Buying health insurance plans in India is a simple, efficient & trustable process today. M… Buying health insurance plans in India is a simple, efficient & trustable process today. Many insurers provide top health plans on an individual & family floater basis, providing comprehensive healthcare benefits to you & your family. When buying one, look for offerings like quick claim settlement, network hospitals, rewards & benefits to get the best advantages.
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Buying a health insurance policy in India will help you protect yourself financially during a medical emergency. The best health insurance plan can cover hospitalization, day care treatment costs, surgery expenses, ambulance charges, and much more. Additionally, you will also get tax benefits under section 80D of the Income Tax Law, 1961 on the premium amount paid to the insurer.
Let’s talk a little more about what health insurance is.
Video reviews
Walkthroughs from the PolicyX team — pros, cons, real claim experiences and who should buy.
Easy steps to buy health insurance
All About Health Insurance Policy
How to Choose Best Health Insurance Plan
How Health Insurance Premiums are Calculated ?
What Is Health Insurance?
Health Insurance is your financial security blanket for all emergency and planned medical expenses. In India, 50% of healthcare expenses are paid out-of-pocket. Raising awareness and investing in health insurance will help change these statistics nationwide.
An affordable health plan in India covers hospitalization, OPD, room rent, surgery expenses, and many more healthcare expenses for you and your family. However, you must select the right medical insurance for yourself and your family.
Extraordinary Facts
According to Plum, an average Indian household is one serious medical incident away from slipping into poverty. This highlights the importance of health insurance, especially considering these facts:
India is the diabetes capital of the world
1 in 5 adults are pre-diabetic
1 in 4 deaths are caused due to cardiovascular issues
1 in 4 Indians have hypertension, which is a major contributor to cardiac ailments
What Are The Types of Health Insurance Plans?
It is important to understand the health insurance policies available in the market to make an informed decision. You have Individual, family, senior citizen, women, critical illness, and other categories.
Let us take a look at the categories for health insurance in India in detail.
Individual Health Insurance
Individual health insurance, as the name suggests, covers an individual under the health plan. It is among the most common types of medical insurance sold in India. The premiums are generally affordable and depend on various factors such as age, medical history, lifestyle, sum insured selected, location, riders/add-ons, etc.
*Premiums are calculated for base SI INR 10 lakhs & for a 30-year-old individual including GST
Family Health Insurance
Family health insurance policies or family floaters are similar to individual health plans. However, family floater plans have a higher sum insured shared between family members. The best part about investing in a family floater health plan is that you do not need to manage medical insurance for different family members separately.
*Premiums are calculated for base SI INR 10 lakhs & for 2 Adults (30 yrs male + 28 yrs female) + 1 Child (5 yrs) including GST
Senior Citizen Health Insurance
Senior citizen health policies are designed for individuals who are over 60 years of age. Senior citizens are prone to health ailments, which is why premiums are usually higher than other health insurance plans. Many senior citizen medical policies do not stress pre-policy medical check-ups and even provide domiciliary care and annual health check-ups.
*Premiums are calculated for base SI INR 10 lakhs & for individuals aged 60 years including GST
Critical Illness Health Insurance
Investing in a critical health policy is your saving grace against serious ailments like cancer, kidney failures, heart attacks, and others. Critical illness health plans offer lump sum amounts when you are diagnosed with the listed critical ailments.
*Premiums are calculated for base SI INR 10 lakhs & for a 30-year-old individual including GST
Health Insurance For Women
Health insurance policies for women cover delivery expenses, pre-natal and post-natal care, newborn baby medical care expenses, first-year vaccination, and more. Investing in a good maternity plan well before starting a family is advised to avoid waiting period hurdles.
