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Best Health Insurance Plans in India
- DetailsWritten by PolicyBazaar -
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Updated date : 12 September 2019
Health insurance is amongst the most intricate insurance products, as it comes with numerous riders and benefits, and hence, there are so many variants to it. The insurance marketplace nationwide is quite competitive. You must consider comparing the best health insurance plans in India, to end up buying one for you and your dependents.
Needless to say, it is imperative to buy the right health insurance policy, as it helps you to keep up with the ever-soaring healthcare costs and assures you and your family of a healthy future without having to worry about the medical bills and hospitalization expense. And, when it comes to buying health insurance, you might get confused about which plan to buy out of many.
Now, you can put a halt to your confusion because we, at PolicyBazaar, are passionate about getting you the best of insurance. In order for you to pick out the best health insurance policy in India, we have chosen 10 policies since they stand superior on certain parameters, such as eligibility, uniqueness of features, coverage, affordability, limits and exclusions.
List of Best Health Insurance Plans in India
Keeping medical inflation in mind, health insurance coverage is a must in India. There is a wide range of best health insurance plans available in the insurance market. Such a plan has to be the best in terms of offered insurance coverage as well as insurance premium. Ideally, a best health insurance policy is the one that offers maximum insurance coverage in exchange for an affordable insurance premium. Usually, people confuse the best insurance plans with the cheapest ones. For an insurance plan to be the best there must be a perfect balance between insurance premium and insurance coverage. While a plan can be rated as number 1, it still might not be the perfect fit for you. It’s because the coverage you get isn’t the coverage you need. Before you buy a health insurance plan, analyse your insurance expectations and make sure that the plan you opt for fulfils your insurance expectations. To simplify this task, here we have a list of plans with their respective benefits:
Following are the top Health Insurance Plans in India that offer Comprehensive Protection for you and your Family
- Star Family Health Optima Plan
- Max Bupa Health Companion Individual Plan
- ManipalCigna Prohealth Plus
- HDFC ERGO Health Suraksha Gold Regain
- Star Senior Citizen Red Carpet Health Insurance Plan
- Apollo Munich Optima Restore
- Religare NCB Super Premium
- Royal Sundaram Lifeline Supreme
- Aditya Birla Active Assure Diamond
- Universal Sompo Privilege
Top Health Insurance Plans in India at a Glance:
Star Family Health Optima
Minimum- 16 Day
|Rs. 2 Lakh, Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, Rs. 10 Lakh, and Rs. 15 Lakh||Lifetime||
Max Bupa Health Companion Individual
Minimum - 90 days
Maximum - Age no bar
For Variant 1 - Rs. 1 Lakh, Rs. 2 Lakh, Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh and Rs. 10 Lakhs
For Variant 2 - Rs. 5 Lakh Rs. 7.5 Lakh, Rs. 10 Lakh and Rs. 12.5 Lakh.
For Variant 3 - 15 Lakh, Rs. 20 Lakh, Rs. 30 Lakh, Rs. 50 Lakh and Rs. 1 Crore
ManipalCigna Prohealth Plus
Minimum- 91 days
Maximum- No limit as such
|Rs. 4.5 Lakh, Rs. 5.5 Lakh, Rs. 7.5 Lakh and Rs. 10 Lakh.||Lifetime||
HDFC ERGO Health Suraksha Gold Regain
Minimum- No limit as such
|Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, Rs. 7.5 Lakh and 10 Lakh||Lifelong||
Star Senior Citizen Red Carpet
|Rs. 7.5 Lakh and 10 Lakh||Lifetime||
Apollo Munich Optima Restore
|Rs. 3 Lakh – Rs. 50 Lakh||Lifelong||
Religare NCB Super Premium
Minimum- 91 days
Maximum- No age bar as such
Starting from Rs. 5 Lakh
Royal Sundaram Lifeline Supreme
Minimum- 90 days
Maximum- 25 Years
Minimum- 18 Years
Maximum- No bar as such.
Rs. 5 Lakh, 10 Lakh, 15 Lakh, 20 Lakh and 50 Lakh.
Aditya Birla Diamond
Minimum Entry Age - 5 years
Ranging from Rs. 2 Lakh to Rs. 200 Lakh
Universal Sompo Privilege
Minimum- 90 days
For Basic Plan -1 Lakh – Rs. 2 Lakh. For
Essential Plan- Rs. 3 Lakh t Rs. 5 Lakh. For
Privilege Plan-Rs 6 Lakh to Rs 10 Lakh.
Disclaimer: The ranking of the insurance companies in this content is not in any particular order. The list is not complied as per the IRDA ranking.
Apollo Munich Optima Restore
Optima Restore by Apollo is a comprehensive and affordable health plan that comes with a restore benefit that automatically restores the sum insured in case it is exhausted. Here are the details of this plan.
Features and Benefits
Here are features and benefits of Apollo Optima Restore health insurance plan.
- Wider Coverage: The family floater version of this plan extends insurance coverage to proposer’s spouse, dependent children, dependent parents, and parents-in-law.
- Long-Term Coverage: The plan comes with a long-term policy option up to 2 years. Additionally, 7.5 percent discount is offered if an insured selects a 2-year policy period.
- In-Patient Hospitalization: The plan covers incurred medical expenses due to hospitalization for more than 24 hours. Additionally, this cover comes with no room rent limits.
- Day-Care Procedures: The plan covers incurred medical expenses of all the day-care procedures that don’t require hospitalization for a minimum time-period of 24 hours.
- Pre-Hospitalization and Post-Hospitalization Coverage: The plan offers pre-hospitalization cover for diagnostic tests, routine medication, doctor consultations fees and investigative tests up to 60 days before hospitalization and post-hospitalization cover up to 180 days after hospitalization.
- Domiciliary Treatment: The plan covers incurred medical expenses of treatment underwent at home which would need hospitalization in the first place
- Organ Donor Expenses: The plan covers expenses incurred on harvesting organ for the insured’s organ transplant.
- Daily Cash Benefit: The plan comes with a daily-cash benefit if an insured opts for a shared accommodation. Under this benefit, the insured gets a lump sum amount if he/she shares a room in an authorized hospital.
- Emergency Ambulance Cover: The plan covers emergency air ambulance charges for transportation in an air ambulance for the seeking treatment for a life-threatening illness/disease.
- Health Check-up Benefit: The plan provides reimbursement for a yearly preventive health check-up if the opted plan has a sum assured of Rs. 10 Lakh and the two-yearly basis for sum assured of Rs. 5 Lakh.
- Restore Benefit: The plan provides automatic restoration of the base sum insured in case the basic sum assured and the multiplier benefit have been exhausted. This benefit can be availed on an annual basis.
- Stay Active Benefit: The plan offers a benefit to the insured for being active. Under this benefit, he/she gets a discount upon policy renewal if he/she accomplishes the average step count (ASC) target as set by Apollo’s mobile app within the assigned time duration.
- E-opinion: The plan offers E-opinion benefits for an insured diagnosed with a critical illness from a network-listed health expert. This benefit is offered once per policy year.
- Additional Cover for Critical Illness: The plan comes with an optional cover for 8 critical illnesses- coronary artery bypass surgery, cancer, organ harvesting from a donor for an organ transplant, aorta graft surgery, pulmonary artery graft surgery, heart valve repair or replacement, bone marrow transplant, and neurosurgery.
- It covers incurred transportation cost (for insured as well as accompanying relative) accommodation charges, second opinion benefit and post-hospitalization charges for insured.
- Policyholders having a sum insured of Rs. 10 Lakh or more can opt for this cover.
- The cover is available within the individual plan as well as family floater plan.
