Individual Health Insurance
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  • Separate Health Cover
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Individual health insurance
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Individual Health Insurance Plans

In the last few years, people have realised the importance of having health insurance and are keeping themselves financially secure. If you are a young, independent person, an Individual health insurance policy is helpful to cover all healthcare-related costs. Such policies are designed to help meet the medical expenses related to hospitalization, diagnostics, treatments against Critical Illnesses, and several other conditions or unexpected emergencies.

Best Individual Health Insurance Policy in 2023

Below-given is the list of 10 Individual health insurance plans that will help you get an insight of the coverage provided and will help you choose better.

  • Aditya Birla Activ Health Platinum
  • Care Plan
  • HDFC ERGO Optima Restore
  • NivaBupa Health ReAssure Plan
  • Bajaj Allianz Health Guard
  • ICICI Lombard Complete Health
  • Reliance Health Gain Insurance Policy
  • SBI Arogya Supreme
  • Star Comprehensive Plan
  • Tata AIG Medicare Health Insurance

A comprehensive health insurance plan that offers comprehensive coverage against medical bills & comes with access to Chronic Management Program.

Unique Benefits

  • Chronic illness cover
  • Modern treatments covered
  • Double coverage

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

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

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

Health Reassure Plan (Pros)

  • Booster benefit
  • Organ donor transplant
  • ReAssure
  • Live Healthy Benefit
  • Second Medical Opinion

Health Reassure Plan (Cons)

  • No OPD Cover
  • No Maternity Cover
  • No Sleep Disorder Covered
  • No Suicide Cover
  • No War Injury Cover

Health Reassure Plan (Other Benefits)

  • Air Ambulance
  • Hospital Cash
  • Personal Accident Cover
  • Domiciliary hospitalization
  • Day care treatment

Health Reassure Plan (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - No Age Limit
  • SI - 3 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 comprehensive health insurance policy that covers you and your family with SI of up to 50 lakhs. Provides additional benefits as well.

Unique Features

  • Available in 4 different variants
  • 100% Automatic Restoration of SI
  • Riders for enhanced coverage

Available in Individual as well as Family Floater Plans, the plan offers comprehensive coverage with in-patient treatment, and several add-on features.

Unique Features

  • Avail waiver of premium
  • Consumables Covered
  • Cumulative Bonus of 33.33%

Health Gain Insurance Policy (Pros)

  • Second Opinion Cover
  • Vaccination Cover
  • Health Check-up Cover
  • Home Care Treatment
  • Vision Correction Cover

Health Gain Insurance Policy (Cons)

  • Unproven Treatments Unavailable
  • Overseas treatment Unavailable
  • Hazardous Activity not covered
  • Infertility Treatment not covered
  • Cosmetic Surgery unavailable

Health Gain Insurance Policy (Other Benefits)

  • Companion Cover
  • Child Care Cover
  • Radio Taxi Cover
  • Convalescence Cover
  • Air Ambulance Cover

Health Gain Insurance Policy (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 3 L to 1 Cr
  • Waiting Period - 30 Days

A comprehensive health insurance plan that offers a 15% increase in cumulative bonus for every claim-free year and comes with 8 optional coverage options.

Unique Features

  • Bariatric Surgery cover
  • 573 Day Care procedures covered
  • Domestic Air Ambulance cover

SBI Arogya Supreme (Pros)

  • E - Consultations
  • Sum Insured Refill
  • Air Ambulance
  • Long-term Policy
  • AYUSH Cover

SBI Arogya Supreme (Cons)

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

SBI Arogya Supreme (Other Benefits)

  • Multiple Discounts
  • Annual Health Check-up
  • Mental Health Care
  • Cataract Treatment
  • E-Opinion

SBI Arogya Supreme (Eligibility Criteria)

  • Entry Age - 91 Days
  • Max Entry Age - 65 Years
  • SI - 5 L to 50 L
  • Waiting Period - 30 Days

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

Unique Features

  • Health check-ups for claim-free years
  • Hospital Cash Benefit
  • 100% Automatic Restoration

A health plan that supports you in times of medical emergencies. The plan comes in 3 types, Tata AIG MediCare, Tata AIG MediCare Protect, and Tata AIG MediCare Premier.

