Individual Health Plan Features
Opting for an individual health insurance plan might be the smart choice for a lot of people, as per their needs and requirements. Some of the features of an individual health plan are listed below:
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Covers Young Individuals
One of the best things a young individual can do is purchase an individual health plan. It is an ideal health plan for those transitioning from education to their first job. As the sum insured is to be utilized by only one individual, it is best to avail of individual coverage as the premiums at a young age will be minimal and provide you with optimal coverage.
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Add-Ons
Customers can choose among multiple additional rider benefits to elevate the overall coverage benefits of their individual health plans. Rider availability and options may vary from insurer to insurer. Some common riders offered with individual health plans are critical illness, personal accident, hospital cash, OPD, global coverage, and more.
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Cumulative or No-Claim Bonus
With individual health plans, a certain percentage of no-claim bonus is offered to insured individuals, which is added to the sum insured at the time of policy renewal, increasing the overall coverage amount. This no-claim bonus benefit is offered to the customers if they undergo their policy tenure without filing for any claims.
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Lifetime Renewability
Individual health plans offer a lifetime renewability option wherein an individual is eligible to continuously avail of medical care coverage for as long as they can pay premiums. Once you have invested in a health plan, you can continue to enjoy the benefits every 1, 2, or 3 years as per your renewal cycle.
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Multiple Discounts
Multiple discounts are applicable under individual health plans, such as long-term discounts for purchasing health plans for 2 or 3 years. Good health discounts are offered by individual health plans wherein if someone has maintained their health, a certain percentage of discounts are applicable on premiums.
Best Individual Health Insurance Plans 2026
Mentioned below are some of our top picks for individual health plans that will help you make an informed decision:
Individual Health Plan Eligibility Criteria
| Criteria |
Details |
| Entry Age |
Minimum: 18 Years
Maximum: 65 to 70 Years
Some plans offer lifelong renewability |
| Sum-Insured |
5 L to 6 Crores |
| Policy Tenure |
1/2/3 Years |
| Initial Waiting Period |
30 Days |
| Pre-existing Disease Waiting Period |
2 to 4 years, depending on insurer |
| Tax Benefits |
Under Section 80 D |
Who Should Buy Individual Health Plans?
Individual health plans are an excellent choice for you if:
- You are in your early 20s and have just transitioned into the workforce. It is best for you to invest in individual health plans. It is the key to accessing the best healthcare for yourself at affordable premiums and also an excellent tax-saving tool.
- You are an unmarried individual and have minimum family responsibilities. It is best to purchase an individual health plan for yourself as it guarantees medical care in times of emergencies.
- You are someone with a field job or work in an industry that has an increased risk of injuries, such as mining, civil engineering, construction, chemical factories, or similar. It is best to invest in an individual health plan.
- You have a family history of ailments that run in your family. It is best to invest in an individual health plan with adequate additional coverage for critical illnesses if required.
- You have an employer health plan but still want an additional healthcare plan.
How Much Coverage Do You Need?
When buying an individual health insurance plan, a common question frequently asked is if the amount of sum insured chosen is sufficient. As per various insurance experts, it is advised that the individual health plan sum insured should be a minimum of INR 10 Lakhs or 50% of your annual income. Individual health plans can offer a wide range of sums insured going up to INR 1 crore or more. For example, if your annual income is INR 20 lakhs, you must invest in a minimum of INR 10 lakhs health cover.
5 Factors To Keep In Mind When Buying Individual Health Plans
There are certain factors that you must keep in mind before you invest your hard-earned money in individual medical insurance:
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Claim Settlement and Reliability
Before selecting an individual health plan, make sure you check the claim settlement ratio of the company. The higher the claim settlement ratio, the easier the claim settlement process will be. CSR is the indicator of the number of claims settled by the insurance company as compared to the number of claims received.
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Network Hospitals
When purchasing an individual health plan, take care to review the list of network hospitals provided by the insurer. Network hospitals are the list of hospitals that have a tie-up with the insurance provider, providing cashless treatments to the policyholder.
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Sum Insured
Purchase an individual health plan that offers you an adequate sum insured as per your needs and requirements. It is easy to overestimate the sum insured you need and pay a higher premium thinking you may require a higher sum insured, but often it may not be true. Consider all factors like age, health conditions, family medical history, and more before selecting your sum insured value.
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Add-On Riders
Individual health plans offer a plethora of additional riders like critical illness, personal accident, hospital cash, and more. It is essential to opt for those riders that are required by you in order to enhance the overall protection of your health plan.
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Affordability
The ability to pay individual health plan premiums is of vital importance. Purchasing a health plan and not being able to pay the health premiums leads to cancellation of policies and default in premium payments, which might lead to policy dismissal. Opt for an individual health plan that offers affordable premiums.