- Multiplier Benefit: For every claim free year, the plan offers a bonus of 50 percent to 100 percent of the amount insured upon policy renewal. If a claim is filed/ processed the bonus will decrease by 50 percent of amount Insured upon renewal
- Cashless Claim Benefit: The plan comes with a benefit of cashless claim service. In order to avail this benefit, an insured must obtain a pre-authorization certificate for a planned hospitalization minimum 2 days before the scheduled hospitalization. In case of an emergency, the insured must inform the insurer within 24 hours of the hospitalization.
- Enhancement of Sum Insured: Upon renewal, the plan enables an insured to enhance the base amount insured. To be eligible to avail the benefit, the insured must have a claim-free history.
- Tax Benefits: The plan offers tax benefits for the premium paid as per Section 80D of the IT Act.
Here are the exclusions of Apollo Optima Restore health insurance plan.
- Waiting Period- All the medical treatment expenses incurred during the first 30 days of policy commencement (except any incurred medical treatment expenses for an accidental injury).
- Pre-Existing Illnesses- Any pre-existing illness will be covered only after a 3-year waiting period.
- Disease-Specific Waiting Period- Coverage for pre-specified diseases such as hernia, cataract, surgery of hydrocele, joint replacement surgeries etc. comes with a waiting period of 2 years.
- HIV/AIDS- Any incurred expenses for the treatment of HIV, AIDS or related infection/diseases.
- Disease-Specific Exclusions- Insurance coverage ceases to exist in case of treatment for congenital diseases, insanity, mental disorders, weight control programs/ treatments and cosmetic surgery.
- Drugs Induced Illnesses or Injuries- Any illnesses or injuries induced by intoxicants and hallucinogenic substances such as intoxicating drugs & alcohol.
- War- Any illness/ injuries caused due to an act of war, biological, nuclear or chemical or weapon, radiation etc.
- Pregnancy- Any incurred expenses due to pregnancy, childbirth, abortion, miscarriage, and related consequences.
- Dental Treatment Expenses- Any treatment expenses incurred on dental treatment.
- External Aids- Any expenses incurred due to external aids and equipment.
- Personal Comfort Goods- Any incurred expense due to personal comfort & convenience items/goods.
- Unauthorized Treatment- Any incurred expense due experimental treatment, unproven treatment and investigative treatment is it in terms of devices or pharmacological regimens.
Religare NCB Super Premium
NCB Super Premium by Religare Health is a unique health insurance plan. It offers an enhanced sum insured along with the comprehensive insurance coverage. The plan is loaded with NCB benefit which increases the insurance benefits. Here are the details of this plan.
Features and Benefits
Mentioned below are the features and benefits of Religare NCB Super Premium plan.
- Pre-Hospitalization and Post-Hospitalization Coverage: The plan offers pre-hospitalization cover for diagnostic tests, routine medication, doctor consultations fees and investigative tests up to 30 days and post-hospitalization cover for up to 60 days.
- Ambulance Cover: The plan offers reimbursement for the ambulance expenses incurred in order to transport the insured to the nearest hospital. When needed, this cover can be expanded for covering air ambulance as well.
- In-Patient Hospitalization: In case of in-patient hospitalization for a minimum time period of 24 hours, the plan covers incurred room rent, nursing expenses, intensive care unit expenses, doctor's fee, surgeon's fee, anaesthesia charges, blood charges, oxygen charges, operation theatre expenses, etc.
- Daycare Treatment: The plan covers incurred medical expenses for 540 plus covered day-care procedures if the insured undergoes a covered day-care treatment that doesn’t need hospitalization for a time period more than 24 hours.
- Room Rent: The plan offers reimbursement for incurred expense as per the sum insured while insured is staying in a single/private room.
- ICU Charges: The plan covers ICU charges as per the sum insured.
- Domiciliary Hospitalization: The plan offer coverage for a medical emergency that doesn’t allow an insured to go to a hospital and he /she undergoes treatment at home for a period more than 3 consecutive days.
- Health Check-up: The plan covers an annual routine check-up for insured on an annual basis.
- Automatic Recharge of Sum Insured: The plan offers automatic recharge of the amount insured in case it is exhausted due to previous claims.
- No Claim Bonus: The plan offers up to 50 increases in sum assured upon renewal if no claims have been filed.
- Organ Donor Cover: The plan covers reimbursement for incurred medical expenses for harvesting an organ for an organ transplant of the insured.
- Reassurance of a Second Opinion: The plan offers a second opinion in case the insured has any doubts regarding the diagnosis.
- No Upper Age Restriction for Enrolment: The plan offers comprehensive insurance coverage by offering no age restriction on the upper age limit for enrolment.
- Lifelong Renewability: The plan comes with an option of lifelong renewability that enables an insured person to avail health insurance coverage throughout his/her life.
- Alternate Treatment Coverage: The plan offers insurance coverage for Ayurveda, Unani, Siddha and Homeopathy treatment in accordance with the sum insured.
- No Claim Bonus Super: The plan offers NCB Super coverage that increases the sum insured by up to 100 percent for every claim free year. The combined benefit for NCB and NCB Super for 5 consecutive years increases the amount insured up to 150 percent.
- Everyday Care Benefit: The add-on cover covers routine visits to hospitals, doctor’s consultation fees, and diagnostic test expenses up to 1 percent of sum insured.
- Unlimited Automatic Recharge: This add-on optional cover offers automatic recharge of the sum assured in case it is exhausted.
- Domestic Air-Ambulance Cover: The plan offers air-ambulance coverage in case an insured is recommended to undergo a medical treatment in some other city in India.
- Personal Accident Coverage: The plan offers a personal accident add-on that covers accidental death and permanent total disability up to 10 times of the amount insured.
- International Second Opinion: The plan covers the second opinion for medical treatment. As per the coverage opted, the insured can avail a second opinion and consultation from doctors overseas.
- Global Coverage: The plan comes with a Global coverage add-on that allows an insured to avail cashless medical treatment at network-listed hospitals across the globe as per the opted coverage.
Here are the exclusions of Religare NCB Super Premium plan.
- Waiting period- Any illness or diseases diagnosis, surgery, or any procedure occurring within the first 30 days of policy commencement.
- Self-Inflicted Injury- Any expenses incurred due to self-inflicted injury/ suicide/ attempted suicide.
- Usage of Intoxicant- Any expenses incurred due to an injury/sickness related to use and abuse of intoxicants such as alcohol, drugs, etc.
- AIDS- Any expenses incurred for the treatment of AIDS or related infections/diseases.
- Pregnancy- Any incurred expenses due to pregnancy, childbirth, abortion, miscarriage, and related consequences.
- Congenital Disease- Any incurred treatment expenses due to to congenital conditions.
- IVF Treatment- Any tests & treatment expense due to infertility treatment and IVF (in-vitro fertilization).
- War- Any treatment expenses related to injuries arising out of war, strikes, nuclear weapons and riots.
Star Family Health Optima
Family Health Optima by Star offers comprehensive insurance coverage on a family floater basis. As a health insurance, it is one of its own kinds. It offers various insurance benefits and comes at an affordable premium.
Buying and maintaining individual health insurance plans for every member of a family can be cumbersome and expensive. Family floater health plans are formulated to ease things out. It widens the umbrella of insurance coverage for the entire family.
Features and Benefits
Here are the features and benefits of Family Health Optima plan.
- Comprehensive Coverage: This plan offers comprehensive coverage for the whole
- Auto-Recharge: The plan offers extra amount insured at no added
- Health Check-up: The plan offers routine check-up benefit if no claim has been filed during a policy year.
- Amount Insured Restoration: The plan offers 100 percent restoration benefit in case the sum assured is exhausted.
- Assisted Reproductive Cover: The plan covers assisted reproductive treatments.
- New Born Baby Cover: The plan covers a newborn baby from 16th day onwards.
