Health Insurance Plans In India: Compare & Buy Online

Health insurance plans in India are policies that provide coverage for medical expenses incurred by individuals or families and give access to avail quality healthcare services without having to bear the full burden of expensive medical treatments and procedures. These plans can be offered by employers, government programs, or purchased directly by individuals from insurance providers. Many plans now offer coverage for preventive services, such as vaccinations, screenings, and annual check-ups, with no out-of-pocket costs. Regardless of the type of health insurance plan, individuals must understand their coverage details, network providers, and any limitations or exclusions. Read More

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What is the Health Insurance Plan?

A Health Insurance Plan is a contract between a policyholder and an insurer, providing financial coverage for medical expenses up to a specified limit. Policyholders pay regular premiums, and in return, the insurer covers a portion or the entire cost of healthcare, ranging from emergencies to planned hospitalizations. Beyond offering crucial financial protection, health insurance policy allows for tax savings under Section 80D of the Income Tax Act, 1961.

Categories Specifications
Sum Insured Rs.50,000 to up to Rs.6 crore
Maternity Cover Available
Pre & Post-hospitalization Expenses Covered
OPD Cover Available
ICU Charges Covered
Free Health Check-ups Available
Pre-existing Diseases Covered
Ambulance Cover Available
Day Care Procedures Covered
Tax Benefits Up to Rs.75,000 per financial year
health-plan

Benefits to Buy Health Insurance Plans in India

Health insurance plans in India offer several benefits to the insured, to meet diverse healthcare needs and cover pre-existing disease, day care procedures, and many more.

Here are the benefits of purchasing a health insurance plan in India:

Hospitalization Expenses Coverage

Hospitalization Expenses Coverage

The health insurance policy covers the expenses incurred during hospitalization, extending coverage to room rent, doctor’s fees, medication costs, and diagnostic test fees.

Pre & Post Hospitalization Expenses

Pre & Post Hospitalization Expenses

Comprehensive coverage extends to re-hospitalization and post-hospitalization expenses are reimbursed for a fixed number of days, as specified in the policy document.

ICU Charges Inclusion

ICU Charges Inclusion

Health insurance policy also covers the costs associated with availing treatment in an Intensive Care Unit (ICU) during hospitalization, easing the financial burden of critical care.

Ambulance Cost Reimbursement

Ambulance Cost Reimbursement

Coverage extends to the expenses incurred for availing ambulance services during a medical emergency, ensuring transportation to the nearest hospital without financial strain.

Cashless Treatments at Network Hospitals

Cashless Treatments at Network Hospitals

All health insurance providers in India facilitate cashless treatment at their network hospitals. This eliminates the need to arrange funds for hospital bills.

Day Care Procedures Coverage

Day Care Procedures Coverage

Health insurance plans in India also cover the costs associated with daycare treatments that necessitate hospitalization for less than 24 hours, reflecting the evolving landscape of medical care.

Pre-existing Diseases Coverage

Pre-existing Diseases Coverage

The best health insurance plans in India policies extend coverage for pre-existing diseases, subject to completion of a waiting period.

AYUSH Treatment

AYUSH Treatment

The health insurance policy covers the costs of medical treatments offered by AYUSH (Ayurveda, Unani, Homeopathy, Siddha, and Yoga) schools of medicine, promoting holistic healthcare options.

Features of the Health Insurance Plans in India

Health insurance plans in India offer several features to the policyholder and their insured families to cover medical expenses such as maternity coverage, no-claim bonus, and many more.

Here are the features included with purchasing a health insurance plan in India:

What is covered in a Health Insurance Policy?

A health insurance policy typically covers a variety of medical expenses and services. The specific coverage may vary depending on the insurance company and the plan chosen.

Below, we have mentioned the common covers in most medical insurance plans:

  • Hospitalization

    Expenses related to inpatient care, such as room charges, nursing care, surgical procedures, and medications, are usually covered by health insurance policy.

  • Doctor's visits

    This includes expenses for consultations, examinations, diagnostic tests, and treatments provided by physicians or specialists.

  • Emergency services

    Medical insurance policy often covers visits to the emergency room for sudden and unexpected medical conditions or accidents..

  • Prescription drugs

    Coverage may include a wide range of prescribed medications, either in generic or brand-name form, depending on the plan.

