Cover
ProHealth Protect SB 2.5lacs, 3.5lacs, 4.5lacs
  • Restore Benefits
  • Ambulance Charges
  • Organ Donor
  • Alternative Benefit
  • Maternity Cover
HDFC ERGO Health Insurance 8318 Health Suraksha Plus - Gold 3lacs, 4lacs, 5lacs, 7.5lacs, 10lacs
  • Health Check Up
  • Maternity Cover
  • Organ Donor
  • Restore Benefits
  • OPD Coverage
Health Suraksha Plus Regain - Gold 3lacs, 4lacs, 5lacs, 7.5lacs, 10lacs
  • Health Check Up
  • Restore Benefits
  • Maternity Cover
  • Dental Cover
  • OPD Coverage
Health Suraksha Plus Regain - Silver 3lacs, 4lacs, 5lacs, 7.5lacs, 10lacs
  • Restore Benefits
  • Ambulance Charges
  • Maternity Cover
  • Convalescence Benefit
  • OPD Coverage
Health Suraksha Plus Silver 2lacs, 3lacs, 4lacs, 5lacs
  • Ambulance Charges
  • Domicillary Hospitalization
  • Restore Benefits
  • Maternity Cover
HDFC Life 4342 Health Assure (Gold) 5lacs, 7.5lacs, 10lacs
  • Health Check Up
  • Ambulance Charges
  • Domicillary Hospitalization
  • Maternity Cover
  • OPD Coverage
Health Assure (Silver) 3lacs, 5lacs
  • Ambulance Charges
  • Domicillary Hospitalization
  • Restore Benefits
  • Maternity Cover
Iffco Tokio Health Insurance Swasthya Kavach (Basic) 1lac, 2lacs, 3lacs, 4lacs, 5lacs
  • Domicillary Hospitalization
  • Organ Donor
  • Health Check Up
  • Restore Benefits
Swasthya Kavach (Wider with Critical Illness Cover) 1lac, 2lacs, 3lacs, 4lacs, 5lacs
  • Health Check Up
  • Domicillary Hospitalization
  • Restore Benefits
  • OPD Coverage
Swasthya Kavach (Wider) 1lac, 2lacs, 3lacs, 4lacs, 5lacs
  • Ambulance Charges
  • Organ Donor
  • Restore Benefits
  • OPD Coverage
L&T Health Insurance 4435 my:health Medisure Classic 1lac, 2lacs, 3lacs, 4lacs, 5lacs
  • Health Check Up
  • Ambulance Charges
  • Maternity Cover
  • OPD Coverage
  • Restore Benefits
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FAQ's

What is Health Insurance?

Ans:

The term health insurance (popularly known as Medical Insurance or Mediclaim) is a type of insurance that covers your medical expenses. Health insurance comes in handy in case of severe emergencies. Health Insurance provides a financial coverage for medical and hospitalization expenses, in case of an illness/disease or accident.

Health insurance provides for medical expenses to the insured in case of hospitalization for more than 24 hours caused due to illness or accident. Health insurance covers Medicare needed by individual or family for surgeries, nursing care, consultation fees, diagnostic tests, hospital accommodation et al. Health insurance also pays for regular checkups. The insured in return pays a specified amount called premium on an annual or biennial basis.

Why Health Insurance?

Ans:

Health insurance comes with dual benefits where you get a health cover as well as save on tax under section 80(D). With increasing risk of medical emergencies due to modern lifestyle patterns and exorbitant medical expenses, health insurance is important so that you do not compromise on a good medical treatment. Health Insurance provides protection to your family and yourself with hospitalization in best hospitals along with best medical facilities. Good medical treatment is necessary for fast recovery. This is why everyone needs health insurance.

How much cover do I need?

Ans:

Your age, lifestyle pattern, city of residence and annual income are vital parameters that help to determine the appropriate coverage required for you.

Documents required?

