Individual Health Insurance
  • Independent Sum Insured
  • Separate Health Cover
  • Lifetime Renewability
Individual health insurance
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Individual Health Insurance Plans in India 2024

Individual health plans secure you financially from the stress caused by medical emergencies or hospitalizations and planned treatments and allow you to focus on recovery. It is your shield against all your medical care worries. These plans are designed to combat medical care inflation that is on a consistent rise across the globe including India. A recent study shedding light on the workforce of India found that India has the highest medical inflation in Asia, reaching 14%. The consistent rise in medical inflation puts a heavy burden on the country's workforce.

What is Individual Health Insurance?

Individual health insurance offers medical care to individuals on an individual sum insured basis. In simple words, individual health plans have a separate premium for each family member in case each family member purchases an individual health plan. The sum insured is assigned to the policyholder for their utilization and can not be applied to any other family member. Individual health plans provide coverage for in-patient hospitalization expenses like room rent, doctor's fees, OPD, and pharmacy, along with other features like AYUSH treatments, daycare procedures, emergency ambulance service, and more. Individual health plans can be purchased for a tenure of 1/2/3 years and offer a lifetime renewability feature to customers. Individual health plans are offered by multiple health insurance providers regulated by the IRDAI.

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

  1. 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.

  2. 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.

  3. 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.

  4. 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 1/2/3 years as per your renewal cycle.

  5. 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 2024

Mentioned below are some of our top picks for individual health plans that will help you make an informed decision

Individual Health Plan
Sum Insured
Entry Age
Unique Feature
Care Supreme Health Plan 7 L to 1 Crore 18 to 99 Years Cumulative bonus of up to 500%
Niva Bupa Reassure 2.0 5 L to 1 Crore 18 years to no age limit Carry forward unutilized sum insured to the next policy year
Star Health Youngstar Plan 3 L to 1 Crore 18 to 40 years Additional basic sum insured available for road accidents
Aditya Birla Activ Health Platinum Enhance 2 L to 2 Crore 5 years to no maximum entry age Mental Illness hospitalization available
ManipalCigna Prime Advantage 5 L to 1 Crore 18 years to no maximum entry age Switch off your health plan for 30 days and get discounts on renewal premiums
Bajaj Allianz Health Guard Plan 2 L to 1 Crore 18 to 65 Years 100% sum insured reinstatement in case of exhaustion
Cholamandalam Flexi Health 5 to 25 Lakhs 18 to 65 Years Additional sum insured available for road accidents
Future Generali Health Absolute 3 L to 1 Crore 18 years - no maximum entry age Features such as fitness tracking, mental health cover, teleconsultation, and more
HDFC Ergo My Health Suraksha 3 L to 75 L 18 to 65 Years Avail post-diagnosis support with the plan
ICICI Lombard Health AdvantEdge 5 L to 3 Crores 18 to 65 Years Multiple optional benefits like domestic air ambulance, worldwide cover, ambulance assistance, etc.
Kotak Health Premier 2 L to 2 Crore 18 to 65 Years Earn health rewards and points to gain discounts on renewal premiums
Liberty Health Connect 3 to 15 L 18 to 65 Years Enhance your cumulative bonus as per the plan variant chosen
Magma HDI One Health Plan 2 L to 1 Crore 18 years to no maximum age limit Opt for deductibles as per your choice up to INR 10 L
Raheja QBE Health QuBE Plan 1 to 50 L 18 to 65 Years Choose from 4 different plan options along with sub-limit waiver add-on cover
Reliance General Health Infinity Insurance Plan 5 L to 5 Crores 18 to 65 Years Avail premium discounts for maintaining BMI and good health
Royal Sundaram Lifeline Health Plan 2 L to 1.5 Crore 18 years to no maximum age limit App based cabs available as a part of ambulance cover for customer convenience in the time of emergency
SBI General Super Health Insurance 3 L to 2 Crores 18 years to no maximum age limit Get 3 times coverage of your base sum insured on diagnosis of a serious illness
Universal Sompo A Plus Health Insurance 5 L to 1 Crore 18 to 75 Years Covers psychiatric illness under the plan
National Young India Mediclaim Policy 3 to 10 L 18 to 43 Years Affordable health plan with covid vaccination, and wellness discounts
The New India Premier Mediclaim Policy 15 L to 1 Crore 18 to 65 Years Avail of critical care benefit as optional coverage
Oriental Youth Eco Care Plan 3 L to 1 Crore 18 to 45 Years Avail of mental illness cover under this plan
United India Individual Health Insurance 2 to 20 Lakhs 18 to 65 Years Avail daily cash allowance optional cover
What is Entry Age?