  • Laboratory and diagnostic tests

    This covers costs associated with different lab tests, including blood tests, imaging studies (like X-rays, CT scans, MRIs), and pathology examinations.

  • Preventive care

    A Medical insurance policy often includes coverage for preventive services, such as vaccinations, screenings, and preventive screenings like mammograms, pap smears, or colonoscopies.

  • Maternity care

    A health insurance policy provides coverage for prenatal care, maternity consultations, delivery, and postnatal care for both the mother and the newborn.

  • Mental health and substance abuse services

    Health insurance plans in India may provide coverage for counseling, therapy sessions, and treatment related to mental health disorders and substance abuse.

  • Rehabilitation services

    This includes coverage for physical therapy, occupational therapy, and other types of rehabilitation services needed for recovery from illness, injury, or surgery.

  • Home healthcare

    Some health insurance plans in India include coverage for medical care or nursing services provided at home, particularly for individuals who are unable to leave their homes due to medical conditions.

What is not covered in a Health Insurance Policy?

A health insurance policy typically covers a wide range of medical expenses, but certain services are generally not covered. These exclusions can vary depending on the insurance company and the specific policy.

Below, we have mentioned the common covers in most that are typically not covered in a health insurance policy:

  • Cosmetic procedures

    Health insurance plans In India typically do not cover elective or cosmetic procedures, such as facelifts, liposuction, or breast augmentation, unless deemed medically necessary for reconstructive or therapeutic purposes.

  • Experimental or investigational treatments

    If a medical treatment is considered experimental, unproven, or not widely accepted within the medical community, health insurance is unlikely to cover it.

  • Alternative and complementary therapies

    Some health insurance plans may not cover alternative or complementary therapies, such as acupuncture, chiropractic care, naturopathy, herbal medicine, massage, energy healing, or homeopathy.

  • Long-term care

    Health insurance policies are generally not designed to cover long-term care, including services provided in nursing homes or assisted living facilities.

  • Non-emergency medical services abroad

    Unless specified in the policy, health insurance usually doesn't cover medical services received outside your home country, except in cases of emergencies.

  • Over-the-counter medications

    Health insurance plans In India typically cover prescribed medications, but they usually do not cover over-the-counter drugs or medications not prescribed by a healthcare professional.

  • Some pre-existing conditions

    Insurance companies may exclude coverage for pre-existing medical conditions for a certain period, especially in individual or private health insurance policies.

Are You Confused?
Are You Confused?

What are Riders In the Health Insurance Policy?

Riders in the health insurance policy refer to additional coverage options that can be added to a base policy. These riders provide extra benefits and coverage to meet the unique needs of individuals and families. There are various types of riders available in health insurance plans in India, each offering specific coverage enhancements.

Here are some common riders that policyholders can consider before buying health insurance plans in India:

1

Maternity rider

This rider provides coverage for prenatal, childbirth, and postnatal expenses. It covers costs associated with doctor visits, hospital stays, laboratory tests, and delivery-related services.

2

Dental and Vision rider

This rider adds coverage for dental treatments like regular check-ups, fillings, extractions, and vision-related expenses such as eye exams, glasses, and contact lenses.

3

Critical illness rider

Critical illness riders offer coverage for life-threatening conditions such as cancer, heart attack, stroke, and kidney failure. The rider pays a lump sum benefit upon diagnosis of any covered critical illness.

4

Hospital cash rider

Hospital cash riders offer a fixed daily cash benefit for each day spent in the hospital due to illness or injury. This rider helps cover incidental expenses like transportation, meals, and lodging.

Are You Confused?
Are You Confused?

How to Save Taxes with a Health Insurance Policy?

Saving taxes is a common goal for many individuals, and one way to achieve this is by buying a health insurance policy. Health insurance plans in India not only provide financial protection against healthcare expenses but can also offer tax benefits.

One way to save taxes with a health insurance policy is by taking advantage of tax deductions. In India, health insurance premiums are tax-deductible. By looking at your deductions, you can include the amount you paid for health insurance premiums throughout the year.

Lastly, some governments offer tax credits for those who purchase health insurance plans through government exchanges. These credits are meant to make medical insurance plans more affordable for individuals and families, ultimately reducing the tax burden for those who qualify. Overall, having a health insurance policy can provide various tax-saving benefits while also ensuring you have comprehensive coverage for your medical needs.

