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Health Insurance

Health insurance is an insurance policy that provides required financial help in case you fall ill or diagnosed with any serious disease. It assists with the cashless treatment or expense reimbursement so that you can completely focus on speedy recovery instead of the cost of the treatment. In case of an illness which leads to hospitalization, a health insurance policy will reimburse for expenses associated with the same.

Highlights

  • It provides financial assistance to deal with the expenses of treatment at any hospital and lighten the financial burden.

  • Allows you to avail cashless treatment in a network hospital and also reimburses insured in case of non-network hospitals.

  • Tax benefits in the form of tax exemption under section 80D of the Income Tax Act,1961.

PolicyX.com is here to help you with all health insurance needs. If you want to avail in-depth knowledge, compare health insurance plans from top insurance companies, buy the best health insurance, all your requirements associated with health insurance will be fulfilled by the team of PolicyX.com

Importance of Health Insurance

Investing in a health insurance policy is highly important for yourself and your family because of the growing inflation rate in the healthcare industry, especially in the private sector. A sudden medical emergency that leads hospitalization can create a hole in your pocket and can easily derail your finance. It will become highly tough if the breadwinner of the family is now in a hospital bed. You can easily avoid all this by buying a health insurance plan. By paying a small annual premium, you will get the required financial assistance, which will lessen your stress in case of any medical emergency.

Buy buying an effective health insurance policy; you will get the required cover against expenses made towards doctor consultation fees, costs towards medical tests, ambulance charges, hospitalization costs and even post-hospitalization recovery costs and much more.

Example - Ramesh is a full-time employee of an organization. He is working in a good position and carries several responsibilities on his shoulder. He was living a healthy lifestyle. But suddenly, one day he met an accident that leads him towards hospitalization and a few surgeries as well. He was not insured with any health insurance policy and nor his family's financial condition was good enough to deal with all expenses associated with the treatment.

So his wife borrows money from their relatives, and that was quite embarrassing for them. He got the treatment and recovering fast. But this incident strikes him hard. After this, Ramesh understands the importance of having savings and insurance as well. Since then, he makes sure to insure each and every member of the family with an effective health insurance plan and carries a decent amount of savings in the bank account for emergencies.

Ramesh was lucky enough that he got the required assistance on time, but this doesn't happen with all. So to deal with such emergencies of life, it is important to have an investment in a health insurance plan. And people should invest in the same at the earliest.

At PolicyX.com, which is an IRDA (Insurance Regulatory and Development Authority) approved website, you can buy the best health insurance plan according to your needs. You can freely compare on the basis of premium, features, health insurance benefits and can select the best plan according to your needs in just a few minutes.

Best Health Insurance Plans in India 2019

Religare Care with Smart Select

ManipalCigna ProHealth Protect

HDFC Ergo Health Suraksha

Royal Sundaram Lifeline Supreme

Diamond with Unlimited Reload by Aditya Birla

Apollo Munich Health Wallet

Insurance Companies Plan Cover Features Renewability Premium / Year
Religare Health Insurance Care with Smart Select 2 Adult +2 children Co-Pay - You pay 0% of the claim.
Maternity - Not Covered.
Hospital Room - Single Private Room
No Claim Bonus - Rs 0.5L per year upto Rs 2.5L
Restoration - Upto Rs 5L
Lifelong renewability 12535
HDFC ERGO Health Suraksha 2 Adults & 2 Children Co-Pay -You pay 0% of the claim.
Maternity - Not Covered
Hospital Room - All categories.
No Claim Bonus - Rs 0.25L Per Year Upto 2.5L.
Restoration - NA.
Lifetime renewability 14290
Aditya Birla Capital Diamond with Unlimited Reload 2 Adults & 2 Children Co-Pay - You pay 0% of the claim.
Maternity - Not Covered
Hospital Room - Single Private Room
No Claim Bonus - Rs 0.5L per year upto Rs 2.5L.
Restoration - Upto Rs 5L Unlimited times.
Lifelong renewability 15896
ManipalCigna ManipalCigna ProHealth Protect Policy 2 Adults & 2 Children Co-Pay - You pay 0% of the claim.
Maternity - Not Covered
Hospital Room - Single Private Room
No Claim Bonus - Rs 0.275L per year upto Rs 11L.
Restoration - Unlimited.
Lifelong renewal 14965
Royal Sundaram Lifeline Supreme 2 Adults +2 Children Co-Pay - You pay 0% of the claim.
Maternity - Not Covered.
Hospital Room - No capping on room rent.
No Claim Bonus - Rs 1L per year upto Rs 5L.
Restoration - Up to Rs 5L.
12443
Apollo Munich Health Wallet 2 Adults & 2 Children Co-Pay - You pay 0% of the claim.
Maternity - Not Covered
Hospital Room - Actual - No capping on room rent
No Claim Bonus - 50% Multiplier Benefit is Applicable.
Restoration - Upto Rs 5L
Lifelong renewal 25042

(5 lac -sum assured, Age of Head person-32)

Table Data Updated - March'19

Types of Health Insurance Plans

In India, there are many types of health insurance to cater different needs of customers. So for choosing the right one which can go well with your needs, you should first learn how many forms are there that you can explore.

Following are the major types of health insurance policies available in India.

Individual Health Insurance

The basic and most common form of health insurance is Individual health insurance. It covers a single person, but there's always flexibility of availing the bigger sum assured. The premium that we pay annually depends on the amount of sum assured. Individual health insurance is the need of every individual.

Family Floater Health Insurance

Family Floater Health Insurance is the best health insurance policy that allows to insure all family members under a single policy. All the family members can enjoy the benefit of the entire sum assured. It's a rare situation when any two members of the family fall ill simultaneously. As a result, the entire sum assured can be utilized by a single member. The amount of premium paid for such kind of policies is quite less as compared to other plans. Members who can get covered under Family floater health insurance policy includes your spouse, dependent children and the parents.

Critical Illness Plan

Critical Illness plan offers a fixed benefit, payout in case of any critical illnesses specified under the policy. With the lump sum benefit you will be able to pay the huge hospitalization costs and can get the treatment on time.

Senior Citizen Health Plan

Senior Citizen Health Plan is designed especially for the old age people, particularly the age above 60 years. This plan is great to fight against all medical contingencies during old age. As per the IRDAI regulations, every insurance company must insure people up to the age of 65 years.

Maternity Health Insurance

Nowadays, almost every health insurance company cover pre and postnatal care, child deliveries, and sometimes vaccination expenses of newborn babies as well. In short, it provides cover to all your maternity expenses. However, features and exclusions can vary from insurer to insurer.

Unit Linked Health Plan (ULHP)

Health insurance companies have recently introduced ULHPs. It is a combination of health insurance and investment. Along with the health protection, ULHPs will help you in building a corpus which can be used by the investor to meet expenditures that do not get covered under health insurance plans. The return, of course, depends upon the market conditions at that time. But these plans are still in the development stage and are recommended for those who can handle products like unit-linked insurance plans (ULIPs), and unit-linked pension plans (ULPPs).

Benefits of Health Insurance Policy

To buy any insurance plan, the most important thing is to focus on the features of the same. Below are a few features that you will get with a basic health insurance plan. With the understanding of the following features, buying an effective health insurance plan will become easier for you.

Cashless Treatment

Cashless treatment is a feature that allows the insured to get the required treatment at the network hospital without paying a single penny. In a cashless treatment option, the insurance company will pay on your behalf and allows you to have complete focus on your treatment. It will be a big help in case of hospitalization as you do not have to arrange funds during medical emergencies and can pay more attention to the treatment.

No Claim Bonus (NCB)

No claim bonus is a discount that you will receive from the insurer for every claimless year. It is a bonus that motivates a lot of policyholders not to file any small medical claims. You should keep in mind that NCB comes as a discount on the payable premium at the time of the renewing policy or whenever you want to increase the sum assured amount. At the time of renewal, you must check that you are getting your no claim bonus or not.