The age (last birthday) at which you buy an insurance policy is your entry age to that policy. Insurance policies usually come with a minimum and maximum age at entry which means that you must attain a specific age or should be less than the maximum age to buy a policy.

What is Sum Insured?

Sum insured is the maximum monetary coverage that a health insurance policy provides you. You should decide your sum insured based on the cost of medical treatments, your health, income, and lifestyle habits.

A unique healthcare plan offering extensive coverage to individuals and families under a single plan with affordable premiums.

Unique Features

  • Unlimited E-consultations
  • Unlimited Automatic Restoration
  • Avail Up to 30% Discounts

Care Supreme Plan (Pros)

  • Day Care Treatments
  • No Sub-Limits
  • Emergency Ambulance
  • No-Claim Bonus
  • Organ Donor Cover

Care Supreme Plan (Cons)

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

Care Supreme Plan (Other Benefits)

  • Unlimited Recharge
  • 30% Renewal Discount
  • Unlimited E - Consultation
  • Wellness Benefits
  • Nutrition and Fitness Coaching

Care Supreme Plan (Eligibility Criteria)

  • Entry Age - 90 Days
  • Max Entry Age - No age limit
  • SI - 5 L to 15 L
  • Waiting Period - 30 Days

Niva Bupa Reassure 2.0 provides insurance holders with a high sum insured through their platinum, titanium, and bronze variants along with a multitude of other features.

Unique Features

  • Booster+ Benefit
  • Lock premiums at entry age
  • Health check-ups from day 1

Health ReAssure 2.0 Plan (Pros)

  • Personal accidents covered
  • Acute Care
  • Emergency Ambulance
  • Three Plan variants
  • Home Care Treatments

Health ReAssure 2.0 Plan (Cons)

  • No OPD Cover
  • No Maternity Cover
  • No Sleep Disorder Covered
  • Pre-Existing Diseases after 3 yrs.
  • Alcoholism not covered

Health ReAssure 2.0 Plan (Other Benefits)

  • Air Ambulance
  • Modern Treatments
  • Second Opinion
  • Booster Benefit
  • Shared Accommodation Benefit

Health ReAssure 2.0 Plan (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - No Age Limit
  • SI - 5 L to 1 Cr
  • 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

Activ Health Platinum Enhanced

A unique Plan with features such as a chronic management program, modern treatments, covid-19, and more.

Unique Benefits

  • High SI
  • Affordable Premiums
  • Wellness Benefits

Activ Health Platinum Enhanced (Pros)

  • Earn 100% Health Return
  • Cover for Dental Consultations
  • Modern Treatment Cover
  • Wellness Coach
  • Mental Illness Cover

Activ Health Platinum Enhanced (Cons)

  • Illness due to intoxicants
  • Change Of Gender Treatment
  • Hazardous Activity not covered
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable

Activ Health Platinum Enhanced (Other Benefits)

  • Chronic Management Program
  • Premium Waiver Benefit
  • Reload of SI
  • Road Ambulance Cover
  • Second e-opinion

Activ Health Platinum Enhanced (Eligibility Criteria)

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

A plan with 3 variants offering up to 1 Cr SI. It covers expenses incurred during hospitalization resulting from serious illness or accident.

Unique Features

  • Avail Discounts
  • Maternity cover available
  • Organ Donor expenses covered

Bajaj Allianz Health Guard (Pros)

  • Convalescence benefit
  • Super Cumulative bonus
  • Daily cash benefit
  • New Born Baby Cover
  • Pre & post hospitalization

Bajaj Allianz Health Guard (Cons)

  • No Global Coverage
  • No Dental Treatment
  • No Parkinson's Cover
  • HIV/AIDS not covered
  • No Obesity/Weight Cover

Bajaj Allianz Health Guard (Other Benefits)

  • Health prime rider
  • Non-medical expense rider
  • Wellness benefits
  • Bariatric surgery cover
  • SI reinstatement benefit

Bajaj Allianz Health Guard (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 1.5 L to 1 Cr
  • Waiting Period - 30 Days

A plan with sum insured, premium payments and tenure options. Provides coverage for alternate treatments besides allopathy too.

Unique Features

  • Flexible Sum Insured
  • Avail Newborn Baby Coverage
  • Travel reimbursement

A plan that provides physical & mental health coverage .The plan also includes accidental hospitalization and wellness benefits.