Best Health Insurance Plans in India

At Okbima, we're here to assist you in finding the perfect health insurance plans in India for your needs. Below, we have provided a list of medical insurance plans from leading companies in India.

Health Insurance Plans Sum Insured Rs. Network Hospitals Claim Settlement Ratio (CSR)  
Aditya Birla Activ Assure Diamond Plan Min – 2 lakh | Max – 2 crore 10500+ 99.41% Get a Quote
Future Generali Health Total Policy Min – 3 lakh | Max – 1 crore 8000+ 98.76% Get a Quote
Care Health Insurance Plan Min – 3 lakh | Max – 75 lakh 21100+ 98.66% Get a Quote
Liberty HealthPrime Connect Policy Min – 10 lakh | Max – 1 crore 5800+ 98.50% Get a Quote
Bajaj Allianz Health Guard Policy Min – 1.5 lakh | Max – 1 crore 58000+ 98.31% Get a Quote
Kotak Mahindra Health Premier Policy Min – 25 lakh | Max – 2 crore 7000+ 98.28% Get a Quote
IFFCO Tokio Individual Health Protector Plan Min – 50,000 | Max – 20 lakh 7000+ 98.02% Get a Quote
Magma HDI OneHealth Insurance Plan Min – 2 lakh | Max – 1 crore 7200+ 97.99% Get a Quote
Cholamandalam Flexi Health Supreme Plan Min – 5 lakh | Max – 5 crore 10500+ 97.39% Get a Quote
Digit Health Insurance Plan Min – 2 lakh | Max – 3 crore 7200+ 96.44% Get a Quote

Types of Health Insurance Plans In India

Health insurance plans in India offer various benefits to cater to the diverse healthcare needs of individuals and families. Understanding the types of medical insurance plans can help individuals make informed decisions based on their specific requirements

Here are the common types of health insurance plans in India:

Who Should Buy the Health Insurance Policy?

Anyone who meets certain eligibility criteria can buy health insurance plans in India.

The following are common categories of people who can purchase a health insurance policy:

Individuals

People who are not covered by an employer-sponsored health insurance policy or a government-funded healthcare program can purchase individual health insurance plans in India. This includes self-employed individuals, freelancers, students, or those who are unemployed.

Individuals

Families

Health insurance plans In India often cover not only an individual but also their dependents, such as a spouse and children. The specific terms and coverage options may vary depending on the insurer and the policy chosen.

Families

Employees

Many employers provide health insurance coverage to their employees as part of their employee benefits package. Employees typically have the option to enroll in a health insurance policy during an open enrollment period or when they are newly hired.

Employees

Businesses

Companies, regardless of size, can purchase group health insurance plans In India for their employees. Group health insurance policy often includes more affordable premiums and comprehensive coverage options compared to individual plans.

Businesses

Why Do You Need a Health Insurance Policy?

Health insurance plans in India are essential for individuals for several reasons such as rising healthcare costs, tax benefits, and many more.

The following are common categories of people who can purchase a health insurance policy:

Rising Healthcare Costs

Rising Healthcare Costs

In recent years, medical treatments, hospital expenses, and prescription medications have become more expensive. A health insurance policy ensures that you can afford quality medical care without worrying about bills.

Financial Protection

Financial Protection

A major illness or injury can lead to substantial financial and a health insurance policy provides financial protection by covering the costs of hospitalization, surgeries, diagnostic tests, and other medical treatments.

Access to Quality Healthcare

Access to Quality Healthcare

Many health insurance plans in India have tie-ups with a network of hospitals and healthcare providers. This enables policyholders to access quality healthcare services at these authorized centers

Tax Benefits

Tax Benefits

Health insurance premiums paid towards individual or family policies are eligible for tax deductions under Section 80D of the Income Tax Act, 1961. This means that policyholders can claim deductions while calculating their taxable income.

Benefits to Buy the Health Insurance Plans In India Online

Buying Health Insurance Plans In India Online offers many benefits such as lower premiums, better customer support, and many more.

Here are some of the key advantages of buying a health insurance policy online:

 
Convenience

Convenience: Buying health insurance plans in India online is much more convenient than the traditional method of visiting an insurance office or agent. It can be done from the comfort of your own home, at any time that suits you.

 
Comparison and Research

Comparison and Research: Online platforms provide the ability to compare different health insurance plans in India from various providers, such as the coverage or features, allowing you to make informed decisions.