Ans:

Generally documents required are age proof, address proof and identity proof. Specific documents may be required in case the person needs to undergo medical tests. This can be checked on the Price quotes page.

Type of Health Insurance

Ans:

  • Individual health insurance
  • Family Floater
  • Senior Citizen Health Insurance
  • Hospitalization Insurance
  • Travel Health Insurance

What if the insurance company refuses to settle my claim and I want to file a complaint? Or I am not happy with processed claim amount.

Ans:

In order to monitor grievances and turnaround times of policyholders, IRDA has implemented the Integrated Grievance Management System (IGMS). It is a platform where policyholders can register their complaints with insurance companies first and if required, it can be escalated to IRDA Grievance Cells. You can reach IRDA Grievance Call Centre (IGCC) through-

Call - Toll free number 155255 for voice calls

Email - complaints@irda.gov.in

Can I cancel my health insurance? If yes, will I get my premium back?

Ans:

Yes, you can cancel your health insurance. A free look period of 15 days from the date of policy receipt is available to you to review terms and conditions of the policy. In case you are not satisfied with the terms of the policy, you may seek cancelation of it. In such an event, insurance company allows refund of premium paid after adjusting underwriting costs, cost of pre-acceptance medical screening, etc.

What are pre-existing diseases or conditions?

Ans:

Any health problem faced by an individual prior to seeking insurance policy is called pre-existing diseases. Insurance companies are reluctant to cover pre-existing diseases as it is a costlier affair for them.

The problem is that people with pre-existing conditions usually do not get warm welcome from insurance companies. But it should not deter you from buying a health cover even if you have a pre-existing ailment.

Every insurance company has its own conditions regarding pre-existing illness. Some insurers prefer to check a person’s entire medical history to know pre-existing condition status, while other insurers will look for medical records over the past four years. Individual health policies bring pre-existing illnesses into the ambit of coverage after the waiting period. So while choosing a policy, you should also need to compare waiting period stipulated in policies for covering pre-existing ailments.

What are the fine prints which I should know before buying health policy?

Ans:

A) Buying health insurance can be a painstaking process, so you should make sure you keep below things in mind before buying a health insurance policy-

B) What’s covered and what’s not covered in the policy= No health policy covers all diseases, so it is important to know the list of covered diseases

c) Pre-existing diseases= Be upfront about your current health state and pre-existing diseases. Concealing information may become the reason of claim rejection.

d) When does the cover start= No health insurance offers coverage from Day 1. So it is important to know when your coverage will start. If you will undergo treatment before that period, you will not be entitled to get a claim.

e) Family floater or individual policy= A family floater offers insurance coverage for the entire family under one plan and is cheaper than individual policy. However, it is crucial to check what happens if the main policyholder of the plan dies. Some policies may lapse while some won’t. Also, taking a family floater with your ageing parents would mean that most of your coverage would go in their treatment and less coverage would be available for the rest of the family.  

f) Understand the premium= Costs of healthcare services are rising exponentially. Thus, it is important to have comprehensive health coverage so that timely treatment could be made. However, before you buy a plan, it is crucial to compare costs with the total sum assured and coverage. There is no sense in taking up low priced plan if it covers very few diseases.

What are the exclusions of a health insurance policy?

Ans:

Make sure you know what is not covered by your health policy to get its optimum benefits. Following are treatments and medical expenses which do not covered by health insurance companies-

  • Any pre-existing disease that was diagnosed 48 months prior to policy issuance.
  • Any disease contracted during first 30 days of the inception of the policy, except those arising out of the accident.
  • Medical expenses incurred on AIDS.
  • Congenital disease.
  • Test/treatment related to infertility and vitro fertilization.
  • Accident in an inebriated state.
  • There are expenses like joint replacement, non-infective arthritis, etc; which are covered after completion of 2 years continuous policy.
  • Expenses attributable to self-inflicted injury, including suicide attempt or suicide.
  • Insured person committed or attempting to commit criminal or illegal activity.
  • Cost of spectacles, dental treatment and any cosmetic surgery.