Unique Benefits

  • Diagnostic & Fitness Tracking
  • Discount on fitness
  • Discount on Health Brands

Health Absolute (Pros)

  • Home Health Care Expenses
  • Alternative Treatments
  • Accompanying Person Cover
  • E-Opinion Cover
  • 3 Variant Plan

Health Absolute (Cons)

  • No Newborn Baby Cover
  • No Infertility Treatment Cover
  • No War Injury Cover
  • No Joint Replacement Cover
  • No Obesity Treatment Cover

Health Absolute (Other Benefits)

  • Organ Donor Expenses
  • Maternity Expenses
  • Global Coverage
  • Emergency Medical Evacuation
  • Child Vaccination

Health Absolute (Eligibility Criteria)

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

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

ICICI Lombard Health AdvantEdge is a holistic plan that covers the policyholder against 20 critical illnesses including cancer.

Unique Features

  • New Born Baby and Vaccine Cover
  • Domestic Air Ambulance
  • 24x7 video/telephone consultation

A comprehensive health plan that offers protection plus rewards and value-added benefits. Additionally, the plan also comes with in-built maternity coverage.

Unique Features

  • Long Term & Family Discounts
  • Zone-wise premium classification
  • Critical Illness cover

Liberty Health Connect Policies

A plan designed to cover you and your family with 4 different variants to choose from Basic, e-connect, Elite, and Supreme. The plan offers a sum insured up to 15L.

Unique Features

  • Domiciliary Treatment Provided
  • Road Ambulance available
  • Avail Loyalty perks

It is a comprehensive insurance policy that comes in an Individual and Family Floater option, wherein you can cover up to 4 adults and 3 children under a floater policy.

Unique Features

  • Covers Critical Illnesses
  • Covers Accidents
  • 5 Variants

One Health Insurance Policy (Pros)

  • Free Health check-up
  • Recharge of SI
  • Loss of Income Benefit
  • Bariatric Surgery Cover
  • Lasik Surgery Cover

One Health Insurance Policy (Cons)

  • Hazardous Sports Not Covered
  • Substance Abuse Unavailable
  • Hazardous Activity not covered
  • 10% Copay
  • Cosmetic Surgery unavailable

One Health Insurance Policy (Other Benefits)

  • Early Joining benefits
  • Second E-Opinion
  • Fitness rewards
  • Wellness services
  • Hospital Daily Cash benefit

One Health Insurance Policy (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 2 L to 1 Cr
  • Waiting Period - 30 Days

Raheja QBE Health QuBE plan

A health plan suitable for individuals and families. The given plan offers a sum insured for up to 50L.

Unique Features

  • Avail organ donor benefit
  • 4 variants available
  • Medical checkup covered

Raheja QBE Health QuBE plan (Pros)

  • In-Patient Hospitalization
  • Room Rent Cover
  • ICU Cover
  • Doctor Fee Cover
  • Daily Allowance Benefit

Raheja QBE Health QuBE plan (Cons)

  • Obesity
  • Cosmetic Surgery
  • Injury Due To Illegal Activity
  • Injury Due To Hazardous Activities
  • Adventure Sport Injuries

Raheja QBE Health QuBE plan (Other Benefits)

  • Avail Cashless Treatment
  • Regular Medical Check-Up
  • Organ Donor Benefit
  • Recharge Benefit
  • Domiciliary Hospitalization

Raheja QBE Health QuBE plan (Eligibility Criteria)

  • Entry Age - 90 Days
  • Max Entry Age -65 Years
  • SI - 1 L to 50 L
  • Waiting Period - 30 Days

A plan that covers you and your family offering a sum insured of 5 lakhs to 5 crores. The plan offers 15 different types of discounts.

Unique Features

  • No Sub-limits on benefits
  • Robotic surgery for quick recover
  • 90 days free cancellation

Health Infinity Insurance (Pros)

  • 10% Online discount
  • 5% Early Bird Discount
  • 10% Stay Healthy Discount
  • Credit score discount
  • Concurrent Disclosure Discount

Health Infinity Insurance (Cons)

  • No Obesity Treatment Cover
  • Infertility Treatment Unavailable
  • No Alternative treatments
  • Out-patient not covered
  • Cosmetic Surgery unavailable

Health Infinity Insurance (Other Benefits)

  • 5% Girl Child Discount
  • Restore Benefit
  • 2.5% Vaccination Discount
  • 5% BMI Discount
  • 2.5 % Renewal Discount

Health Infinity Insurance (Eligibility Criteria)

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

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

Unique Features

  • Healthcare & wellness services
  • No capping on room rent
  • Global hospitalization

An all-inclusive insurance cover to cater to your health & fitness needs. It is an individual and family floater policy with 7 optional covers to select from.