These medical policies are designed specifically keeping in mind the different healthcare needs of individuals with conditions like Autism, congenital diseases, and more. Special health plans reduce out-of-pocket expenses for various medical expenses. Some popular and affordable policies for special needs are mentioned below:
Government health insurance in India is an ideal option for many. Families from weaker economic sections of society highly benefit from these schemes. Central and multiple state government medical insurance schemes like Ayushman Bharat Pradhan Mantri Bima Yojana are ideal for senior citizens and families alike. Other government schemes include Mukhyamantri Amrutam Yojana, Dr YSR Aarogyasri, Bhamashah Swasthya Bima Yojana, and others.
Ayushman Bharat Yojana is a flagship health insurance in India launched by the government of India. It is an important move by the government to achieve universal health coverage. It is important to note that PM-JAY is the world’s largest health insurance/assurance scheme fully financed by the government.
A state government policy launched by the state government of Gujarat. It is designed to cover families belonging to the weaker sections of society. Multiple benefits including the cost of diagnosis, medicines, hospital fees, and others are covered.
The Aarogyasri scheme is a medical insurance provided by the government of Andhra Pradesh to families belonging to the weaker sections of society. INR 5 lakhs are provided annually to families that cover cashless services for multiple ailments.
Bhamashah Swasthya Bima Yojana
SI Up to INR 3 L
Affordable health insurance policy launched by the state government of Rajasthan. The scheme offers treatment benefits of up to Rs. 30,000 for general illnesses and Rs. 3 lakhs for critical diseases.
Want to know more if you are eligible for these public health insurance plans? Click Here
Eligibility Criteria of Mediclaim Insurance Policies
Investing in the best mediclaim policy is an important factor for financial planning. However, to achieve that goal, it is important to compare medical policies in the market. Consider the important factors mentioned below.
You should be a citizen of India to buy a health insurance plan in India.
Children are covered from the day of their birth till they turn 18 years old under a family floater health policy.
Most health insurance in India gives coverage till the age of 85 years. But certain plans give coverage till death.
You can get coverage for your extended family members in the family floater health insurance plan.
Eligibility criteria are the general requirements made by your health insurance provider before it issues a health policy to you. Factors like age, employment status, residency status, and more matter. Check your policy documents carefully before buying.
Key Benefits of Health Insurance
Let us look at the top 10 benefits of health insurance for you and your family:
Hospitalization Expenses Covered
If you are admitted to a hospital for 24 hours or more, your health policy covers hospitalization expenses like room rent, doctor’s consultation fees, diagnostics, pharmacy bills, and more.
Annual Health Check-ups
All top health insurance companies in India offer policyholders the facility of annual health check-ups, covered by health insurance.
Maternity and Newborn Cover
With maternity and newborn medical care benefits, health insurance plans offer holistic medical coverage for both mother and child.
Accident Care
Accident health policies safeguard your financial health by offering accident cover. Accidents can happen anytime, and one must have a robust health plan to cover medical expenses in such situations. Most bestselling personal accident plans/riders offer lumpsum payouts, child education grants, nominee benefits, etc.
Emergency Ambulance
Your health policy offers emergency ambulance coverage when you need to reach your nearest hospital. The coverage varies from policy to policy as some offer unlimited coverage, while others have a sub-limit amount on ambulance coverage.
Better Financial Management
It helps you manage your finances better and bridges the gap between consistently rising medical care expenses and affordable health insurance premiums.
All-in-One Coverage
All-in-one coverage for you and your family members with comprehensive health plans offering all-round protection and assistance.
Save Your Tax Deductions
An excellent financial tool, apart from safeguarding your health, it also offers tax benefits under section 80D of the Income Tax Act as per Indian laws.
Shield Against Critical Illnesses
Expensive treatments like cancer, organ transplants, etc., have the potential to drain your life savings but are now easier to treat with health insurance support.
Buy health insurance online to avail the following benefits:
Compare Multiple Plans at Once
With online platforms like PolicyX, you can select, customize, and compare multiple health plans available in the market online.