- Organ Transplantation Cover: The plan covers donor expenses for harvesting the organ required for transplantation.
- Domiciliary Hospitalization Cover: The plan covers domiciliary hospitalization charges for any treatment exceeding a minimum time period of 3 days.
- Day Care Procedures: The plan covers all day-care
- Grace Period: The plan comes with a grace period of 120 days in case a policyholder fails to renew the plan.
- Hospitalization Expenses: The plan covers incurred hospitalization expenses as per the sum insured for room expenses, boarding & nursing charges, surgeon fees, anaesthetist fees, medical practitioner fees, consultant’s fees, specialist fees, operation theatre expenses, diagnostics expenses, oxygen charges, imaging expenses, medicines & drugs charges, blood expenses, pacemaker charges etc.
- Emergency Ambulance Charges: The plan covers emergency ambulance charges for transportation to the nearest hospital as per the sum insured.
- Air Ambulance Expenses: The plan covers air ambulance expenses up to 10 percent of the amount insured.
- Pre-Hospitalization and Post-Hospitalization Charges: The plan covers pre-hospitalization charges up to 60 days and post-hospitalization charge up to 90 days.
- Domiciliary Hospitalization: The plan covers incurred medical treatment due to domiciliary hospitalization for illnesses/diseases exceeding 3 consecutive days.
- Organ Donor Expenses: The plan covers organ donation expenses for harvesting an organ required for transplant up to 10 percent of the amount insured or Rs. 1 Lakh, whichever is lesser.
- Health Check-up: The plan covers incurred expenses due to routine health check-up as per specified limits.
- New Born Baby cover: From 16th day onwards, the plan covers newborn baby up to 10 percent of the amount insured or Rs. 50,000, whichever is (lesser).
- Emergency Domestic Medical Evacuation: The plan covers incurred transportation expenses of the insured up to the pre-decided limits.
- Compassionate Travel: The plan offers reimbursement for air transportation expenses up to Rs.5, 000 for an immediate family member in case insured is hospitalized in another town.
- Repatriation of Mortal Remains: In case of death, the plan offers reimbursement up to Rs.5, 000 for repatriation of the mortal remains to insured’s hometown (if applicable).
- Shared Accommodation Expenses: The plan covers shared accommodation expenses as per the opted sum assured.
- AYUSH Treatment: The plan covers Ayurveda, Unani, Siddha, & Homeopathy treatment as per the opted sum assured.
- Second Medical Opinion: The plan covers a second opinion from Doctor of a network-listed hospital.
- Assisted Reproductive Treatment: The plan offers reimbursement for the incurred medical expenses up to Rs. 2 Lakhs for assisted reproduction treatment for sub-fertility.
- Additional SI Cover: The plan offers road traffic accident cover for accident-related in-patient hospitalization. Under this benefit, basic amount insured is enhanced by 25 percent subject to a maximum of Rs.5 Lakh. This cover ceases to exist in case insured doesn’t wear a helmet while riding a two-vehicle as a rider or pillion rider.
- Sum Insured Restoration: The plan offers 100 percent restoration of sum insured thrice during a policy period in case the basic sum assured is exhausted.
- Recharge Benefit: The plan offers recharge benefit as per the opted amount insured.
- No Claim Bonus: The plan offers a No Claim Bonus upon renewal for a claim-free year.
Max Bupa Health Companion Individual
Health Companion by Max Bupa is a comprehensive and affordable health insurance plan formulated especially for individuals and nuclear families. Here are the details of this plan:
In order to fulfil different insurance needs of different insurance buyers, this plan comes in three variants.
It offers 2 sum insured options: Rs. 3 Lakh and Rs. 4 Lakh. In order to enhance the insurance coverage, it comes with a top up with an Annual Aggregate Deductible (AAG) option of Rs. 1 Lakh, Rs. 2 Lakh, Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh and Rs. 10 Lakhs.
It offers 4 sum insured options: Rs. 5 Lakh, Rs. 7.5 Lakh, Rs. 10 Lakh, and Rs. 12.5 Lakh. In order to enhance the insurance coverage, it can be loaded with a top up with Annual Aggregate Deductible (AAG) option of Rs. 1 Lakh, Rs. 2 Lakh, Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, and Rs. 10 Lakh.
It offers 5 sum insured options: Rs. 15 Lakh, Rs. 20 Lakh, Rs. 30 Lakh, Rs. 50 Lakh, and Rs. 1 Crore. In order to enhance insurance coverage, it comes with a top up with Annual Aggregate Deductible (AAG) option of Rs. 1 Lakh, Rs. 2 Lakh, Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh and Rs. 10 Lakh.
Features and Benefits
Here are the features and benefits of Health Companion by Max Bupa.
- In-Patient Hospitalization: The plan covers the incurred medical expenses in case the insured is hospitalized for any covered treatment/illnesses.
- No Cap on Room Rent: The plan covers hospital accommodation costs (except suite and above-room category) without any cap on room rent.
- Pre- Hospitalization and Post-Hospitalization Charges: The plan will reimburse pre-hospitalization charges up to 30 days and post-hospitalization charges for 60 days for a covered illness or injury.
- Day Care Treatments: While this plan covers all the day-care treatment expenses, such procedures shouldn’t have been undertaken in the outpatient department.
- Refill Benefit: If an insured has exhausted his/her base insured amount, the refill benefit acts as a life-saver, both literally and metaphorically. This benefit offers an amount equal to the base sum insured as an additional amount for a subsequent claim against any different and unrelated illness.
- Alternative Treatments: This plan offers in-patient coverage for alternative treatments like Ayurveda, Unani, Siddha, & Homeopathy, up to the base amount insured.
- Long-Term Policy Benefits: When a policy is purchased for 2-year policy tenure, a discount of 12.5 percent is offered on the premium.
- Renewal Benefits: After the completion of first policy year, this plan offers the following renewal benefits.
- No Claim Bonus- Base sum insured is enhanced by 20 percent up to 100 percent of the base amount insured for every claim-free year.
- Health check-up- For variant 1, free routine health check-up is offered to the insured and his/her family members (if applicable) once in 2 years. For variant 2 and variant 3, the same benefit is provided annually.
- Emergency Ambulance Expenses: This plan covers emergency ambulance expenses incurred while transporting the insured to the nearest hospital. The limit is Rs 3,000.
- Organ Transplant Cover: The plan covers organ donation expenses, organ harvesting for organ transplantation for the insured person.
- Domiciliary Treatment: The plan covers domiciliary treatment expenses if a hospital bed is unavailable or such a treatment is advised by the attending doctor. Under this cover, medical treatment is administered at home.
Here are the pre-requisite conditions to avail this cover:
- Attending doctor must confirm that the insured can’t be transferred to the hospital or a hospital bed is unavailable.
- The treatment must continue for a minimum time period of 3 consecutive days.
- Animal Bite Vaccination: This plan offers reimbursement up to Rs. 7500 (or as per the variant opted) for OPD treatment expenses for vaccinations/immunizations for treating an animal bite.
- Hospital Cash Benefit: Optionally, this plan offers a lump-sum payout of Rs. 4,000 (or as per the variant opted) on a daily basis as daily cash benefit if an insured is hospitalized for a minimum duration of 2 days. The benefit can be availed up to 30 days.
- No Bar for Enrolment: For this plan, the minimum entry age for infants is 90 days. For a senior citizen, there is no age restriction.
- Tax Benefit: The plan offers tax benefit as per Section 80D of the Income Tax Act.
- Life Time Renewal Benefits: The plan offers lifetime renewability benefit if an insured renews his/her policy without fail.
- Direct Claim Settlement: The plan offers hassle-free and smooth claim settlement as the claims are directly processed by Star Health Insurance’s in-house customer support team.
- Cashless Facility: The plans offer cashless facility at the network-listed hospitals.