Unique Benefits

  • Tax Benefits
  • Reinsure Benefit
  • Health Multiplier

Super Health Insurance (Pros)

  • Enhanced Cumulative Bonus
  • Daycare Procedures
  • Maternity Cover
  • Annual Health Check-up
  • Optional Covers

Super Health Insurance (Cons)

  • Cosmetic Treatment
  • Injury Due To Illegal Activity
  • Injury Due To Hazardous Activities
  • Adventure Sport Injuries
  • Unlawful Activities

Super Health Insurance (Other Benefits)

  • OPD Expenses
  • International Treatment
  • SI up to 2 Crores
  • Flexible-Premium Payment
  • Domestic Staff Cover

Super Health Insurance (Eligibility Criteria)

  • Entry Age - 91 Days
  • Max Entry Age - No Limit
  • SI - 3 L to 2 Crore
  • Waiting Period - 30 Days

A versatile health insurance policy available on an individual and family floater basis offering various optional covers.

Unique Features

  • No pre-policy Check-up
  • Health Incentives
  • Tax Benefits

Young India Mediclaim Policy (Pros)

  • Multiple Discounts Available
  • Zone Wise Premium
  • COVID Vaccination
  • Daycare Treatment Cover
  • Comprehensive Cover

Young India Mediclaim Policy (Cons)

  • Treatment outside India
  • OPD Diagnostics
  • Injury Due To Illegal Activity
  • Injury Due To Hazardous Activities
  • Adventure Sport Injuries

Young India Mediclaim Policy (Other Benefits)

  • High SI
  • Cataract Cover
  • Maternity Cover
  • AYUSH Treatment Cover
  • Personal Accident Cover

Young India Mediclaim Policy (Eligibility Criteria)

  • Entry Age - 3 Months
  • Max Entry Age - 43 Years
  • SI - 3 L to 10 L
  • Waiting Period - 30 Days

The plan comes in 2 different variants offering a sum assured up to 1 Cr. The policyholder can cover his/her entire family under one policy.

Unique Features

  • Critical illness covered
  • AYUSH treatment covered
  • AYUSH treatment covered

United Individual Health Insurance

An individual health insurance policy that covers hospitalization, day care and ayurvedic expenses.

Unique Features

  • Ambulance charges covered
  • Daily hospital cash
  • Free health check-ups

Individual Health Insurance(Pros)

  • AYUSH Treatment Cover
  • Daycare Treatment Cover
  • Room Rent Cover
  • Domiciliary Hospitalization
  • Organ Donor Benefit

Individual Health Insurance(Cons)

  • 2 Years WP for Cataract
  • Obesity Treatment Unavailable
  • Unproven Treatments Not Covered
  • 2 Years WP for Hernia
  • 4 Years WP for Joint Replacement

Individual Health Insurance(Other Benefits)

  • 3 Policy Variants
  • Spouse Cover
  • Cataract Treatment Cover
  • Surgical Procedures Cover
  • Senior Citizen Cover

Individual Health Insurance(Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age -65 Years
  • SI - 2 L to 20 L
  • Waiting Period - 30 Days

Individual Health Plan Eligibility Criteria

The generic eligibility criteria of individual health plans are mentioned below

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 health care for yourself at affordable premiums and also an excellent tax-saving tool.
  • If 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.
  • If 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 such it is best to invest in an individual health plan.
  • If 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.
  • If you are someone who has an employer health plan but still wants an additional health care 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 for me. 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.

  1. Claim Settlement and Reliability

    Before selecting an individual health plan, make sure you check for the claim settlement ratio of the company. The higher the claim settlement ratio the easier will be the claim settlement process. CSR is the indicator of the number of claims settled by the insurance company as compared to the number of claims received.

  2. Network Hospitals

    When purchasing an individual health plan take care of 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.

  3. 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 times it may not be true. Consider all factors like age, health conditions, family medical history, and more before selecting your sum insured value.

  4. 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.