Unique Features

  • Global Coverage
  • 540+ Day care treatments
  • Compassionate Travel up to 20K

Medicare Health Insurance (Pros)

  • Qualified Nurse
  • Restore Benefit
  • Room Rent
  • Organ Donor
  • Domiciliary Treatment

Medicare Health Insurance (Cons)

  • Injury due to Suicide Attempt
  • Death due to Drugs
  • Injuries Due to Breach of Law
  • Injuries/Death due to Aviation
  • STDs

Medicare Health Insurance (Other Benefits)

  • AYUSH Benefit
  • Health Checkup
  • Bariatric Surgery Cover
  • Vaccination cover
  • 50%Cumulative Bonus

Medicare Health Insurance (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 65 Years
  • SI - 3 L - 20 L
  • Waiting Period - 30 Days

What is an Individual Health Insurance Policy?

Individual Health Insurance is a type of health insurance policy wherein one can avail of medical coverage on an individual sum insured basis. Individual Health Insurance plans offer scope for customizations, which allows you to include family members/dependents under separate covers. With these plans, come several benefits such as offering wider coverage including in-patient hospitalization, pre and post-hospitalization expenses, daycare procedures, ambulance charges, etc.

Eligibility Conditions

  • Any adult above the age of 18 years is eligible to invest in an Individual Health Insurance policy
  • Further, there is generally a waiting period of 2-4 years in case the policyholder suffers from a pre-existing medical condition.
  • Individuals in the age bracket of 45-65 years and above may need to undergo pre-medical screening prior to policy issuance.

Why do I need Individual Health Insurance?

   Protection against lifestyle diseases and Mental Health issues: Lifestyle conditions such as PCOS, diabetes, obesity, coupled to mental stress and anxiety are likely to increase your expenses significantly. An Individual Health Insurance policy that offers psychiatric benefits in addition to covering the cost of health check-ups can help you deal better under such circumstances. However, the coverage of Mental Illnesses varies from Insurer to Insurer, therefore, it is advised to always read the policy brochure in detail.

   Quality treatment against Critical Illnesses: Critical or Terminal Illnesses such as cancer are associated with huge costs. Treatment, diagnosis, surgeries etc. require an individual to spend a large portion of their capital. However, a Health Insurance Cover at this stage can ensure quality care without the financial burden, given that these plans offer a percentage of the Sum Insured towards such expenses.

   Security over healthcare inflation: Healthcare inflation rose from 3.8% in December 2019 to 7.7% in June 2021*. If you are the sole earning member in your family, investing in an Individual Health Insurance plan should be one of your key priorities. It is important to remember here that prices are only going to increase with time which makes Health Insurance a crucial investment.

   Opportunities to maximise Savings: When you are covered under a Health Insurance policy, the Insurance Provider is liable to pay the expenses associated with your medical conditions. This allows you to save on unexpected healthcare expenditures and, in turn, protect/grow your existing capital reserves.

   Individual Coverage amount for each member: Sum Insured with an Individual Health Insurance plan is separate for each member covered under the policy. Therefore, claims raised are independently addressed, eliminating the need to wait for the Life Insured’s claim to be settled.

* Source - The Hindu

Features & Benefits of Individual Health Insurance

Lifelong Renewability

An Individual Health Policy can be renewed for life without any kind of restrictions.

Tax Benefits

Under section 80D of the Income Tax Law, policyholders can avail of Tax Deductions subject to a limit of Rs. 25,000 to Rs. 50,000.

Wider Coverage

On receiving treatment at a Network Hospital, the Health Insurer covers your hospital bills, eliminating the need to pay out of pocket.

Cashless Hospitalization

On receiving treatment at a Network Hospital, the Health Insurer covers your hospital bills, eliminating the need to pay out of pocket.