 
Lower Premiums

Lower Premiums: Online medical insurance plans often offer lower premiums compared to traditional plans due to reduced administrative costs for the insurance providers.

 
Customer Support

Customer Support: Online insurance companies provide comprehensive customer support through various channels such as live chat, email, or helpline numbers.

 
renewable claim process

Renewal and Claims Process: Online health insurance plans in India often have a simplified renewal process. You can renew your medical insurance policy online without any paperwork, saving time and effort.

Factors to Consider Before Buying Health Insurance Plans In India Online

There are some important factors that you should look at before deciding to buy health insurance plans in India.

Below, we have mentioned those factors to look at before buying a health insurance policy:

Eligibility Criteria to Buy a Health Insurance Policy

Eligibility criteria to buy a health insurance policy may vary from one insurance provider to another. However, there are certain common factors that most insurance companies consider when determining an individual's eligibility for purchasing a health insurance policy.

These criteria typically include:

Age

Eligibility criteria to buy a health insurance policy may vary from one insurance provider to another. However, there are certain common factors that most insurance companies consider when determining an individual's eligibility for purchasing a health insurance policy.

Nationality/Residency

Often, health insurance plans in India are limited to citizens or residents of a specific country. Insurance providers usually require individuals to provide proof of nationality or residency to be eligible for coverage.

Medical History

Insurance companies generally assess an applicant's medical history to determine their eligibility for coverage. Pre-existing medical conditions and certain chronic ailments may lead to exclusions or higher premiums.

Premium Payments

Health insurance plans in India require regular premium payments. Insurers usually evaluate an individual's financial ability to pay premiums before coverage is granted.

Documents Required to Buy Health Insurance Plans In India

To buy health insurance plans in India, certain documents are commonly required by insurance companies. These documents are necessary to authenticate your identity and assess the risk involved in providing you with coverage.

Here are the documents typically required to buy the health insurance policy:

Identity proof

Identity Proof

You will need to provide a valid identification document such as an Aadhaar card, PAN card, passport, voter ID card, or driver's license.

Address proof

Address Proof

You are required to submit proof of your residential address, which can include documents like an Aadhaar card, voter ID card, passport, or driver's license, in your name.

Age proof

Age proof

To validate your age, documents like a birth certificate, passport, Aadhaar card, PAN card, voter ID card, or school leaving certificate can be submitted.

Income proof

Income Proof

Some health insurance plans in India may ask for income proof to determine the premium to be charged. This can include salary slips, bank statements, income tax returns, or Form 16.

Previous insurance policy details

Previous Insurance Policy Details

If you already have a health insurance policy, the insurance company may want to see your previous policy documents to assess your claims history, waiting period, or any pre-existing illness coverage.

Medical history

Medical History

You may be required to disclose your medical history, including any pre-existing illnesses, hospitalizations, surgeries, or ongoing treatments. This helps the insurance company understand your health condition and any potential risks.

How to Calculate the Health Insurance Premium?

Health insurance premiums are the amount of money you pay periodically to your insurance provider to maintain your coverage. The premium you pay is determined by various factors, such as your age, medical history, location, and the type of coverage you choose.

Here is a step-by-step guide on how to calculate health insurance premiums:

Understand your coverage needs

  • Look for the type of health insurance coverage you require such as individual coverage, coverage for your family, or coverage through your employer.

Gather personal information

  • Collect all the necessary information required for calculating the premium. This includes your age, gender, location, and any pre-existing medical conditions.

Determine the type of plan

  • Choose between the different types of health insurance plans in India, such as individual plans, family floater plans, senior citizen plans, critical illness plans, etc.

Calculate the base premium

  • The base premium is the starting point for determining your health insurance premium. Insurance providers use various actuarial calculations and statistical analysis to determine the base premium.

Consider additional coverage

  • Depending on your needs, you may opt for additional coverage, such as dental, vision, or maternity coverage. These additional coverages will increase your premium.
Calculate Health Insurance Premium

Calculate Health Insurance Premium

How to Choose the Best Health Insurance Plans in India?

Choosing the right health insurance policy is crucial to ensure quality healthcare and financial security.

Here are a few key points to consider when choosing the best health insurance plans in India:

Identify your needs

Begin by identifying your healthcare needs, such as pre-existing conditions, age, family history, and the potential need for maternity or specialized treatments.