- Free Look Period: The plan ensures transparency and complete satisfaction by offering a 15-day free look period. During this time period, a plan can be cancelled by stating a valid reason.
Insurance coverage for Max Bupa Health Companion ceases to exist for the following expenses/treatment.
ManipalCigna Prohealth Plus
Prohealth Plus by ManipalCigna offers various health insurance policy benefits and complete value for money. It offers comprehensive insurance coverage at an affordable premium. The plan is formulated to fulfil various insurance needs of different health insurance buyers. The plan is loaded various benefits that make it stand out. The plan details are mentioned below.
Features and Benefits
Here are the features and benefits of Prohealth Plus.
- Enhanced Sum Insured: The plan comes with enhanced sum insured to fulfil individual insurance needs. Insurance buyers can opt for desired coverage from 4 sum insured options- Rs. 4.5 Lakh, Rs. 5.5 Lakh, Rs. 7.5 Lakhs and 10 Lakhs. For the first three sum insured options, medical screening for insurance buyers who are 46 years old or above is mandatory. If opted for 10 Lakh sum insured option, medical screening for insurance buyers who are 41 years old and above is mandatory.
- Covered Hospitalization Expenses: The plan covers hospitalization expenses for treatment expenses, diagnostics test charges, drugs and consumables expenses, medicine expenses, accommodation charges for a single private room, Intensive Care Unit expenses, surgeon’s fees, oxygen charges, blood charges, operation theater charges, nursing charges, anesthesia charges, surgical equipment charges etc. as per the opted plan.
- Renewal Benefit: The plan offers lifetime renewal option.
- Long-Term Policy Period: The policy, as per the proposer’s discretion, can be long-term. Insurance buyers can opt the plan for 1-year, 2-year or 3-year policy tenure, depending on his/her preference.
- Pre–Hospitalization and Post–Hospitalization Charges: The plan covers pre-hospitalization expenses such as doctor’s fees, pharmacy expenses, diagnostic tests charges etc. incurred up to 60 days. Additionally, the plan covers post-hospitalization charges for consultation fees, pharmacy expenses, and diagnostic tests charges etc. up to 180 days.
- Day-care Cover: The plan covers a few specific day-care treatments which require hospitalization for less than 24 hours such as dialysis, cataract surgery, radiation therapy, etc.
- Domiciliary Treatment: The plan covers treatment underwent at home due to shortage/unavailability of bed or if the doctor-in-charge prescribes home-care.
- Emergency Ambulance Cover: The plan covers ambulance charges up to Rs. 3,000 for transportation to the nearest hospital.
- Donor Expenses: The plan covers organ transplant and medical charges incurred due to organ harvesting for the transplant.
- Worldwide Emergency Coverage: The plan offers emergency medical coverage across the globe. In case an insured is travelling abroad, he/she can avail this benefit up to the sum insured and insurer will reimburse it later.
- Restoration Benefit: The plan offers restoration benefit in case the sum insured & cumulative bonus (CB) or cumulative bonus booster (if applicable) is inadequate due to previous claims. Under this benefit, 100 percent of the sum insured will be restored once per policy year and can be used for all unrelated illnesses or injuries.
- Health Maintenance Cover: The plan offers reimbursement of Rs. 2, 000 on an annual basis for out-patient charges such as pharmacy expenses, doctor’s consultation fees, diagnostic tests fees, alternative medicines (AYUSH) etc.
- Maternity Expenses: The plan covers maternity expenses up to Rs. 15,000 in case of normal delivery and Rs. 25,000 for a C-section.
- First Year Vaccinations: The plan covers first-year vaccinations expenses of the newborn baby (if applicable).
- Medical Check-Up: The plan offers a comprehensive routine medical check-up for the insured members who are aged 18 or above.
- Critical Illness Expert Opinion: The plan covers the fees of experts who are approached for second opinion for covered critical illness such as stroke, cancer etc. However, the expert should be a medical practitioner of a network-listed hospital.
- Deductible: The plan offers a flexible option to decide a deductible from the options- Rs .1 Lakh, Rs. 2 Lakh and Rs. 3 Lakh. The deductible will be applicable to the claims filed in that policy term.
- Voluntary Co-Payment: The plan comes with an option of voluntary co-payment wherein the insured decides whether he/she will pay the first 10 percent or 20 percent of the claim.
- Decreased Maternity Waiting Period: On the payment extra premium, the waiting period pertaining to maternity can be reduced. This also applies to optional benefits -newborn baby cover and first-year in such a case, the waiting period (applicable from the inception of the policy) shall be reduced from 4 years to 2 years.
- Waiver of Senior Citizen Mandatory Co-Payment: The plan comes with an alternative to eradicate mandatory co-payment applicable to an insured person aged 65 years and above by paying additional premium.
- Critical Illness Additional Covers: The plan comes with a critical illness add-on for policyholders between 18 - 65 years of age. This add-on offers a lump sum equivalent to the amount insured after the first diagnosis of a covered critical illness. For a family floater, this benefit provides 100 percent reinstatement of the insured sum.
- Free Look Period: The plan comes with a free look in duration of 15 days from policy commencement. During this period, a policyholder can cancel the plan by stating a legitimate reason. If no claims are filed, the paid premium will be refunded.
- Grace Period: The plan comes with a grace time period of a month. During this period, a policy can be renewed and the insurance coverage will be restored.
- Tax Benefit: The plan comes with tax benefits as per Section 80D of Income Tax Act, 1961.
- Easy Cancellation: The plan can be cancelled any time and premium will be refunded accordingly.
Here are the additional discounts that can be availed under Prohealth Plus plan.
- Family discount- The plan offers 10 percent discount on the premium paid for the enrolment of 2 or more family members in an individual plan.
- Long-term discount- The plan offers a discount of 7.5 percent if a 2-year policy term is selected and a discount of 10 percent is offered if a 3-year policy term is selected.
- No Claims Bonus- The plan offers enhanced sum insured ranging from 10- 100 percent after every claim-free year.
- Healthy Rewards- The plan offers reward point’s equivalent to 1 percent of the premium on an annual basis. Additionally, reward points equal to up to 10 percent of the premium can be accumulated by opting for Cigna’s online wellness programs. These points can be redeemed upon renewal. Each reward point is equal to 1 Rupee.
As per Prohealth Plus health insurance plan, mentioned below are the policy-duration-based exclusions.
- Maternity Coverage- Maternity coverage can be availed after 48 months of policy inception.
- First Year Vaccination- This cover shall be available after a waiting period of 48 months.
- Waiting Period or 30 Days - No claims can be filed during a waiting period of first 30 days from the commencement of the plan. This waiting period isn’t applicable in case of an accident and ported health insurance policies.
- Survival Period- During first 90 days from the commencement of policy, no critical illness-related claims can be filed.
- 2 Years Waiting Period- There is a 2-Year Waiting period from the commencement of policy, for pre-decided illnesses.
As per Prohealth Plus health insurance plan, mentioned below are the permanent exclusions.
- HIV/AIDS- Any incurred treatment expenses due to HIV/AIDS or related diseases/infections.
- Genetic Disorders- Any incurred treatment expenses due to genetic disorders.
- Mental Disorders- Any incurred treatment expenses due to mental disorders
- Drug Abuse or Suicide - Any incurred treatment expenses due to suicide or drug abuse,
- Child Birth/ Pregnancy- Any incurred treatment expenses due to childbirth or pregnancy-related
- Restoration Benefit- Any claim filed under maternity cover, newborn baby cover, worldwide emergency cover will lead to losing out on restoration benefit.
- Voluntary Co-Pay and Deductible- Voluntary co-pay and deductible can’t be selected in the same plan.
- Pre-Existing Illnesses- Pre-existing illnesses will be covered only after a waiting period of 36 months.