Coverage against Pre-Existing illnesses

You can avail cover for treatment expenses related to Pre-Existing medical conditions, subject to the waiting period.

Pre- and Post Hospitalization costs

An Individual Health Policy covers up to 60 days of Pre-Hospitalization charges and up to 90 days of Post-Discharge charges.

Ambulance / Day Care charges

Certain Health Policies cover the expenses incurred as a result of Day Care procedures and road ambulance costs.

Cumulative Bonus

With each claim free year, the Insurer increases the Sum Insured by a certain amount.

Individual Sum Insured

Sum Insured is specific to every member covered under the policy.

AYUSH benefits

Individual Health Plans also cover Ayurveda, Yoga, Unani, Siddha, Homeopathy based treatments.

Eligibility Conditions

  • Any adult above the age of 18 years is eligible to invest in an Individual Health Insurance policy.
  • Further, there is generally a waiting period of 2-4 years in case the policyholder suffers from a pre-existing medical condition.
  • Individuals in the age bracket of 45-65 years and above may need to undergo pre-medical screening prior to policy issuance.

Cost of Individual Health Insurance

The premiums charged for an Individual Health Insurance policy depends on the policyholder’s Age, Annual Income, Pre-Existing medical conditions, Location, Family Members and Sum Insured, among others. It is important that you consider these aspects and decide on a budget that ensures comprehensive coverage.


Usually, the more benefits you wish to cover under your Health Plan, the more will be the premium that you have to pay.

Age & Income

Age and income directly affect the premium amount. Higher the age and annual income of an individual, higher is the premium payable.


The cost of healthcare is likely to be more expensive in metropolitan areas. Therefore, for individuals living in metros, a high cover is required, which effectively means that you’ve to pay higher premiums.

Medical Conditions

Those who are at high risk in terms of their health, should opt for an Individual Health Insurance plan. This ensures that they don’t have to share the collective Sum Insured, unlike plans on a Floater basis.

Policy Tenure

Opting for a multi-year Health Insurance Policy makes you eligible for discounted premiums.


Adding a member to the policy increases the premium payable against it.

For in-depth insights into how premium amounts vary, visit ‘Health Insurance Price Index’.

Claim Settlement for Individual Health Insurance

The Health Insurance provider, upon validating the legitimacy of your condition, moves to settle the claims raised. The amount paid is subject to the Sum Insured by the policyholder. For your information, Claim Settlement is done either through Cashless Hospitalization or Reimbursements.

Cashless Claims

If the policyholder chooses to get treated in a Network Hospital, they can avail Cashless Hospitalization. This means that the Insurance Provider directly settles the bills with the hospital, eliminating the need for the policyholder to pay out of pocket.

Claim Intimation

Fill up the requisites at the hospital and notify your Health Insurer.

Claim Approval

Following review, the Insurer updates you about the status of your claim.

Claim Settlement

On approval, the Insurer settles your claim directly with the hospital.

Reimbursement Claims

If you choose to get treated in a hospital other than the ones in the Insurer’s network i.e. a Non- Network Hospital, you will need to pay the bills yourself and then later claim Reimbursement for the same.

Claim Registration

After hospitalization, send bills, invoices, etc. to your Insurer.

Claim Verification

The Insurer verifies the invoices and treatment related documents.

Claim Settlement

Once approved, the Health Insurer transfers the claim amount to your account.

Tax Savings with Individual Health Insurance Plans

Under the current Tax laws in India, there are certain Tax Benefits that you can avail of on purchasing an Individual Health Insurance Policy. These are:

   Tax Benefits on Single Premium Payment: As per prevailing Income Tax Laws in the country, Tax deductions (up to Rs. 25,000 or Rs. 50,000) can be availed under Section 80D for lump sum premium paid towards a multi-year plan.