Pay Premiums Instantly
Select your preferred medical policy, and pay premiums instantly. Premium payments are quick and easy with online health insurance purchases.
Better For The Planet & Best For You
Buying health insurance online saves paper, and we all know what saving paper means: a better planet for all! Not just that, the online buying process simplifies the concept of insurance and allows people to compare health insurance plans to select the best one from the comfort of their home or office, without moving an inch.
Available 24/7
You do not have to worry about talking to insurance agents to purchase a health policy when you can purchase health plans online in a jiffy!
Digital Payment Options
Buy health insurance online with digital modes of payment that allow you to pay for your policy securely and quickly.
Multiple Online Discounts
Buy health insurance online and you will be eligible for multiple discounts as most companies offer online purchase discounts.
Tax Benefits on Health Insurance
While health insurance plans are an excellent way to safeguard your family from unforeseen medical expenses, they are also capable of helping you save taxes. Tax benefits under section 80D are as follows as per the age criteria for different individuals. Insurance holders are eligible to buy the best health insurance plans with the tax deductions mentioned above. You are eligible for the following tax deductions as per the Income Tax Laws in India.
For parents
Rs. 25,000
Below 60 Years
Senior Citizen
Rs. 50,000
Above 60 Years
For self and spouse
Rs. 25,000
Below 60 Years
For dependent children
Rs. 25,000
Below 25 Years
Let us understand tax benefits through a real-time scenario:
Raj is a 30-year-old working professional and his father is 70 years old. He purchases an individual health plan for himself and a senior citizen health plan for his father separately. He pays premiums of INR 30,000 and 35,000 respectively for individual and senior citizen health plans.
As per section 80D, Raj can claim tax deductions up to INR 25,000 for his health plan and INR 35,000 for the separate senior citizen health plan taken for his father. Raj can claim a total of INR 60,000 in tax deductions.
Inclusion vs Exclusions
COVID-19CataractOPD CareAmbulance CoverMaternity CoverAYUSH TreatmentsDaycare ProceduresModern TreatmentsAccident CoverMedical TestsDiagnostic and Pharmacy CoverPre and Post-hospitalization Expenses
Injuries due to illegal activitiesInjuries due to involvement in adventure sportsCosmetic proceduresObesity-related treatmentsSelf-inflicted injuriesWar, riots-related injuries
Riders In Health Insurance In India
To compare health insurance policies in India, considering riders is important. Health insurance riders are additional coverage options in addition to your base health coverage. The additional cost of health insurance riders depends on factors like age, type of rider, sum insured, and others but is comparatively much lower than investing in another health plan.
Below are some common riders you can avail of with your health policy:
Critical Illness Rider
With the rise in critical illnesses among people due to lifestyle and environmental factors, having a critical illness rider is a must-have today!
Personal Accident Rider
It also protects the future of your family by offering a child education fund, loss of income coverage and many more exclusive features.
Hospital Daily Cash
Loss of income caused due to hospitalization can be recovered with a daily hospital cash rider. The rider pays you a fixed amount daily as per pre-defined sub-limits.
Maternity Benefit Rider
Expenses during pregnancy and childbirth may be expensive without a health cover; this is when a maternity add-on steps in and helps you manage your health and finances, altogether.
Consumables Cover
Consumables rider in medical insurance offers coverage for all non-payable medical expenses. Items used for medical treatments such as cotton, gloves, bandages, thermometers, masks, etc., are paid for under this rider. The cost of consumables often contributes a significant amount to your total hospital bill, increasing the overall out-of-pocket cost.
Waiting Period Waiver
Waiver of premium rider in your health insurance policy waives off premiums for the policyholder in case he/she becomes critically ill or is disabled. The rider works under certain terms and conditions, and you might be required to fulfill an additional fee at the time of purchase or renewal to avail of this rider.
Health Insurance Premium Calculator
Calculate your insurance policy premiums with PolicyX to compare health insurance plans and make an informed decision. With the PolicyX health insurance calculator, you can do so without any charges. Follow these steps to use the PolicyX premium calculator.
