What is Health Insurance? A Complete Guide

One thing that we all have learned during the COVID-19 pandemic is the relevance and importance of health insurance in 2020. You would already know that health insurance plans keep you financially protected and help you meet the expensive cost of healthcare services. And if you want to more about health insurance in India firstly you would need to understand how it works.

Read More

Policybazaar exclusive benefits
  • 30 minutes claim support*(In 120+ cities)
  • Relationship manager For every customer
  • 24*7 claims assistance In 30 mins. guaranteed*
  • Instant policy issuance No medical tests*

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply

*Tax benefit is subject to changes in tax laws. Standard T&C Apply

Find affordable plans with up to 25% Discount**
  • 1
  • 2
  • 3
  • 4

Who would you like to insure?

  • Previous step
    By clicking on “Continue”, you agree to our Privacy Policy and Terms of use
    Previous step

      Popular Cities

      Previous step
      Previous step

      Do you have an existing illness or medical history?

      This helps us find plans that cover your condition and avoid claim rejection

      Get updates on WhatsApp

      What is your existing illness?

      Select all that apply

      Previous step

      When did you recover from Covid-19?

      Some plans are available only after a certain time

      Previous step
      Advantages of
      entering a valid number
      You save time, money and effort,
      Our experts will help you choose the right plan in less than 20 minutes & save you upto 80% on your premium

      When you buy health insurance you have to pay a fixed premium amount against the annual coverage that you get. The health insurance company will pay for your medical expenses up to the maximum coverage i.e. the sum insured that you have opted for.

      For example, if you have opted for a health insurance cover of Rs 10 lakh and you got admitted to the hospital and have to pay a bill of Rs 5 lakh, then the insurer will pay the bills. However, your coverage amount for the year will be reduced to Rs 5 lakh as you have already used half of the sum insured.

      If you want to know more about health insurance in India you can check out this complete guide on health insurance:  

      Why do we Need Health Insurance Policies?

      We need health insurance to improve the healthcare standards in our country, to reduce the out-of-pocket expenditures of the people so that everyone can avail of the right healthcare services at the right time.

      Did you know?

      • In 2020, almost 500 million people were covered under health insurance across India. Most of them were covered under government health insurance schemes, and only a few percentage of people had individual health insurance plans.
      • As per the World Bank data about 62.67% of Indians pay for health expenditures from their pocket
      • Insufficient allocation of healthcare funds has pushed a lot of people below the poverty

      Looking at these numbers the situation is quite dire especially with the ongoing pandemic. Therefore the need for affordable health insurance plans rises even more.

      Understand how you can benefit from Health Insurance?

      We all want to know the benefits of insurance in our lives. The main purpose of having health insurance is to help you pay for hospitalization expenses and high medical bills. Check out the scope of health insurance in points below:

      • Coverage against Hospitalization Expenses- The policy covers daycare procedures, hospitalization expenses, ambulance charges, domiciliary expenses, among others. With this, you can focus on your speedy recovery instead of worrying about treatment costs
      • Coverage against Critical Illnesses- Health Insurance providers now offer critical illness cover as a rider benefit or as a standalone plan. Critical illness plans are useful in treating serious illnesses like kidney failure, cancer, bone marrow transplant, among others
      • Accidental Hospitalization- The cost incurred while seeking treatment after accidental hospitalization is covered under health insurance plans
      • Coronavirus Treatment Cover- The cost related to COVID hospitalization and any consumable expenses like the cost of PPE kits, ventilators, oximeters, gloves, masks, etc. is covered
      • Tax Benefits- The premium that you pay for health insurance is eligible for tax-benefits u/s 80 D of the Income-tax Act and the limit is up to Rs 1, 00,000

      Types of Health Insurance Plans in India

      • Individual Health Insurance Plans - There are different types of health insurance for individuals that cover different types of diseases. The sum insured is available on a standalone basis and therefore the coverage provided is higher.
      • Family Health Insurance - A family of 3 or 4 people can easily get insured under a family health insurance plan. The coverage provided is the same as individual medical plans but the insurance amount is on a floater basis.
      • Coronavirus Health Insurance - The one in popularity is COVID-19 health insurance that helps you pay for the treatment of a global disease whose treatment is not established yet. The cost of the treatment can shoot in lakhs, thus insurance is important.
      • Critical illness Insurance - Cancer, TB, tumors, organ failure, and kidney transplants are common these days. The cost of such treatments can be very high; therefore, it is important to have critical illness cover that can help you pay for such expensive treatments without any financial stress.
      • Top-up Health Insurance Plans - A lot of people buy top-up health plans over and above their basic health plans as it provides buffer coverage over and above the existing policy.
      • Critical Illness Plans for Women in India- There are quite a few women health insurance plans that cover women-specific critical illnesses and cancers. Read more about women-specific health plan here
      • Maternity Health Insurance- There are a few health plans that cover maternity expenses after the waiting period is over. But you can buy maternity-specific health plans that pay the expenses with a minimal waiting period of 9-months only.

