Finding the best health insurance plan from so many different health insurance companies can get confusing for many people. While selecting the best health insurance policy, you must look into the various factors including health insurance riders, benefits, coverage, network hospitals etc.
Needless to say, it is imperative to buy the best 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 plans, you might get confused about which plan to buy out of many.
We at Policybazaar can help you select a top health insurance plan to meet your requirements. You can compare & select the best health plan for yourself and your family that will cover medical expenses including pre & post hospitalization expenses, day-care expenses, coronavirus treatment, critical illness hospitalization, etc. depending on your preferences.
How to Select Best Health Insurance Policy
You cannot have one health insurance policy that meets all of your requirements. There are a number of health insurance policies that are available and each policy offers some unique coverage benefits. You need to ascertain the benefits and know what all is covered and what is excluded, and then select the best health insurance policy. You can do some online research or you can speak to our customer care team, and opt for the one that suits your requirements.
Mentioned below are a few tips that you can consider while selecting a best health insurance plan:
Choose Adequate Sum Insured Amount
Always go for the plan that offers maximum health coverage and maximum coverage amount to help you meet any medical emergency. With medical inflation, health care expenses are going up drastically and therefore, you’ll need a sufficient amount to deal with the inflation.
Today, a basic heart surgery can cost around Rs 4-5 Lakh and for a middle-class family this amount is quite huge. Therefore, make sure that you choose an adequate coverage amount to ensure financial security to meet future financial emergencies.
Choose the Right Coverage Type
Individual health plans are designed keeping the needs of an individual in mind. However, if you have more members in your family, we will advise to buy a family floater plan, which covers your entire family. This way you aren’t required to buy a separate policy for each member and can keep their health secured.
The premium is also lesser as compared to individual plans and the sum assured is higher. Most importantly, anyone can utilise the amount during a medical treatment. Also, you can cover your senior citizen parents as well by paying a slightly higher premium.
Check the Flexibility to Increase the Total Amount You Are Insured For
The cost of living fluctuates every year and so does the cost of medical treatment. Most of the insurance companies have the provision to increase the sum insured over the time. At times, when you renew your policy timely and have No-Claim-Bonus benefit on your current plan, then your insurer might reward you by increasing the total amount of sum insured.
Check the Pre-existing Disease Waiting Period
Every health insurance plan has its own set of terms and conditions regarding pre-existing diseases. It means if you have any disease prior to taking a plan, the claim made for taking treatment against that illness will be accepted after the insured serves a defined waiting period.
In most cases the waiting period ranges anywhere from 2-4 years, however, some best plans have a lesser waiting period like mediclaim policy. While purchasing a health policy, you should opt for the one with a lesser waiting period.
Check the Maximum Renewal Age
Policy renewal is one of the most important aspects when selecting a health insurance policy for your family. Most of the health insurance companies allow policy renewal until the age of 65 years only. But there are certain policies, which offer lifelong health insurance renewal lifelong renewal facility. You should pick the most appropriate one for yourself based on your family health history and other health parameters.
Insurer with High Claim-settlement Ratio
Claim settlement ratio is the number of claims settled by the insurer over the total claims it receives. Always opt for a health plan from an insurer that has a high claim settlement ratio. This way you will ensure that your claim will not be rejected until the insurer has a valid excuse. However, you should be careful at the time filing a claim. Make sure you’ve attached all the relevant documents and proofs supporting your claim.
Smooth Claim Settlement Process
Mostly the claim-settlement process is similar for all insurance companies (as instructed by the Insurance Regulatory and Development Authority); there might be minor changes due to some difference in the company's functionality. It is advisable that you understand both cashless and reimbursement claim settlement process of your health insurance provider before purchasing the policy.
With health insurance, you are entitled to avail treatments from network hospitals which are a group of hospitals associated with a particular insurer. Almost every health insurance company provides cashless hospitalization, saving you from the trouble of running from pillar to post for document collection and filling it. This facility is applicable in their network hospitals only.
Cashless hospitalization simplifies the claim settlement process and makes it a hassle-free task for the policyholder. Then again, it is advisable to cross-check the list of the hospitals that are included in the list, before making the claim.
Don’t Forget to Compare Premium
It is essential to compare the plans as well as the premium. There are many online aggregators that, help you compare the insurance policies in terms of benefits, features, premiums, maximum returns, etc.; picking a plan without weighing all the options available in the market is like inviting regret. By comparing the plans you can avail all the benefits at a comparatively cheaper premium rate.
Check the Reviews
Customer reviews of different health insurance companies are essential when it comes to purchasing medical insurance online. Reviews are always a mixture of negative and positive opinions which highlight the relevant pros and cons. This will help you take a firm and informed decision.
Read the Exclusions
Most of the policyholders ignore the limitations of exclusion in a health insurance policy and end up experiencing something unexpected. If a plan covers something, it is equally entitled to not cover some illnesses, like some plans that exclude Hernia, Cataract, Sinusitis, Gastric, Joint Replacement etc. in the initial period. While some others exclude expenses incurred on dental treatment, HIV/AIDS, eye-related healthcare, STD, cosmetic surgery etc. You should choose a health plan with fewer exclusions.