Step 1
Visit the official website of PolicyX
Step 2
Select ’Health Insurance’ on the website
Step 3
Fill in the details required in the form such as the number of members to be covered, city, age, name, and contact details
Step 4
Click on ’Get Free Quotes’ to view all available health insurance plans with premium quotes
Step 5
Compare the list of health insurance plans with premiums as per your requirements
Premium Calculator Factors
City
Age
Pre-existing conditions
Sum insured, and more.
Number of people covered under a policy
Premium Calculator Benefits
Accurate premium calculation
Economical and hassle-free
Helps you compare health insurance plans and buy the best
Additional filters like riders, adding family members, etc., can show premium price changes in real-time
Customize your health policy as per your need
Key Factors To Consider Before Buying the Best Health Insurance
Coverage Features
When selecting a health insurance policy, you must consider the coverage scope of your policy. Compare the benefits offered by the health policy you want to purchase with others in the market. Hospitalization expenses, OPD covers, sub-limits, accident cover, maternity cover, etc.
Sum Insured Options
What is the maximum health insurance sum provided by your health policy? A minimum coverage of INR 10 Lakhs is advisable looking at the consistent rise in medical expenses in India. Investing in a 1 crore health insurance plan is also beneficial as it offers a wider scope of coverage at affordable premiums.
Co-payment
Look for a co-payment clause in your health insurance policy as it determines your premium costs. Many policies have a mandatory co-payment clause. This means you have to pay a certain percentage of the claim amount. Co-pay in health insurance helps you reduce your overall premiums.
Sub-limits
Many health policies have sub-limits for various features. A sub-limit in health insurance is the upper limit of expenses your health insurer gives at the time of claim. For example, if you have health insurance of INR 3 lakhs, and your daily room rent limit is 1%, your health insurer will pay INR 3,000 per day. You will pay additional room rent charges.
Network Hospitals
Before selecting health insurance, look at the cashless network hospitals list. A health insurer with multiple cashless hospitals in your city will help you in case any emergency medical assistance is required.
Why You Should Invest In Health Insurance At An Early Age?
The medical inflation rate in India is at 14%, leading to a constant increase in the prices of basic medical care. One of the many reasons you must invest in a health insurance policy at a young age is to make it affordable in the future. Other reasons include:
Comprehensive coverage for you and your family members for health emergencies and planned treatments without draining your savings.
You can wait out the waiting periods for coverages like maternity, which may be your plan. So when the time comes for you to plan a family, you do not have to worry about the waiting periods.
Affordable premiums are one major point of attraction to purchase a health insurance plan in your early 20s.
You are eligible for tax benefits under section 80D.
Who Should Invest In A Health Policy?
Investing in the best health insurance plan is essential for everyone. However, pay close attention to investing in a health insurance plan if:
You are between 25 to 65 years old and are a salaried employee
You are planning to start a family
You are a newly married couple
You have dependent children, parents, or grandparents
If you are seeking tax savings tools
Why Compare Health Insurance Plans Online?
You must have heard this many times, but comparing mediclaim policies online is important. Why? you ask. Well, for starters, it narrows down your choices based on the features you require as per your healthcare needs.
However, we understand that the process can be confusing and often overwhelming. PolicyX is a platform where you can compare health insurance plans and select the best suited for you.
Instant Information
You have access to instant and accurate information related to all health insurance plans available in the market. It saves you from unnecessary spam calls from insurance agents.
Compare Health Insurance Plans In A Click
You can easily compare all health insurance plans online with the PolicyX calculator. It is economical and hassle-free. In addition, you can perform multiple functions like paying premiums, opting for additional riders, downloading policy documents, etc.
Read Health Insurance Reviews
You can compare and read all the reviews from different people who have been associated with the health insurer. Understand the company’s ability to settle claims and solve insurance-related queries through verified customer reviews.
