IPD Health Insurance

What is IPD Cover in Health Insurance?

IPD cover in health insurance pays for the medical bills incurred while staying overnight at a hospital. It covers the cost of getting hospitalized for at least 24 hours to treat major illnesses and complex medical conditions that require continuous monitoring and cannot be managed on an OPD basis. However, health insurance companies in India cover in-patient treatment only if a qualified doctor recommends it.

While some medical insurance plans cover in-patient hospitalization up to the sum insured limit, others may levy a room rent limit or set a hospital room category. For instance, Plan A covers in-patient treatment expenses for up to 1% of the sum insured, and Plan B allows hospitalization in a single private AC room.

Benefits of IPD Health Insurance

Here are the key benefits of buying IPD health insurance plans:

Coverage for Hefty Hospital Bills

Hospitalization is expensive in India, especially in metro cities. As per the IIT Jodhpur study in 2022, the average hospitalization cost is ₹6,788 per day in private hospitals and ₹2833 per day for government hospitals. The price is higher if the patient is admitted to the Intensive Care Unit (ICU) or hospitalized for a long period. With health insurance, people do not have to spend their hard-earned money on hefty hospital bills.
Crucial During Emergencies

Medical emergencies come without notice and lead to sudden hospitalization. This gives us little to no time to arrange money and pay hospital bills. A mediclaim policy provides financial support to policyholders so that they can pay their hospital bills during emergencies and focus completely on their recovery.
Reduces Out-of-Pocket Expenses

According to the National Health Accounts Estimates, out-of-pocket expenses account for 39.4% of total healthcare expenses in India. The only way to reduce out-of-pocket expenses is to buy a medical insurance policy, as the insurance company takes care of the medical bills.
Access to Best Hospitals

Not everyone can afford IPD treatment at a top hospital, as it translates into long hospital bills. As a result, many people miss out on the best treatment to avoid going to a big hospital. However, health insurance enables them to access the best quality treatment at a top hospital without worrying about paying the bills.

List of IPD Health Insurance Plans

Check out the list of health insurance plans that cover in-patient treatment expenses:

IPD Health Insurance Plans	Sum Insured (₹)	Entry Age	Room Rent Limit
Aditya Birla Activ One Plan	2 lakh to 6 crore	Adult: 18 years onwards Child: 91 days to 25 years	No room rent limit
Bajaj Allianz My Health Care Plan	3 lakh to 5 crore	Adult: 18 to 65 years Child: 90 days to 30 years	Single private AC room for up to ₹10 lakh sum insured
Care Supreme Plan	5 lakh to 1 crore	Adult: 18 years onwards Child: 91 days to 24 years	No room rent limit
Cholamandalam Flexi Health Plan	50,000 to 25 lakh	Adult: 18 to 65 years Child: 90 days to 26 years	₹2000 per day for up to ₹2 lakh sum insured
Digit Health Care Plus Plan	10,000 onwards	Adult: 18 years onwards Child: 91 days onwards	Option to choose between 1%, 1.5%, 2% of the sum insured or no limit
Future Generali Health Absolute Plan	3 lakh to 1 crore	Adult: 18 years onwards Child: 1 day to 25 years	No room rent limit
Galaxy Promise Plan	3 lakh to 1 crore	Adult: 18 to 65 years Child: 16 days to 25 years	1% of the sum insured for up to 10,000 per day under the Premier plan, Deluxe room for sum insured between ₹5 lakh to ₹20 lakh under Elite and Signature plans
HDFC ERGO Optima Secure Plan	5 lakh to 2 crore	Adult: 18 years onwards Child: 91 days to 25 years	No room rent limit
ICICI Lombard Elevate Plan	5 lakh onwards	Adult: 18 to 125 years Child: 91 days to 30 years	Up to a single private AC room
IFFCO Tokio Individual Health Protector Plan	50,000 to 20 lakh	Adult: 18 to 65 years Child: 91 days onwards	1.75% of the sum insured for below ₹5 lakh SI, 1.5% of the sum insured for cities other than Class A cities
Liberty HealthPrime Connect Plan	10 lakh to 1 crore	Adult: 18 to 65 years Child: 91 days to 25 years	No room rent limit
Magma HDI OneHealth Insurance Plan	2 lakh to 3 crore	Adult: 18 years onwards Child: 91 days to 26 years	1% of the sum insured under the Support plan, Single private AC room under the Secure plan
ManipalCigna ProHealth Prime Plan	3 lakh to 1 crore	Adult: 18 years onwards Child: 91 days to 25 years	1% of the sum insured for ₹3 lakh SI under the Active plan, Single private AC room under Protect & Advantage plans and ₹5 SI onwards under the Active plan
National Mediclaim Plus Plan	2 lakh to 50 lakh	Adult: 18 to 65 years Child: 90 days to 18 years	1% of the sum insured under Plan A, Up to ₹15,000 per day in Plan B, Up to ₹20,000 per day under Plan C
New India Assurance Floater Mediclaim Plan	2 lakh to 15 lakh	Adult: 18 to 65 years Child: 90 days to 25 years	No room rent limit
Niva Bupa ReAssure 2.0 Plan	5 lakh to 1 crore	Adult: 18 to 99 years Child: 91 days to 30 years	No room rent limit
Oriental Happy Family Floater plan	1 lakh to 50 lakh	Adult: 18 to 65 years Child: 1 day to 25 years	1% of the sum insured per day
Raheja QBE Health QuBE Plan	1 lakh to 50 lakh	Adult: 18 to 65 years Child: 90 days to 25 years	1% of the sum insured per day under Basic, Super Saver and A la Carte plans
Reliance Health Gain Plan	3 lakh to 1 crore	Adult: 18 to 65 years Child: 91 days to 25 years	No room rent limit
Royal Sundaram NeXT Gen Health Insurance Plan	5 lakh to 1.5 crore	Adult: 18 to 75 years Child: 91 days to 25 years	Single private AC room
SBI Arogya Supreme Plan	1 lakh to 5 crore	Adult: 18 to 65 years Child: 91 days to 25 years	1% of the sum insured under the pro plan, Single private AC room under the Plus plan
Star Smart Health Pro Plan	5 lakh to 1 crore	Adult: 18 to 75 years Child: 91 days to 25 years	Single private AC room
Tata AIG MediCare Plus Plan	3 lakh to 1 crore	Adult: 18 to 65 years Child: 91 days to 25 years	No room rent limit
United India Individual Health Insurance Plan	2 lakh to 20 lakh	Adult: 18 to 65 years Child: 91 days to 17 years	Up to 1% of the sum insured or at actuals, whichever is lower
Universal Sompo Complete Healthcare Insurance Plan	1 lakh to 50 lakh	Adult: 18 to 75 years Child: 91 days to 25 years	No room rent limit
Zuno Health Insurance Plan	1 lakh to 1 crore	Adult: 18 to 65 years (No age limit under the Platinum variant) Child: 90 days to 26 years	1% of the sum insured for up to ₹2 lakh SI, Single private AC room under Gold & Platinum plans and Silver plan for SI above ₹2 lakh
Zurich Kotak Health Premier Plan	2 lakh to 2 crore	Adult: 18 years onwards Child: 91 days to 25 years	No room rent limit

See more plans

What is Covered by IPD Health Insurance?

IPD health insurance plans cover the following medical expenses during hospitalization:

Room rent
ICU (Intensive Care Unit)/ ICCU (Intensive Cardiac Care Unit) charges
Surgeon/anaesthetists/specialist fees
Diagnostic tests and investigative procedures
Medicines and drugs
Boarding charges
Nursing expenses
Operation theatre charges
Prosthetics and other devices/equipment implanted during surgery
Cost of intravenous (IV) fluid, enteral feeding and blood transfusion
Surgical appliance costs
In-patient dental treatment due to an injury or disease
Plastic surgery due to an injury or disease
Cost of consumables (Available under some plans)

What is Not Covered by IPD Health Insurance?