Add-on Rider/Critical Illness Rider/Accidental Rider
With a critical illness rider, you ensure that your financial planning would not get disturbed if any unplanned medical expense arises. Critical illness cover is a rider benefit that you can avail by paying an extra premium. In return, you can avail health coverage against life-threatening diseases such as cancer, kidney failure, tumour, etc.
Benefits of Best Health Insurance Plan in India
If you think that health insurance covers medical expenses only in the case of hospitalisation, then you’re wrong. Apart from providing financial assistance during hospitalisation, the best health insurance policy in India comes with other more benefits as well. Let's have a look:
- Cashless Treatment: 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 best. The insured just needs to complete the paperwork with the hospital authority and avail the facility while the health insurance company will take care of the bill.
- Daily Allowance: Some health insurance companies 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.
- Tax Benefits: 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 medical 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 the following benefits:
- Free medical check-ups
- Free health consultation with doctors
- Consultation with nutritionists
- Tie-up with health service providers
- Lucrative offers on healthcare services.
Brief Description of Best Health Insurance plans
Aditya Birla Activ Assure Diamond plan is one of the best health insurance plan offered by Aditya Birla Health Insurance Company. This plan is designed for individuals and families seeking comprehensive coverage benefits with higher sum insured options. It covers medical hospitalization expenses as well as second opinion on critical illness and domestic/ international emergency healthcare assistance services. The best part is that this health insurance policy also offers optional cover for cancer hospitalization booster, any room upgrade and reduction of pre-existing diseases waiting period.
Features and Benefits
- Sum Insured Reload Benefit : This health insurance policy offers a 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 per cent additional sum insured (50 lakh 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 Rs. 500 as a 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 : This policy 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 : This plan offers free routine health check : up to all insured once per policy year. It is customized as per the insured’s age and opted sum insured.
- Donor Organ Transplant Expenses : This plan covers donor expenses up as per the 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 : It covers 586 day care procedures such as dialysis where 24 : hour hospitalization is not required.
- 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 30 days which may include the doctor’s fee, diagnostic tests, physiotherapy, medicines, drugs & other consumables and post-hospitalization expenses up to 60 days. Post-hospitalization coverage is extended to domiciliary hospitalization/ In-patient hospitalization/ day-care treatment.
- AYUSH Treatment (In-patient): This policy 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. It also covers the cost of air ambulance services if applicable.
- 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 2 years to 1 year for claims related to pre : existing illnesses.
- No Claim Bonus : The plan offers a bonus ranging from 10 per cent to 50 per cent sum assured after a claim : free year at the time of renewal
- Unlimited Sum Insured Reload : This option cover reinstates the sum insured amount 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 per cent upon renewal for every claim : free year. Super NCB acts as an add : on to your No Claim Bonus.
- Accidental Hospitalization Booster : In case of hospitalization due to a road mishap, this add : on cover provides additional amount insured equal to the amount insured for in : patient hospitalization.
- Cancer Hospitalization Booster : In case of hospitalization of insured more than 18 years of age due to cancer, this optional cover provides an 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.
- First 30 day waiting period for all treatment and illness
- A 2-year waiting period for specific illnesses/ treatments including cataract, glaucoma, sinusitis, all cysts/ fibroids related reproductive surgeries, joint replacement surgery, gall bladder stone, urinary stones, hernia, skin tumors, varicose veins and internal congenital anomaly
- A 4-year waiting period for genetic disorders
- Injuries due to war or act of war, breach of the law, nuclear activity or explosion
- Intentional exposure to danger such as for adventure sports, military operations, self- injury, etc.
- Use or abuse of hallucinogenic or intoxicating substances
- Treatment to control weight, correct eyesight, cosmetic surgeries and baldness
- Non : allopathic treatment expenses
- Routine health check-ups, organ donor screening expenses
- Unjustified hospitalization, investigational/ experimental/ unproven treatment, irrelevant diagnostic procedures
- Parkinson disease, HIV AIDS, venereal diseases
- Cost of medical equipment like contact lenses, spectacles, hearing aids,
- Dental treatment including cost of dentures, implants, etc.
- Convalescence and rehabilitation, behavioural disorders
- Stem cell therapy, pregnancy and childbirth : related procedures, sterility or infertility
- Bariatric surgeries, robotic surgeries
- Medical treatment taken outside India
Bajaj Allianz Health Guard plan is a comprehensive health insurance policy that protects the insured person against any major healthcare medical expenses that may create a financial burden. It is a comprehensive plan that is available for individuals as well as for families. The best part is that this medical insurance plan provides medical coverage during pregnancy as well as to the new born baby.
Features & Benefits :
- In-patient hospitalization : This plan covers in-patient hospitalization expenses incurred by the insured including room rent, ICU charges, surgery cost and nursing expenses.
- Pre-hospitalization coverage : It covers any pre-hospitalization expenses incurred up to 60 days before getting admitted in the hospital.
- Post-hospitalization expenses : This plan by Bajaj Allianz covers medical expenses incurred up to 90 days after getting discharged from the hospital.
- Road ambulance : This plan covers the expenses incurred on road ambulance up to a maximum amount of Rs. 20,000 every policy year.
- Day-care procedures : It covers the cost of day-care procedures where the insured was provided with in- patient care for less than 24 hours and not in OPD or outpatient department.