What is Covered Under Individual Health Insurance
Listed below are the benefits and key inclusions of an individual health plan:
| Individual Health Plan Inclusions |
What Does It Do? |
| In-patient hospitalization |
All medical expenses accumulated at the time of hospitalization like room rent, doctor’s fee, OPD, pharmacy, surgery costs, etc., are covered by the individual health plan. |
| Daycare Procedures |
The policyholder is covered for all daycare procedures that require less than 24 hours of hospitalization as per the list of daycare procedures provided by the individual health plan. |
| Organ Donor Cover |
Insurance holders are covered for expenses related to the surgery or acquiring an organ donor for the insured individual under an individual health insurance. |
| Ambulance Cover |
Emergency road ambulance cover is available for insured individuals as per the sub-limit defined by the individual health plan. |
| AYUSH Cover |
Also known as alternative treatments in the fields of Ayurveda, Unani, Siddha, and Homeopathy, these are covered by an individual health plan. |
| Annual Health Check-Ups |
The facility of annual health check-ups and expenses related to the same are covered by individual health insurance plans. |
| Pre and Post Hospitalization |
Expenses incurred before and after the hospitalization tenure are covered by individual health plans. |
| Domiciliary Hospitalization |
On the recommendation of a doctor, if the insured individual requires medical attention at their own home, it is covered by individual health plans. |
Exclusions of Individual Health Insurance
Individual health plans do not cover the following conditions:
- Injury or hospitalization due to involvement in any terrorist activities, act of war, civil war, or any criminal activity.
- Hospitalization and injuries caused due to intoxication or overdose of drugs or alcohol will not be covered.
- Injury caused due to adventure sports.
- Infertility treatments are not covered.
- Obesity and cosmetic procedures are not covered.
- Treatment of HIV/AIDS is not covered under most individual health plans.
- Congenital ailments are not covered.
Waiting Periods of Individual Health Insurance
A waiting period is a common clause under individual health plans. During this time period, the individual health plan sum insured amount cannot be claimed by the insured individual until they fulfill the waiting period tenure. Waiting periods vary from insurer to insurer and are of different types, as mentioned below:
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Initial Waiting Period
The initial waiting period is generally 30 days. It is the time period from the purchase of an individual health insurance policy until the policy is activated. During this time period, no features of the health plan are active and cannot be claimed by the insured individual.
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Specific Waiting Periods
Specific ailments and diseases like cataracts, joint replacement surgery, knee bariatric surgery, and other specific procedures have a waiting period of 24 to 48 months as per your individual health plan terms and conditions.
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Pre-existing Disease Waiting Period
The pre-existing waiting period is applicable for certain conditions that an insurance holder has before they purchase the individual health plan. PED waiting periods can vary between 2 to 4 years as per the plan you choose.
Individual Health Insurance Plan Riders
Riders are responsible for enhancing the overall coverage of the health plan by offering coverage against critical illnesses, personal accidents, and more. The riders offered vary from insurer to insurer, and one must understand their requirements before opting for a rider:
| Health Insurance Riders |
Benefits |
| Personal Accident Rider |
Will provide the insured individual with a lump sum amount or their nominee if the insured suffers from partial/total disability due to an accident. |
| Critical Illness Rider |
Critical Illness riders offer a lump sum amount to the policyholder on the diagnosis of a critical illness such as cancer, kidney failure, brain surgery, heart attack, or more listed ailments in the policy. |
| Daily Hospital Cash Rider |
As the name suggests, daily hospital cash riders offer a hospital cash allowance on a daily basis until the time you are hospitalized. |
| Reduction In Waiting Period Rider |
The reduction in waiting period riders offers the insurance holder a reduced waiting period for most PEDs. |
| OPD Rider |
OPD riders cover medical expenses incurred due to doctor’s consultation fees, X-rays, ECGs, other diagnostic tests, medicine bills, and more. |
| PED Coverage From Day 1 Rider |
PEDs like diabetes, hypertension, and asthma are covered from day 1 on purchase of the PED rider. |
Difference Between Family And Individual Health Plans
Certain key differences between family and individual health insurance are mentioned below:
| Features |
Individual Health Insurance |
Family Health Insurance |
| Who Is Covered? |
The individual health plan provides medical care coverage to a single person. |
A family health insurance plan offers medical care for up to 15 family members or more, depending on the insurer. |
| Sum Insured |
The sum insured is assigned to the policyholder on an individual basis, and no one else can file a claim under an individual health plan other than the policyholder themselves. |
In a family health insurance, a single sum insured is used to cover all the registered family members under the policy until the sum insured is exhausted. |
| Premiums |
Premiums are calculated on the basis of age, lifestyle, income, and other factors of the insured individual. |
Family health insurance premiums are calculated with respect to the oldest member of the family. |
How To Purchase Individual Health Insurance on PolicyX?
Follow these simple steps in order to purchase the best health insurance plans in India:
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Step 1: Visit the official website of PolicyX.
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Step 2: Click on the 'Health Insurance' tab, which will open up a digital form for you to fill out.
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Step 3: Fill in all the necessary details such as your age, the sum insured required, and click on 'View Plans'.
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Step 4: Select your city and click on 'Proceed'.
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Step 5: Further, fill in your name and mobile number and click on 'Get Free Quotes'.
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Step 6: You will be directed toward a list of health insurance plans wherein you can compare the plans of your choice and pay for the one you want as per your needs and requirements.
Conclusion
Individual Health plans are essential for everyone. You do not have to share the total sum insured with your family members; it is utilized entirely by you. An excellent financial tool for young individuals who are transitioning into professional jobs, as it not only protects you but also provides tax benefits. So go ahead and start your financial planning by investing in an individual health plan with PolicyX and gain important comparisons and insights into the best individual health plans for you.
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