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Health Insurance

Health insurance in recent times has become an essential part of everyone's life. With the rising healthcare costs, availing of quality healthcare can leave a family financially struggling. Therefore, with the right health insurance you can ensure to avail quality treatments without burning out your savings completely.

Health policy purchases in India are steadily increasing, but there is still a long way to go. According to the most recent NFHS-5 survey, 41% of Indian families have at least one individual covered by a Medical Insurance plan, up from 28.7% in the previous NFHS-4 study. Because of the pandemic, the Indian population has realized the value of health insurance. However, it is a crucial tool for protecting yourself and your family during times of medical emergency.

Ideally, a policyholder must compare Health Insurance Plans in order to make the best possible purchase for oneself and their family. There are certain points to keep in mind while comparing health insurance. For instance, compare health insurance, the entire package, and not just one component of the policy. The ideal step for a policyholder is to compare online health insurance plans based on premiums, coverage, services, inclusions, exclusions, and claim settlement. Yes, we understand it is a lot of work! This is why here we are, we will guide you on how to go about comparing health insurance plans in India.

All About Health Insurance Policy

What is Health Insurance

Health insurance is an agreement between the insurance company and the insured, where the insurance company provides financial coverage for medical expenses in case the insured falls ill or meets with an accident. A health insurance policy provides cashless hospitalization, in-patient, and out-patient hospitalization, critical illness benefits, accident coverage, organ donor expenses coverage, day-care treatments, OPD coverage, domiciliary hospitalization, senior citizens coverage, and coverage for your dependent parents and children. Health Insurance in India also provides you with tax exemptions under section 80D of the Income Tax Act.

To avail the coverage against medical expenses, the policyholder needs to pay a specific amount (monthly, quarterly or annually) which is called a premium. The premium of the health insurance plans differs from person to person and depends on certain parameters such as your age, sum insured chosen, lifestyle etc.

Snapshot of Medical Insurance in India

The standard eligibility criteria and features for health insurance in India are depicted below for better understanding.

Entry Age Minimum Entry Age :Adult: 18 Years Child: 91 Days
Maximum Entry Age Adult: 65 Years Child: 25 Years
Claim Settlement Cashless Claim Settlement at network hospitals
Renewability Available with lifetime renewability
Preventive Check-ups Available
Tax Benefits Available under section 80D
SI INR 50k to 2 Cr
Maternity and New Born Cover Available
Organ Donor Cover Available
OPD Available
DayCare Treatments Available
Annual Health Check-ups Available
Road and Air Ambulance Available
Special Covers Critical Illness/ Senior Citizen/ Vector Borne Diseases/ Covid

Health Insurance Plans

Health Insurance companies in India provide numerous medical insurance policies with regard to the needs of an individual as well as families. Let us compare health insurance policies to understand their advantages in detail.

Comprehensive Health Insurance Plans

A comprehensive health plan for individual and family with SI of 3 lacs to 6 Cr. with global coverage.

Unique Benefits

  • In-built maternity cover
  • No upper age limit for enrollment
  • Coverage for modern treatments

This policy is designed to provide complete protection against all health care eventualities to you and your family.

Unique Features

  • Avail free health check-ups
  • Hospital Cash Benefit
  • 100% Automatic Restoration

Star Comprehensive Plan (Pros)

  • 99.6% CSR
  • Up to 1 Cr SI
  • Maternity Cover
  • New Born Baby Cover
  • Road and Air Ambulance

Star Comprehensive Plan (Cons)

  • No Global Coverage
  • No IVF Treatment
  • No compassionate Travel
  • HIV/AIDS not covered

Star Comprehensive Plan (Other Benefits)

  • Individual and family floater
  • Mid-term inclusion available
  • Accidental Death
  • Permanent Total Disablement
  • Star Wellness Program

Star Comprehensive Plan (Eligibility Criteria)

  • Entry Age - 3 Months
  • Max Entry Age - 65 Years
  • SI - 5 L to 1 Cr
  • Waiting Period - 30 Days

An individual and family plan that covers all day care treatments, modern treatments, comes with a safeguard add-on and provides annual health check-ups.

Unique Features

  • No room rent capping
  • 20% no-claim bonus on SI
  • 100% SI restoration

Health Companion V2022 (Pros)

  • 5% Doctor Discount
  • 10% Family discount
  • Tenure Discounts of upto 15 %
  • Annual Aggregate Deductible
  • Home Care Treatments

Health Companion V2022 (Cons)

  • No OPD Cover
  • No Maternity Cover
  • Cosmetic Surgery Uncovered
  • Specific Diseases after 2 yrs
  • No Alcoholism Cover

Health Companion V2022 (Other Benefits)

  • Air Ambulance
  • Modern Treatments
  • Vaccination on Animal Bite
  • Organ Donor Benefit
  • Domiciliary treatments

Health Companion V2022 (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - No Age Limit
  • SI - 3 L to 1 Cr
  • Waiting Period - 30 Days

A comprehensive plan with 5 different variants suitable for individuals and young couples, offering sum insured up to 1Cr.

Unique Features

  • Avail family discount
  • Worldwide emergency protection
  • Avail healthy lifestyle benefits

Provides comprehensive medical coverage to individuals and families with different budgets by offering SI options ranging from 5 Lakhs to 50 Lakhs.

Unique Features

  • Free health checkup
  • 2X multiplier benefit
  • 100% SI restoration

Optima Restore Policy (Pros)

  • Daily Hospital Cash
  • Ambulance Cover
  • Modern Treatment
  • Lifetime Renewal
  • Pre and Post Hospitalization

Optima Restore Policy (Cons)

  • No Dental Cover
  • No Maternity Cover
  • No Non-Allopathic treatment
  • Pre-Existing Diseases after 3 yrs
  • Alcoholism not covered

Optima Restore Policy (Other Benefits)

  • Sum Insured Enhancement
  • Tax Benefit
  • E-Opinion
  • 10% Family Discount
  • 7.5% discount on 2 years premiums

Optima Restore Policy (Eligibility Criteria)

  • Entry Age - 91 Days
  • Max Entry Age - 65 years
  • SI - 3 L to 50 L
  • Waiting Period - 30 Days

The plan is ideal for the families who want to get covered under single sum insured.