Family/Loyalty Discounts

It is a discount that you will receive on enrolling family member or any person in the health insurance policy. It is a form of reward that insurance company pays to the existing policyholder on referring people to them.

Round-The-Clock Customer Support

With almost all health insurance plans, you will get the benefit of 24/7 customer service. To provide more ease to customers and to solve their queries, all health insurance companies offer 24/7 customer service.

Sum Assured Restoration

The benefit of sum assured restoration is that once the sum assured amount is completely used, the insurance company will restore the amount automatically any you don't have to pay any additional cost for it. Usually, health insurance plans with restoration benefit are expensive as compared to normal health insurance policies.

Online Application and Renewal Facilities

Insurance companies offer you the benefit of buying a new plan and renew the existing one from the comfort of your home. Almost all insurance companies own websites and updated the same regularly to stay in touch with their existing customers, to make new ones, to sell and to introduce new insurance products. With such great services, it becomes easier for a customer to buy a new plan within a few seconds from the comfort of your home and can also renew the existing one.

Free Health Check-Ups

To motivate all policyholders towards a healthy life, insurance companies offer free medical check-up facility once in a while. Depending on the company and the type of policy that you hold, you may be eligible for a master health check-up.

Lifelong Renewability

Lifelong Renewability is the benefit that keeps you insured for the long term. While buying a health insurance plan, pay attention to the benefit of Lifelong Renewability.

Tax Benefits

No doubt, it is a plus point of investing in a health insurance plan. On buying any insurance policy, you will be liable to receive tax benefits, and the same thing is here with the health insurance plan. With a health insurance policy, you will get tax advantages for the premiums under Section 80D of the Income Tax Act, 1961.

Portability

Portability offers the advantage to switch from one insurer to another. The plus point is that you don't have to compromise with the waiting period or any other features and benefits that you are receiving with the existing insurer.

Health Insurance Plans Eligibility Criteria

Before buying anything, it is important to check the eligibility criteria so that you can have an understanding of the plans and your needs. You can easily invest in the best health insurance plan just by comparing several plans online. You can go for an individual plan or can also choose a family floater. Here are the eligibility criteria:-

  • Entry age(Adults)- 18 to 65 years (Exclusive plans are there for 70 years and above)

  • Entry age (Children)- 90 days to 18 years.

  • Renew-ability- Lifelong renew-ability(varies from plan to plan).

What Should Be The Ideal Health Insurance Cover?

To define the cost of mediclaim, the cost of the same depends upon the sum assured, health history, current health conditions, age of the customer, and many other things. If you are looking for a higher sum assured, then you must have to pay a higher premium as well. What should be the ideal health cover is like a question for many, but the answer is there within your needs. An ideal health plan will be the one which can provide the needful health cover to you on-time.

In India, offering health insurance plans to its employees has already become a trend, and almost every company is doing the same to motivate its employees and to make them feel secure. It also often covers hospitalization expenses of the spouse, dependent children, and parents. It's advisable to take the mediclaim irrespective of the amount covered because you don't have to pay any premium for that. Now, whether you need to take another health insurance policy will depend on a few factors. Is the cover provided by your employer is sufficient? Is the insurance company good enough? What will happen when you change jobs?

Mediclaim is provided as an incentive to employees. So it's important that you understand the insurance policy details and also check the coverage. Ask your human resource (HR) department for the details; what's covered and what's not. In many cases, employees are satisfied over the fact that their company is providing health insurance but later found that several things are not included at all or were covered only in parts.

Example 1:- If we talk about a middle class family, a 5 lakh cover as the minimum sum assured is necessary. A person can opt for family health cover, and if he/she is going for a family floater, then the minimum sum assured should be Rs 7.5 lakh. Moreover, for extra cover, a top up plan can be bought, which can be used when your basic health insurance plan's limit is crossed. A decent cover that a family should have in the urban areas is of Rs 10 lakh as the sum assured. They can go up to Rs 15 lakh to Rs 20 lakh as required.

Example 2:- If we talk about buying health insurance with pre-existing disease, then there is important to understand the seriousness of the diseases. Like how much the treatment will cost. And think about the future as well.

Like, if a heart surgery cost Rs 5 lakh today, then in the next 20 years the price will rise to Rs 80 lakh 20 years later. To deal with such scenarios, a minimum cover of 20 lacs is a need. You must go with the policy which keeps on increasing the cover on every claim free year. You must go for a top-up cover to enhance your existing health insurance cover. Top-up plans are cheaper as compared to others. Buy a health insurance cover at a young age and don't rely on the health insurance plan provided by the employer.

Health Insurance For Senior Citizens

Even about a decade back, mediclaim companies were unwilling to extend cover to the aged and senior citizens. But of late, several insurance companies are providing health insurance plans for parents. Insurance cover paid to an individual aged 65 years or above can lead to an additional tax relief of up to Rs 20,000. But remember that premium payable for senior citizens is much higher. If you are employed and have a mediclaim cover from your employers, approach your HR manager and negotiate with the insurance company to provide an additional cover for your parents. The insurer may provide the cover at an attractive premium because the volume will be high.

Top 5 Senior Citizen Health Insurance Plans

Insurance Company Plan Benefits Premium/Years
Religare Care Senior Co-Pay - You pay 20% of the claim
Hospital Room - Single Private Room
No Claim Bonus -Rs 0.5L per year upto Rs 2.5L.
Restoration - Upto Rs 5L.
27762
HDFC ERGO Health Suraksha Gold Regain Co-Pay -You pay 0% of the claim
Hospital Room - All categories.
No Claim Bonus - Rs 0.5L Per Year Upto 5L
Restoration - Yes
36470
Aditya Birla Diamond with Unlimited Reload Co-Pay - You pay 20% of the claim
Hospital Room - Single Private Room
No Claim Bonus - Rs 0.5L per year upto Rs 2.5L
Restoration - Upto Rs 5L Unlimited times
37676
Star Health Insurance Senior Citizen Plan Co-Pay - Fresh Illness : 30% For any Claims and in case of cover against PED : 50% For any Claims
Hospital Room - Upto Rs 6000
No Claim Bonus - Not Applicable
Restoration - Not Applicable
42480
ManipalCigna ManipalCigna ProHealth Plus Policy Co-Pay - You pay 0% of the claim
Hospital Room - Covered up to any Room except Suites
No Claim Bonus - Rs 0.55L per year upto Rs 11L.
Restoration - Unlimited
48343

Table Data Updated - March'19

Health Insurance vs Critical Illness Insurance

HEALTH INSURANCE CRITICAL ILLNESS INSURANCE
It is a base policy that provides insurance coverage against medical expenses incurred by the policyholder during the policy period. It is a defined benefit policy where the insurer pays out a lump sum benefit if and when the insured individual is diagnosed with a pre-specified critical ailment.
A health insurance policy remains active even when a claim has been made, until the sum insured limit is exhausted. Once the lump sum benefit is paid, the policy ends.
There is generally an initial waiting period of 1 month for illnesses and 1-3 years for pre-existing ailments. There is generally an initial waiting period of 3 months.

Health Insurance vs Term Insurance

HEALTH INSURANCE TERM INSURANCE
Health insurance provides medical cover against hospitalization and surgical expenses during the policy period. Term insurance is a pure risk life insurance product that pays out the sum assured upon the demise of the life insured.
The sum insured can only be used to cover medical expenses. The sum assured can be used in any manner the nominee wants - to cover expenses related to children's education, wedding, etc.
Tax deduction can be claimed on premiums paid under Section 80D of the Income Tax Act, 1961. Tax deduction can be claimed on premiums paid under Section 80C of the Income Tax Act, 1961.

Health Insurance vs Mediclaim policy

People with a lack of knowledge about health insurance often get confused between health insurance and mediclaim. Basically, a mediclaim offers coverage for hospitalization expenses for a definite pre-specified illness till a certain time as per the sum assured. Under mediclaim policy, the maximum limit for all claims is fixed at a definite amount.