- Tax Benefit- If the premium is paid in cash, tax benefits under Section 80D would not be applicable.
HDFC ERGO Health Suraksha Gold Regain
Health Suraksha Gold is the latest plan launched by HDFC ERGO that offers comprehensive health insurance coverage. This plan is an affordable plan and offers benefits such as inpatient treatment expenses, pre & post-hospitalization charges with zero sub-limits, hospital room charges, and other medical expenses.
Additionally, the plan offers enhanced cumulative bonus for every claim-free year from a minimum of 10 percent up to 100 percent of the amount insured upon renewal.
Features and Benefits
Here are features and benefits offered by Health Suraksha Gold.
- Comprehensive Coverage: This plan offers optimized health insurance coverage at an affordable premium.
- Wide Network of Hospitals: This plan offers a wide network of 6000 plus network-listed hospitals that offer cashless claims service.
- No Entry Age Restriction: This plan comes without any restriction on entry age.
- Various Sum Insured Options: This plan offers various sum insured option: Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, Rs. 7.5 Lakh, and 10 Lakh.
- AYUSH Coverage: This plan covers Ayurveda, Unani, Siddha, & Homeopathy treatment without any sub-limit.
- Cumulative Bonus: After every claim free year, this plan offers enhanced cumulative bonus ranging from 10 percent up to 100 percent of the sum insured upon renewal.
- Coverage Basis: As per the need of an insurance buyer, this plan can be availed on the individual as well as family floater basis.
- Tax Benefits: This plan offers tax benefits as per Section 80D of the Income Tax Act
- Minimal Paperwork and Hassle-free Claims: For a seamless claim settlement process, this plan comes with minimal paperwork.
- Zero Sub-limits: This plan comes with no sub-limits on any illness, disease, hospital charges, doctor fees and room rent.
- In-patient Treatment Expenses: This plan covers hospital expenses for room rent, medicines, nursing and ICU.
- Pre-Hospitalization and Post-Hospitalization Charges: The plan offers reimbursement for pre-hospitalization charges for 60 days and post-hospitalization charges for 90 days for a covered illness or injury.
- AYUSH Treatments: This plan offers treatment coverage for Ayurveda, Unani, Siddha, & Homeopathy as per the sum insured.
- Maternity Benefit: This plan covers maternity expenses up to 15, 000 for normal delivery, Rs. 25,000 for Caesarean section and Rs.15, 000 for pregnancy termination.
- Domiciliary Treatment Expenses: This plan covers incurred medical expenses for domiciliary treatment.
- Organ Donation Expenses: This plan covers incurred medical expenses for organ harvesting for transplant.
- Regain Benefit: This plan offers Regain benefit that allows automatic availability of amount insured in case it is exhausted.
- Regain Benefits Terms and Conditions
- Basic amount insured will be re-instated once per policy year.
- If the Regain amount insured isn’t utilized in a policy year, it wouldn’t be carried forward.
- Regain benefit can’t be withdrawn upon subsequent policy renewals.
Regain/reinstated sum insured can be used specifically for future claims as it can’t be used against any claim for a covered disease or illness and its complications for which a claim has already been made in the current policy tenure.
Long-Term Discounts- Additionally, upon renewal, this plan offers 10 percent discount if the insured renews his/her health plan for 2 years.
Family Discount- A family discount of 10 percent is offered if 2 or more family members are individual policyholders of Health Suraksha.
As per Health Suraksha Gold Regain plan, mentioned below are the policy-duration-based exclusions.
Waiting Period- Any health treatment during the first 30 days of buying the policy, excluding the treatment for any accidental injury.
- Specific Diseases- Surgical procedures for specific diseases such as tonsils, sinuses, internal tumour, and cysts will be covered only after a 2-year waiting period.
- Pre-Existing Illnesses- Treatment for Pre-existing illnesses during first 48 months of the policy. As per Health Suraksha Gold Regain plan, mentioned below are the permanent exclusions.
- HIV/AIDS Treatment- Any incurred expenses for the treatment of HIV/AIDS or related illnesses/infections.
- Specific Diseases- Any expenses incurred on the treatment of mental disorders, insanity, weight control surgery/ treatment, and cosmetic surgery.
- Drugs Abuse- Any incurred expenses for treatment due to abuse of hallucinogens or intoxicants, such as drugs & alcohol.
- War- Any incurred expenses for any treatment due to war (nuclear and chemical), biological weapon, radiation, terrorist activities or radioactivity.
Royal Sundaram Lifeline Supreme
Lifeline Supreme, by Royal Sundaram, offers comprehensive health insurance coverage, which includes annual health check-up, health and wellness benefits, a second opinion in case of critical illness etc.
Anyone aged 18 years and above can get this plan. This plan is offered on an individual basis as well as a family floater plan for self, spouse and dependent children.
This plan offers adequate health insurance coverage along with add-on health benefits for the treatment of severe illnesses and conditions as well as critical illnesses (if opted). Lifeline Supreme comes with various insured sum options of Rs. 5 Lakh, 10 Lakh, 15 Lakh, 20 Lakh and 50 Lakh.
Benefits and Features
Here are the benefits and features of Royal Sundaram Lifeline Supreme plan.
- In-patient Hospitalization Charges: The plan covers in-patient hospitalization charges up to the amount insured.
- Pre-Hospitalization & Post-Hospitalization Charges: The plan provides reimbursement of pre-hospitalization charges for 60 days and post-hospitalization charges for 90 days for incurred medical treatment expenses for a covered illness or injury.
- Day-Care Procedures: The plan covers all the day-care procedures up to the amount insured.
- Ambulance Expenses: This plan covers ambulance expenses to the nearest hospital up to Rs. 5,000.
- Organ Transplant Cover: The plan covers organ donor expenses for harvesting organ up to the sum insured.
- Domiciliary Treatment: The plan covers incurred domiciliary hospitalization charges up to the insured sum.
- No Claim Bonus: Upon renewal, the plan offers a No Claim Bonus ranging from 20 percent up to 100 percent of the sum assured. Even if a claim is lodged, the NCB is retained.
- Sum Insured Re-Load: The plan re-loads the amount insured up to 100 percent if the sum insured is completely exhausted.
- AYUSH Treatments: This plan offers in-patient coverage for alternative treatment for Ayurveda, Unani, Siddha, & Homeopathy up to Rs. 30,000.
- Animal Bite Vaccination: This plan covers incurred expenses up to Rs. 5,000 for vaccinations/immunizations for an animal bite.
- Yearly Health Check-up Benefit: The plan offers yearly health check-ups for covered family members over 18 years of age regardless of whether a claim is filed or not.
- Second Opinion Benefit: The plan covers expenses incurred in getting a second opinion on the diagnosis & treatment of 11 specified critical illnesses.
- Emergency Domestic Evacuation Expenses: The plan covers emergency evacuation across India up to Rs. 1 Lakh.
As per Lifeline Supreme health insurance plan, mentioned below are some policy duration-based exclusions.
Pre-existing Illnesses- Pre-existing illnesses and medical conditions mentioned in the policy document will not be covered up to 36 months of continuous insurance coverage. In case the policy lapses, no claim will be settled.
- Waiting Period- Any illnesses or diseases contracted by the insured within the first 30 days after buying the plan will not be covered.
- Critical Illnesses- Critical illnesses contracted by the insured within the first 90 days of buying the plan.
- Particular Diseases- Diseases such as benign prostatic hypertrophy, cataract, hip or knee replacement, chronic renal failure or end-stage renal failure etc., won’t be covered for the first two years after buying the plan.
As per Lifeline Supreme health insurance plan, insurance coverage ceases to exist for the following expenses/treatment.
- Treatment expenses due to participation in adventure or hazardous Sports activities.