Unique Features

  • Automatic Restroration of SI
  • Instant Recharge UPTO 30% of SI
  • New born baby cover from 16th day

Family Health Optima Policy (Pros)

  • No Pre-Policy Check-up
  • Lifelong Renewability
  • High SI available
  • COVID-19 cover
  • OPD covered

Family Health Optima Policy (Cons)

  • PED cover not available
  • Obesity Treatment Unavailable
  • Hazardous Activities
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Family Health Optima Policy (Other Benefits)

  • Long term discounts
  • Premium Payment flexibility
  • Health Check-up Cover
  • Domiciliary Hospitalization
  • Modern Treatment Cover

Family Health Optima Policy (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 1 L to 25 L
  • Waiting Period - 30 Days

This is a plan that provides comprehensive range of sum insured from Rs. 200K to Rs. 2cr.

Unique Features

  • Health Coach
  • Unlimited Reload of SI
  • 30% Return of Premium

Offers 360 degrees protection to you and your family with multiple SI options of 3 to 75 Lakhs. Comes with EMI and lifelong entry option.

Unique Features

  • Fitness discounts during renewal
  • Room rent capping and co-pay
  • Loyalty discounts

my:health Suraksha (Pros)

  • Renewal Benefit
  • Wellness Benefit
  • Premium Payment Options
  • Reduced Premium Benefit
  • 1,2,3 Years policy Period Option

my:health Suraksha (Cons)

  • No Return Transportation Cost
  • Suicidal Injuries
  • No Non-Allopathic treatment
  • Adventure Sports Injuries
  • Alcoholism

my:health Suraksha (Other Benefits)

  • Pregnancy Complications Covered
  • Newborn Complications Covered
  • Loss of Job Covered
  • Post Diagnosis Support
  • 41 Critical Illness Covered

my:health Suraksha (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 3 L to 75 L
  • Waiting Period - 30 Days

Specialized Health Insurance Plans

A flexible and comprehensive health plan, securing your today & tomorrow. With 'Reserve Benefit' features, this plan grows unused policy amount @6% interest rate.*

Unique Features

  • Automatic SI restoration
  • Multiplier benefit
  • Free preventive health checkup

Wallet Family Floater (Pros)

  • Reserve Benefit
  • 100 % Restore Benefit
  • Recovery Benefit
  • 50% Increase On SI on Renewal
  • World Wide Coverage

Wallet Family Floater (Cons)

  • External Congenital diseases
  • Drugs Treatments
  • Miscarraige Not Covered
  • Deductibles (Optional)
  • No Cosmetic Surgery

Wallet Family Floater (Other Benefits)

  • Ambulance Cover
  • 5 Year Policy Cover
  • Portability
  • 30 Days Grace Period
  • Sum Insured Enhancement

Wallet Family Floater (Eligibility Criteria)

  • Entry Age - 91 Days
  • Max Entry Age - 65 Years
  • SI - 3 L to 50 L
  • Waiting Period - 30 Days

Buy a cover of up to 2 crores to secure you and your loved ones against 20 major critical illnesses with the Niva Bupa CritiCare plan.

Unique Features

  • Daily hospital cash
  • Accident care available
  • Lifelong renewability

NivaBupa CritiCare (Pros)

  • 20 critical illnesses Covered
  • Long-term tenure savings
  • Different pay-out options
  • Tax benefits
  • Direct claim settlement

NivaBupa CritiCare (Cons)

  • Accident Death
  • No Total Disability Cover
  • AIDS Not Covered
  • Child Education Benefit
  • Funeral Expenses

NivaBupa CritiCare (Other Benefits)

  • Flexibility Plan Options
  • Surgeon's Fee Covered
  • Renewal for life
  • Diagnostic Procedures/Therapies
  • Prosthetic Implants Covered

NivaBupa CritiCare (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 3 L to 3 Cr
  • Waiting Period - 30 Days

An ideal health plan for people with a pre-existing critical illness or a family history of critical illnesses. Get comprehensive coverage for 15 critical illnesses.

Unique Features

  • One-time lump sum payment
  • No medical checkup up to 45 years
  • Lifelong renewability

Critical Illness Policy (Pros)

  • In- Patient Hospitalization
  • High Cover at Low Premium
  • 1 or 2 Year Policy Period
  • End Stage Liver Failure
  • No Cover ceasing age

Critical Illness Policy (Cons)

  • 10 Lakh Fine on Wrong Claim
  • Tuberculosis Not Covered
  • PED after 48 months
  • Kaposi's sarcoma Not Covered
  • Lymphomas in brain Not Covered

Critical Illness Policy (Other Benefits)

  • 3 Variants (Silver, Gold, Platinum)
  • Two Year Policy Period
  • Guaranteed Renewal for Life
  • Loading on Renewal
  • Individual and Floater SI Options

Critical Illness Policy (Eligibility Criteria)

  • Entry Age - 5 Years
  • Max Entry Age - 65 Years
  • SI - 1 L to 50 L
  • Waiting Period - 90 Days

Star Cancer Care Gold (Pilot Product)

Covers the risk of spreading/recurrence of first cancer (metastasis) & second cancer (second malignancy)

Unique Features

  • Pre-hospitalization (30 days)
  • All daycare procedure
  • Nursing Expense

Comprehensive health plan for people above 60 to make their second inning stress-free from health-related financial worries.