Any insured person’s participation or involvement in military, air force operations, racing, scuba diving, parachuting, mountain climbing and any other dangerous activity

What are the inclusions of a health insurance policy?

Ans:

Almost all health insurance policies cover following expenses-

A) Day care treatment where 24 hours hospitalization is not required due to technology advancement.

B) Hospitalization

C) Domiciliary hospitalization where care & treatment is taken at home due to unavailability of room in the hospital or the condition of the person is critical and cannot be moved to hospital under any circumstances.

Critical illnesses like cancer, heart attack, coma, major burns, organ transplantation, etc.

What do you mean by no claim bonus?

Ans:

No claim bonus (NCB) is a discount on the base premium if no claim on the health policy is made during the policy term. This bonus is usually given in the form of a discount in premium rates or enhancement of sum insured. Some insurers also add to the sum insured at a pre-defined rate. However, more commonly NCB is offered in the form of discount on premium. NCB is quite attractive for a healthy person who has bought health insurance policy for emergency situations. He/she doesn’t need to make small claims at regular intervals and thus, he can enjoy NCB.  However, for a person who is suffering from chronic heart ailment, NCB is almost not applicable.

How can I exercise portability procedure on my current health insurance?

Ans:

Portability can be exercised only at the time of renewing a policy, not at any time during the policy term. Switching to a new insurer can be easy if you follow below simple steps.

  • A policyholder needs to send an application to port the policy to the new insurer which should reach at least 45 days prior to the last day of renewal of the current policy. Though the insurance company is free to consider a proposal even if the policyholder fails to approach them before 45 days of policy renewal, but in that case it will not be legally bound to consider your application. So, chances are high that your application will be rejected.

 

  • Once your request is received by the new insurer, he will send proposal and portability forms along with details of different products offered by it. Choose the insurance product which suits you most and fill up the proposal and portability forms and submit them to the new insurer.

 

  • After receiving both the forms, insurance company will approach your current insurer seeking details like medical history and claim history. The data will be received through a common data sharing portal developed by IRDA for all insurance companies. The current insurer will have to furnish all details about your policy within seven working days.

 

After the new insurer receives all details regarding your previous policy, he has to take a decision on underwriting your insurance application within 15 days. If the new insurer fails to abide by this duration, he will be bound to accept your application. 

What are the various riders and benefits available in a health insurance policy?

Ans:

A rider is an add-on option that can be added to a current health policy to get additional coverage. There are various riders available in health insurance sector and some of the major ones are listed below-

  • Critical illness rider= There are certain critical ailments, such as heart attack, paralysis, cancer, etc; for which hospitalization expenses are too high to be covered under a regular health insurance policy. Under critical illness rider, mostly lump sum is paid to the insured and this amount is substantial to cover massive expenses which are involved due to critical illness.

 

  • Hospital Cash= Insurer provides fixed cash on a daily basis to compensate the loss of income & meet petty expenses of the policyholder during hospital stay

 

  • Top-ups= In case there is a change in coverage needs or premium paying ability increases, it is better to opt for a top-up insurance plan than buying an individual plan. It helps in expanding the existing health insurance coverage. 

 

  • Attendant allowance= Some insurers are giving attendant allowance to accompany the insured person who is hospitalized.

 

  • Co-Payment= It is the portion of the claim that a policyholder agrees to pay in the event of a claim. For a policyholder, main benefit comes in the form of low premium. Higher the co-payment ratio, lower will be premium. A healthy individual whose chances of being hospitalized are low can consider buying a policy with a co-payment clause. 

 

  • Deductible= Also known as ‘excess’, deductible is the uninsured part of the claim amount which an insured has to pay before the insurance company takes over and pays remaining expenses as per the policy. Since the insurer shifts the small portion of risk on you, he gives you discounts on premium. Unlike co-payment, insured has to first pay his portion and then only insurer settles the remaining portion.