  5. 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 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, individual health plan sum insured amount can not be claimed by the insured individual till they fulfill the waiting period tenure. Waiting periods vary from insurer to insurer and are of different types that are mentioned below

  1. 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 till the policy is activated. During this time period, no features of the health plan are active and can not be claimed by the insured individual.

  2. 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

  3. 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.

Health Insurer Network Hospitals

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 hospital cash allowance on a daily basis till 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 insurer to 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 till 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

  • Step 1

    Visit the official website of PolicyX.

  • Step 2

    Click on the 'Health Insurance' tab which will open up a digital form for you to fill out.

  • Step 3

    Fill in all the necessary details such as your age, the sum insured required, you want and click on 'View Plans'.

  • Step 4

    Select your city and click on 'Proceed'.

  • Step 5

    Further, fill in your name and mobile number and click on 'Get Free Quotes'.

  • 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.

Wrapping It Up

Individual Health plans are essential for everyone. You do not have to share the total sum insured with your family members and it is utilized entirely by you. An excellent financial tool for young individuals who are transitioning into professional jobs from education as it not only protects you but also provides you with 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.

Individual Health Plans: FAQs

1. Top 5 individual health insurance plans in India based on claim settlement ratio.

The following are the top 5 individual insurance plans in India based on the latest claim settlement ratio (CSR) for the year 2021–22:

  1. Care Supreme Health Planc
  2. Niva Bupa Reassure 2.0
  3. Star Health Youngstar Plan
  4. Aditya Birla Activ Health Platinum Enhance
  5. ManipalCigna Prime Advantage

2. What is an individual health insurance?

Individual health insurance offers medical care to individuals on an individual sum insured basis. In simple words, individual health plans have a separate premium for each family member in case each family member purchases an individual health plan. The sum insured is assigned to the policyholder for their utilization and can not be applied to any other family member. Individual health plans provide coverage for in-patient hospitalization expenses like room rent, doctor’s fees, OPD, and pharmacy, along with other features like AYUSH treatments, daycare procedures, emergency ambulance service, and more.

3. What are the tax benefits available with individual health insurance?

Tax benefits under section 80 D of the Income Tax Act are applicable for insured individuals.

4. What are the eligibility criteria for investing in an individual health plan?

The general eligibility criteria for investing in an individual health plan is from 18 to 65 years for most health insurance providers.

5. What is the difference between individual and family health plans?

An individual health plan provides a sum insured to one policyholder and the medical coverage and benefits are applicable only to that individual. Whereas, in a family health insurance a single sum insured is utilized by all the family members that are covered under a family floater plan.

6. What are the waiting periods applicable in individual health insurance plans?

The general waiting period applicable in an individual health plan is an initial waiting period of 30 days along with specific ailments and pre-existing diseases waiting period which may vary between 24 months to 36 months depending on the insurer.

7. How much sum insured is ideal for an individual health plan?

It is advised to invest in an individual health plan with a sum insured value of at least 50% of your annual income. For example, if your annual income is INR 20 Lakhs your sum insured should be INR 10 Lakhs at least.

8. What is covered under an individual health plan?

The various inclusions of an individual health plan are

  • In-patient hospitalization
  • OPD expense
  • Daycare Procedures
  • AYUSH Treatments
  • Modern Treatments
  • Domiciliary Hospitalization
  • Organ Donor Expenses
  • Annual Health Check-ups and more

9. What are the various riders that are available with individual health plans?

Policyholders can opt from the following riders available

  • Critical Illness
  • Personal Accident
  • Hospital Cash
  • OPD and more

10. Can I buy an individual health plan at the age of 21 years?

Yes, it is advised to invest in individual health plans as early as possible as the premiums are much lower in your 20s than they will be in your 30s. Buying an individual health plan also provides you with holistic medical care features as well as tax benefits.

11. Can I avail Tax Benefits under Individual Health Insurance plans?

Yes, policyholders can avail of Tax Deduction under section 80D of the Income Tax Act. Tax deductions can range from Rs. 25,000 to Rs. 1 Lakh, depending on the age and number of members added to the plan.

12. What is covered under an individual health insurance plan?

Individual health insurance covers the following expenses:

  • Medical examinations
  • Emergency services
  • Hospitalization
  • Laboratory services
  • Physician fee
  • Room, boarding expenses
  • Maternity and newborn care

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Simran Kaur Vij

Written By: Simran Kaur Vij

Simran is an insurance expert with more than 3 years of experience in the industry. She may have all the answers to your insurance queries. With a background in Banking, she proactively helps her readers to stay on par with all the latest Insurance industry developments.