- Treatment expenses related to puberty and aging.
- Alternative treatment expenses excluding AYUSH.
- Expenses related to artificial life maintenance.
- Incurred expenses for medical papers or documents.
- Treatment expenses related to circumcision.
- Incurred expenses due to conflicts & disasters.
- Treatment expenses due to congenital conditions.
- Expenses related to convalescence and rehabilitation.
- Treatment expenses related to cosmetic surgery.
- Expenses related to dental and oral treatment.
- Expenses related to drugs
- Dressing for OPD treatment.
- Expenses related to eyesight treatment.
- Expenses related to health spas.
- Expenses related to nature cure treatment.
- Treatment expenses related to wellness clinics.
- Treatment expenses related to HIV & AIDS.
- Treatment expenses related to hereditary conditions.
- Expenses related to hospitalization for investigative or observational purpose.
- Expenses related to Items of personal convenience and comfort.
- Treatment expenses related to psychosomatic and psychiatric conditions.
- Treatment expenses related to obesity.
- Expenses related to OPD Treatment.
- Treatment expenses related to preventive care & reproductive medicine.
- Treatment expenses related to self-inflicted Injuries.
- Treatment expenses related to sexual problems, dysfunctions, and gender-related problems.
- Treatment expenses related to sexually transmitted diseases and infections such as HIV AIDS.
- Treatment expenses related to sleep disorders and speech disorders.
- Stem cell implantation
- Expenses related to the treatment of alopecia
- Expenses related to the treatment of developmental problems.
- Expenses related to the treatment received outside the geographical boundaries of India.
- Treatment expenses related to experimental or unproven treatment.
- Expenses related to the treatment by an unrecognized physician at an unrecognized hospital.
- Expenses related to unrelated diagnosis.
- Treatment expenses for any injury due to participation in any unlawful activity.
Aditya Birla Active Assure Diamond
Active Assure Diamond by Aditya Birla offers comprehensive health insurance coverage. The plan has an affordable premium that offers various benefits and wide insurance coverage. The plan is formulated to offer comprehensive health insurance coverage.
Features and Benefits
Here are features and benefits of Aditya Birla Active Assure Diamond plan.
- Sum Insured Reload Benefit: The plan offers sum insured reload in case the sum insured and No Claim Bonus / Super No Claim Bonus (if applicable) is exhausted/ insufficient due to claims filed earlier. As per this cover, an insured gets up to 150 percent additional sum insured (50 Lakhs at highest) for hospitalization due to an unrelated illness.
- Daily Cash Benefit: For each day the insured is hospitalized, he/she is entitled to an extra benefit of 500 Rupees as daily-cash benefit. This benefit is applicable for sum insured up to Rs. 4 Lakh and will be payable for up to 5 days only.
- Vaccination Benefit: The plan covers Vaccination charges for insured individuals up to 18 years old as per the opted coverage. This cover is specifically available for sum insured of Rs. 1 Crore or more.
- Medical Check-up program: Annually, the plan offers free routine health check-up for every claim-free year. It is customized as per the insured’s age and opted sum insured.
- Donor Organ Transplant Expenses: The plan covers donor expenses up as per opted sum insured for harvesting organ for transplantation.
- Domiciliary Hospitalization: The plan covers incurred expenses for domiciliary hospitalization underwent at home due to the health condition of the insured or due to a lack of available bed in the hospital for covered treatment/diseases.
- Day Care Procedures: The plan covers 586 day-care procedures such as dialysis.
- Hospitalization Expenses: The plan covers room rent, boarding expenses, medical consultants’ fees, specialist fees, oxygen charges, nursing expenses, surgeon fees, anaesthetist fees, medical practitioner fees, operation theatre charges, diagnostics fees, medical imaging modalities expenses, medicines & drugs fees, blood charges, pacemaker charges.
- Emergency Ambulance Expenses: The plan covers emergency ambulance expenses for transportation to the nearest hospital.
- Pre-Hospitalization and Post-Hospitalization Coverage: The plan offers pre-hospitalization cover for 60 days which may include the doctor’s fee, diagnostic tests, physiotherapy, medicines, drugs & other consumables and post-hospitalization expenses up to 180 days. Post-hospitalization coverage is extended to domiciliary hospitalization/ In-patient hospitalization/ day-care treatment.
- AYUSH Treatment (In-patient): The plan covers Ayurveda, Unani, Siddha, & Homeopathy treatment up to the pre-decided limits.
- Second Opinion for Critical illness: The plan covers a second opinion from a doctor of a network-listed hospital for a major critical illness such as cancer, heart attack, kidney failure.
- Domestic and International Emergency Medical Evacuation: The plan covers expenses incurred while transporting the insured from one hospital to the other as per the opted sum assured.
- Health Coach Benefit: The plan provides covers personalized coaching by a health professional who will guide the insured person in case he/she is suffering from hypertension, hyperlipidemia, asthma, diabetes mellitus etc.
- Decrease in Pre-Existing Diseases waiting period: This optional cover reduces the waiting period of pre-existing diseases from 4 years to 2 years for claims related to pre-existing illnesses.
- Unlimited sum Insured Reload: This option cover reinstates the sum insured unlimited number of times in case the base sum insured is exhausted due to earlier claims.
- Super NCB: This cover increases the sum insured by 50 percent upon renewal for every claim-free year. Super NCB acts as an add-on to your No Claim Bonus.
- Accidental Hospitalization Booster: Optionally, in case of hospitalization due to a road mishap, this cover provides additional amount insured equal to the amount insured for in-patient hospitalization.
- Cancer Hospitalization Booster: In case of a hospitalization of insured more than 18 years of age due to cancer, this optional cover provides additional amount, equal to the sum insured, for in-patient hospitalization.
- Any room upgrade: This optional cover offers the much-needed liberty for deciding the preferred accommodation. This cover can be availed by the insured having a sum insured of Rs. 5 Lakh or more.
- No Claim Bonus: The plan offers a bonus ranging from 10 percent to 50 percent sum assured after a claim-free year at the time of renewal.
Star Senior Citizen Red Carpet Health Insurance Policy
Senior citizens are prone to frequent hospitalizations due to age-related illnesses. When buying senior citizen health insurance, adequate insurance coverage is a must-have. Red Carpet health insurance plan is formulated while keeping the insurance needs of senior citizens in mind. The plan offers comprehensive insurance coverage that fulfills the insurance needs of the elderly extensively.
Benefits and Features
Here are the benefits and feature of Red Carpet health insurance plan.
- Coverage: The plan caters to the senior citizens aged between 60 – 75 years.
- No Medical Screening: The plan comes without any preliminary medical screening.
- Pre-existing Illness Cover: The plan covers pre-existing illnesses after one year of waiting period.
- Medical Consultation Cover: The plan covers medical consultations under outpatient cover in an insurer-authorized hospital.
- Enhanced Sum Insured: The plan comes with high sum insured up to Rs. 10 Lakh.
- Lifelong Renewals: This plan comes with guaranteed lifelong renewal.
- Discounts: When Red Carpet health insurance plan is purchased online, 5 percent discount can be availed on the premium.
- Hospitalization Coverage: The plan covers an insured’s inpatient hospitalization expenses for a hospitalization of minimum of 24 hours. Under this cover, expenses such as nursing & boarding charges, room rent, surgeon fees, anaesthetist fees, medical practitioner fees, consultants’ fees, specialist fees, medicines & drugs expenses are covered up to the opted sum insured.
- Emergency Ambulance Cover: The plan covers pre-decided emergency ambulance expenses for transportation to the nearest hospital.
- Post-Hospitalization Expenses: The plan covers post-hospitalization expenses (lump-sum) up to the pre-decided
- Day Care Procedures: The plan covers specific day-care procedures.