Unique Benefits

  • No pre-policy Medical Checkup
  • Lifelong Renewability
  • Automatic SI Recharge

Care Senior Citizen (Pros)

  • No pre-policy check-up
  • Annual Health Check-up
  • 540+ Day Care Treatments
  • EMI premium options
  • Discounts Available

Care Senior Citizen (Cons)

  • Change of Gender Treatments
  • Obesity Treatment Unavailable
  • Hazardous Activity Not Covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Care Senior Citizen (Other Benefits)

  • Organ Donor Cover
  • Second Opinion Available
  • Affordable Premiums
  • Covid-19 Treatment
  • Ambulance Cover

Care Senior Citizen (Eligibility Criteria)

  • Entry Age - 61 Years
  • Max Entry Age - No age limit
  • SI - 3 L to 10 L
  • Waiting Period - 30 Days

Newly Launched Health Insurance Plans

A comprehensive family floater plan that decides your policy premium based on the living cost of the city you reside in.

Unique Benefits

  • Covers IVF treatment
  • Compassionate travel coverage
  • Unlimited e-consultation

Care Classic (Pros)

  • Zone-Based Health Insurance
  • Family Floater Plan
  • Affordable Plan
  • High Sum Insured
  • Value Added Services

Care Classic (Cons)

  • Change of Gender Treatments
  • Obesity Treatment Unavailable
  • Hazardous Activity Not Covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Care Classic (Other Benefits)

  • Unlimited e-consultations
  • Annual Health Check-up
  • Wellness Services
  • OPD care
  • ENT Consultations

Care Classic (Eligibility Criteria)

  • Entry Age - 91 Days
  • Max Entry Age - 65 Years
  • SI - 5 L to 15 L
  • Waiting Period - 30 Days

Created for young individuals under 40 years of age. It also offers various benefits such as discounts on renewals, incentive-led wellness programs, lowest waiting periods.

Unique Features

  • No-claim bonus
  • Hospital daily cash
  • Automatic restoration of SI

Star Young Star Policy (Pros)

  • Mid-term inclusion
  • 10% discount on early purchase
  • Star Wellness Program
  • Flexible-Premium Payment
  • 2 Plan variants

Star Young Star Policy (Cons)

  • PED waiting period
  • Obesity Treatment Unavailable
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Star Young Star Policy (Other Benefits)

  • Hospital Cash Benefit
  • Lifelong Renewal
  • E-opinion
  • No-claim bonus
  • Automatic Restoration

Star Young Star Policy (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 40 Years
  • SI - 3 L to 1 Cr
  • Waiting Period - 30 Days

A complete health insurance policy that covers you and your family with a wide range of SI (3 Lakh to 1 Crore) and continues to give you more benefits.

Unique Features

  • Covers a maximum of 6 members
  • Unlimited SI restoration
  • Coverage for modern treatments

Active Health Essential

This is a plan that provides coverage for Covid-19 hospitalization and chronic diseases

Unique Features

  • Chronic Management Program
  • 586 Day Care Treatment
  • Worldwide Emergency Assistance

A high SI plan for women's medical requirements. The plan covers major critical illnesses including cancer treatment.

Unique Features

  • Avail Global OPD
  • Cancer treatment
  • Avail high sum assured

A comprehensive health plan that comes with 3 variants and up to 1.5 crores Sum Insured.

Unique Features

  • Preventive healthcare & wellness services
  • No capping on room rent
  • Worldwide Emergency Hospitalization

A fixed premium plan that offers coverage up to 3 Lakhs and offers protection against the expenses incurred during OPD and hospitalization.

Unique Features

  • Coverage for HIV/AIDS
  • Genetic Disorders covered
  • Internal Congenital Diseases covered

Looking for more medical insurance plans? PolicyX has a complete list of the Best health insurance plans for you.

Types Of Medical Policies In India

There are various types of insurance plans in India and we have mentioned the categories for a better understanding as

Family Floater Health Plan

Covers all the family members (you, your spouse, children, and parents) in a single policy

Family Floater Health Plan

Critical Illness Health Plan

Provides financial coverage to the insured in case he/she is diagnosed with a listed critical illness/disease.

Critical Illness Health Plan

Top-up Health Plan

Provides extra coverage if your existing health plan is not enough to meet the medical bills.

Top-up Health Plan

Senior Citizen Health Plan

Offers quality healthcare treatment such as domiciliary hospitalization and psychiatric care to people who are above 60 years of age.

Senior Citizen Health Plan

Individual Health Insurance

Provides coverage only to an individual and covers medical expenses such as hospitalization for injuries and illnesses, surgery costs, room rent, daycare procedures, and more.

Individual Health Insurance

Personal Accident Insurance

Covers the medical expense that occurred due to an accident while providing coverage to the policyholder in case of partial disability, permanent disability, and accidental death

Personal Accidental Insurance

Indemnity Health Insurance

This form of medical policy in India operates on both a cashless and reimbursable basis up to the sum insured selected by the insured individual. It is a basic health insurance plan that individuals must own for their health care.

Indemnity Health Insurance

Fixed Benefit Medical Policy

It is a lump sum benefit-based health insurance plan and pays you in one go. This type of medical health insurance policy is beneficial for dealing with endless medical expenses arising out of critical ailments like Cancer, Paralysis, etc.

Fixed Benefit Medical Policy

Benefits of Health Insurance Policy in India

Having dedicated Medicare in India for you and your family not just protects you from unannounced medical emergencies, but also comes with several benefits. The benefits one can avail of are countless. Explore the major advantages of having an effective medical insurance policy.

Cashless Treatment

No cash payments are required to settle medical bills. Your insurance provider will pay the cost of your medical treatment when hospitalized in a network hospital.