- Organ donor cover : The plan covers expenses incurred in the treatment of organ donor in an organ transplant surgery.
- Convalescence benefit : Under this plan, the insured is paid Rs. 5000 every policy year if he is hospitalized for an illness or injury for more than 10 consecutive days. This benefit available to insured with a policy term of more than a year.
- Daily cash benefit : This plan provides daily cash of Rs. 500 for up to 10 days to the parent/ legal guardian accompanying the insured child of less than 12 years to the hospital.
- Ayurvedic/homoeopathic treatment : It covers the cost of medical treatment taken visa Ayurveda or homeopathy where the insured was admitted for more than 24 hours.
- Maternity expenses : The plan will cover the medical expenses incurred on childbirth, abortion, miscarriage or other related procedures.
- New-born baby cover : This plan by Bajaj Allianz will also cover any medical expenses incurred ion treatment of a new born baby including hospitalization and vaccination cost for a maximum of 90 days from its birth.
- Bariatric surgery cover : The cost of bariatric surgery is covered under this plan if the insured fulfils the eligibility criteria.
- Free preventive health check-up : This plan provides the insured with free medical check-ups at the end of every three consecutive years.
- Waiting period : This plan by Bajaj Allianz is subject to certain waiting period :
- A waiting period of 36 months of pre-existing diseases
- A waiting period of 24 months for certain specific diseases
- No medical expenses incurred in the first 36 months will be covered under this plan
- Dental treatment : The expenses incurred on any kind of dental procedure will be not be covered under this plan.
- In-patient care : This plan does not cover the cost of unwarranted in- patient hospitalization without the supervision of doctor or nursing staff.
- War : It does not cover the expenses incurred on hospitalization resulting due to war or an act of war, invasion, civil unrest, insurrection, etc.
- Treatment received outside India : This plan does not cover the cost of any treatment undertaken by the insured outside India.
- Cosmetic surgery : It does not cover the cost of any cosmetic surgery, plastic surgery or any aesthetic treatment or gender change surgery.
- External appliances : Any expenses incurred on purchasing external appliances such as contact lenses, spectacles, crutches, dentures, hearing aids, etc. are not covered under this plan.
- External Equipment : The plan does not cover the cost of any external medical equipment used post-hospitalization at home such as instrument used to treat Sleep Apnoea Syndrome, etc.
- Intentional self-injury : It does not cover the treatment expenses of any intentional self : injury including suicide, attempt to suicide or overuse/ abuse of alcohol or drugs.
- HIV : This plan by Bajaj Allianz does not cover the medical expenses incurred in the treatment of HIV or related diseases.
- Infertility : It does not cover the cost of any treatment related to infertility, impotence, erectile dysfunction, etc.
- Obesity : The plan does not cover the cost of any treatment or procedure related to obesity.
This health insurance plan provided by Bharti AXA Health Insurance Company offers the coverage against all the medical expenses and emergency hospitalization. The insurer has been awarded with the Customer Service Excellence Award, in 2019. Moreover, there are certain exclusive benefits offered under this plan including tax saving, renewal discounts as a no-claim bonus and free health check-ups. Have a quick look at the plan details below:
Features and Benefits
- Anyone aged between 91 days to 65 years can buy the policy
- Sum assured limit is Rs. 3/4/5 lacs
- In a family floater plan, coverage is provided to you, your spouse and 2 dependent children who are between the age group of 90 days to 23 years
- 5% to 25% no-claim renewal discount
- Coverage for critical illnesses
- Recuperation benefit provided for critical illness or dread diseases
- 30-40 days pre-hospitalization cover and 60 days of post-hospitalization cover is provided
- Day-care treatment is compensated up to the amount of sum insured
- Ayush Treatment cover
- Domiciliary hospitalization cover up to 10% of the sum insured
- Any critical illness that is diagnosed in the initial 30 days from the inception (in benefit plan) and 60 days from inception (in reimbursement plan).
- Specific ailments which cannot be insured before one year
- Complication arising from or traceable pregnancy including abortion in the first 12 weeks of conception, caesarean delivery. This is not applicable or ectopic pregnancies.
- Claim made for any pre-existing diseases before completion of 48 months waiting period
- Expenses incurred dental surgeries unless it requires hospitalization
- Birth control measures
- Hormonal treatment
Care Health Care Insurance Plan is an all-inclusive popular health insurance plan offered by Care Health Insurance Company (Formerly Religare Health Insurance Company). This plan provides health insurance coverage to both individuals as well as the entire family. Also, it provides a wide range of health insurance coverage to the insured including domiciliary hospitalization, alternative treatment, air ambulance cover and international second opinion.
Features & Benefits:
- Individual & floater cover : The sum insured amount under the plan is available under individual as well as family floater basis.
- Pre-hospitalization coverage : This plan covers all pre-hospitalization expenses including cost of tests and investigations for up to 30 days before getting admitted
- In-patient hospitalization : It covers in-patient expenses including ICU charges and room rent when admitted in a hospital.
- Day-Care Expenses : This health insurance policy covers day care expenses or expenses incurred on medical treatment that doesn’t require you to stay admitted in a hospital for more than 24 hours.