- Sub-limits: The plan comes with sub-limits only for specific illnesses.
- Hassle-free Claim Settlement: The plan offers smooth claim experience as there is no involvement of any third-party administrator. Star health insurance’s in-house claim team settles claims directly.
- Cashless Hospitalization: The plan offers cashless hospitalization at network authorized hospitals.
- Wide Network: The plan offers a wide network of 8400 plus hospitals all over India.
Here are the premium details of Red Carpet Health Insurance Plan:
Premium Excluding Tax
Premium Including Tax @ 18%
Rs. 1 Lakh
Rs. 2 Lakh
Rs. 3 Lakh
Rs. 4 Lakh
Rs. 5 Lakh
Rs. 7.5 Lakh
Rs. 10 Lakh
Universal Sompo Health Insurance
This health insurance plan offers comprehensive individual as well as family floater insurance. In order to fulfil various health insurance needs of different insurance buyers, this plan offers a range of sum insured options. For individual health plans, it offers sum assured ranging from Rs. 1 Lakh to 10 Lakh. In a family floater plan, it offers sum assured of Rs. 1 Lakh to 10 Lakh.
Mentioned below are 3 options for Universal Sompo Privilege plan.
- Basic Plan- It offers sum insured from Rs. 1 Lakh to Rs. 2 Lakh.
- Essential Plan- It offers sum insured from Rs. 3 Lakh to Rs. 5 Lakh.
- Privilege Plan- It offers sum insured from Rs. 6 Lakh to Rs. 10 Lakh.
Features and Benefits
Here are the features and benefits of Universal Sompo Privilege plan.
- Speedy Policy Issuance: This plan can be purchased online with minimal paperwork/documentation.
- No Medical Screening: This plan comes without any medical screening for healthy individuals up to 55 years of age.
- Entry Age: The plan offers insurance coverage for 3-month-old babies to 55 years old adults.
- Cashless facility: The plan offers cashless treatment facility at more than 4000 network-listed hospitals across the country.
- Fast and Hassle-free Claims Process: This plan offers prompt and hassle-free claims process for cashless claims as well as reimbursement claims.
- Inpatient Treatment: This plan covers medical expenses for nursing, room rent charges, boarding expenses, Intensive Care Unit charges, medical practitioner’s fees, anaesthesia charges, blood charges, oxygen charges, surgical appliances charges, operation theatre charges, diagnostic procedures charges, medicines, drugs and consumables expenses and prosthetic expenses.
- Daycare Procedures: This plan covers medical expenses for 141 day-care procedures (where an insured undergoes a procedure/surgery for less than 24 hours) in a hospital or a day-care.
- Pre-hospitalization and Post-Hospitalization Expenses: This plan covers expenses incurred up to 60 days before the date of hospitalization and post-hospitalization expenses up to 90 days.
- Domiciliary Treatment: This plan covers incurred medical expenses for covered domiciliary treatment underwent at home.
- Organ Donor Expenses: This plan covers incurred medical expenses for harvesting an organ required for transplant.
- Ambulance Expenses: This plan covers incurred medical expenses on the ambulance used for transferring the insured to the nearest hospital.
- Dental Treatment (In case of Accident): This plan covers incurred medical expenses on dental treatment for damages/injuries caused due to an accident.
- AYUSH Benefit: This plan covers incurred medical expenses for in-patient treatment underwent as per Ayurveda, Unani, Siddha or Homeopathy treatment.
- Daily Cash Benefit: This plan offers a daily cash benefit, as per the sum assured, to an adult for accompanying an insured child who is 12 years old or below.
- Vaccination Benefit: This plan covers medical charges for vaccination/immunization as per the sum assured in case of an animal bite.
- Out-Patient Treatment: This plan covers up to 50 percent of the incurred medical charges in case outpatient consultation, diagnostic tests, out-patient dental treatment, spectacles, contact lenses, and hearing aids etc. are required
- Convalescence Benefit: Annually, this plan offers lump sum amount as per the sum assured in case the insured is hospitalized for a minimum duration of 10 consecutive days.
- Mother and Child Care Benefit: Under mother & childcare benefit, the plan offers the following benefits but for 2 deliveries only.
- Pregnancy Cover: It offers medical coverage related to the delivery of a child including caesarean-section and complicated deliveries.
- Pre & post-Natal Expenses: It offers medical coverage related to pre-natal & post-natal expenses as per the opted sum assured.
- Newborn Care: It offers medical coverage for the newborn baby from the first day till the expiry of the plan or until the baby is 91 days old, whichever happens earlier.
- Restore Benefit: In case the basic sum insured or no claim bonus (if applicable) is exhausted due to claims filed during one policy tenure, restoration of the sum insured equal to 100 percent of the amount insured will be available.
- HIV/ AIDS Cover: In case an insured is diagnosed with HIV/ AIDS and requires inpatient hospitalization, the plan will offer the following benefits:
- Medical charges incurred due to Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome or related diseases/ infections will be covered up to 20 percent of sum insured for diagnostic procedures charges, room rent charges, medical practitioner’s fees nursing fees, medicines, drugs & consumables and boarding expenses.
- Renewal Benefit: This plan offers the renewal benefit in the form of a cumulative bonus. In case no claim has been filed, the sum assured is increased by 10 percent at the time of renewal.
- Dial-a-Doctor: This plan covers expenses incurred in availing medical advice from a doctor over the telephone or online.
- Health Educational Library for People (HELP): This plan provides access to Universal Sompo’s Library for People and online medical experts for availing various features such as live chat, ask-an-expert, & online health videos and guides.
- Second Opinion: Once a year, this plan offers a facility of the second opinion if a doctor recommends the insured to undergo a surgery in order to treat an illness/disease.
- Specialist Consultation: This plan offers a facility of specialist e-consultation with 2 follow-up sessions in case the insured wants to seek expert opinion on any chronic illness.
- Wellness Package: This plan offers vouchers for availing certain health services/ products.
Here are the exclusions of Universal Sompo Privilege plan.
Waiting Period- With an exception to injuries caused due to an accident, no medical treatment will be covered for 365 days after the commencement of the
Specific Waiting Period- Diseases and treatments listed below will be covered after one year of waiting period.
- Non-infective Arthritis
- Calculus diseases related to a urogenital system and gallbladder
- Fissure/fistula in the anus
- Pilonidal Sinus
- Gout and rheumatism
- Gastric & duodenal ulcers
- Internal tumours
- Breast lumps
- Age-related osteoarthritis and osteoporosis
- Sinusitis and related diseases
- Polycystic ovarian diseases
- Skin tumours unless malignant.
- Benign ENT (ear, nose, and throat) disorders & surgeries including adenoidectomy, tonsillectomy mastoidectomy, & tympanoplasty
- Hysterectomy for fibromyoma or menorrhagia or prolapsed of uterus, unless it is necessitated by any malignancy
- Dilation and curettage (D&C)
- Myomectomy for fibroids
- Joint replacement
- Gallbladder & bile duct surgery unless it is necessary due to any malignancy
- Surgery for genitor-urinary system unless it is necessary due to any malignancy
- Benign prostatic hypertrophy surgery
- Surgery of hydrocele
- Surgery for hernia
- Prolapsed intervertebral disk surgery
- Surgery for varicose ulcers and varicose veins
- Tonsils and sinuses surgery
- Nasal septum deviation surgery
Maternity & Childcare Benefit - There is a waiting period of 3 years for availing maternity & childcare benefit.
Out-patient Treatment - There is a waiting period of 3 years for availing out-patient treatment benefit.
Domiciliary Treatment - Following illnesses are not covered in domiciliary treatment.
- Arthritis, rheumatism, and gout
- Asthma, tonsillitis, bronchitis, upper respiratory tract infection, pharyngitis, laryngitis, influenza cough & cold.
