Health Premia Plan vs Individual Mediclaim Policy Health Insurance Plan 2026 | PolicyX

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Health Premia is a health insurance plan that covers hospitalization expenses along with key medical needs like pre and post-treatment costs, daycare procedures, and emergency care. It also offers higher sum insured options and added benefits like restoration of coverage and global treatment support, making it suitable for both individual and family protection.

PLAN DETAILS

Health Premia Plan

Individual Mediclaim Policy

Product Type Individual and Family Health Insurance Individual
Key Features
(Key features of the plan)
  • Global medical coverage
  • Unlimited sum restoration
  • Comprehensive family protection
  • AYUSH Benefits Covered
  • Inclusions and Exclusions
  • Lifetime Renewability
OPD Details
(In some policies, OPD (Out patient department) expenses are also covered.)
Covered Covered
Room Rent
(A limit of room rent cover during hospitalization if any)
Covered Covered
Domicillary Hospitalization
(It is the expenses incurred on treatment of the patient at home)
Covered Covered
Pre-hospitalization
(Expenses before the insured is hospitalized)
Covered Covered
Post-hospitalization
(Expenses after discharge from the hospital)
Covered Covered
Day Care Treatment Covered
(Day care treatments refers to the treatments that do not necessarily require 24hrs of hospitalization like MRI.)
Not Covered Covered
Hospital_network
(Number of Hospital Network in city)
10000 4000
Organ Donor Expenses
(Expenses incurred on organ donor in case of organ transplants)
Covered Covered
Hospital Daily Allowance
(Some plans offer daily allowance to take care of expenses like food, etc)
Covered Covered
Ambulance Charges
(Expenses incurred on ambulance charges)
Covered Covered
Maternity Benefits
(All Hospitalization cost covered at the time of pregnancy.)
Covered Covered
New Born Baby Covered
(Newborn babies can be covered under the insurance plan after a certain period)
Covered Covered
Health Checkup
(An added benefit of one time full health checkup of policy holder.)
Covered Not Covered
Sub Limit
(Sub-limit is a monetary capping that applies on specific diseases like cataract)
Covered Covered
Co-pay
(Mentioned %, if any is to be borne by Insured and rest will be borne by insurer)
Not Covered Covered
Plan Entry Age 18 - 65 Years 18 to 65 Years
Plan Premium Entry Age and S/A 16436 2,933
Plan Waiting Period 30 30
Plan Coverage Inpatient hospitalization expenses, pre and post-hospitalization cover, daycare treatments, ambulance charges, AYUSH treatment cover, organ donor expenses, maternity and newborn cover, and optional global emergency treatment coverage. -
Plan Sample Premium 16436 2,933
Plan Brochure Brochure URL Brochure URL
Policy Term 1 & 2 years 1 Year
ICU Charges Covered Covered
Covid-19 Treatment Covered Covered
Cataract Covered Covered
Automatic Restoration Covered Not Covered
Ayush Treatment Covered Covered
Modern Treatment Covered Covered
E Consultation Covered Covered
Air Ambulance Covered Covered
Global Coverage Not Covered Not Covered
Claim Ratio 94.4 91.62
Solvency Ratio 3.03 -1.03
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