- Post Hospitalization : The plan reimburses post-hospitalization expenses including pharmacy bills, investigation charges and doctor’s fee for up to 60 days of getting discharged from the hospital.
- Domiciliary Hospitalization : It covers the cost of domiciliary hospitalization for a treatment that extends for more than 3 days in cases when admitting the patient to the hospital is not possible and treatment is given at home.
- Ambulance Cover : The plan reimburses the charges for availing ambulance service on road in emergency situations. Certain plan variants also cover the cost of air ambulance if opted as an add-on cover by the insured.
- Daily Hospital Allowance : Under this plan, daily allowance to meet day-to-day hospital expenses is provided.
- Organ Donor Cover : The plan will reimburse any medical expenses borne by the organ donor during the organ transplant surgery.
- Alternate Treatment : It also covers the cost of undertaking alternative treatment using Ayurveda, Homeopathy, Siddha and Unani.
- Second Opinion : This health insurance plan will also cover cost of obtaining an international second opinion from another doctor.
- Tax Saving Benefits : This plan allows you to avail tax benefits on premium under the Section 80C of the Income Tax.
- Waiting period : A waiting period of first 30 days is applicable under this plan. No medical expenses will be covered during this period.
- Self-Inflicted Injuries : The plan does not cover treatment expenses of any self-inflicted injuries including suicide and attempt to suicide.
- Use of alcohol/ drugs : It does not cover the treatment cost of any injury or illness arising out of use, overuse or abuse of alcohol and drugs.
- AIDS : The plan does not cover the expenses incurred on treatment of HIV AIDS.
- Pregnancy & related illness : Treatment cost of any illness or condition resulting due to pregnancy, childbirth, abortion, miscarriage and related procedures are not covered under this plan.
- Congenital diseases : The plan does not cover the treatment expenses incurred on congenital diseases.
- Infertility : It does not cover medical expenses incurred on tests or treatment of infertility or IVF.
- War : The plan does not cover the cost of hospitalization resulting due to war, strike riot, nuclear weapons/ explosions, etc.
Chola MS Healthline is a comprehensive health insurance that provides coverage on family floater basis. The best part of this policy is that it compensates for expenses incurred on both Allopathy and Ayurvedic treatments. The health insurance coverage benefits can be extended to your children and spouse under a single plan.
Features and Benefits
- The sum assured limit is up to INR 15 Lakh
- It offers coverage for maternity expenses
- No medical check-up is required up to 55 years of age
- Option to choose from Standard, Superior, and Advanced Plan
- Organ transplantation cost including donor treatment costs (except for the organ’s cost)
- External Aids – Spectacles, Contact lens, and hearing aids, OP Dental treatments, etc. are covered
- Expenses incurred during the initial 30 days of policy purchase except for accidental cases
- Specific diseases that are excluded for one year and two-years ( check policy wordings)
- Pre-existing illnesses until 2 years of the continuous policy term
This is a new and comprehensive health plan that covers some of the unique illnesses and treatments. This medical insurance policy comes with minimal limitations making it a relevant choice for you in today’s times.
Features and Benefits
- This health plan also covers pandemics like COVID-19
- No age-specific co-pay clause is applicable
- No Room Rent Restrictions
- Cumulative Bonus is provided
- Psychiatric illness cover
- Covers all hospitalization treatment expense up to the sum assured
- Add-on benefits that you can avail are maternity benefits, Ayush cover, and zone up-gradation
- Prenatal and postnatal expenses
- Pre-existing diseases
- Hospitalization without doctor's recommendation
The insurer offers this policy in three variants i.e. Silver, Gold, and Platinum. You can select one as per your sum assured requirements. This health insurance policy comes with the unique and extensive coverage benefits at an affordable premium.
Features and Benefits
- There is no capping on ICU charges
- Day care treatments are also covered
- Organ donor expenses are also included
- Ayush treatment cover is also provided
- Maternity benefit and critical illness cover is also offered
- Medical referral facility
- Compassionate visit cover
The plan does not cover the following expenses:
- Suicidal attempts
- Sexually transmitted diseases/complications
- Any kind of deliberate attempt
Future Generali CritiCare plan is the most-suited critical illness plans by Future Generali Health Insurance Company that is designed to cover medical expenses incurred on the treatment of 12 Critical Illnesses as mentioned in the policy wordings. Once diagnosed the insurer pays the sum insured in lump sum to treat healthcare expenses. The coverage amount options under this critical illness policy range between Rs. 1 lakh to Rs. 50 lakh.