Pre & Post Hospitalization Expenses

Any medical expenses incurred before and after the hospitalization will be covered by the sum insured under your health insurance policy.

Tax Benefits

Health Insurance offers tax benefits under section 80D of the Income Tax Act, 1961.

No Claim Bonus (NCB)

The policyholder gets the extended coverage amount for not making any claim in a policy year.

Free Health Check-Ups

Insurance companies offer free health checkups, motivating the policyholder to maintain a healthy lifestyle.

Domiciliary Hospitalization

Covers medical expenses generated while receiving medical treatment at your home if you are unable to reach a hospital for a justifiable reason

Lifetime Renewability

Get your policy renewed for a lifetime without any restriction on the age limit.

AYUSH Treatment

Coverage for the expense related to Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) treatments

Restoration of Sum Insured

Allows you to refill your sum insured in case it is exhausted in a policy year.

Additional Rider Benefits

Riders allow the policyholder to enhance the basic coverage of their chosen Health Insurance plan. Medicare can be customized as per your healthcare needs.

Read below the list of health riders available under the various health insurance plans for an informed decision:

Add-on Covers What is Covered?
Maternity Cover Expenses related to pregnancy, childbirth, and the vaccination of newborn babies
Personal Accident Cover Expenses of accidental injuries including disability, death, etc.
Reduction in Waiting Period Cover Reduces the waiting period for Pre-Existing Diseases
Room-rent Cover Flexibility to increase your policy's sub-limit for hospital room rents or opt for no sub-limit at all
Hospital Daily Cash Cover Provides a daily cash allowance to the insured to take care of additional expenses such as food, travel, etc. while he/she is in the hospital
Air Ambulance Cover Air ambulance cost generated for shifting the insured in case of a medical emergency
Zone Upgrade Cover Offers additional financial coverage based on the zone in which the insured is hospitalized

Reasons to Buy a Medical Insurance in India

Medical care is costly in the country and it is essential that you provide your family with a financial cushion in case of any medical emergency. We have mentioned below the top reasons to invest in a good medical insurance policy.

  • Affordable medical care
    Investing in a good medical policy will provide you with a wider network of cashless hospitals and also increase your chances at availing the best medicare across the country without any stress of finding a good hospital or a good doctor.
  • Cover against life-threatening diseases
    Medical insurance policy offers riders as well as inbuilt critical illness coverage in medical policies. The plans enable you to seek the best medical care against serious illnesses such as paralysis, stroke, cancer, cardiovascular diseases, and more.
  • Tax Exemption
    Mediclaim policies offer tax exemption benefits under section 80D of the Income Tax Act. Insurance holders can avail of the tax benefit and utilize medical insurance policies as a way of not just protection but tax savings.
  • Safeguard your hard-earned savings
    Medical Insurance in India enables policyholders to obtain the best medical care for a variety of health concerns without depleting their hard-earned cash. You do not have to be concerned about the cost of pricey treatments in the event that advanced treatments or urgent sickness treatments are required.
  • Wellness Benefits
    Multiple health policies in India offer customers wellness benefits that encourage them to take care of their health in a better way and invest in a healthy lifestyle. Earning points after completion of various tasks such as 5k steps in a day and regular doctor visits can be redeemed at the time of policy renewal as premium discounts.

Health Insurance Companies

Finding a reliable insurance company is as critical as purchasing suitable medical insurance plans to avail of all the expected benefits of the policy. Here are the 28 most trusted health insurance providers in India.

Why Compare Health Insurance Plans Online in India ?

Every individual must compare health insurance plans online before investing as it saves time, money, and efforts. Here's why comparing health insurance/medical plans online is the way to go.

  • Quick glance at policy quotes for free: Before you invest money in any insurance plan you should get to know the health insurance premium for a particular policy. Free quotes are available on PolicyX as well as on the insurer's website.
  • Understand plan features: Take the time out to check the features and quotes of a health insurance policy on the internet on your smart devices. This helps you to save your precious time wasted in visiting an agent's office to buy or select a health plan.
  • Make confident decisions: After gaining the necessary information available online, you can go through inclusions and exclusions, compare, and find the best match.

Benefits of Comparing Health Insurance Online

Listed are the benefits of spending some time researching online and comparing health plans before buying them.

  • Buy the best health insurance plans: An individual understands their health risks and future possibilities and hence prepares accordingly to secure themselves and their loved ones. This is how you make an informed decision and buy what you need rather than buying what you are sold.
  • Find plans worth your money: When you aim to buy the cheapest health insurance plan you miss out on essential features and coverage that a good health insurance plan offers. Comparing health insurance plans online helps you find a plan that balances not only your health needs but also your health requirements.
  • Analyze health insurance plans to your satisfaction: Analyzing all the factors in a health insurance plan online such as room rent, waiting period, claim process, and more gives you a sense of satisfaction before buying the plan.

What to Keep in Mind When Comparing Health Insurance?

The following pointers play a significant role when you select a health insurance plan. Make sure you go through all these factors when comparing a health insurance plan for yourself:

  • Adequate amount of sum insured: This refers to the maximum amount that the insurer will cover for you. Very often, a policy that provides a low premium might also offer a low SI. Before you get insured make sure you choose an adequate sum insured to provide you with assistance in time of need.
  • Coverage provided by an insurer: It is something that goes beyond the sum insured. It comprises of the inclusions and exclusions in a health insurance policy along with the sum insured.
  • PAN India network hospitals: While comparing a health insurance plan you must go through the list of network hospitals provided by the insurer. It is essential to invest in a plan that provides PAN India network hospitals for maximum efficiency in any case of emergency.
  • Co-pay clause in a policy: A co-pay clause in a policy indicates that you have to contribute towards claim settlement. A co-pay has an upside as it reduces the policy premium by sharing the burden of claim settlement between you and the insurer.
  • Add-ons and riders: Many times insurers provide additional features as a part of a comprehensive health insurance plan which can, in turn, make insurance premiums expensive, which is why you must choose your add-ons carefully while comparing health insurance plans.