Find Insurance Literature Online
You do not have to contact insurance agents for paperwork like brochures, prospectuses, premium charts, etc. Purchasing health insurance online will give you access to all information with a click of a button.
How To Compare Health Insurance?
Selecting the best health insurance in India is a challenging job. You must compare the sum insured, affordable premiums, network hospitals, and more. However, to make your job easier, we have compiled a list of factors that will further help you to compare health insurance in India.
Comparison Parameters
How Will It Help?
Incurred Claims Ratio (ICR)
Compare health insurance companies’ ICR. It is the ratio between the total claim amount paid by the health insurer to the premium amount collected in a financial year.
Network Hospitals
Look for network hospitals associated with your health insurance provider to compare health insurance plans.
Riders & Add-ons
It is always beneficial to have some extra coverage when it comes to health insurance. Compare your health insurance plans and look for rider/add-on options available.
Waiting Period
When comparing health plans in India, look for minimal waiting periods offered by different plans.
Co-payment
Look for minimal co-pay/co-pay waiver options in your health insurance when comparing the best health insurance for yourself or your family.
Pre-policy Medical Check-up
Does your health insurer demand a pre-policy medical check-up? If so, will it be covered by the health insurer? Compare health plans for pre-policy medical check-up terms.
Health Insurance Myths Vs. Facts
Let’s bust some common myths related to health insurance in India:
Myth 1
Myth 2
Myth 3
Myth 4
Myth 5
Myth
I am young, I do not need a health insurance
Fact
Often young individuals think they do not require medical insurance as they do not have any health issues. However, health issues come uninvited. There are many health risks like unfortunate accidents, and seasonal illnesses like malaria, dengue, etc., which can easily stretch your medical bills from INR 50,000 to 1 Lakh. However, it is important to note that buying a health plan in your early 20s will be affordable as compared to buying it in your 30s. Many insurance companies offer benefits like premium locking at a young age, like Niva Bupa (Lock-the-Clock). This keeps your premium constant for years unless you apply for a claim.
Myth
Health insurance plans are only for individuals with existing health problems
Fact
Data states that Indian individuals are pre-diabetic and have hypertension and multiple other ailments but are unaware of the same. It is wise to have health insurance for everyone, not just for young individuals.
Myth
I am a regular smoker, I cannot get health insurance
Fact
This is a very common myth among people who are smokers, but it is not true. Health insurance plans are for everyone. However, the premiums for smokers are comparatively higher due to the higher risk of illnesses.
Myth
Health insurance plans will cover all my medical bills
Fact
The coverage offered by health insurance plans varies from insurer to insurer. It is important to read health policy documents before purchasing as IRDAI sets multiple exclusions.
Myth
I cannot change my health insurance plan once I buy it
Fact
It is not true. IRDAI gives customers the facility to port their health insurance plan from one insurer to another if not satisfied with their current service. You can also discontinue your health policy at the time of renewal and switch to a better health insurance plan suited to your needs with the help of PolicyX.
How to File a Health Insurance Claim?
With the latest initiative of ‘Cashless Everywhere’ by the government, it is easy to file claims. Earlier policyholders couldn’t avail of cashless treatments at non-network hospitals. Now, you can access cashless claims regardless of the hospital you are admitted to.
Cashless Claim
Cashless claims are filed when you avail of medical treatments in a network hospital. Once your treatment is complete, your hospital will settle the medical bills directly with your health insurer. Often, the claim settlement process is hectic and confusing for many. We, at PolicyX, understand such problems. If you face claim settlement issues, connect with our experts at PolicyX for hassle-free claim settlement.
Reimbursement Claim
If you avail medical treatments from a hospital, not listed on the panel of your health insurer, you can file for a reimbursement claim. After the completion of treatment, pay your medical bills, collect all the documents, and file for a reimbursement claim at the TPA desk or on the official website of your health insurer.