Features and Benefits
- Individual as well as family health insurance coverage benefits including children and spouse
- 12 Critical illness like Cancer, Kidney failure, etc. are covered with tax benefits
- Lump sum payment benefit
- Cashless treatment in network hospitals
- Pre-existing diseases
- Sexually transmitted diseases/complications
- Any kind of deliberate attempt
- Fertility treatments
- External or internal congenital diseases
- Suicidal attempts
- Depression and anxiety-related disorders
HDFC ERGO General Insurance has designed this my:health Suraksha Silver plan for individuals, senior citizens and families who are looking for a health insurance cover between Rs 3 Lakh to Rs 5 Lakh. The details of the plan are given below:
Features and Benefits
- Under this plan hospitalization expenses, day care treatments, Ayush hospitalization, and mental healthcare expenses are paid by the insurer
- There is no room rent capping under this policy
- There is no age restriction under this health insurance plan
- It offers rebound of the sum insured in case the existing amount gets exhausted
- Free health check-up facility is provided every year on every renewal
- This plan also includes cashless home healthcare treatment cover
- This plan does not cover self-inflicted injuries
- Adventure sports injuries are also not covered
- Accidents related to Participation in defence operations are not included
- Venereal diseases and STDs are not covered
- Obesity and cosmetic treatments are also not covered
Optima Restore plan by HDFC ERGO Health is one of the top health insurance plan that provide extensive medical coverage right from pre-hospitalization to post-hospitalization expenses. This comprehensive plan comes with a restore benefit that automatically restores the sum insured in case it is exhausted. Moreover, HDFC ERGO Health (formerly known as Apollo Munich Health Insurance) is known for faster claim settlements, which means the healthcare expenses will be reimbursed in the minimum possible time.
Features and Benefits
- 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 for up to 2 years. Additionally, a 7.5 per cent 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 daycare 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 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 including 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 per cent to 100 per cent of the amount insured upon policy renewal. If a claim is filed/ processed the bonus will decrease by 50 per cent of the sum 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.
- 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.
Iffco Tokio Health Protector plan offers coverage against hospitalization expenses to individuals and families in case of any high-cost treatment required for any illness or injury. There is an option to choose the deductible amount, which you pay through your existing health insurance plan, or pay on your own. This policy also provides additional coverage over and above the deductible amount. Health Protector Plus health insurance plan helps you meet the exorbitant medical costs in a very convenient manner.
Benefits and Features
- Anyone between 18-65 years of age can purchase the plan
- Option to choose from one-year plan or a top-up or super top-up plan
- Even if you don’t have a base health insurance plan, you can buy this policy
- The cost incurred on the purchase of vitamins and tonics as part of the hospitalization treatment
Claims arising due to the following circumstances are not covered:
- Any treatment cost incurred in the initial 30 days from the policy inception date
- Any hospitalization required for cosmetic or plastic surgeries
- Treatment for HIV/AIDS infection
- Mental disorders and treatment for anxiety or depression
- Hospitalization for genetic disorders
Kotak Health Premier Plan is a comprehensive health insurance policy that offers both medical protection and value-added benefits to the policyholders. Health and wellness rewards are also provided under this health policy.
- This health plan is available in individual and family floater options
- The family floater plan can cover up to 3 adults and 3 dependent children
- The policy period can be 1, 2 and 3 years
- Family discounts and long-term policy discounts are also available
- The lifelong renewal option is available in all the plan variants
- Optional critical illness and personal accident cover is also provided
- Experimental, unproven or non-standard treatment
- Cosmetic surgeries
- STDs and related treatment
- Aesthetic treatment
- Self-inflicted injuries
Connect Supra Top-up health plan offered by Liberty insurance acts as a Stepney in case the sum insured of your existing health plan gets exhausted. The sum insured in the top-up plan goes up to Rs 20 lakh and in the super top-up plan; it goes up to Rs. 1 Crore.
Features and Benefits
- This health insurance policy covers pre and post hospitalization expenses
- It also covers in-patient treatment costs such as ICU, room rent, etc.
- 405 Day-care procedures are covered
- Some of the add-on include reload of the sum assured, Ayush Treatment, overseas coverage, and Wellness & Assistance Program
- Pre-existing diseases are not covered until completion of 36 months of the policy term
- 30-days of waiting period after policy commencement
- 2-years of waiting period applies to specific diseases such as Internal tumors, hernia, cataract, etc.
Max Bupa Health Companion plan is the best-suited health insurance policy offered by Max Bupa health insurance Company. It is a comprehensive and affordable medical insurance policy formulated especially for individuals and nuclear families. It is available in three variants that provide a different range of medical coverage to the insured. It comes with an option of two- year policy tenure and also covers the cost of vaccination in case of an animal bite.
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 lakh.
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
- 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 per cent is offered on the premium.
- Renewal Benefits : After the completion of the first policy year, this plan offers the following renewal benefits.
- No Claim Bonus : Base sum insured is enhanced by 20 per cent up to 100 per cent 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 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 lumpsum pay-out 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 for up to 30 days.
- No Age 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-days free look period. During this time period, a plan can be cancelled by stating a valid reason.
- Artificial life maintenance
- Ancillary hospital charges, unjustified hospitalization, unrecognized doctor or hospital
- Hazardous activities, conflict & disaster and unlawful activity
- Circumcision and external congenital anomaly
- Complementary & Alternative Medicine (CAM), experimental/ investigational or unproven treatment, inconsistent/ irrelevant or incidental diagnostic procedures, OPD treatment and off-label drug or treatment
- Cosmetic & reconstructive surgery and obesity & weight control procedures
- Dental or oral treatment and eyesight & optical services
- HIV AIDS & related diseases and sexually transmitted infections & diseases
- Convalescence & rehabilitation, mental & psychiatric conditions and substance-related & addictive disorders and sleep disorders
- Non-medical expenses
- Puberty or menopause related disorders, reproductive medicines and other maternity expenses
- Robotic-assisted surgery, LASER and light based treatment
- Treatment received outside India
Prohealth Plus health insurance plan by ManipalCigna provides medium coverage but does include smaller OPD expenses along with worldwide emergency coverage in case of hospitalization during his overseas trip. This health insurance policy comes with an option of unlimited restoration of the sum insured apart from offering healthy maintenance benefit. It also covers maternity expenses, new born baby expenses, including the first-year vaccinations.