Why is Health Insurance Important in India?

Now-a-days, quality healthcare treatment is quite expensive. Getting admitted to a hospital to obtain good healthcare service has the potential to wipe off all your savings in a few days.

Health Insurance is essential, as it safeguards your family from unexpected medical bills that may cause a strain on your finances. When you invest in medical insurance, you don't need to worry about your bank balance during medical emergencies.

Below mentioned are some of the reasons why you should consider buying health insurance.

  • Medical Inflation: Getting admitted to the hospital due to an illness or injury can punch a hole in your pool of savings. Moreover, with an increase in healthcare services, a hospitalization of mere 3-4 days can derive big hospital bills. Therefore, it becomes necessary to have a health insurance plan that will not only cover the hospitalization expenses but will also offer several benefits.
  • Coverage for the Whole Family: With family health insurance, you can protect the medical expenses of your whole family. You can even cover your parents, spouse and children as well.
  • Avail Quality Treatment: With a health insurance plan, one can avail of timely and quality healthcare services. One can choose a hospital from the list of the impaneled network hospitals, and get the treatment. One can avail of treatment up to the chosen sum insured.
  • Secure Your Savings: By buying comprehensive health insurance, one can ensure that all their healthcare requirements are taken care of, and when required, he will get coverage for the medical expenses. Thus, the policyholder can fully concentrate on his/her treatment without worrying about the hospital bills.
  • Covers for critical illnesses: In many cases, unfortunately, people are diagnosed with critical illnesses affecting various organs of the body. With a customized health plan, if you suddenly get any critical ailment, it's covered after 30 days. These include illnesses related to the heart, lung, liver, kidney, diabetes, blood pressure & many more.

Steps To Select Ideal Medical Policy in India

Health needs vary from person to person, and what may be best for one may not suit the other. However, to meet your ever-changing requirements, you need to be vigilant while selecting your ideal health plan.

At PolicyX.com, we have listed down a few steps that may help you to choose a perfect health plan for yourself and your family.

  • Step 1: Choose your Ideal Health Insurance Company:
    Go with a company that offers cashless facility, has good customer service, comes with a decent market share and offers a wide range of health products that will cater to the different needs of customers.
  • Step 2: Evaluate your Needs and Requirements:
    Once you have chosen your ideal company, evaluate your family's health needs thoroughly, and decide the type of plan you want to buy. For example, if you have a nuclear family (yourself, wife and a kid), a family floater plan with Rs.5-10 Lakhs coverage will be enough (generally speaking). However, if you want to cover your parents (above 60 years) under health insurance, senior citizen plans will be a good option.
  • Step 3: Compare Coverage and Premiums:
    After you have shortlisted a few plans on the basis of your needs and requirements, just compare their benefits with each other. Ideally, it's recommended to go with a plan that offers maximum benefits (including decent coverage) and doesn't hurt your wallet.

Which Factors Affect Health Insurance Premium?

Health Insurance in India today is beginning to gain a lot of importance. In urban India with the lifestyle choices made by individuals, life is becoming highly unpredictable. Amidst a pandemic, people have realized why they should compare the best health insurance best suited to their requirements before purchasing one. While you buy online health insurance the insurance companies do a thorough check of your health profile. Based on their review, they fix the premium charges. Here is a list of factors that insurance companies consider affecting the premium cost.

  • Age: This is one of the critical factors that affect the premium amount. The insurance companies follow the rule of thumb wherein the higher the age, the higher the premium.
  • Past Medical Records: If you have a history of suffering from illnesses or have a pre-existing disease, then your premium will be higher. However, if you have a healthy life, then your premium will be lesser.
  • Smoking Habits: Smoking increases health risks, and insurance companies view smokers as high-risk insurance buyers, and therefore charge high premiums.
  • Body Mass Index: Insurance companies charge people with higher BMI a higher premium than those who have a normal BMI as higher BMI individuals are more likely to suffer from various diseases like diabetes, and heart-related problems requiring medical care.
  • Your choice of Plan: When you compare health insurance the coverage you choose to include in your health insurance will affect your premium. If you have chosen add-on covers, your premium will increase.
  • Co-pay Feature: If you opt for co-pay, the premium will be less. In co-pay, for any claim, you pay a specific portion of the claim, and the insurance company gives the rest.

Common Myths related to Health Insurance in India

Online Health Insurance is the most sought-after solution for the Indian population yet it is one of the most misunderstood financial products which stems from a lack of knowledge and understanding about insurance in general.

Below listed are a few common myths about health insurance policies, and the reality behind them.

Myth 1

Health Insurance is not needed when I am young and healthy, I will think about it when I am old!

Fact

The truth is that when an individual is young and healthy it is the best time to compare health insurance and buy the best option available. Young insurance holders can get coverage at an affordable premium because the risk of getting hospitalized at a young age is minimal.

Myth 2

The best health insurance policy is the one that is cheap!

Fact

Individuals make their insurance buying decision based on the premium. While it is fine to buy health insurance with a low premium, you must be aware that such policies have restricted offerings and may not be able to provide you with adequate coverage according to your needs.

Myth 3

I am a smoker. I can not buy Health Insurance.

Fact

Most health Insurance providers are concerned about pre-existing medical conditions. If you are a smoker and have suffered from any medical condition due to smoking you must disclose this as a pre-existing medical condition. The insurance providers may charge a higher premium but they will not deny health cover.

Myth 4

My health insurance benefits will be void if I do not renew the health insurance on time.