It works on the principle of indemnity in which hospitalization is a specific requirement to think about any claim. Even those people who are policyholder under a mediclaim policy need to pay hospitalization expenses from their pocket, and the insurer will pay them later. Under a health insurance policy, policyholders will get the comprehensive coverage that will cover pre and post hospitalization as well.

The policyholder can also get coverage on ambulance charges, compensation for lost income, etc. but that all depends upon the riders associated with the health insurance policy. The upper limit of a health insurance policy can go as far as Rs 60 lakhs. Normally, health care policies also offer discounts regularly a definite period of time.

There is also a difference between a health insurance policy and mediclaim based on tax deduction. Health insurance premium paid towards a health insurance policy provides a tax exemption under section 80D of the Income Tax Act, the funds paid towards mediclaim premium paid for self or spouse or children are appropriate for tax exemption of Rs 15,000 under section 80D.

HEALTH INSURANCE MEDICLAIM POLICY
Health insurance provides a comprehensive health cover. Besides covering hospitalization expenses, it reimburses pre and post-hospitalization expenses, ambulance fees and pharmacy bills. Mediclaim policy covers only expenses related to hospitalisation and treatments.
A health insurance policy may cover critical illnesses. This policy does not cover critical illnesses.

Individual Health Insurance vs Family Health Insurance

INDIVIDUAL HEALTH INSURANCE FAMILY HEALTH INSURANCE
Individual health insurance, as its name would suggest, covers a single person. Family health insurance, also referred to family floater policy, covers the whole family under a single policy.
Individual health plans have a dedicated sum insured. The sum insured under a family floater policy is shared by all the covered family members. When one member files a claim, the cover reduces for the others by that much.
Since individual health policies are availed for only one member, the premiums will be determined on the basis of the age of that member, among other factors. Premiums of a family floater policy are determined by the age of the eldest member insured.

Government Health Insurance vs Private Health Insurance

GOVERNMENT HEALTH INSURANCE SCHEMES GOVERNMENT HEALTH INSURANCE SCHEMES
These schemes are initiated by the government mainly for the welfare of low-income groups. They are offered by private companies, with varying sum insured and premiums to suit different client needs.
Government schemes are normally offered for free. Insurance premiums are determined on the basis of a number of factors, like age of the policyholder, sum insured, etc.

Tax Exemptions in Health Insurance

Did you know that apart from the basic medical cover, a health insurance plan provide several additional benefits and tax benefits? PolicyX.com is here to make you understand the important benefit of buying a health insurance policy. Below are a few circumstances to understand how you can get tax benefits with health insurance.

No one over 60 years

In a case where no one in the family is over 60, the deduction is up to Rs 25,000. For health insurance paid for parents below 60, the deduction is up to Rs 25,000. Hence, total deduction a person can avail is up to Rs 50,000.

Either parent over 60 years

In case where one of the parents is over 60, the tax benefit of up to Rs 50,000 is allowed. Also, if a person pays a premium for family-self, spouse and children enjoys Rs 25,000 as a tax deduction. This means on a total; a person can avail tax benefits up to Rs 75,000 in a year.

Eldest member in the family over 60 years

Where a family member (self, spouse, or children) is over 60, one can claim up to Rs 50,000 in tax benefit on medical insurance. Additionally, for parents over 60, a person can get up to Rs 50,000 as a tax benefit. So, the total deduction, in this case, would be around Rs 1 lakh a year.

For Example - Rohit is a young marketing officer who is working in a reputable company and get Rs 45000 monthly salary. He bought a health insurance plan for himself and his parents, who are not over 60 years. He invests very smartly in a health insurance plan and shows the same at the time of filing ITR. With the help of both health insurance plans, he managed to save Rs.50000 on tax, which is a big relief for him.

How Can You Choose Best Health Insurance Policy?

To choose the best health insurance policy, you must take advantage of PolicyX.com's online comparison services. Some of the leading brands which offer health plans are MaxBupa, Bharti-AXA, Tata AIG, Apollo Munich, Star Health, etc. PolicyX.com helps you compare and choose the best health insurance plan for you.

You just have to compare health insurance plans provided by top insurance companies on our website. With the basic information that you fill in our website, we will search for the most suitable health plans for you and offers the relevant quotes which make the whole process of buying health plan easier for you.

With the available free quotes, it will be easier for you to compare plans on the basis of features, cost, riders, exclusions, benefits and, much more.

The level of coverage mostly depends upon the type of medical insurance policy. A lot of companies now offer health insurance in India, and therefore, as a consumer, you have multiple choices from leading brands.

Steps to choose the best Health Insurance Plan

  • Visit at the "Get Quotes From Top Insurers" section of PolicyX.com's Health Insurance page.

  • Put basic details in the form like your name, contact number, email Id, and age.

  • Click on the tab "CONTINUE"

  • After this, you will land in the quotes section.

  • Compare quotes on the basis of features, benefits, premium, pre-existing cover, no claim bonus, company, and much more.

  • You can check the brochure as well.

  • Select the desired plan, and click on "BUY THIS PLAN" Tab.

  • Then you will get the Policy form to fill. Under the same, you have to share your medical history, identity proof, and necessary document.

  • Then you can make payments through the online payment methods.

  • And you are done- You are insured now.

  • The team of PolicyX.com will instantly share policy documents over email.

(Note: Medical test would be done according to the plan features and insurance company's norms).

Health Insurance Companies In India

In India, there are 24+ health insurance companies which serves multiple health insurance products to cater to your needs. Below is the list of such health insurance companies for your understanding:-