Features and Benefits
- Enhanced Sum Insured : The plan comes with an enhanced sum insured to fulfil individual insurance needs. Insurance buyers can opt for desired coverage from 9 sum insured options- Rs. 4.5 lakh, Rs. 5.5 lakh, Rs. 7.5 lakh, 10 lakh, 15 lakh, 20 lakh, 25 lakh, 30 lakh and 50 lakh.
- 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 theatre charges, nursing charges, anaesthesia 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, up to 30 days.
- Emergency Ambulance Cover : The plan covers ambulance charges up to Rs. 3,000 every time the insured needs to be transported 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, once per policy year. 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 per cent 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 delivery.
- New Born Baby Cover : This plan will cover hospitalization expenses of the newborn baby if any.
- First Year Vaccinations : The plan covers first-year vaccinations expenses of the new born 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 the 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 per cent or 20 per cent 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- new born 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 option to eradicate mandatory co-payment applicable to an insured person aged 65 years and above by paying an 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 per cent reinstatement of the insured sum.
- Free Look Period : The plan comes with a free look in the 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.
- Family discount : The plan offers a 25 per cent 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 per cent if a 2-year policy term is selected and a discount of 10 per cent is offered if a 3-year policy term is selected.
- No Claims Bonus : The plan offers enhanced sum insured ranging from 10-200 per cent after every claim-free year.
- Healthy Rewards : The plan offers reward point’s equivalent to 1 per cent of the premium on an annual basis. Additionally, reward points equal to up to 19 per cent 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 the first 90 days from the commencement of the 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 Pro-health 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, new born baby cover, the 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.
This is a popular health plan by National Health Insurance company with higher sum insured up to Rs 50 lakh with a number of lucrative coverage benefits and features that best suited for you. You can include your entire family including self, children, spouse, parents, and parents-in-law on floater basis.
Features and Benefits
- The minimum and maximum entry age for Adult: 18 to 65 years and Children: 3 months to 18 years
- Cashless hospitalization is provided
- Option to choose 1, 2 and 3 years of policy term
- Lifelong policy
- y renewal option
- Comprehensive cover at an affordable premium
- Both individual and family floater plans are available
- Coverage to pre-existing diseases after the completion of the waiting period
- Tax benefits on the premium paid
- Pre-existing diseases unless the waiting period is completed
- Pregnancy -related complications
- Treatment for obesity and genetic disorders.
- Cosmetic treatment and hormone replacement therapies
- Treatment for STD
- Hospitalization required for unproven treatments
- Psychosomatic & psychiatric disorders
Undoubtedly, hospitalization expenses can make a hole in anybody’s pocket. New India Assurance Senior Citizen Mediclaim policy covers the cost of the medical expenses and offers various add-on benefits to enhance your coverage benefits.
Features and Benefits
- Anyone between the age of 60 to 80 years can buy this plan
- The sum insured can be Rs. 1 lakh or Rs. 1.5 lakh
- You can avail 5% of cumulative bonus for every non-claim year or policy renewal, maximum up to 30%
- 10% of family discount is offered if the spouse is also insured
- Cover for Ayurvedic, homeopathic and Unani treatment is provided in government hospitals. Only a certain amount is covered, check policy documents for same
- After 18 months of policy purchase, pre-existing medical conditions are also covered
- After payment of additional premium certain pre-existing ailments like diabetes, hypertension, and related complications can be covered after completion of 18 months
- Pre-existing diseases until 18 months of continuous policy coverage
- Claim filed for an illness that was diagnosed in the initial 30 days of the policy commencement date
- Pre-existing illnesses such as diabetes mellitus, diabetes, and blood pressure can be covered after 18 months of the policy term. This benefit has an extra premium cost attached to it.
- Cosmetic surgeries unless it is an accidental case
- Complications related to childbirth and pregnancy
- HIV and STD Treatments
This is one of the most popular mediclaim insurance policy offered by Oriental health insurance. It can be acquired by individuals between the age group of 18 years and 65 years. One of the best part is that it offers discount on family floater cover.
Features and Benefits
- The maximum entry age is extendible to 70 years
- Sum assured ranges from Rs. 1 lakh to Rs 10 lakh
- 10% family discount is also offered
- A medical test is not required up to the age of 55 years
- Covers general hospitalization expenses like surgeon fees, ICU charges, room charges, OT charges, X-ray, diagnostic tests, dialysis, chemotherapy, lab tests, etc.
- Illness resulting due to drug and alcohol overdose
- Self-inflicted injuries
- Suicidal attempts
- Injuries due to involvement in dangerous activities
Raheja QBE Health QBE Comprehensive Plan available in basic, comprehensive, super saver. It offers coverage to people within the age group of 90 days to 65 years. For dependents the age limit is 18 years and maximum 65 years.