   Tax Deductions for Senior Citizen Health Policies:Tax Deduction up to Rs. 50,000 can be claimed by policyholders for the premiums paid towards a Health Insurance policy bought for their parents. The Tax Deduction limit can range up to Rs. 1 Lakh for expenses incurred as a result of pre-specified illnesses.

   Tax Savings on Preventive Health Check-Ups: Costs incurred due to Preventive Health Check-Ups are eligible for Tax Benefits, to the limit of Rs. 5,000. Further, charges related to OPD consultations and Diagnostic Tests are also associated with tax exemption benefits.

Key Pointers to Note before Buying

In order to choose the best Individual Health Insurance policy for yourself, it is important that you scout through the available options carefully. There are certain pointers that you should take a note of prior to making a purchase. These are:

  1. Scope of Health Insurance coverage

    If you suffer from an illness, you should estimate the costs that you might incur as a result of it. You must consider Diagnosis and Consultation fees, potential need for future Hospitalization, Cost of Medical Procedures related to your condition, etc. This will help you decide the extent of coverage that you need and further shortlist Health Insurance providers offering these benefits.

  2. Sum Insured adequacy

    With healthcare inflation on the rise, your Sum Insured should be sufficient to cover expensive treatment costs. The amount should reflect both current and future medical needs. Ideally, experts recommend a range of Rs. 7 Lakhs to Rs. 10 Lakhs for an Individual Cover.

  3. Pre-Existing Illnesses and Waiting Period

    Pre-Existing medical conditions such as diabetes, thyroid, cardiac and renal conditions are associated with a Waiting Period. The benefits under your Health Insurance policy start only after this period has lapsed. Different Insurance providers have set different waiting periods against these ailments.

  4. Premiums and Co-payment

    You must ensure that the premium charged is worth the coverage offered by the plan.

    Alternatively, if you wish to lower your premium against the plan chosen, look for options to share the medical charges with the Health Insurer.

    While Co-payment does not affect the Sum Insured, it can reduce the burden of high premiums to a certain extent.

    You need to check with your Insurance Provider to confirm if the plan comes with the Co-payment clause.

  5. Limits to room rent

    Room Rent sublimit is an important factor to consider when buying an Insurance policy. The clause basically caps the maximum amount that can be availed for the hospital room against the total Sum Insured. Typically, you should look for plans with minimal or no sub-limits in order to avoid paying out of pocket.

  6. Network Hospitals and Cashless Claim Settlement

    Network hospitals in your vicinity can guarantee Cashless Hospitalization, subject to the Sum Insured. Check for the list of hospitals networked with an Insurance Provider to come to a decision.

  7. List of Inclusions and Exclusions

    It is always advisable to check the benefits offered and Exclusions which your Individual Health Insurance plan does not cover. The following list mentions certain inclusions and exclusions applicable under a standard Individual Health Insurance cover.

    Pre- and post hospitalizationCosmetic/ plastic surgeries
    In-patient hospitalizationCost of Ambulance
    Day care treatmentsInjuries while being engaged in war, unlawful activities, adventurous sports, etc.
    Health check-upsSexually transmitted diseases
    Domiciliary hospitalizationSex-changing surgeries
    AYUSH Benefits

Does Individual Health Insurance have any Waiting Periods?

Yes, all Individual Health Insurance Plans come with a waiting period. To begin with, you cannot file a non-accidental claim within the first 30 days of your policy's inception. Arthritis, cataracts, joint replacement surgery, bariatric surgery, and other ailments and surgical treatments are covered after a 1 to 3-year waiting time, depending on the plan. Similarly, you can file a claim for pre-existing conditions after a 2- to the 4-year waiting period, depending on the policy terms.

If you have added critical illness coverage to your personal health insurance, you will be eligible to file a claim 90 days after the policy starts. Furthermore, the claim will be authorized after a 30-day surviving period.

Comparison between Individual Health Insurance and Family Floater

The following table highlights distinguishing features of an Individual Health Insurance Plan and a Family Floater plan.