  • Aditya Birla Health Insurance
    Aditya Birla Health Insurance Company is a renowned insurance company when it comes to the health insurance industry. The company is founded after the amalgamation of Aditya Birla group and South Africa based MMI Holdings Ltd, which owns a 49% stake. The company is offering a wide range of health insurance products to cater to the different needs of customers at an affordable price. It also promotes a healthy lifestyle and for the same, it provides a digitally integrated, incentivized, wellness program.
  • Apollo Munich Health Insurance
    Apollo Munich is a well-known insurer of the healthcare industry. It is a collaboration between Apollo Hospitals and Munich Health. The company has already spread its wings across all Indian subcontinent. It is delivering affordable yet effective health insurance plans to deal with the growing needs of customers. The company receives appreciation for its amazing concept through a number of awards for instituting innovative health insurance which can easily go we with customers of different age groups as well.
  • Bajaj Allianz Health Insurance
    Bajaj Allianz Health Insurance company refers to be the leading health insurance company of India. It is a joint venture Bajaj Finserv Limited and Allianz SE. The company aims to offer innovative healthcare products and comes out with multiple benefits for the ease of customers. The long list of health insurance products and the claim settlement ratio of the company is enough to attract many customers towards it and becoming a trusted insurance provider.
  • Bharti Axa Health Insurance
    Bharti AXA Health Insurance Company Limited is a joint venture between AXA 26% stakes and Bharti Enterprises. It is the fastest growing insurance company with dual certification of ISO 9001:2008 and ISO 27001:2005. The company carries around 59 branch offices across India that deals in multiple forms of health insurance products. Bharti AXA Health Insurance is great at keeping its promises associated with best customer support to maintain a relationship, easy claim settlement, and much more.
  • Cholamandalam Health Insurance
    Cholamandalam MS General Insurance Company is founded by the collaboration between two renowned companies- Murugappa Group and Mitsui Sumitomo Insurance Company Limited, Japan. Chola MS provides a wide range of helpful health insurance products that are customized in a way which can easily meet the different needs of customers. Chola MS follows a philosophy of T3, which reflect Trust, Transparency, and Technology. The company carries around 109 branches and over 9000 agents across the country.
  • ManipalCigna Health insurance
    ManipalCigna health insurance company which is formerly known as CignaTTK health insurance company is basically a joint venture between Manipal Group and Cigna Corporation. The company has its presence in 30+ countries and serving more than 160 million+ customers around the world. With a focus on improving health, the company offers a full suite of health insurance solutions.
  • Future Generali Health Insurance
    Future Generali Insurance is founded by a joint collaboration of Future Group of industries, and Indian Company (its flagship chains in the supermarket sector viz. Food Bazaar, Big Bazaar, and several other retail stores) and Generali group, an Italy based Company. The company is serving multiple health insurance to deal with the growing healthcare needs of its customers.
  • HDFC ERGO Health Insurance
    It is a renowned health insurance company which is established by a collaboration between HDFC Ltd., India's premier Housing Finance Institution and ERGO International AG, that is basically a primary insurance entity of Munich Re Group. HDFC ERGO refers to be the 4th largest general insurance company in India. The company is offering a long list of health insurance plans that you can compare and choose as per your age and needs.
  • IFFCO Tokio Health Insurance
    IFFCO Tokio HEalth Insurance Company is a joint venture between the Indian Farmers Fertilizer Co-operative (IFFCO) and its associates and the Tokio Marine and Nichido Fire Group. The company was established in December 2000 and since then the company is serving to the people of the nation with the helpful health insurance products. The company is also good at settling claims in a short span of time.
  • Max Bupa Health Insurance
    Max Bupa Health Insurance Company is a consolidated collaboration between Bupa Finance Plc, and Max India which has specialization in the healthcare industry. The company comes out with great healthcare solutions and serving more than 29 million customers. The company has its presence in 190 countries. The company is offering a range of effective health insurance plans and also assist in getting the best medical consultant and care.
  • National Health Insurance
    National Health Insurance refers to be the oldest general insurance companies. It was founded in 1906 and got nationalized in the year 1972. The company has its headquarters in Kolkata. It is a fully-government owned insurance company which is catering unique insurance needs of an individual, family, and senior citizen among others. The company designed all plans in the ways that each and every plan looks like a comprehensive one.
  • New India Health Insurance
    New India Health Insurance is a section of the New India Assurance that carries a presence in international countries as well with its headquarters in India. It is one of the oldest general insurance companies which operates worldwide and offering effective health insurance plans to people of all genders and age group as well. The company has started its operations in 1920 and right now functioning in more than 28 countries including Japan, Mauritius, Singapore, London, St. Lucia, Dominica, Myanmar, Nigeria, etc.
  • Oriental Health Insurance
    Oriental insurance is a renowned name of the health insurance industry in India. The company was founded in Bombay on 12th September 1947. It is a wholly owned subsidiary of the Oriental Government Security Life Assurance Company Ltd. The company carries a wide range of health insurance products to serve better. Earlier it was a subsidiary of Life Insurance Corporation of India from 1956 to 1973 (till the General Insurance Business was nationalized in the country). In 2003 General Insurance Corporation of India acquired all shares of the company has been transferred to Central Government.
  • Reliance Health Insurance
    Reliance General Insurance Company is a renowned company in India which offers a wide range of healthcare products at an affordable price and best claim settlement service as well. The company is getting popular because of its innovative products and easy to access services. The company has its presence in around 102 cities with 139 offices. The company aims to insure each and every individual with a suitable health insurance plan and thus comes out with multiple products.
  • Religare Health Insurance
    Religare Enterprise Private Ltd, Union Bank of India and Corporation Bank joined hands to established Religare Health Insurance. The company got the IRDA approval in 2012 and it always comes out with helpful health insurance products for the comfort of customers. It serves many other products as well but it carries specialization in health insurance products. The company is offering a wide range of health insurance products ranging from individual health insurance to family to group health insurance as well.
  • Royal Sundaram Health Insurance
    Royal Sundaram Health Insurance - a popular name in the health insurance industry which customized products on the basis of customerís safety and convenience. The company also receives ISO 9001 - 2015 for the customer service and have won the 'Celent Model Insurer Asia Award' for the intelligent claims management system. The wide range of health insurance products is helping customers to meet their requirements within budget as well.
  • SBI Health Insurance
    SBI Health Insurance Company aims to serve people with the best solutions against the growing health insurance emergencies. SBI Health insurance was founded with the same motive in 2010 and since then it is helping millions of people on a daily basis. To make its plan accessible. The company is offering the same at really affordable prices. With the same, it becomes easier for the insurer yourself and your families as well. The wide range of health insurance plans is a plus point that you will get with this health insurer.
  • Star Health Insurance
    Star health insurance refers to be India's first standalone health insurer. The company was established in 2006 and since then it keeps on growing well. The company carries expertise in providing health insurance plans at really affordable prices. It has more than 8000 network hospitals which are helping in availing cashless treatment. The company has more than 340 branches in the country which is ready to serve the people with great plans and features.
  • TATA AIG Health Insurance
    TATA AIG is a renowned health insurance company that caters into multiple domains of health care. It is a joint venture between the famous Tata Group and the American International Group (AIG). The company is in the market from the last 19 years and providing amazing health insurance products to cater to different needs of customers. It keeps on introducing innovative products and services over the years. The company is accredited with iAAA rating by ICRA for highest claims-paying ability.
  • United India Health Insurance
    United India Health Insurance Company was founded in 1938. This insurance company is great at designing complex covers for renowned customers and big companies such as ONGC Ltd, GMR- Hyderabad International Airport Ltd, Mumbai International Airport Ltd Tirumala-Tirupati Devasthanam, and many more. The company designed the products with the help of experts to make it highly effective and useful for customers. The company is also great at settling the claim on time without any hassles.
  • Universal Sompo Health Insurance
    Universal Sompo Health Insurance Company is basically a private-public partnership venture which is growing well in India. The collaboration to established this insurance company took place between two nationalized banks namely Allahabad Bank and Indian Overseas Bank, a private sector bank in Karnataka Bank, Dabur Investment Corp- and Sompo Japan of Tokyo. The company is great at offering innovative products. It offers a wide range of effective health insurance products.

How to Choose the Right Health Insurance Company?

As discussed above, it is important to have a health insurance policy. But don't forget that choosing the appropriate policy which can go well with your needs is also very important. A wrong policy with inadequate sum assured would be of no use. So it is always advisable to choose the right health insurance policy for yourself. For the same, there are a few things that you must keep in mind while choosing the best insurance plan according to your needs. Below mentioned are a few of them that will help you in the long run.

Reputation

The reputation of the company plans an important role. It is advisable to go for a company that carries a good brand image. Word of mouth recommendation and sound research will help you choose the right health insurance provider.

Financial Stability

It is important for you to understand that research is important before finalizing things. You must check the financial solidity of the company, and you can do the same by taking the help of the Credit Rating Information Services of India Limited (CRISIL) rating. Go for a company with AAA rating as it considered to have the highest financial strength to meet its obligations.

Product Portfolio

Don't forget that insurance is a vast industry and keeps on changing by time. It does not remain the same all the time and so your needs. That's why it is important to go for a company that offers a wide range of helpful insurance policies to cater different needs of customers.

Smooth And Quick Claim Settlement Process

You buy an insurance policy for your future emergencies, and there is no doubt that you expect the claim on time as well. Filing a claim can be a tedious job. It is true that no one wants to go through the long claim process that includes submitting papers along with supporting documents and a long wait for the approval. It would get worse if the company rejected your claim. Hence, it is advisable to search for an insurance company that follows the simple and easy claim settlement process.

Customer Service

Buying insurance is like building a new relationship, and thus you always need someone who can help you in a hard time and can support you to clear your queries. For the same, you will need to contact your insurer's customer service center from time to time. So, it is also important to pay attention to the quality of customer service of your insurance company. Choose the company that offers online chat, email assistance, or phone assistance.

Insurance Advisor

Insurance is tough to understand by a common person. But now many insurance companies start appointing an insurance advisor to every consumer to provide ease. Insurance advisors will help you in choosing an appropriate insurance plan according to your needs. When it comes to claim-related queries, they can provide prompt assistance. 24/7 customer support will be there with a toll-free helpline number to resolve customer queries.