Features and Benefits
- Lifelong renewals are possible
- The policy term can be 1 or 2 years
- The coverage is available on both individual and family floater basis
- Covers organ donor expenses for the insured recipient
- In a family floater plan coverage can be provided to a maximum of 2 adults and 2 children
- Some specific non-medical expenses are also covered
- Medical treatment that is received outside India
- Non-allopathic treatment
- Pregnancy related complications
- Sexually transmitted diseases and related illnesses
Lifeline Supreme health insurance policy is of the most popular health plan provides coverage for hospitalization, day care procedures, domiciliary hospitalization as well as AYUSH treatments to the policyholder. It offers comprehensive health insurance coverage to individuals as well as families. This health insurance plan also covers medical expenses incurred on vaccinations for an animal bite, annual health check-up, second opinion on 11 critical illnesses and emergency domestic evacuation.
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.
Features & Benefits
- 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 per cent up to 100 per cent of the sum assured. Even if a claim is lodged, the NCB is retained.
- Sum Insured Re-Load : The plan re lads the amount insured up to 100 per cent 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, once per policy year.
- Emergency Domestic Evacuation Expenses : The plan covers emergency evacuation across India up to Rs. 1 lakh.
- Hospital Cash Benefit : The plan provides hospital cash of Rs 2000 per day up to 30 days if the insured is hospitalized for more than 2 days. However, this cover can be obtained on payment of an extra premium amount.
Time Based Exclusions
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.
- Treatment expenses due to participation in adventure or hazardous Sports activities.
- Treatment expenses related to puberty and ageing.
- 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 the unrelated diagnosis.
- Treatment expenses for any injury due to participation in any unlawful activity.
Reliance Critical health insurance policy covers specified life-threatening diseases and acute illnesses. The insurer pays for the healthcare expenses and medical treatment incurred on the specified critical illnesses that can otherwise create havoc with anybody’s bank balance.
Features and Benefits
- If you are below 45 years of age, then you do not require pre-medical screening
- anyone above the age of 18 years can buy this
- Diseases like Cancer, Organ Transplant, Multiple Sclerosis, Heart Valve Replacement or repair, Third Degree Burns, Aorta Graft Surgery, Coma, Total Blindness and Renal Diseases.
- Easy online payment is possible with NEFT, UPI, Debit/Credit card etc.
- Treatment for diseases such as HIV/AIDS
- Intentional injuries/suicidal attempt
- Health ailments resulting due to consumption of drugs and alcohol
- Any illness/injury resulting from a criminal activity
- Congenital diseases
- Dental surgeries or treatment
- Treatment for mental disorders
- Cosmetic and aesthetic treatments
Star Senior Citizen Red Carpet health insurance plan is best suited for elderly people. Senior citizens are prone to frequent hospitalizations due to age-related illnesses and this health insurance plan provides comprehensive coverage for pre-existing diseases. The best part is, it not only exempts the applicant from appearing for a pre-policy medical screening but also covers healthcare expenses incurred on medical consultations. Moreover, it is available on individual as well as family floater basis.
Benefits and Features
- Coverage : The plan caters to the senior citizens aged between 60-75 years.
- No Medical Screening : The plan comes without any preliminary medical screening. However, a 10% additional discount is given if the reports of BP, sugar, Blood urea & creatinine and stress thallium is submitted.
- Pre-Existing Illness Cover : The plan covers pre-existing illnesses after a waiting period of one year.
- Medical Consultation Cover : The plan covers medical consultations under outpatient cover in an insurer : authorized hospital.
- Enhanced Sum Insured : The plan comes with a higher sum insured amount up to Rs. 25 lakh.
- Lifelong Renewals : This plan comes with guaranteed lifelong renewal.
- Discounts : When Red Carpet health insurance plan is purchased online, a 5 per cent discount can be availed on the premium.
- Hospitalization Coverage : The plan covers an insured’s inpatient hospitalization expenses for hospitalization of a 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.
- Out-Patient Consultations : The plan reimburses Rs 200 per consultation if outpatient consultations made at one of the network hospitals of the insurer.
- Health Check-up : The plan covers the cost of health check-up for every claim-free year, only if the check-up is done at a network hospital.
- Free-Look Period : The plan offers a 15-days free-look period during which the policy can be cancelled without any cancellation charges.
- Tax Benefit : The plan allows the insured to avail tax benefit under Section 80D of the Income Tax Act.
- Waiting period of first 30 days for all illnesses
- A waiting period of 2 years for certain specific diseases including cataract, thyroid-related diseases, joint replacement surgery, hernia, reproductive treatment procedures, prostates, varicose veins, congenital internal diseases and any transplant surgery
- A one-year waiting period for pre-existing diseases
- Circumcision and related procedures
- Inoculation or vaccination (except for medical treatment or for post-bite treatment)
- Congenital external anomalies or defects
- Dental treatment or surgeries, Lasik laser surgery
- Psychiatric, behavioral or mental disorders, Intentional self-inflicted injury
- Use of intoxicants, including smoking, drugs and alcohol
- Sexually transmitted diseases & venereal diseases, HIV AIDS & related diseases
- War, war-like situation or act of foreign enemy
- Pregnancy, childbirth and related procedures, treatment for subfertility and assisted conception
- Treatment for obesity and bariatric surgery
- Medical or surgical treatment for sleep apnoea
- Cost of High- Intensity Focussed Ultrasound, deep brain stimulation, fibroid embolization, balloon sinuplasty and related procedures
- Inconsistent diagnostic procedures and unjustified hospitalization
- Untested, experimental, unconventional or unproven treatment
- Stem cell therapy, procedures relating to Platelet Rich Plasma procedures and chondrocyte implantation
- Oral chemotherapy
- Cosmetic, aesthetic treatment, plastic surgery
- Cost of contact lenses and spectacles, cost of tonics and vitamins
- Ancillary hospital charges
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
SBI Arogya premier policy is a comprehensive health plan from SBI health insurance that covers hospitalization expenses up to 60 days and post-hospitalization expenses up to 90 days. The best part is that this policy also covers air ambulance charges up to Rs. 1 lakh and maternity expenses after the completion of 9 months of the waiting period.