What is the right time to buy health policy?

Ans:

ASAP- As soon as possible is the perfect answer to this question. By buying at a younger age, you can enjoy low premium rates. Moreover, for critical illnesses and maternity, every insurer has its own waiting period. By buying it a young age means you get access to health coverage when the need actually arises. So don’t wait for any accident or a medical condition to occur before you hit a panic button and buy a health insurance policy. 

What do you mean by health card?

Ans:

It is a card that comes along with health insurance policy. Similar to the identity card, this card will allow you to avail cashless hospitalization at any network hospital.

How much does health insurance cost?

Ans:

• Buying a health policy is not an easy task. There are various factors that collectively play an important role in deciding the total cost which you need to shell out to get coverage. Young, healthy people need to pay far less for insurance cover than their old counterparts. Similarly, if you are buying an individual policy then premium would be low in comparison to a family floater plan as the latter is a comprehensive plan that covers the entire family, whereas the former covers only individual. Similarly, corporate health insurance is cheap as it is similar to buy policies in bulk. However, in individual policy, you spend more to get coverage.

• The cost of health insurance also depends upon sum insured. If you opt for a higher sum insured, your premium rates will increase. Similarly any rider attached with the plan increases its premium cost. For instance, premium rates of a basic health policy offering Rs 3 lakh sum insured to an individual aged 30 years, would vary between Rs 3000-4000/annum. But if you take a critical illness rider, you have to spend more 1500-2000/annum.

• The cost of health insurance also varies on the basis of the health condition of a person. For example, an unhealthy person who is already suffering from any pre-existing condition may need to pay higher premium in the form of loading as compared to a healthy person who doesn’t need to pay the loading charges.

• Also, in certain cases, the premium may vary from the city to city. For example, a person living in metro city may need to pay the higher premium as compared to the other person of same age and family size living in the remote area, for the same sum insured.

What are the different types of health insurance?

Ans:

There are various types of health insurance plans available in the market and some of the major ones are-

  • Individual health plan It offers coverage to an individual against illnesses. There are various factors that affect the cost of health insurance premium like age of the insured, sum insured, personal health, etc. To know more about individual health plan and available options, Read more 

  • Family Floater health plan With this policy, you can cover the entire family under a single plan. Here the sum insured is shared by all members of a family. It means, if a family of 5 members takes a cover of Rs 5 lakh, the entire family can claim up to Rs 5 lakh. Read more about family floater health plan.

  • Critical illness plan Insured is entitled to get payment either as a lump sum or as an indemnity, in accordance to the policy chosen. Under lump sum payment, insured is entitled to get the total sum insured irrespective of the total hospitalization cost. However, in indemnity, the company will reimburse only the hospitalization cost, provided it should be within sum insured. For instance, if your hospitalization cost is Rs 2 lakh and the policy sum insured is Rs 5 lakh, you will get Rs 5 lakh under lump sum payment plan. However, in case of indemnity plan, you will get only Rs 2 lakh. The policy offers coverage to insurer against a fixed number of serious ailments after certain survival period. It can be bought alone or as a rider on a health insurance policy. To know more about insurance plan, Read Here

 

  • Senior citizen health plan It offers coverage to protect you from health issues during old age. Many companies have devised special plans for aged people. It is important to choose a plan offering vast coverage as the probability of falling ill increases with age.

What is Convalescence benefit?

Ans:

After a long period of hospitalization, a policyholder may not be able to get back to work immediately. This means there may be a loss of income. At this point of time, he/she may need extra funds to take care of the household expenses, medicines, etc. Convalescence benefit is an additional benefit offered with health insurance to take care of such expenses.

What is cumulative bonus?

Ans:

An increase in the sum assured by a percentage for every claim free year is called cumulative bonus. It is important to renew the policy without a break to avail cumulative bonus benefit.

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