Customer Feedback and Reviews

One of the most important and common aspect. Before buying anything, you must look for the customer ratings and feedback of an insurance company. For the same, you can take the help of IRDAI website to check the number of complaints and resolutions against the insurance company.

Things to Keep in Mind While Buying Health Insurance

The best health insurance for you is something that can go well with your needs. While buying a health insurance plan, there are a few things that you should keep in mind such as

Understand Your Policy

Before taking any final decision, it is important for you to understand what it would cover and what would not. Check what it offers exactly. Look for all the coverage options against pre-existing illness, accident-related expenses, day care procedures, and maternity expenses. Then, go for a plan which is enough for you and your family.

Check Exclusions

Normally people look for features and benefits, they forget that exclusions play a much more important role as it helps you in getting a clear image of where your insurance policy wouldn't support you. You can easily get the same on your policy's documents. But people normally avoid reading it, but you should read it thoroughly. Exclusions vary from insurer to insurer and plan to plan. Some of the popular exclusions are:

  • Dental services

  • Pregnancy

  • Cosmetic surgeries

  • Injuries caused by war, terrorism, commotion, protest, or strike

  • Joint replacement surgery

  • Homeopathy

  • Ayurveda

  • Injuries caused when under the influence of any drug/alcohol

Think About Co-Pay

While you are searching for a health insurance plan, you will often get the option of Co-pay. You have to decide whether you need it or not. For this, first you have to understand what co-pay is? At the time of filing claims, if you have opted for a co-pay then you have to pay a pre-agreed percentage of the claim and the insurer will take care of the remaining.

You should keep in mind that the sum assured amount under the plan will not be affected by co-payments. So, before taking a final decision, make sure that you need it or not.

Premium Payment Frequency

You have to renew your policy regularly to keep it active. You will get the option of paying the premium either monthly/quarterly/semi-annually/annually. However, before taking a final decision, check that you will be able to pay the premiums and renew the policy on time.

Claim Settlement Ratio 2017-2018

It is one of the most important things that you should look for. If you check the report online, then you would come to know that the claim settlement ratio of many insurance companies have gone up in the last few years.

It is an important thing as it shows the number of claims that an insurer has settled versus rejected. With this ratio, you will be clear in choosing the right insurance company for your health plan. Ensure that you are going for a high claim settlement ratio.

Insurance Companies Claim Settlement Ratio (2017-2018)
Apollo Munich Health Insurance Company 62.47
Bajaj Allianz General Insurance Co Ltd 77.61
Bharti AXA General Insurance Company 98.50
Cholamandalam Health Insurance Company 39.96
Manipalcigna Health Insurance Company 46.29
Future Generali Insurance Company 87.42
HDFC ERGO Health Insurance 52.58
Iffco Tokio General Insurance Company 90.69
Liberty Videocon General Insurance Company 74.58
Magma HDI General Insurance Company 34.93
Max Bupa Health Insurance 50.19
National Insurance Company 115.55
New India Assurance Company 103.19
Oriental General Insurance Company 113.86
Raheja QBE General Insurance Company 18.19
Reliance General Insurance Company 106.54
Religare Health Insurance Company 51.97
Royal Sundaram General Insurance Company 61.41
SBI General Insurance Company 52.93
Shriram General Insurance Company 50.83
Star Health Insurance Company 61.76
TATA AIG General Insurance Company 60.68
United India Insurance Company 110.95
Universal Sompo General Insurance Company 104.17

Portability Option

It is normal that sometimes we are not happy with the current insurer and want to switch to another insurance company. In such cases, you can take advantage of the portability option. The policyholder will be allowed to switch insurer, and the best thing is that he/she does not have to compromise with the waiting period or any other features and benefits which were available with the existing insurer.

Lifelong Renewability

Check for this benefit while you are buying a new health insurance plan or changing the existing one. It is normal that people look for a plan that offers protection for the long term, especially when it comes to old age. That's why the health insurance companies start offering lifelong renewability option.

No Claim Bonus (NCB)

NCB or no claim bonus is the percentage of discount that the policyholder receives on completion of every claimless year. It motivates people not to make petty claims. Insurance companies offer this as a discount on the premium, or the policyholder may choose to increase sum assured amount at the time of renewal. At the time of buying a policy, look for the no claim bonus option and percentage that the company offers.

Restoration Option

Look for this feature to get most of your health insurance plan. To offer optimum use of sum assured, insurance companies these days offer sum assured restoration benefit. Under a plan with restoration option, once the sum assured amount is completely used, it gets automatically restored without paying the additional cost. Health insurance plans with restoration benefits are more expensive than regular health insurance policies.

Our Health Insurance Partners

Health Insurance Portability

Usually, we have seen that many policyholders look for better coverage or better insurance company for various reasons. Sometimes they are not happy with the current insurance company, sometimes, the plan doesn't look sufficient enough; sometimes the needs are more, affordability can be an issue or else attractive towards any other health insurance plan can be one of the reasons behind the change. Almost all health insurance companies do allow you to change the insurer and plan at the time of renewal. Yes, at the time of renewal you can opt for any other insurance plan provided by any other insurance company, and this is known as health insurance portability.

Health Insurance portability is a simple format under which the insured is free to change the insurance company and the plan. With the same he/she doesn't have to compromise with the existing benefits, waiting period, and bonus. He/she can carry the same with the new insurance company as well. It seems to be an effective procedure which is helping millions of people daily in getting sufficient health insurance plan, or you can say a more comprehensive cover at affordable premiums. There are many ways to porting your health insurance plan, but the online health insurance comparison seems to be the best when. The reason behind the same is that

  • You will get free insurance quotes from top insurance companies.

  • Multiple options to choose from.

  • Can compare easily from a single page.

  • Comparison can be made on the basis of features, benefits, price, coverage and many more are there in the list.

  • Can buy directly from the page in a few minutes.

  • Less documentation & Hassle free process.

Pros & Cons of Portability

Pros Cons
Portability allows a person to avail better health insurance plans in terms of coverage, benefits, and much more. He/she can modify the health insurance plans as per their health conditions/requirements. A person can take advantage of portability at the time of renewal only.
On switching to a new one, you become entitled to Sum Assured and cumulative bonus which you are getting in the current one. There will be no compromise with the same Policies and features vary from insurer to insurer, so you need to opt for the new insurer very carefully
You can make sure about better claim settlement from all the companies while you plan to change your insurance company The new insurance company can reject the policy, keeping in view your medical history and claim.

"Porting has never been so easy before"

Why Is Health Insurance Comparison Important?

With the growing awareness about health insurance, many insurance companies have come up with the several and irresistible options of health insurance. The needs of a health insurance plan may vary from person to person, and that's why a single plan can go well with all of your requirements. To deal with such scenarios, insurance companies have come up with so many effective health insurance plans. But to choose the best out of all is again a daunting task. So that's why it is important to compare all available plans before buying the desired one.

We have seen that many people do make inappropriate health insurance investment that completely doesn't go well with your needs. What people usually do, they keep their focus at the premium of the plan rather than the features. To get a low premium plan, they end up with the inappropriate health insurance policy. And some people buy the costly one which is also a waste.

  • You should compare health insurance policies to get the best one out of all

  • You should make the comparison to keep yourself protected against unwanted deals.

  • You should compare health insurance to understand how much you actually need

  • You should compare to save your time and money

Why Compare Health Insurance With PolicyX.com?

Well, if you are thinking of comparing health insurance by visiting offices one by one, then let me tell you it will make things worse. By visiting offices physically and standing in the long queues to attain information is not a smart choice. It will take so much of your time and energy as well. Moreover, in this era where you can have almost everything at your doorstep, moving out for the same will not be a wise decision. You must take the help of an online insurance web aggregator such as Policyx.com for the same.

The benefits of choosing an online comparison site are unlimited such as unbiased quotes, ease to compare, hassle-free buying process, comfort, saves time and money, etc.