Family Floater Health PlanIndividual Health Plan
Sum Insured
A Family Floater plan is a comprehensive Health Cover for the entire family, wherein the Sum Insured is shared among every member.On the contrary, the Sum Insured under an Individual Health plan is specific to the individual who bought it.
When a claim is made by a member covered under a Family Floater plan, the total Sum Insured for the entire family reduces by the amount that has been claimed.In case of an Individual plan, a claim raised by another member of the family does not affect the cover amount of the remaining members.
Premium Payable
The premium payable against the Health Plan is calculated (among other factors) based on the age of the oldest member covered under the policy.Under an individual policy, the age of the insured person who bought the policy determines the premium.
Premium vs. Coverage
While the premiums are lower under a Family Floater policy, the coverage offered by an Individual Health Insurance policy is more extensive.

Individual Health Plans: FAQs

1. Best individual health insurance plans in India?

Following are the best individual health insurance plans in India:

  1. Aditya Birla Activ Health Platinum
  2. Care Plan
  3. HDFC ERGO Optima Restore
  4. NivaBupa Health ReAssure Plan
  5. Bajaj Allianz Health Guard
  6. ICICI Lombard Complete Health
  7. Reliance Health Gain Insurance Policy
  8. SBI Arogya Supreme
  9. Star Comprehensive Plan
  10. Tata AIG Medicare Health Insurance

2. Are vision and dental related expenses covered by Individual Health plans?

No, dental, vision and hearing related treatments are not covered by Individual Health plans. Please check with your Insurance Provider for special clauses applicable under their plans.

3. Who should ideally buy a Family Floater plan?

Ideally, a young, nuclear family should buy a Health Plan on a Family Floater basis. The premiums are lower and also the possibility of requiring serious medical assistance at this stage is low.

However, if you, your spouse or your children suffer from illnesses that could incur significant expenses, a separate plan for each person is advisable.

4. 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.

5. What is meant by Cumulative Bonus in Health Insurance?

Cumulative Bonus is offered against each claim-free year, wherein the Sum Insured increases by 5%-10% annually, depending on the Insurance Provider chosen by you.

6. What does Claim Settlement Ratio mean?

Claim Settlement Ratio is an aspect whose importance can not be undermined. It tells you the number of claims settled by an Insurance Provider of the total number of claims filed.

Visit ‘Health Insurance - Claim Settlement Ratio’ for insights into the CSRs of various Healthcare Insurance Providers in India.

7. 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

8. Is there a minimum age for purchasing individual insurance?

Individual insurance can be purchased by anyone at any age.

9. Will there be any additional charges other than standard premiums?

Aside from regular premiums, there are a few other additional charges that have to pay: Co-payments, Deductibles, and Coinsurance.

10. What is the benefit of buying personal health insurance at a young age?

If you buy personal health insurance at a young age your premium of health insurance will be lower. Also, you might get some extra benefits along with basic health insurance coverage.

11. Is it possible for a minor to purchase personal health insurance?

Personal health insurance offers complete coverage for the insured, although in some situations, the plan can also cover parents and in-laws.

12. What is an Individual health insurance?

The policy that an individual buys for himself and that comes with a single sum assured is called an individual health insurance policy. Individual health insurance plans offer medical coverage to an individual only.

13. Why are individual health insurance plans needed?

If you are an independent individual, individual medical insurance will help you at the time of healthcare needs. Having a health insurance policy saves you from financial burden when you want to get medically treated due to various reasons.

14. How is individual health insurance policy different from group health insurance?

When you buy health insurance for yourself on your own it is called individual health insurance whereas, when an employer or an association buys health insurance for its employees aur members it is called group health insurance.

15. Should I get individual medical insurance from work or buy it on my own?

If you buy individual medical insurance then it will provide you with extensive coverage but the premiums can be on the higher side. Whereas, a group health insurance gives basic coverage and the premiums are on the lower side.

16. What is the waiting period in an individual health insurance?

The waiting period in an individual health insurance policy depends on the type of policy, insurer and certain ailments.

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