Fact

This is in fact one of the most common myths when individuals purchase Health Insurance. It is of utmost importance that you renew your health insurance every year before the due date to maintain the continuity of health benefits. However, every insurance provider has a grace period of 30 days wherein you can renew your policy.

Myth 5

My employers have provided me with Health Insurance, I do not need to buy another one.

Fact

Multiple organizations do provide employees with health insurance, however, don't ignore the importance of having individual health insurance. Even though corporate policies are useful, they might not extend cover to your aged parents/dependents. In addition to that, your policy will only be in effect till the time you are employed with the organization.

Health Insurance Premium

Medical insurance premium depends on various factors:

  • The number of members covered under a single policy
  • The age of the eldest member
  • Sum Insured
  • Types of features chosen in a plan

Get an approximation of medical insurance premiums based on different age groups and Sum Insured.

If you are 26 years old, Click Here

AGE 26

Sum Insured 1 Adult 2 Adult 2 Adult+1 Child 2 Adult+2 Child Average Premium
5L 7844 11172 13539 16491 12,262
10L 9999 14459 17539 21014 15,753

If you are 36 years old, Click Here

AGE 36

Sum Insured 1 Adult 2 Adult 2 Adult+1 Child 2 Adult+2 Child Average Premium
5L 8938 13146 15534 18225 13,961
10L 11563 17257 20291 23436 18,136

If you are 46 years old, Click Here

AGE 46

Sum Insured 1 Adult 2 Adult 2 Adult+1 Child 2 Adult+2 Child Average Premium
5L 14145 21980 24097 27061 21,821
10L 18527 29402 32010 35476 28,854

If you are 56 years old, Click Here

AGE 56

Sum Insured 1 Adult 2 Adult 2 Adult+1 Child 2 Adult+2 Child Average Premium
5L 24025 36009 38395 41899 35,082
10L 31274 47808 50984 55302 46,342

Check Your Premium

Health Insurance Exclusions List

Every Health Insurance Plan comes with a certain list of illnesses or treatments that are not covered by them. These exclusions may vary from company to company. As per IRDAI, some common diseases or medical conditions that are not covered under health insurance plans are:

  • Pre-existing diseases (PEDs), however, some companies cover PEDs after a waiting period
  • Eyes and Dental care, but some new plans have started covering them
  • Suicidal injuries or intentional self-injuries
  • STDs like HIV
  • Health issues that arise due to the consumption of alcohol or drugs
  • Health issues or injuries caused due to war, act of war, nuclear, chemical, or biological weapons

**To know all the exclusions of your plan, refer to the product brochure or directly get in touch with your respective insurer.

How much Coverage do I Need?

Choosing an ideal Health Insurance plan among all the available plan in itself is a difficult task. But once you choose a plan suiting your requirements, you need to evaluate the coverage you need

It is imperative for you to choose the amount that provides you with more coverage and financial security. Do not forget to compare the health insurance plans.

In the below section, we have shown some of the pointers that will help you to figure out how much health insurance you'll need to protect yourself and your family:

Decide who all should be insured in a single health insurance plan.

We would recommend buying plans for your immediate family and a separate plan for your parents as:

  • A medical policy generally covers up to 2 adults and 4 children up to the age of 18**.
  • Your parents' needs are quite different from yours in terms of Sum Insured, medical history, pre-existing conditions, requirements of co-payment, etc.

**For some companies children up to the age of 21 can be covered under a policy

Below are the recommendations of minimum covers you may require based on your age and city of treatment.

Health Insurance Coverage (Metro)

Metro Above 35 10 Lacs
Metro Below 35 5 lacs

Health Insurance Coverage (Non - Metro)

Non - Metro Above 35 7.5 Lacs
Non - Metro Below 35 5 lacs

Why Buy Health Insurance Online?

Below-mentioned are the benefits of buying a Mediclaim insurance plan online:

  • Time-Saving By opting for buying a Health Insurance scheme online, you may save a lot of time by not having to talk with an insurance representative in person. Rather, you can easily get the quotes for plans immediately via the internet in a fraction of the time. As a result, the selection you make online is not influenced by the agents.
  • Easy to Compare It is considerably easier to compare all the available Medical Insurance in India online than it is to do so on paper. All insurers, in general, give thorough information on their websites. For more convenience, you can turn to PolicyX.com and can compare all the Health Insurance Plans in India on one platform.
  • 24*7 Availability Unlike Insurance agents, the digital world is not time-bound, which means that you can seek any information on your mediclaim insurance anytime round the clock.
  • DiscountsBuying your policy online will help you to avail of similar or better benefits at a lower premium, as many Health Insurance providers offer several discounts when you buy health insurance online, from their website.
  • Helps in Making an Informed DecisionAll necessary information, such as health insurance benefits, policy quotations, exclusions, terms and conditions, and so on, is easily available online, making it much easier to compare different health insurance policies. Having all the information in front of you helps you in making the right decision.

With PolicyX.com offers a simple process to buy online health insurance in just 4 easy steps and you are all good to have online health insurance.

  • Go to the top of this page, and fill in the form 'Get Quotes from Top Insurers'.
  • Compare quotes from different insurers.
  • Choose your preferred plan and proceed to buy.
  • Pay the premium online and the policy will be shared at your email address.