There is no doubt in saying that health insurance has become a necessity, and everyone is looking for an effective yet affordable health insurance plan. There are multiple plans to select from, but to get the best out of all is still a task. Thus to help you with the same, here we are.

PolicyX.com assists you entirely in getting free quotes and provides free comparison services. We have tie-ups with the top insurers in India and hence, we can provide free quotes easily to you on a single page.

You can get complete information about the plans and products on our portal. PolicyX.com is a one-stop shop for all your insurance related needs. So start the comparison of health insurance and get the best health insurance plan in India.

Teams at PolicyX.com make sure that you are getting the best deal within your budget and you are away of fake promises and products. We try to provide the easiest buying process. Our systems and teams are well equipped to help you with the whole buying procedure from starting to the end.

Through our portal, we try to help you with the required information so that you can compare plans wisely.

Here are a few points to make you understand why PolicyX.com is best for health insurance comparison:-

  • PolicyX.com is the leading and most trusted online insurance web aggregator.

  • It is an IRDA (Insurance Regulatory and Development Authority) registered portal that follows the norms of IRDA for accurate, reliable comparison service.

  • PolicyX.com offers a free comparison service.

  • PolicyX.com provides plan comparison from leading brands such as Religare Health, Max Bupa, Bharti Axa, Tata AI, Apollo Munich, Star Health, etc.

  • Allows insured to buy the desired plan from the comforts of home in a few minutes by filling up the online proposal. Most of our health plans are online, and you can get your policy instantly by making an online payment.

  • Allows insured to compare health insurance plans from over 10 companies within 30 seconds: You can buy the best health insurance policy according to your needs in 5 minutes.

Check the Credibility of the Company

If you are planning to buy a plan, go through the history of the insurance company. Select the company based on the following parameters:

ICR: Incurred Claim Ratio (ICR), is the most crucial parameter to check for when comparing health insurance companies.

It is calculated using the following formula every year:

ICR=Amount settled as claims/Amount collected as Premium

Look for the average ICR of all companies, when taking in account the ICR of a company, and go for the one which is closest to the average for a period of few years.

Some Important Terms of Health Insurance

Here are some of the important terms that you will come across while subscribing to a health insurance policy.

Sum Assured

The sum assured, in simple terms, is the maximum coverage amount you get with your insurance policy. It forms the basis of all your claims. Consider the increasing costs of hospitalization, medicines, and treatment before you decide on your sum assured. It's advisable to select a higher cover. At the same time, the cover shouldn't be high enough for you to dig into your pockets for paying the premium.

Co-pay and Sub-Limits

Co-pay is a fixed amount paid by a patient to the provider of service before receiving the service. Some health insurance companies have introduced the co-pay and sub-limit system to prevent hospitals from billing unreasonable room rents to patients. In a co-pay policy, you need to pay a part of the expenses irrespective of the sum assured. For instance, if a policy has 10% co-pay, then the insurance company will pay 90% of the expenses, and you have to bear the rest.

Besides, some insurers cap the expenses of treatments to reduce the claims of hospitals. This is known as sub-limit. While buying a mediclaim, choose a policy which has fewer sub-limits. Some mediclaim policies have no co-pay or sub-limits. Try to select such a plan.

Critical Illness

Critical illness refers to life-threatening diseases. There is a long list that comes under this section such as heart attack, kidney failure, cancer, and many more.

Restore Benefit

The restore benefit refers to a feature of the plan that reinstates your basic sum assured if you have already exhausted the same as well as the multiplier benefit within your policy year. But in most cases, the benefit is not available on the same illness if the limit is already used up.

But a restoration benefit can be useful if you have subscribed to a family floater plan where the full sum assured is exhausted for treating only a single family member. The remaining members will have no cover to fall back upon in case of hospitalization for the rest of the policy year.

No Claims Bonus (NCB)

No Claim Bonus, as the name suggests, is the insurance company's reward to the policyholder for not claiming in the preceding years.

Insurers usually extend an NCB to a policyholder if there has been no claim in the preceding year. While buying a mediclaim, check the NCB amount before signing on the dotted lines. NCBs can range from 5% to even 100% of the sum assured. A high NCB gives cover against medical inflation, and you don't need to worry about increasing your coverage year-on-year.

Pre-existing illness, Waiting Period

Pre-existing diseases refers to those diseases that you have before subscribing to the mediclaim policy. Most health insurance companies specify a waiting period for these illnesses. If you have a pre-existing illness, the insurance company is unlikely to give a cover against the same. In most cases, a pre-existing illness is covered after at least two years of buying the policy.

Exclusions

It simply means the diseases that are not covered under the mediclaim. For instance, if you have diabetes while taking the policy, then kidney ailments are likely to be excluded from cover if the same happens because of diabetes. Never hide any pre-existing ailments from your insurer while buying a mediclaim policy. It may reduce your hospitalization claims.

Top up Plans

Top-up health policy is additional coverage for people who have an existing individual plan or a mediclaim from the employer.

Medical costs are increasing. It calls for large covers. But not all can afford a high premium. A top-up plan is useful in such a case. It reduces the cost of deductibles i.e., the amount you pay before the insurance company pays up. The insurance company will only pay up to the sum assured. A top-up plan, on the other hand, doesn't pay until the hospital bill breaches a specific limit.

Suppose, if the hospital bill is Rs. 8 lakhs with Rs 3 lakhs as deductible, you need to pay the latter, while the insurer pays the balance Rs 5 lakhs. But you can use your individual/group policy to pay the deductible amount. This is usually helpful because a combination of a basic mediclaim plan along with a top-up plan is much cheaper than a single cover. For instance, the premium for a Rs 5 lakhs regular cover for a 26-year old male, will be around Rs 6,500. A top up with Rs 15 lakh cover will entail an additional premium of Rs 5,000, which is far cheaper than a standalone policy of identical amount.

Mistakes to Avoid While Buying Health Insurance Plan Online

There is no doubt in saying that choosing the right insurance company for your health insurance needs is a daunting task. Today, all internet facilities and several options of health insurance plans have made it easy for a person to buy the same in a few seconds, but this doesn't mean that you should become an impatient buyer.

Just because of our busy schedule and the long list of terms and conditions, we should not skip the same in a rush to make a decision. But, we are making a mistake while buying a health insurance plan. One of the common mistakes that people usually do and you should avoid are as follows:-

Insufficient coverage

Don't go for insufficient cover just because of the low premium; it will not be able to provide the desired coverage in the hour of need.

The cost that people pay towards his/her health insurance plays a vital role in deciding which policy you should go for. Hence, just because of saving an amount, people end up in choosing a plan with less coverage, or you can say insufficient coverage. It is true that cost plays an important role in choosing a health insurance plan, but it should not be the only element that you are looking for.

Avoiding the fine print

While many of the individuals are aware of different treatment and expenses that will get the needful cover under your health insurance policy. There is no doubt in saying that having an idea about the coverage area of your health insurance plan, but you should not skip the exclusions part of the same. It is equally as important as knowing the coverage part.

Don't rely on a single insurer or plan

Don't go with the first insurer that you got. While buying, or renewing the existing health insurance plan, it is vital for you to understand that comparison of several plans will help you in getting the best and most suited plan which can easily go well with your needs.

If you get something better than your existing health insurance plan, then you should switch the insurer without any hesitation. Many companies are offering exciting health insurance plans to remain at the top and to attract consumers from time to time. Just take advantage of the same and get yourself enrolled in the most suited plan according to your needs and budget.

Hiding medical history

This is the most common mistake that people usually do, and this becomes the biggest reason behind the rejection of health insurance claims by the insurer. While looking for a health insurance plan it is very important to be transparent about your medical history, don't hide anything and let your insurer know about all your medical problems in advance.

Not choosing co-pay wisely

If you do not choose co-pay wisely, then you may end up in the wrong situation at the time of claim. There can be a chance of rejection; you might have to pay a big amount from your pocket, not able to get the required coverage and several others.

