Individual Health Insurance Plans

The COVID-19 pandemic made people realise the importance of staying healthy and keeping themselves financially secure. For this reason, people are focusing on buying health insurance today more than ever. People in India have either enrolled themselves in a government health insurance scheme or an individual health insurance policy.

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      What is Individual Health Insurance?

      Individual health insurance is an insurance plan that offers medical coverage to a person on an individual sum insured basis. It refers to the type of health insurance plan that needs to be purchased separately for each family member. It allows you to customize the coverage as per your own health needs and not of the entire family.

      Most individual health insurance plans provide comprehensive coverage to an individual for emergency medical expenses resulting from hospitalization costs, day care procedures, road ambulance services, alternative treatment, organ donor expenses, etc. However, the premium and coverage of an individual health policy cannot be shared amongst your family members.

      Features and Benefits of Individual Health Insurance

      An individual health insurance policy comes with the following features and benefits:

      • Solo Coverage - It ensures that the sum insured can be utilized only by you.
      • Suitable for Older People- It is more suitable for elderly people with greater health risks.
      • Sum Insured – It comes with a maximum sum insured of Rs 1 crore depending on the plan.
      • Wider Coverage- Individual health insurance policies offer a wider coverage including in-patient hospitalization, pre and post-hospitalization expenses, daycare procedures, ambulance charges, etc.
      • Add-on Covers- It provides you with the option of buying add-on covers, such as critical illness cover, outpatient treatment benefit, restoration benefit, maternity benefit, etc.
      • Multiple Claims- You can make multiple claims in a year as long as the sum insured is not exhausted.
      • Family Discount- Most individual health plans offer a family discount if more than two family members are covered on an individual basis.
      • Cumulative Bonus – It provides a discount on premium if you do not file a claim in the previous policy year.
      • Renewal for Life- The plan comes with lifetime renewability.
      • Tax Benefits– It offers tax savings on the paid premium under Section 80D of the Income Tax Act

      What is Covered under Individual Health Insurance Plans?

      An individual health insurance policy provides coverage for the following:

      • In-patient Hospitalization Expenses– It covers the medical expenses incurred due to getting admitted to a hospital for more than 24 hours. It includes room rent, medicine cost, ICU charges, etc.
      • COVID-19 Treatment– It provides coverage for the expenses incurred on the treatment of COVID-19.
      • Day Care Procedures– It covers the cost of availing day care procedures that requires less than 24 hours of hospitalization.
      • Pre and Post-hospitalization Expenses– It covers the medical expenses incurred before getting admitted to the hospital and after getting discharged.
      • Domiciliary Hospitalization– It pays for the cost of availing medical treatment at home on the recommendation of a doctor.
      • Emergency Road Ambulance– It covers the charges for availing road ambulances services in case of a medical emergency.
      • Alternative Treatment– It provides coverage for the treatment taken through the alternative schools of medicine, including Ayurveda, Unani, Siddha, Yoga and Homeopathy.
      • Organ Donor Expenses– It pays for the expenses incurred on harvesting a major organ from a donor if you need an organ transplant.
      • Preventive Health Check-up– It covers the cost of availing preventive health check-up facility.

      What is Not Covered under Individual Health Insurance Plans?

      Individual health insurance plans do not provide coverage for the following:

      • Dental treatment
      • Self-inflicted injuries
      • Abuse of alcohol or drugs
      • Obesity treatment
      • Infertility treatment
      • Cosmetic treatment
      • Injures due to participation in dangerous sports
      • Congenital external anomalies
      • HIV AIDS
      • Injuries or illness due to war or nuclear perils

      Is Cashless Treatment Available under Individual Health Insurance Policy?

      Yes. A cashless treatment facility is available under the individual health insurance policy. Under this facility, your insurance provider pays your hospitalization bill amount directly to the network hospital where you were undergoing treatment. It does not require you to pay the medical expenses out of your own pocket. You can avail cashless hospitalization facility at any of the network hospitals of your insurance company.

      Are There Any Waiting Periods under Individual Health Insurance Plans?

      Yes. All individual health insurance plans come with certain waiting periods. Firstly, you cannot raise a non-accidental claim during the first 30 days of the policy commencement. Specific diseases and surgical procedures like arthritis, cataract, joint replacement surgery, bariatric surgery, etc. are covered after a waiting period of 1 to 3 years depending on the plan. Similarly, you can raise a claim for pre-existing diseases after a waiting period of 2 to 4 years as per the policy terms.

      In case you have opted for a critical illness add-on cover, you will be able to raise a claim after 90 days of the policy commencement date. Moreover, the claim will be approved subject to a survival period of 30 days.

      How to Buy an Individual Health Insurance Policy Online?

      You can easily buy an individual health insurance policy online at the website of Policybazaar Insurance Broker Private Limited. Follow the steps given below to purchase individual health insurance online:

      • Visit the website of Policybazaar.com
      • Click on the icon of ‘Health Insurance’
      • Enter your name, gender, mobile number and age
      • Choose the city in which you live
      • Provide details of any existing diseases or previous surgeries
      • Individual health insurance plans from multiple insurers will be shown
      • Select the most suitable plan and pay its premium online
      • Your policy will be issued in less than 2 minutes.

      To make a better decision, make sure to compare individual health insurance plans offered by various insurers and choose the plan that best covers your health requirements.

      How Much Individual Health Insurance Coverage Should You Have?

      As per insurance experts, the coverage under your health insurance policy should be at least 50% of your yearly income. A minimum of Rs 10 lakh of medical insurance cover is required to meet expensive treatments like bypass surgery, COVID-19 treatment and related complications, etc. The coverage can go as high as Rs 1 crore depending on the plan.

      Things to Keep in Mind While Buying an Individual Health Insurance Policy

      While buying an individual health insurance policy, you must keep the following things in mind:

      • Analyze Your Health Requirements– Before you begin the process of buying an individual health policy, you should analyse your health requirements. Make a list of coverage and service benefits that you want under your policy. Also, estimate the ideal coverage amount to help you choose the right sum insured.
      • Check the List of Network Hospitals– At the time of selecting the policy, remember to check the list of network hospitals of the insurance company. Find out if you have any network hospitals near your home and office. If not, then go for a policy by another insurance company.
      • Affordability of the Plan– You should buy an individual health insurance policy with affordable premiums. Do not opt for an expensive policy to get higher coverage as it may create an unnecessary financial burden. Instead, choose a policy that best fulfills your coverage expectations without overshooting your budget.
      • Check for Any Sub-Limits– Most health plans may come with a sub-limit for certain covers. You must check the applicable sub-limits under various covers before choosing a policy. This would ensure that you get sufficient coverage under different covers as per your expectations and are not in for a surprise during claims.  
      • Go Through the Claim Process– Before selecting a health insurance plan, you must go through the claim of the insurance company. Check if the claim procedure is easy or cumbersome. Also, find out the number of days that the insurance company takes to settle the claim. Do not opt for a plan with a lengthy and complicated claim process.
      • Check the Claim Settlement Ratio– While buying an individual health insurance policy, you must check the claim settlement ratio of the insurance providers. A company with a high claim settlement ratio is more likely to approve your claim than a company with a lower ratio.

      Bottom Line

      Individual health insurance plans are a must for people who have their own health issues. It offers your sum insured amount exclusively for you and you do not have to share it with your family members on a floater basis. So go ahead and buy an individual health insurance policy for yourself from Policybazaar.com after an in-depth comparison.

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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

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      Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

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