- Nephritic syndrome and chronic nephritis
- Insipidus and diabetes mellitus
- All kinds of dysenteries
- Psychosomatic or psychiatric disorders
How to Choose Best Health Insurance Plan?
Choosing the right health insurance plan is imperative to fulfil your insurance needs. As the health insurance market is flooded with a plenty of insurance plans, it is confusing for one to settle with the Best Health Insurance Plans in India. However, thanks to experts, we’ve got insurance calculator, using which, one can compare the plans online. Online comparison can help you find a better plan in case you are not happy with your existing one. It compares the plans on parameters such as coverage, features, benefits, incurred claim ratio, premium etc. This way, you can compare different plans and opt for the one that best suits your requirements.
Benefits of a Best Health Insurance Plan in India
If you think that health insurance covers expenses only in the case of hospitalisation, then you’re wrong. Apart from providing financial assistance during hospitalisation, the best medical insurance plans in India come with other benefits as well. Let’s have a look:
With a good health insurance plan, you can avail cashless treatment at a network hospital. It is a boon as you don’t need to pay out of your pocket. The insured just needs to complete the paperwork with the hospital authority and avail the facility while the insurance company will take care of the bill.
Some insurers offer a daily amount for each day of hospitalisation. This doesn’t affect the actual sum assured. This amount can be availed up to a certain daily limit and can be spent on medicines or other health-related requirements.
Save on Tax:
Section 80D of Income Tax Act says that the insured can claim for tax deduction against the premium paid for health insurance. An individual can claim a deduction of up to Rs. 25,000 on health insurance premium. If one is paying the insurance premium for his/her elderly parents, then a deduction up to Rs. 30,000 is permissible.
Covers Life-threatening Illnesses:
Lifestyle diseases are deadly and expensive at the same time. A person with an average income may not be able to afford the treatment required for these diseases. If one owns a health insurance plan with critical illness cover, then a lump sum amount will be paid towards the expenses incurred in the treatment after the diagnosis. As this comes as a rider cover, one can cover critical illnesses under his/her health plan on the payment of an extra premium.
Avail Allied Benefits:
Some health insurers in India have come up with preventive check-ups and enhanced diagnostics, which usually are not included in a basic health insurance plan. Obviously, this is a smart move and includes:
- Free medical check-ups
- Free health consultation with doctors
- Consultation with nutritionists
- Tie-up with health service providers
- Lucrative offers on healthcare services.
- By selecting the right plan, you can avail these facilities along with the basic cover.
Which Type of Health Insurance Policy in India will be the Best-fit for you?
The Indian insurance marketplace is quite competitive and people nationwide have multiple options to choose from, when it comes to buying the best health insurance policy in India. At PolicyBazaar, we have made it much easier for you to choose the best health insurance policy, based on a thorough comparison in terms of various insurance aspects, such as premium, entry age, policy tenure, sum assured etc. The following is a quick guide to selecting the best health insurance policy, based on your need.
Health Insurance Policy Type
Your Purpose of Buying Health Insurance
Individual Health Insurance
You must have a health insurance policy for yourself, as you never know when you may fall sick. Medical bills and hospitalization expense could drill a hole in your savings. Gift yourself the best health insurance policy that covers your current and potential healthcare needs.
Family Floater Health Insurance
You must have a family floater health insurance policy if you are married and have a spouse and dependent kid(s) to take care of. This health insurance policy covers your whole family under a single umbrella of coverage. Also, the premium payable for such policies is often affordable.
Senior Citizen Health Insurance
If your age is above 60 years, then a senior citizen health insurance policy is highly recommended since you’re more prone to diseases followed by hospitalization inviting unnecessary medical expense.
Critical Illness Insurance
If you are diagnosed with a critical illness specified in the policy documents, the insurer will pay a lump sum to you, irrespective of whether or not you’ve availed the treatment. Some critical illnesses covered by such policies are a heart attack, cancer of a specific type, etc.
Personal Accident Insurance
If you suffered accidental injuries that led to total or partial permanent disability, the insurer would pay a lump sum to you. Personal accident insurance is available as a rider, which can be included with your existing health insurance policy. Otherwise, you can always check with your insurer about a standalone critical personal accident insurance policy.
Maternity Cover Plan
You regular health insurance policy might not provide coverage for childbirth or pregnancy-related complications. If you are planning to have a baby, then looking for maternity cover is a must for you.
Hospital Cash Plans
Regular health insurance policies do not cover for non-medical expenses incurred during hospitalization. While purchasing a health insurance policy, make sure to opt for hospital cash benefit to avail of coverage for all such expenses, subject to a limit.
Group Health Insurance
Employers, generally, provide their employees with group health insurance coverage as the loyalty bonus or incentive, which does not require pre-policy medical check-up. Employees at all levels are provided with group health insurance. They can avail of cashless treatment at the network hospitals or get a reimbursement for the out-of-pocket medical expenses subject to the policy terms and conditions.
Things to Keep in Mind When Buying Best Health Insurance Policy in India
Health insurance is the safest way to plan for unexpected medical expenses. It comes with a bunch of benefits, provided that one chooses the right plan. To find the best health insurance plans, an individual should consider certain things before settling on any one plan.
Analyse Your Health Needs:
It is the most important thing to consider while buying a health cover. By doing a roundup on how many members have to be covered, the number of adults and kids in the family, if there is any hereditary health issue etc., one will have a rough idea of the required sum assured.
Sum Assured is the amount of monetary cover offered under a policy. At the time of health claim settlement, the insurance company reimburses the incurred expenses up to this sum assured. Hence, it is very important to decide this amount carefully. A larger amount can cover more expenses. If you live in a metro city where the cost of quality medical services is high, you must opt for a higher sum assured. For instance, a heart surgery in a reputed hospital in Delhi will cost you around 5 to 6 Lakh; for a middle-class family, this is a huge amount. It would be a great relief if a mediclaim policy pays this amount. Hence, consider your location while buying a health insurance plan.
Type of Illnesses which are covered:
Best health insurance plans cover critical illnesses as well those which need special attention and are expensive to treat. As most health insurers don’t offer coverage for these illnesses with their basic plans, you can opt for a critical illness rider. Moreover, look for a plan that offers coverage to common medical conditions like diabetes, hypertension etc.
Every health insurer has tie-ups with hospitals, which are called network hospitals. Your insurer should be no exception. Make sure that the network list includes at least a few hospitals that are in your vicinity. It will help you easily access them in an emergency. Hence, always look for plans with a broader network of hospitals.
Incurred Claim Ratio:
Incurred Claim Ratio of the insurer is the most important thing to consider at the time of buying a plan. A higher claim ratio means fewer chances of your claim getting rejected. Likewise, poor claim record will increase the chances of your claim getting rejected by the insurance company. While buying a plan, compare all the available plans based on the incurred claim ratio.
Go for Maximum Sum-limits:
Health insurance companies offer plans with sub-limits which are applicable to room rent or medical expenses. Be careful while choosing a plan with sub-limits. Consider buying the one that offers maximum sum-limits on special expenses.
Choose the Plan with Minimum Waiting Period:
To cover pre-existing illness, the insured has to serve a pre-defined waiting period. This means any claim due to a pre-existing disease will not be entertained by the insurer within this period. In most cases, the waiting period ranges from 2 to 3 years. However, read the policy terms & conditions carefully and go for the plan that comes with a minimum waiting period.
When it comes to insurance, the decision to settling upon one policy is not a child’s play since there are multiple insurers in the market, offering a range of health insurance policies. Buying the best health insurance policy requires you to put in great efforts. At PolicyBazaar, we strive hard to help you take a well-informed decision. So, we came up with 10 best health insurance policies in India. We hope you will be able to take your best pick. Do let us know your experience!
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