Buying Over

There is no need of buying many additional riders if you don't need it. Purchasing too many extra riders will only lead you towards the stage of over policyholder. Spend a few minutes on understanding your needs first, write it down, and then go for a plan that can easily go well with your needs. Make sure you are not over-policyholder.

Delay in Buying

If you delay in buying health insurance, then you might have to pay a high premium, not liable of wider cover, and much more. Moreover, what will you do if you fall ill with serious health diseases before buying it? Invest in health insurance as soon as you can. The older you get, the less will be the options to explore as not all insurance companies will be ready to entertain you.

Rely on Insurance Offered by Employer

Don't rely on the employer's health insurance for a comprehensive cover. It would not be sufficient enough to get the required treatment on time. There is a possibility that you might be getting health insurance coverage by your employer, but it is not necessary that it would be sufficient for you as it is not customized as per your needs. You should also keep in mind that the health insurance coverage that you must be getting from your employer will stop once you changed the company. It is always necessary to opt for a supplemental health insurance plan that would be enough for you. You can also use your employer's health insurance plan to make a claim and enjoy a no-claim bonus on your health insurance plan.

Health Insurance Claims Settlement Process

There is a term called TPAs, and most people are aware of it but they don't know how it got settled. Once a mediclaim policy is sold, the TPA takes up the baton from the insurance company. Some companies offer direct claim settlement process, and some take help of TPAs For claims settlement. Broadly the claim settlement process takes place in two forms which are mentioned below:

Broadly the claim settlement process takes place in two forms which are mentioned below

Cashless

You can avail cashless treatment facilities only in the networked hospitals of the insurance company. The TPA must be notified beforehand in case of planned hospitalization, or within a specified timeframe in case of an emergency. The hospital's insurance desk helps with all the paperwork. The TPA has to approve the mediclaim amount, and the hospital will settle it with the insurer. There are likely to be exclusions i.e., expenses that the TPA won't pay. Such expenses must be settled by the patient party directly at the hospital cash counter.

Reimbursement

The insurer can avail the reimbursement facility both at networked and non-networked hospitals. Here, you can avail treatment facilities and settle the bill directly with the hospital. You can then claim reimbursement of the expenses from the TPA by submitting the relevant bills and receipts.

Steps to Follow- Cashless

  • Inform the insurance provider on a call or through email.

  • Show the health card as provided by your health insurance company along with the identity proof.

  • The hospital will examine the identity of the policyholder and will submit the pre-authorization form to the health insurance company.

  • The insurance company will examine all documents, and if everything is fine according to their norms, then it will process the claim.

  • A few health insurance companies provide a field doctor to help you with the whole procedure.

  • After the completion of all formalities, the claim is settled as per rules of the company

Steps to Follow- Reimbursement

  • Inform the insurance company about your hospitalization as soon as possible

  • Keep all your documents ready with the bills of hospitals.

  • Submit the documents along with the claim forms. Don't forget to attach bills of hospitals.

  • The insurance company will check all the submitted documents and process the claim according to the terms and conditions of the health insurance policy.

  • After the completion of all formalities, the claim is settled as per the terms and conditions of the policy.

Documents Required for Claim Reimbursement

Proof of Age: Acceptable documents are Birth Certificate, PAN Card, Voter's ID, Driving License, Passport, School or College Certificate, etc.

Photo Identity Proof: Aadhaar Card, PAN Card, Driving License, Passport, Voter's ID, etc.

Proof of Address: Acceptable documents are Ration Card, Telephone Bill, Electricity Bill, Passport, Voter's ID, Bank A/C Statement, etc.

Proof of Income: Salary Slip, Employer's Certificate, Form 16, etc.

Medical Checkup: If asked by the insurance company.

Passport Size Photograph.

Linking Aadhar and PAN to Health Insurance Policies

The Insurance Regulatory and Development Authority of India (IRDAI) has made it mandatory for all policyholders to link their Aadhar and PAN/Form 60 with their insurance policies. According to the mandate issued by IRDAI, insurance companies are now mandated to collect Aadhar and PAN/Form 60 details from their customers before issuing a policy.

The mandate also comes with a warning that all medical insurance insurance policies will cease to be operational if the required details are not submitted. It must be noted that the policies will not become void if a customer does not have Aadhar and PAN/Form 60 details. All claims during this period will be kept under abeyance, or temporary suspension, till the Aadhar details are provided to the insurer. All rules related to the submission of Aadhar and PAN/Form 60 details are framed under the Prevention of Money Laundering Act of 2002.

Top Health Insurance Schemes By Government Of India

The government of India is focusing on increasing healthcare awareness, and thus for the same, it came out with several new plans for the people of the country. They are designed to improve the healthcare access for the unorganized sectors and for those who come under the Below Poverty Line (BPL) category. Here is a list of health insurance schemes provided by the government:

Ayushman Bharat

One of the most effective National Health Protection Scheme, which is offering the required health cover to almost 10 crore poor and vulnerable families. It is designed in a way that can offer required cover to around 50 crore beneficiaries. A cover of about 5 lakh rupees per family per year for secondary and tertiary care hospitalization will be there. This effective health program will subsume the current centrally sponsored schemes - Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).

Rashtriya Swasthya Bima Yojana (RSBY)

The Ministry of Labour and Employment introduced a new health protection scheme to provide the helpful cover to offer the needful health insurance coverage, especially for BPL families. With this effective healthcare plan, all beneficiaries can avail hospitalization whenever it requires up to Rs 30,000. To enroll under this effective health insurance plan, there is no specific age limit, and you will be liable to get the cover of pre-existing diseases from day 1 of the policy. It can cover up to 5 members of the family includes spouse, children, and dependents. Beneficiaries have to pay only Rs.30 as registration fee. The central and state government to the insurance company will take care of the rest unpaid premium.

Pradhan Mantri Suraksha Bima Yojana

The universal fact is that accidents are unfortunate incidents which can happen at any place, anytime to anyone. It does not discriminate against people on the basis of rich and poor. In such a scenario, the one who suffers the most is the poor section of the society, who are unable to afford an effective and adequate health insurance policy. To provide the needful assistance to the poor section, the government has come out with this effective health insurance plan called Pradhan Mantri Suraksha Bima Yojana. It offers wider cover at affordable premiums and provides compensation to the family of the deceased or if the policyholder has been disabled partially or permanently following an accident.

Central Government Health Scheme (CGHS)

It was introduced a long time back ago, and since its inception, it is providing great assistance. It is now available in CGHS covered cities like Allahabad, Bhopal, Chandigarh, Ahmedabad, Lucknow, etc. The plan is designed to cover central government employees and pensioners. Under the same, the dependant's member of the government employee would also be able to reap the benefits of this plan. The insurance policy provides coverage against domiciliary care, specialist consultation facilities, laboratory tests, hospitalization, and health education to beneficiaries.

Aam Aadmi Bima Yojana (AABY)

A social security scheme launched in October 2017 intending to provide required healthcare facilities to all the rural and landless households. The head of the household or the earning member of the family will be covered under the scheme. The central and state government will pay a premium of Rs 200 per year is paid by the central and state government. The beneficiary should be between 18 to 59 years of age. With the same beneficiary will receive Rs 30,000 upon the natural death of the policyholder member, Rs 75,000 upon accidental death or permanent disability, and Rs 37,500 on partial permanent disability.

Janashree Bima Yojana (JBY)

This insurance policy was launched in 2000 on 10th August after replacing the Social Security Group Insurance Scheme (SSGIS) and Rural Group Life Insurance Scheme (RGLIS). This policy is specially designed for those people who come under the BPL category and slightly above the BPL category in 45 occupational groups covered under the scheme. Some of the occupations that would be liable to get the cover are beedi workers, carpenters, power loom workers, cobblers, handicraft artisan, agriculturists, construction workers, etc. Aam Admi Bima Yojana and Janashree Bima Yojana have been merged into one scheme and called as Aam Admi Bima Yojana since 2013.