Documents Required to Buy Health Insurance Online

New Insurance Policy Port Insurance Policy Renew Insurance Policy
1. Duly-filled policy form
2. Medical history of pre-existing diseases
1. Address and ID proof
2. Medical history of pre-existing diseases
3. Previous policy documents
1. Existing policy number
2. Medical history of pre-existing diseases

**Document requirement may vary from insurer to insurer

Claim Settlement Process in Health Insurance

Health insurance companies offer 2 types of claim settlement processes to choose from at your convenience. Read along to explore what is Health insurance claim settlement process:

Planned Hospitalization

  • Informed the insurer before 48 to 72 hours of hospitalization
  • The insurance company to provide a confirmation letter
  • Submit your health card and confirmation letter
  • The insurer will settle the medical bills directly with the hospital

Emergency Hospitalization

  • Informed the insurer within 24 hours of hospitalization
  • Fill and submit the cashless claim form
  • Submit other necessary documents
  • The insurer will send an authorization letter to the hospital
  • The insurer will settle the medical bills directly with the hospital

Reimbursement Claim Process

  • Intimate the company within the designated timeline
  • Collect original discharge summary and medical bills and submit with the claim form
  • Fill and submit the claim form along with ID proof (Voted ID/Aadhaar Card/PAN Card) and canceled cheque
  • The insurance company will evaluate the documents.
  • The insurance company will initiate the reimbursement proces.

Trouble connecting with an insurance company?

Contact PolicyX.comCall at our toll-free number 1800-4200-269Email: helpdesk@policyx.com

We are happy to help.

Why Choose PolicyX.com?

Certified by IRDAI, PolicyX.com is a one-stop-shop for all your insurance-related needs.

  • IRDAI Approved The Insurance Regulatory Development Authority of India (IRDAI) is a regulatory body created to protect the policyholder's interest. PolicyX.com follows all the guidelines and protocols approved by the IRDAI.
  • Free Comparison Service With PolicyX.com, you can easily compare the best Health Plans in India without paying the extra amount.
  • Compare 15 Companies in 30 SecondsWith us, you can compare up to 15 companies in just a few seconds.
  • Buy Insurance withing 5 minsWith PolicyX.com, you can buy your policy online without any hassles. We offer an easy 4-step online buying process that allows you to buy your policy without any troubles.
  • 24*7 Customer ServiceThe experts of PolicyX.com are always available to resolve any of your insurance-related queries.
  • Free Future Claim AssistanceOur team will assist you at every step of your claim process. Be it claim intimation, documentation, or any other process, we are always there to help.
Why Choose PolicyX.Com

Health Insurance News

19 May

Can a smoker buy a term insurance policy?

A smoking person can buy a term insurance policy. The premium rates of an insurance policy for smokers are higher as compared to the ones which are for non-smokers. This is because people who smoke are vulnerable to numerous cardiovascular diseases and are more likely to go through heart related and other health issues.

19 May

Surrogacy expenses to be covered in health insurance: IRDAI

The IRDAI has asked all the insurance providers to cover surrogacy expenses in their health insurance products for the families who might require the coverage due to maternity complications. The insurance regulator has directed all insurers to comply with the Surrogacy Act, 2012 and ART (Assisted Reproductive Technology) Act, 2021.

19 May

Star Health and Allied Insurance Company to set up 1,000 new sales offices

The standalone private insurance provider, Star Health and Allied Insurance Company has announced that they plan to set up 1000 new offices to improve their insurance penetration in rural India.

08 May

Aditya Birla Health Insurance launches a new campaign, ‘KyaPeecheChhodaHai’.

Aditya Birla Health Insurance has unveiled its new campaign in the name of ‘KyaPeecheChhodaHai’. The campaign features real customers as its brand ambassadors. The campaign promotes the concept of “Health Assurance not just Health Insurance”.

08 May

Moove announces partnership with Reliance General Insurance

Moove is a mobility fintech firm in India which has joined hands with Reliance General Insurance and plans to provide comprehensive health insurance plans to its customers and their families. The product provides up to 2 lakhs of coverage including the policyholder, his/her spouse and up to two children.

Health Insurance: FAQs

1. What is the average cost of health insurance in India?

In India, the insurance providers use factors like age, health condition, coverage and number of individuals to be covered to determine the premium of a health plan. Let's take the help of an example for better understanding.

At the age of 25, if you want to purchase an individual health plan of the sum insured (Rs.10 lakhs), your premium amount will be Rs.608/month. Whereas, if you want to purchase an individual health plan of the sum insured (Rs.10 lakhs) at the age of 50 with smoking habits, your premium amount will be Rs.1831/month.

If you want to opt for a higher sum insured or require a family floater plan, take the help of our health insurance premium calculator to know the correct amount.

Note -The premium values keep on changing. Please check the amount first before investing in a plan.

2. I am already getting Health Insurance from my office? Do I still need to buy another health policy?

It's good if you are getting health insurance from your company. But what if you decided to switch the job? You will lose all the benefits. Hence, chances are that you will need to pay a higher premium for your new policy because of your growing age. Therefore, to be on the safer side, you can buy a separate health plan that will ensure your and your family's healthcare needs are looked after even if you no longer have your company's health policy.

3. Can I buy Health Insurance for my parents if I am not earning, because my parents are not literate enough to understand the insurance plans and documentation?

Yes, the premium can be paid by any earning member of the family. Documents should be submitted by that member only.

4. If I am interested in alternative therapies, how does health insurance work?

It varies from plan to plan

5. What is the process of updating the nominee, address, phone number and any other information in my policy documents?

You can update at the time of renewal of your plan. Also , if required you can update the nominee, address, phone number by endorsement, or by sending Email to insurer

6. What all factors need to consider while choosing Health insurance plan?

You should consider the claim process, family health insurance, selecting the correct Sum Insured, network hospitals, maternity benefits, pre and post hospitalization, renewal, free medical check ups.

7. Can I use the Health Insurance Portability feature as an insurance policy holder?

You can transfer your existing health insurance policy to another company using the health insurance portability feature. However, portability is possible only at the time of existing policy renewal.

8. What is the right age to buy health Insurance?

There is no right age to buy health insurance, however, most insurance companies suggest purchasing health insurance early in life as you get a low premium amount and are less prone to critical illnesses and hospitalization as compared to someone in their 50s and 60s.