Coverage amount

Determine the sum assured or coverage amount you require. This should be based on factors like your city of residence, anticipated medical expenses, and the general cost of living in your area.

Network hospitals

Check if the health insurance policy has an extensive network of hospitals and healthcare providers in your area. This will ensure easy access to quality medical services.

Benefits and features

Look for the various features and benefits of health insurance plans in India. Look for services like cashless hospitalization, reimbursement for ambulance charges, and critical illness coverage.

Waiting period

Understand the waiting period for pre-existing conditions, maternity benefits, and specific treatments. Compare waiting periods among different insurance companies to select a plan that offers the shortest duration.

Exclusions

Look at the policy document to understand the exclusions. Certain treatments, illnesses, and procedures may not be covered by health insurance policy.

Premiums and deductibles

Compare the premiums and deductibles of different health insurance plans in India. Ensure that the premium is affordable and within your budget.

Customer reviews and ratings

Read customer reviews and ratings of the insurance company to check the customer satisfaction levels. This will give you insights into their claim settlement ratio, and customer service experience.

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How to File a Health Insurance Claim?

Filing a health insurance claim can be a hard task, but it is essential to ensure that you receive reimbursement for your medical expenses.

Health Reimbursement Claims

For treatments in non-network hospitals, policyholders opting for health reimbursement must personally settle the medical expenses, and collect comprehensive documentation including bills, prescriptions, and discharge summaries.

Subsequently, a claim is submitted to the insurer or Third-Party Administrator (TPA) for reimbursement. The insured completes a claim form, attaches the supporting documents, and submits the package through designated channels. Once approved, the reimbursement is credited to the insured's bank account.

Cashless Claims

On the other hand, cashless claims are applicable when seeking treatment in-network hospitals. The insured informs the hospital about their health insurance coverage, and the hospital obtains authorization for cashless treatment from the insurer.

Following treatment, the insurer settles the bills directly with the hospital. Both processes emphasize adherence to documentation guidelines and clear communication with the insurance provider for a seamless and efficient claims experience.

Documents Required for Health Insurance Claim Reimbursement

When filing a health insurance claim for reimbursement following hospitalization, specific documents are required to ensure a smooth and efficient process.

The essential documents include:

  • Discharge Card

    A copy of the discharge card issued by the hospital or network hospital, providing details about the duration and nature of the hospitalization.

  • In-Patient Hospitalization Bills

    Original bills for in-patient hospitalization, signed by the insured to verify authenticity.

  • Doctors’ Prescriptions and Medical Store Bills

    Prescription documents from the treating doctors along with corresponding bills from the medical store for medications prescribed during the hospital stay.

  • Claim Form

    A completed claim form with the insured's signature, providing necessary details about the hospitalization and treatment.

  • Valid Investigation Report

    Any relevant investigation reports, such as diagnostic tests or laboratory reports, supporting the medical treatment undergone.

  • Bills of Doctors’ Consultation

    Original bills related to doctors’ consultations during the hospitalization period.

  • Insurance Policy Copies

    Copies of the insurance policy from the previous year and the current year, or a copy of the ID card of the Third-Party Administrator (TPA).

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FAQs About Health Insurance

It's advisable to buy health insurance in your early 20s or 30s when you're generally healthier, securing coverage and ensuring financial protection against unforeseen medical expenses.

Whether a medical test is mandatory depends on factors like age and health history. Some policies require tests for thorough assessment before approval.

You can usually enhance your sum insured during the policy renewal. Contact your insurer, submit the required documents, and follow their process for increasing coverage.

Pre-existing conditions, certain specific diseases in the waiting period, and exclusions mentioned in the policy, such as cosmetic surgeries, may not be covered. Review your policy for details.

Yes, of course, you can, as it's simple to pay your insurance premium in installments on a monthly, quarterly, half-yearly, and annual basis.

Yes, you can cancel, but refunds depend on the policy terms. Some policies offer a refund during the free-look period.

An insured person can file as many claims as they like within a given year, but each claim must not exceed the maximum amount of the sum assured.

After a claim is filed, the insurer processes it, and if approved, pays the eligible amount. The policy continues with adjusted coverage.

Your insurance provider will grant you a grace period of 15 to 30 days if you miss the deadline for renewing your health coverage.

Renew as soon as possible during the grace period to avoid a lapse in coverage. Late renewals may impact continuity.