Employment State Insurance Scheme (ESIS)

Again a social security scheme that is designed especially to offer the socio-economic protection to the working class and their dependents. The policyholder and his family who will receive complete medical care from day one. Under the policy, the beneficiary will receive cash benefits in times of sickness and temporary or permanent disablement that leads to the loss of earning capacity. This policy will also be covered by the policyholder's dependents as if the dependant is disabled on the job, a monthly pension called the dependents' benefit is provided under the ESI scheme. The scheme applies to non-seasonal factories, theatres, shops, restaurants, hotels, road motor transport undertakings, and newspaper establishments employing more than 20 people. Recently, private medical and educational institutions employing more than 20 people in certain states and union territories have also been included under the scheme.

Universal Health Insurance Scheme (UHIS)

A new health insurance plan that is py-1 font-15 specially designed to provide needful healthcare services to a wide area of the country and to cover poor section effectively. Under this plan, beneficiaries will receive reimbursement for medical expenses up to Rs 30,000 and accidental death cover up to Rs 25,000. This policy is there for the BPL families only. The insurance premium for this scheme is Rs 200 per person, Rs 300 for a family of 5, and Rs 400 for a family of 7. The four public sector/government health insurance companies in India are The New India Assurance Co. Ltd. United India Insurance Company, National Insurance Co. Ltd. and Oriental Insurance.

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Health Insurance FAQs

Before buying health insurance, we are sure you must be having a lot many questions in your mind. Do not worry PolicyX.com is here to help you figure out the best insurance policy for you.

1. What is cashless mediclaim?

These days, most insurers have arrangements with various hospitals spread across the country as part of a network. An individual, if policyholder under a policy which offers the cashless facility, can get treated in any hospital of the network without paying hospital bills because the same is paid directly by a third party administrator (TPA), on behalf of the insurer. However, all expenses beyond the sum insured or the ones not covered under the policy, have to be paid by the policyholder directly to the hospital. Cashless facility is not available if the hospital is not included in the network. In such cases, payment by the insurance company to the hospital is usually carried out on a reimbursement basis.

2. What are the tax benefits of health insurance?

You can claim several tax benefits if you subscribe to a health insurance scheme. Such benefits are extended by section 80D of the Income Tax Act. Presently, subscribers to health insurance, who purchased the policy by a payment mode other than cash, are eligible for Rs 15,000 annual deduction from their taxable income for the payment of health insurance premium for self, dependent children, or spouse. The deduction is higher for senior citizens at Rs 20,000. Also, since the 2008-09 financial year, an additional deduction of Rs 15,000 can be claimed for mediclaim premium paid for parents. It's Rs 20,000 if parents are senior citizens.

3. What factors affect the premium payable for a health insurance policy?

Age is the biggest factor which determines the premium payable. The older you are, the higher will be your premium, because you'll be more prone to illness. Your medical history is another factor that will go into determining the premium. If you don't have any medical history, the premium would be naturally lower. You are eligible for a discount on the further premium payable for the years for which there has been no claim of the insurance money. Some insurance companies cover add-on benefits like free medical checkups and/or diagnostic tests in case of no claim.

4. What are the things not covered under a health insurance policy?

Read the offer document/prospectus and understand it fully before signing on the dotted lines. What's not included will be clearly written in the prospectus. Any pre-existing illness, usually, is not covered under a policy. But read the offer document to understand what the insurer means by pre-existing illness. Also, the majority of the policies generally exclude certain types of diseases in the first year of coverage. A waiting period is also often imposed on such diseases. Some expenses not covered under most health insurance policies include cost of contact lenses, spectacles and hearing aids, dental surgery (unless it requires hospitalization), general debility, convalescence, venereal disease, congenital external defects, use of drugs and alcohol, intentional self-injury, expenses for diagnosis, AIDS, X-ray and/or laboratory tests not connected with the illness requiring hospitalization, treatment related to pregnancy or childbirth, including C-section, naturopathy treatment and others as deemed exclusive by the insurer.

5. What about the waiting period?

As already said, there is usually a 30-day waiting period when you buy a new policy, starting from the day you enrolled in the health insurance scheme. During this period, the insurance company won't pay any hospitalization charges. But this is not applicable in case of an emergency hospitalization arising out of an accident. The waiting period is not applicable for renewal of the policy for subsequent years.

6. What is a pre-existing condition?

It's a medical condition or ailment that existed before you took the health insurance policy. This is a significant point in all policies because insurers don't cover such conditions within 48 months prior to taking the first policy. It means a pre-existing condition may be considered for payment, only after the completion of 48 months of continuous insurance cover.

7. If I don't renew my policy before the expiry date, can I be denied renewal?

The policy can be renewed if you pay your premium within the grace period, which is usually 15 days from the date of expiry of the policy for most insurance companies. However, you will not be entitled to any coverage for the period during which the insurance company did not receive any premium. Also, the policy would lapse if the premium is not paid within the grace period.

8. Is my health insurance policy transferable, without losing renewal benefits?

Yes. According to a circular issued by the Insurance Regulatory and Development Authority (IRDA), with effect from 1 October, 2011, the insured can transfer a policy from one insurer to another, and also from one plan to another. The insured will lose no renewal credit for pre-existing health conditions which he/she enjoyed in the incumbent policy. But the credit would be limited to the sum insured and the bonus eligible under the present policy. Check with your insurance company for the detailed clauses in this regard.

9. What happens to the coverage amount when a claim is filed?

Once an insurance claim is filed and settled, the coverage gets reduced by the amount paid on settlement. For instance, if you take an Rs5 lakh mediclaim policy in January, and in April, the insurance company pays? 3 lakhs towards your hospitalization and treatment, then you will be eligible for the balance Rs 2 lakhs as coverage for the remaining duration i.e., May to December

10. What about "anyone illness"?

This means a continued period of illness and includes relapse within a specified number of days, subject to the terms and conditions are written in the policy. It's usually for 45 days.

11. How many claims are allowed in a year?

There's no limit to the number of claims in a single year unless there's a specific cap laid down in the policy. The sum insured, however, is the maximum claimable limit under the mediclaim policy.

12. What is a family floater?

In a family floater scheme, a single policy covers the hospitalization expenses of the entire family. Such a policy has only one sum insured which can be utilized by a single or all members collectively in the family. The limit of coverage is capped at the sum assured. Family floater plans are considered better than buying a separate health policy for each member of the family. It takes care of all medical expenses, including surgeries, sudden illness, and accidents.

13. How insurance helps in health check-up facility?

Some insurance companies reimburse general health checkup expenses usually once in every four years.

14. Which health insurance plans are available for women?

Women of all walks of life are now progressing and trying to maintain the fine balance between their personal and professional commitments. Hence, it is important that their medical needs are catered to. Various health insurance providers have now come up with unique health insurance plans that specifically cater to female medical conditions such as breast cancer, ovarian cancer, cervical cancer, complications during pregnancy, childbirth or other forms of critical illnesses. Some of the top companies that provide these kinds of health insurance plans are TATA AIG, Bajaj Allianz, etc.

15. How does smoking affect health insurance premiums?

Smoking has an adverse effect to health insurance premiums. This means that if you are a smoker, you end up paying higher premiums as you are subjected to greater medical risks.

16. What if I forgot to pay my health insurance premiums?

In case you forget to pay your health insurance premiums, the provider gives you a grace period that usually varies from one to three months. However, if you fail to pay the premiums during this time as well, your insurance policy lapses and you are no longer entitled to the health insurance benefits of the policy.

17. What is GST and how does it impact health insurance?

Goods and Services Tax (GST) - implemented in 2017 - is an indirect tax levied on the sale of goods and services in India. It has replaced many indirect taxes imposed on goods and services by State and Central Government. Tax slabs under GST have been fixed at 0%, 5%, 12% and 28%.

Before the new tax regime, the service tax rate applicable on health insurance was 15%. However, with the implementation of GST, the tax rate has been raised by 3%- placing health insurance in the 18% tax bracket.

Last updated on 14-06-2019