Eligibility for Health Insurance
  • Explore eligibility for medicare
  • Buy health care plans online
  • Understand common eligibility myths
Understand the Eligibility for Health Insurance
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Understand the Eligibility for Health Insurance

Most of the population today living an urban lifestyle can be considered a culprit of an unhealthy lifestyle. With increased levels of stress and unhealthy work-life balance, individuals are often prey to an irregular sleep cycle and non-nutritious eating habits leading to an open invitation to multiple ailments affecting them in their 40s. Working individuals with a poor work environment along with a lack of good quality air, food, and water quality are often suffering from lifestyle issues like hormonal imbalance in the body, hypertension, developing diabetes, and even early cardiovascular problems. It is essential to give your body regular exercise and a nutritious diet in order to keep health ailments at bay which in turn will break your life savings.

Even though the health insurance industry in India is a growing industry there is still a lack of awareness regarding Insurance. The overall factors contributing to the lack of awareness of the importance of having health insurance are no common understanding of insurance eligibility, lack of resources to educate the population regarding health insurance, and the common misunderstanding of no returns on investment. The general mindset of most individuals is that they want guaranteed benefits or returns on the investment otherwise, it is not considered a worthy investment.

However, post-COVID-19 people have realized the value of a best health insurance plan and how it can protect your life savings from draining in medical bills. To purchase a health insurance that provides overall coverage to you and your family it is essential to understand who is eligible for medicare.

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Factors to consider for Insurance Eligibility?

Selecting a holistic health insurance plan is not an easy task. Insurance eligibility is a key factor in determining which health insurance is suitable for you and your family. Before investing in any health insurance an individual must research if they are eligible for medicare as it makes the task simpler. There are certain factors that determine if an individual is eligible for medicare.

  • Age of the buyer To check if you are eligible for medicare it is essential that you fall under the common age limit threshold of 18 to 65 years. The minimum entry age and maximum entry age for health insurance plans may vary according to the insurance providers. For most adults it lies between 18 to 65 years whereas if you want to cover dependent children the insurance eligibility starts from 91 days to 18 years or 25 years.
  • Pre policy medical check-up Many health insurance providers have the condition of pre-policy medical check up for individuals over the age of 45 years. An individual is eligible for medicare once they undergo the medical tests and their reports come back as healthy and showcase no signs of ailments. If health insurance providers do not ask for pre-policy medical check up they may ask the individual to produce their medical history and records of any medical ailments.
  • Declaration of pre-existing conditions To be eligible for medicare individuals must declare their pre-existing medical conditions transparently to their health insurance provider to avoid any conflicts in claim process in the future. The transparency of information will help the individual to reap the benefits of their health insurance plan and also allow insurance providers to serve you in a better way.

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Busting common myths of Insurance Eligibility

There are common misconceptions regarding insurance eligibility that makes individuals question if they are eligible for medicare. We have discussed a few common myths regarding the same

  • If I am unhealthy I am not eligible for medicare. This is one of the most common misconceptions amongst many individuals when it comes to purchasing a health insurance plan. A high slice of the population has a drinking or smoking habit and might consider themselves ineligible to purchase a health plan which is not true. The individuals who fail to maintain a healthy lifestyle and lead a high risk life will have to pay a slightly higher premium than the rest and will also undergo a few medical tests but they are perfectly eligible for medicare.
  • If I am in need of maternity and newborn cover I am not eligible for medicare. Individuals who are expecting a child are eligible for medicare and will be covered for all their medical needs and requirements ensuring a safe pregnancy and post-natal care of the new born baby. However, there may be some terms and conditions that may vary from insurer to insurer such as waiting period, cover for only 1 child, etc. but that does not mean that an individual is not eligible for medicare. We suggest you understand the terms and conditions of any health insurance policy and decide if it suits your requirements.
  • Declaration of Pre-existing health conditions will affect my insurance eligibility. If you are suffering from any kind of pre-existing condition your insurer may ask you to serve a certain waiting period before they cover your illnesses and may charge you a higher premium. However, if you do not disclose the pre-existing illnesses to your insurer, they may dismiss your application to health insurance entirely leaving you with no coverage. It is essential to be transparent with your health insurance provider for them to serve you better and for you to have hassle-free medical care. Individuals are eligible for medicare even with pre-existing medical conditions.
  • All medical expenses are covered by health insurance providers Health insurance plans do cover hospitalization bills. However, it does not cover consumables like bandages, oxygen masks, gloves and more. There are certain sub-limits that are set up to determine how much coverage is offered by the health insurance providers.
  • Hospitalization claims have to be made only for procedures taking 24 hours and above This is one of the most common myths when purchasing health insurance. You are eligible for medicare even if you are going for a day care procedure like cataract treatment or any other medical procedure that requires less than 24 hours of hospitalization. Almost all of the health insurance plans today cover day care procedures as most medical procedures are now simpler due to advancement of technology in the medical field.


Health insurance plans are a necessary and safe investment that safeguard you in the face of unforeseen circumstances. An individual must gain knowledge and read the policy terms carefully to understand if they are eligible for medicare as it varies from insurer to insurer. A health insurance plan will provide you various benefits such as pre and post hospitalization benefits, room rent, ICU, Day care treatments and more.

How to purchase Health Insurance Plans Online?

Once an individual has locked down on the health insurance plan they want and determined the eligibility of medicare it is fairly simple to purchase any health insurance plan

Buying from PolicyX.com

  • Fill in the details in the 'Calculate Premium' form.
  • The next page will show all the available plans.
  • Choose the Liberty health plan and click on 'Buy Now'.
  • Pay the premium and your policy document will be shared with you on your registered email id.

Why Buy from PolicyX.com?

With so many buying options available in the market, one must think about why he/she needs to choose PolicyX.com. Well, we are here to answer.

  • 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.
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  • Compare 15 Companies in 30 Seconds With us, you can compare up to 15 companies in just a few seconds.
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Eligibility for Health Insurance:FAQ's

1. I am a college graduate and have just started my professional career, am I eligible for medicare?

Yes, young individuals must insure themselves with a health insurance plan as doing so at a younger age will cost them lesser premiums and help them against any unforeseen circumstances. You are eligible for medicare as soon as you turn 18 years old and also can be covered as a dependent child starting from as early as 90 days old.

2. I am a smoker. Will I be eligible for medicare?

Yes, smokers are eligible for medicare. However, the premium rates will be a little higher for them as compared to healthy individuals as they are at a higher risk of attracting illnesses.

3. Are my family members eligible for medicare?

Yes, you can add your family members under the same health insurance plan. You can add your spouse, dependent children, parents and in-laws depending on the health insurance plan terms and conditions which you must read carefully.

4. Are day care procedures included in health insurance plans?

Yes, you are eligible for medicare even if you want to undergo a day care procedure and are seeking minor treatments. Most health insurance plans cover day care procedures under health insurance plans.

5. Am I eligible for a health insurance plan if I do not undergo a pre-policy medical check up?

It depends entirely on the insurance providers. Most individuals over the age of 45 years have to undergo a pre-policy medical check up and some insurance providers do not require this procedure but ask you to present your previous medical records that disclose your medical history of any previous illnesses or any pre-existing conditions. It is necessary to maintain transparency with your health insurance providers to reap maximum benefits.

What Our Customers Have to Say

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May 10, 2024

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April 8, 2024

PolicyX was a great resource when I was shopping for health insurance. Got to know a few insights about the company I hold a policy with, HDFC ERGO.

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March 15, 2024

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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.