The following medical expenses are not covered by IPD health insurance plans:

OPD expenses
Pre-hospitalization expenses
Post-hospitalization expenses
Treatment for alcohol or drug addiction
Dietary supplements and substances
Non-medical expenses
Cosmetic surgery
Congenital external anomalies
Intentional self-injury
Hospitalization for investigative and evaluation purposes
Unproven treatments

How to Buy IPD Health Insurance?

Follow the steps given below to buy an IPD health insurance online:

Step 1: Visit Policybazaar.com and click on the ‘Health Insurance' icon

Step 2: Select your gender, the family members to be insured and provide their ages

Step 3: Enter your city, name, phone number and details of any pre-existing illness

Step 4: Choose if you have an employer health insurance

Step 5: A list of various IPD health insurance plans will be displayed

Step 6: Select the ‘No room rent limit' option above to filter your results

Step 7: Choose the IPD health insurance plan you want to buy and pay its premium online

The insurer will issue the health insurance policy after receiving the premium.

How to File a Claim for IPD Health Insurance?

Take a look at the step-by-step procedure to file an IPD health insurance claim:

Get Hospitalized

Visit any hospital of your choice and get admitted to avail cashless treatment.
Inform the Insurer

Notify the insurance company about your planned hospitalization at least 48 hours in advance. In case of emergency hospitalization, make sure to intimate the insurer within 24 hours.
Show the Required Documents

Display your health card or copy of your health insurance policy for identification.
Cashless Treatment Request

Fill out the cashless pre-authorization form and submit it to the hospital. The hospital authorities will submit it to your insurer along with your medical documents for cashless treatment approval.
Cashless Treatment Approval

The insurance company will verify all the documents and, accordingly, approve or reject your cashless treatment request. They can also ask you to submit additional documents before approving or rejecting your request.
Obtain Treatment

Avail treatment for your illness/injury and sign all the documents at the time of discharge. You also need to pay the bills that the insurance company will not cover.
Settlement of Claim

The hospital authorities will send your medical bills along with your medical documents to the insurer for payment. After verifying them, the insurer will pay the bill amount directly to the hospital.

In case of reimbursement claims, inform the insurer about your hospitalization, obtain the treatment, pay the entire bill at the time of discharge and collect all your documents. Submit the required documents to your insurer within the stipulated time. The insurer will cross-check all the documents and pay you the claim amount.

Documents Required to File an IPD Health Insurance Claim

The following documents must be submitted to file a reimbursement claim under IPD health insurance:

Duly signed claim form
Copy of health card or insurance policy
Hospital discharge sheet
Detailed hospital bills
Bill payment receipts
Pharmacy bills supported by doctor's prescriptions
Reports of investigative and diagnostic tests, like X-rays, MRIs, etc.
Doctor's certificate recommending in-patient treatment
List of consumables used during hospitalization
FIR report in case of accidental hospitalization

Note: The exact list of documents may vary between health insurance companies.

IPD Health Insurance: FAQs

Q1. What is IPD full form in medical insurance?

Ans. The IPD full form in medical insurance is the in-patient department.
Q2. What is IPD in health insurance?

Ans. IPD in health insurance refers to in-patient department treatments that require constant monitoring and hospitalization for 24 hours or more.
Q3. What is in-patient treatment in health insurance?

Ans. In health insurance, in-patient treatment refers to treatments/surgeries/procedures that require hospitalization of at least 24 hours. It includes room rent, doctor’s fees, medicine costs, nursing fees, OT charges, cost of surgical appliances, etc. Doctors recommend an in-patient treatment in case of complex medical conditions, critical illnesses, severe burns, traumatic injuries, etc.

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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