Key Features of SBI Arogya Premier Policy
- Sum Assured option ranging from Rs. 10 lakh to Rs. 30 lakh
- SBI Arogya Premier Policy covers day care expenses up to 142 days
- Applicants up to the age of 55 years do not require any medical test
- Both individual and family floater plans are available
- Tax saving u/s 80 D of Income Tax act
Inclusions of SBI Arogya Premier Policy
- Alternative treatment cover for Homeopathy, Ayurveda, Siddha & Unani
- After 4 consecutive claim-free years, up to Rs. 5000 health check-up reimbursement is provided
- In case your sum insured is reduced due to claim, then 100% of sum insured will be reinstated
- Organ donor expenses are covered
- Domiciliary hospitalization expenses
- Integral expenses incurred on anaesthesia, oxygen, medicines, operation theatre, surgical appliances, chemotherapy, dialysis, radiotherapy, pacemaker cost, and similar
- Physiotherapy and diagnostic procedures
- Room charges, medical consultation fees, dressing charges and nursing expenses
Exclusions of SBI Arogya Premier Policy
- AIDS/HIV and other sexually transmitted diseases
- Self-inflicted injuries and conditions of depression and mental disorders
- Health treatment for drug intoxication and overdose of alcohol consumption
Tata AIG Mediprime is a popular health insurance policy by Tata AIG Health Insurance Company. This comprehensive health insurance plan pays out for medical emergencies leading to hospitalization. It also offers Ayush Benefit cover in addition to other coverage benefits.
Features and Benefits
- 140 different day care procedures are covered
- Domiciliary treatment expenses are covered
- Compensation is provided for organ donor expenses
- In-patient Ayurveda treatment, including Unani, Sidha, or Homeopathy treatment are covered up to a specified limit
- In-patient vaccination charges up to 100% of the sum assured. For outpatient expenses this limit is Rs. 5000 in a year
- Plastic surgeries and cosmetic surgeries
- Unproven and experimental treatments
- STDs, AIDS and HIV
- Venereal diseases
- Donor screening expenses
United India UNI Criticare critical illness policy covering 11 specified life-threatening diseases to ensure you and your loved ones enjoy a secure future. The sum insured is paid in lump sum to the policyholder upon diagnosis of any of the specified critical illnesses.
Features and Benefits
- Anyone who is aged between 21 to 65 years can buy this policy.
- Get insurance from Rs. 1, 3, 5 and lacs and get paid in lump sum by the insurer for the treatment. After a waiting period of 3 months and survival period of 30 days, the insurance company will reimburse your cost of treatment.
- Critical illnesses like Cancer, heart attack, Heart valve replacement, Coronary artery surgery, Kidney failure, Stroke Major organ / bone marrow transplant, Coma, Open chest CABG, Multiple sclerosis, Motor neuron disease, Permanent limbs paralysis are considered under the plan.
- Congenital diseases
- Weight loss procedure and surgeries
- Pregnancy and similar complications
- Self-inflicted injuries and suicidal attempts
As the name suggest Universal Sompo Individual Health Insurance Policy is best suited for individuals and their family members. It provides compensation for hospitalization expenses along with domiciliary hospitalization expenses in case of diagnosis of any disease or accidental injuries.
- Entry age should be less than 55 years
- Add-on cover for Critical Illnesses
- In-house claim settlement team
- Tax saving benefits under section 80 D
- Hospitalization and nursing home expenses, including room rent, nursing & boarding expenses, blood, oxygen charges, and fees charged by specialists etc.
- Domiciliary hospitalization cover for a period exceeding 3 days, in case of lack of accommodation in the hospital or if the patient is in an immovable condition due to the illness
- Premium is calculated depending on the age of the insured and the sum insured selected
- No pre-medical screening required for people below 45 years of age
- Pre-existing illnesses are not covered
- Claims arising on account of any illness that is contracted during first 30 days of policy purchase
- Hospitalization required due to war like conditions, invasion etc.
- Cost of hearing aids and spectacles are excluded
- Dental surgery or treatment unless hospitalization is required
- Venereal diseases are not covered under the plan
*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply.
When it comes to best health insurance, the decision to zero on one policy is not a child’s play. With so many insurance companies in the market, buying the best health insurance plans requires you to put in great efforts. At Policybazaar, we strive to help you make a well informed decision by picking the most suitable health insurance plan in India. We hope you will be able to take your best pick.
Disclaimer : *Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.