      Health Insurance for Cancer Patients in India- What are the Options?

      The number of cancer cases in India is estimated to be 13.9 lakh in 2020 and the cases are likely to increase to 15.7 lakh by 2025.

      The prevalence is marginally higher among women, as per the report. Looking at these numbers it becomes important to secure yourself and your loved ones from this deadly disease by getting the right treatment at the right time and avoid any financial crisis.

      If you want to buy cancer insurance cover then you can find out the best health insurance plans for cancer patients here

      Waiting Period in Health Insurance

      Most people get confused with the waiting period clause. So, when you buy the insurance you can only avail of certain policy benefits after completion of the waiting period. For example, many health insurance plans have a waiting period of 2 to 4 years. Once the waiting period is over you can get coverage for pre-existing health conditions.

      For example, if you have a pre-existing medical condition like diabetes or high blood pressure, you can only file a claim for treatment cost if you continued the policy for 3-4 years.  However, there are now health insurance plans that provide pre-existing disease cover from Day 1, without any waiting period clause. Check out the plans here

      Co-Payment in Insurance

      So, when you are trying to understand health insurance better, one of the most common things that people get confused with is the co-payment clause. There are co-pay clauses in a lot of health insurance plans where the insurer only pays a certain percentage of the hospital bill, and you settle the rest of the bill.

      Simply put, with a co-pay clause you share a percentage of healthcare expenses with your health insurance provider. The premium of these policies is usually on the lower side. Do not just fall for the lower premiums as the cost that you need to bear at the time of treatment can be quite exhaustive. So, opt for it or buy a plan with co-pay if you can pay it else just get a normal health insurance plan with no co-payment clause.

      Health Insurance Portability - Things to Know

      At any point, if you feel dissatisfied with your health insurance policy or the services offered by your insurer then you can definitely port to another insurer. The Insurance Regulatory and Development Authority of India (IRDAI) came up with the concept of Health Insurance Portability to ensure that the common people are not taken for a ride by health insurance companies.

      For smooth portability of your health insurance plan, you need to communicate with your insurance provider at least 45 days before your next renewal is due. Otherwise, the health insurance company can reject your portability application.

      Right Way to Purchase Health Insurance Online

      Flipping through different health plans and looking for the correct way then all you can do is thoroughly understand the different types of health insurance plans, what do they offer, and what are the terms that you need to understand. If you have selected a health insurance plan online, and you don’t go through the details then it might not be the best fit for you.

      So, to ensure that you buy the right kind of policy you need to invest some time in it. Health insurance is one of the most important purchases that you will make and you must browse through different options. Alternatively, you can get in touch with our health insurance experts at Policybazaar.com and discuss your health insurance needs and requirements.

      Our team will then be able to recommend you a health insurance plan that matches your insurance needs. Remember the health insurance details mentioned in this post will make it easier for you to discuss your requirements with us.

      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

      Health insurance articles

      Recent Articles
      Popular Articles
      Reasons to Purchase High-Value Health Insurance Cover

      21 Feb 2024

      When you decide to purchase a health insurance plan for you and
      Read more
      Surgeries Covered by New India Assurance Health Insurance Plans

      22 Feb 2024

      In an era where healthcare expenses are skyrocketing in India, the
      Read more
      Is a 10 Lakh Health Insurance Adequate in Your City?

      10 Jan 2024

      An ongoing medical inflation of 14 percent in India (the highest
      Read more
      Dental Treatment Coverage from Star Health Insurance

      21 Dec 2023

      The rising costs of healthcare services have made it necessary for
      Read more
      11 Reasons Why Senior Citizens Should Buy Aditya Birla Activ One Plan

      05 Dec 2023

      Health insurance is one of the biggest assets that senior citizens
      Read more
      How to Apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)?
      Ayushman Bharat Yojana is a flagship health insurance scheme launched by the Government of India to offer universal
      Read more
      Best Health Insurance Plans for Senior Citizens
      Senior citizens are the most prone to diseases. Considering the medical inflation in India, buying health insurance
      Read more
      Does Health Insurance Provide Coverage for LASIK Eye Surgery?
      A vast majority of the Indian population is suffering from vision problems. For some of them, LASIK eye surgery is
      Read more
      10 Major Benefits of Ayushman Bharat Yojana
      Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the second component under Ayushman Bharat Scheme. PM Narendra Modi
      Read more
      How Senior Citizens can save Tax with Medical Bills u/s 80 D?
      Senior citizens can save on income tax by availing tax benefits on medical expenses under Section 80D of the Income
      Read more

      Download the Policybazaar app
      to manage all your insurance needs.