Health Insurance in Odisha
  • Types of Health Insurance in Odisha
  • Expenses covered
  • How to choose the best
Health Insurance in Odisha
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Health Insurance in Odisha

Odisha, priorly known as Orissa, is also the place of Lord Jagannath. This state is steeped in the rich culture and heritage. It also prioritizes the well-being of its citizens. When it comes to healthcare, you will get multiple options to secure yourself financially if there is any medical emergency. In this article, you will get to know the details about health insurance in Odisha.

Types of Health Insurance in Odisha

If you are in Odisha, there will be two types of health insurance plans available for you.

  • Government-sponsored health insurance scheme
  • Private health insurance plans

Let us have a look to understand in detail.

Government-sponsored Health Insurance Schemes

The Odisha government has launched two government schemes to cater to the healthcare requirements of the citizens:

  • Biju Swasthya Kalyan Yojana (BSKY)

    The plan was launched in 2018, aiming to provide cashless reimbursement coverage for hospitalisation expenses. You will get coverage up to Rs 5 Lakh for families and Rs 10 Lakhs for women.
  • Employees' State Insurance (ESI)

    The government of Odisha have launched this plan to give financial protection to employees working in the organised sectors with a salary below Rs 21,000 per month. It offers a comprehensive medical coverage.

Network Hospitals In Odisha

Private Health Insurance Plans

A senior citizen plan that offers complete protection such as nursing at home, AYUSH cover, personal health coach, etc.

Unique Benefits

  • Avail up to 21% health returns
  • Second E-opinion
  • Worldwide Emergency Assistance

A new-age plan with loaded benefits covering hospitalization expenses arising due to illness or accident.

Unique Features

  • Premium Payment Flexibility
  • Wellness Program
  • Short Waiting Period

Assure Insurance Policy (Pros)

  • Second Medical Opinion
  • Health Check-up Covered
  • 100% Cumulative Bonus
  • Compassionate Travel
  • AYUSH Treatment

Assure Insurance Policy (Cons)

  • 10% Co-pay applicable
  • Deductibles
  • HIV/AIDS not covered
  • Cosmetic Surgery unavailable
  • Injuries due to breach of law

Assure Insurance Policy (Other Benefits)

  • In Utero Fetal Surgery
  • Pain Management
  • Rehabilitation Cover
  • Organ Donor Cover
  • Modern Treatment Cover

Assure Insurance Policy (Eligibility Criteria)

  • Entry Age - 18 Years
  • Max Entry Age - 75 Years
  • SI - 5 L - 2 Cr
  • Waiting Period - 30 Days

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

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

This plan is designed for youngsters and allows the policyholder to go overseas for treatments.

Unique Features

  • Exclusive maternity benefits
  • Adoption is included
  • Borderless facilities

Niva Bupa Aspire Plan (Pros)

  • Overseas treatment coverage
  • Booster benefit
  • Covers organ donor transplant
  • Second medical opinion
  • Teleconsultation

Niva Bupa Aspire Plan (Cons)

  • No suicide cover
  • No war injury cover
  • Baby food & utility charges excluded
  • Laundry charges excluded
  • No certificate charges

Niva Bupa Aspire Plan (Other Benefits)

  • 4 unique variants of the plan
  • Cash-bag benefit
  • WellConsult OPD Wallet
  • Cashless claim settlement
  • AYUSH Treatment

Niva Bupa Aspire Plan (Eligibility Criteria)

  • Entry age - 18 years
  • Max entry age - No AgeLimit
  • SI - INR 3L to 1 Cr
  • 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

Expenses Covered by Health Insurance in Odisha

  • Hospitalisation
  • Surgery
  • Medical treatment
  • Treatment of pre-existing conditions
  • Room rent charges
  • Pre and post hospitalisation
  • Ambulance services
  • Maternity benefits

How to Choose the Right Health Insurance Plan in Odisha?

When you are in Odisha, you need to keep a few things in mind before buying a health insurance plan:

  • If you are young and healthy, you don't need a health insurance plan but getting it earlier can be beneficial as it comes with lower premiums.
  • If you have any pre-existing conditions, make sure that the plan should cover them.
  • Calculate the premium cost carefully.
  • Understand the type of coverage and then go for the best one.

End Note

Choosing health insurance in Odisha offers a balanced approach, both health and finance-related. With the government schemes, you will get a safety net and a diverse range of private plans catering to the needs of the Odia people.

In case of any help, you can call IRDAI-certified health insurance experts of PolicyX.

Health Insurance in Odisha: FAQ's

1. I am employed, will I be eligible for ESI?

Yes, if your monthly income is less than Rs 21,000.

2. Can I switch to between health insurance companies in Odisha?

Yes, you can port/switch your health insurance to any company you want. To know more about the detailed process, call PolicyX.

3. What additional riders can I add to my health insurance plan?

You can add any rider like critical illness, accidental coverage, etc to your health insurance plan. It will give additional coverage for your specific needs.

4. What are some pre-existing conditions covered under health insurance plans in Odisha?

Nowadays, many health plans offer coverage for pre-existing conditions like diabetes and hypertension. However, the coverage for pre-existing conditions may vary from plan to plan.

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