Health Card: How to Get a Physical Copy of Your Health Insurance Policy?
On purchasing a health insurance plan, every health insurer shares a policy document or policy card. This document contains your policy number, name, and other important details. This soft copy helps you avail of medical treatments at network and non-network hospitals.
However, if you want to download the physical copy for your health insurance plan look at the steps below:
Visit the official website of your health insurance provider
Log in with your email ID, name (login credentials)
Go to the policy document section and get it printed
You can also ask for a physical copy of your health insurance policy from your insurer at the time of purchase.
Documents Required for Health Insurance Claim
Documents required for health policy claim settlement are:
Valid photo-ID proof
Indoor case papers
Original bills from pharmacy/chemists
Duly completed and signed claim form, in original
Post-mortem report, if conducted
Medical practitioner’s referral letter and prescription
First Information Report, final police report, if applicable
Any other document as required by the company to assess the claim
Original pathological/diagnostic tests reports/radiology reports and payment receipts
Original bills, receipts, and discharge cards from the hospital/medical practitioner
How to Buy Right Health Insurance Plans Online from PolicyX?
With so much information on the internet, selecting the best health plan can be tiring! However, if you go to the right source the process is efficient and hassle-free. PolicyX comes with 11 years of experience, guiding lakhs of Indians to buy the best health plan suiting their requirements. As a buyer, you have easy access to compare and buy health insurance plans available in the market. Customize your health plan as per needs, add riders, and family members, set your sum insured requirements, and voila! Get the best health plan suggestions with accurate premium prices.
Online Process
You can purchase health insurance in two ways, either with PolicyX.com or via the concerned health insurer. Below mentioned details will give you a clear picture on what works best for you:
Step 1
Visit the PolicyX health insurance page, and enter your details such as name, age, number of members to be covered, and city.
Step 2
Click on ‘Get free quotes’ and compare health insurance plans as per your needs.
Step 3
Select and pay premiums online for the purchased health insurance plan of your choice.
Step 4
Our team of insurance experts at PolicyX will provide you with all the assistance required regarding claims and other queries post-purchase of your health insurance plan.
Health Insurance Words To Remember
Before you purchase a health insurance plan, make sure to tick all these boxes from the PolicyX checklist of purchasing a health plan.
An adequate sum insured must be selected for your health plan
Select the appropriate riders, as per your medical history and future needs
Select a health insurer with enough network hospitals in your city
Select a health insurer with quick and hassle-free claim settlement support
Check for any additional charges such as co-payments, and deductibles, mentioned in your health policy clause
Check for additional benefits like gym memberships, seminars, healthy lifestyle benefits, and others.
PolicyX Health Insurance Glossary
Here are some common terminologies used in health insurance when you go and purchase a health insurance policy.
Automatic Restoration
In case the policy sum insured is exhausted, it is restored automatically to cover you for the next hospitalization.
Add-on Covers
Additional coverage features that you can add to your base policy with slightly higher premiums. Common add-ons are personal accident cover, critical illness cover, etc.
Age Limit
The age limits specified by health insurers for customers to apply for purchasing or renewing a health insurance plan.
AYUSH Treatment
Alternative treatments like Ayurveda, Unani, Siddha, and Homeopathy are covered by most health insurance plans.
Annual Health Check-Up
Yearly health check-ups are covered by your health insurance plan.
Beneficiary
The policyholder or the nominee who receives the health insurance benefits is called a beneficiary. This is especially required when purchasing a personal accident plan.
Cumulative Bonus
The bonus received by a policyholder on completing the policy tenure without raising a claim. A cumulative bonus is received at the time of policy renewal.
Deductibles
The amount of money a policyholder pays out of pocket before the health insurance can cover their medical expenses. It is pre-decided by the policyholder and helps reduce the overall premium price.
Consult for Personalized Insurance Advice
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