9. Is it mandatory to take a medical test before buying health insurance?

Medical tests are not required before buying a health insurance policy. However, most health insurance providers require medical test reports if the age of the applicant is above 45 years. Health Insurance providers also reimburse the cost of these pre-policy medical check-ups depending on the plan you chose.

10. Can I buy more than 1 health insurance policy?

Yes, you are eligible to purchase more than one health insurance policy in India. If you are covered by your corporate health insurance, you can purchase additional online health insurance including your spouse and children.

11. Do insurance companies cover pre-existing diseases?

It varies from insurer to insurer. Some companies do not provide cover for pre-existing diseases, while others cover the same after a waiting period of 4 years (this may vary as per the company).

12. How many insurance companies provide a vast network of hospitals for cashless hospital facilities?

In India, all 24 IRDA registered insurers provide a vast network of hospitals in their health insurance plans. However, before purchasing a health insurance plan from any life insurance company it is important to cross-check their network hospitals and cashless hospital services. Insurance experts like PolicyX can help you chalk out the best picks.

13. Does health insurance policy offer coverage to diabetes patients?

health insurance provides cover to diabetes patients and related complications. However, it may vary from insurer to insurer. Most of the companies provide the same after a waiting period of 4 years.

14. Does health insurance in India cover any kind of diagnostic charges like MRI, X-Ray or any other body scans?

Yes, health insurance covers the medical tests and scans for the inpatient treatment, i.e., during hospitalization for at least 24 hours.

15. Does Health Insurance Plan Covers Ayurveda & Other Treatments?

Nowadays, many health insurers have started offering AYUSH Benefit to their policyholder, that covers Ayurvedic Homeopathic, Unani and Siddha treatment. By availing of this benefit, one can get their inpatient Ayurvedic, Yoga and Naturopathy, Unani, Siddha and Homeopathy treatment reimbursed by the health insurer.

16. Does Health insurance also cover the consultation fee?

Yes, But it can vary from plan to plan.

17. Does Health insurance cover Mental health treatment?

Yes. But it varies from plan to plan

18. Does smoking affect health insurance premiums?

If you are a smoker, you will end up paying higher premiums as you are subjected to greater medical risks.

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

Age is the biggest factor that determines the premium payable. The older you are, the higher is your premium, as 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 also eligible for a discount on the future premium payable if you have not claimed in the previous years.

20. 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 the State and Central Government. Before the new tax regime, the service tax rate applicable to 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.

21. How is the policy premium determined?

Age and gender of the eldest member of the family, city, are the primary pricing factors. With the help of actuarial statistics, these determine your life expectancy. The benefit and Sum Insured you need are the next greatest factor.

22. Can I cancel my Health Insurance Plan? If Yes, then how can I get my premium back?

Yes, you can cancel your Health Insurance. A free look period of 15 days from the date of policy receipt is available to the policyholder to review the terms and conditions of the policy. If the policyholder is not satisfied he may seek a cancellation of the policy. In such cases the Health Insurance Company allows the refund of the premium after adjusting the cost of pre-acceptance medical screening and underwriting cost.

23. What are the modes of payment available for the payment of premium from PolicyX?

PolicyX allows the customers to pay the premium of the Health Insurance Company from various modes of payment such as credit cards, debit cards and internet banking.

24. Will the policy help me to save money if I am healthy and not claiming the assured amount?

No, it can not be your saving.

25. What is cashless hospitalization in health insurance?

It means that all in-patient treatment charges availed by the insured are paid by the insurance company directly to the hospital.

26. What if I get admitted to a non network hospital?

If you get admitted to a non network hospital then you can avail the treatment and file a reimbursement claim after getting discharge.

27. What if I don't claim within the policy period, do I get the refund of my money?

If you donot raise any health insurance claim during the policy years, you cannot get a refund on the premium paid. The only situation you will get a refund is when you cancel your policy during free look period.

28. If I forgot to renew the policy on time, will the company deny to renew it later?

Most insurance companies will not deny the renewal within the grace period, which is usually of 15-30 days from the date of expiry of the policy. 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.

29. What are pre and post-hospitalization in health insurance?

Pre-hospitalization expenses are the expenses incurred before getting admitted to a hospital. Post-hospitalization expenses refer to follow-up tests and consultation treatment charges incurred after getting discharged from the hospital.

30. Will a waiting period be applied if the policyholder increases the sum insured during policy renewal?

The insurer will apply a fresh waiting period on the sum increased by the policyholder(depending on the policy terms). You must check the health insurance policy terms first before increasing the sum insured.

31. What happens if the health insurance medical policy lapse during hospitalization?

The policyholder will not be able to avail the health insurance policy benefits if the policy lapses during hospitalization. So, it is always recommended to renew the health insurance policy benefits timely.

32. Can I get a discount on the renewal of the policy with the same Health Insurance Company?

Yes, you may get a discount on the health insurance premium in the form of a No Claim Bonus if you renew your policy with the same insurer. The only condition provided is ‘the policyholder must not raise the claim during the previous policy tenure’.

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May 1, 2023

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May 1, 2023

I have availed health insurance services from PolicyX in the year 2021 and I must say that they are reliable and have supported me with claim settlement without any delay.

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Durgesh Kumar

Jaipur

March 25, 2023

Best health insurance claim mere leg ka surgery hui h 22.03.2023 ko 2 hrs m claim approval aa gya tha mari policey ko 7 month hi hua h mera claima 44000 rupaye ka tha 100% company n pay kiya h ...

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Delhi

March 24, 2023

Bad experience operate 6th jan 2023 my claim no 31418820 Ajay Kapoor mob 7838722273 till date 24 mar 2023. No reimburse ment amount 67367 not recd . always demand new query. I send you after op...

Naval Goel

Reviewed By: Naval Goel

Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.