Health Insurance policies in India. Know, compare, select, and purchase the best and latest for everyone.

Introduction: Nobody in the world can say that I will not fall ill in the future, or I will not face any medical emergency. Most people may not have sufficient money to cover the costs of life-threatening medical emergencies, costly medical treatment, etc.  If we do not have sufficient money, as mentioned in the last paragraph, how can we arrange the funds? The solution may be a medical treatment loan, financial help, or some specific pre-decided and predefined contract with a company to bear the expenses of costly medical emergencies or medical treatment. The loan or help may not be available according to our needs. Moreover, it depends on the mercy of others. We have no right to claim it. So, the best solution to meet such emergency demand is only the pre-decided and predefined contract with a company or organization to bear the expenses of medical emergency o, medicalreatment, etc. This pre-decided and predefined contract or right with the company is called Health Insurance Policy. In this blog, we will explore the various health insurance companies, their plans, benefits, terms and conditions, etc.

Health insurance plans:  The person who purchases the health insurance policy is generally called the policyholder and the health insurance company is generally called the insurer which provides an insured sum of coverage to the treating hospital for emergency or planned treatment. To get the insured sum of coverage, as per the contract, we pay the premium to the company. Premium is generally paid annually by the policyholder and exempted from Income tax as per rules. The policy may be renewed, topped up, modified as per the contract rules, etc. Premium, benefits, Network of cashless hospitals, Insured sum of amount, Inclusions and exclusion of diseases, treatment, facilities, terms and conditions of a health insurance policy vary from one plan to another and one company to another. It depends upon so many factors. With the rising medical costs and increasing different types of diseases, we must spend a suitable amount of money on health insurance policies. When you have a comprehensive health insurance policy as per your need, you will be tension-free and confidence will build up to meet the challenges of future diseases. Some people think that only old or sick People need health insurance policies. We should come out of this misconception. Everybody needs a health insurance policy. Even if you have a good amount of money, but not having health insurance policy, hefty expenses on medical treatment will surely disturb your financial health. Therefore, whether you are rich or poor, everybody should have a good health insurance policy as per your requirements budget.

Important factors and covers to be considered before purchasing a health insurance policy:

Before purchasing the health insurance policy, please examine all terms and conditions, the scope of coverage, the amount insured, and other parameters and compare it with other companies on third-party platforms like http://www.policybazar.com, etc. Always access the official website of the insurer to know about updated terms and conditions. Similarly, cross-check from other official websites of insurers for comparison. Make a checklist to this effect of what is required and what is given by the insurer. Compromise with unimportant benefits only.  Some of the factors to be considered before purchasing the policy are mentioned below:

How to select it? It depends upon various factors like:

Residential location (Tier 1, Tier2 or Tier 3 cities): Delhi NCR, most of the state capitals or high-living cost cities are coming under the Tier 1 category.

Base sum insured: Base sum means the maximum amount which will be paid by the insurer for a treatment or emergency. If medical expenses exceed the base sum insured, we have to pay from our pocket. For tier 1 cities, it may be 10, 20, and 30 Lakhs for individuals, senior citizens, and families respectively. It may be even more to cover the expenditures on critical and long-duration diseases. It may be a minimum of INR 5 lakhs for poor families in tier 3 cities. It may be a minimum of INR 10 lakhs for lower-middle-class families. It may be half of the annual income.

Premium: Premium is mostly paid annually. It depends on so many factors. Some of the factors are given below: Smokers or diabetic people may have higher premiums. Age: Low age, low premium. A 25-year-old person will have a lower premium than a 50-year-old person. Your medical test report. Your age, health conditions, future needs, and expectations. Pre-existing diseases and illnesses. Financial conditions and job profile. Your entitlement to other health insurance policies or facilities. Your residential city: Tier 1 cities like Delhi Mumbai, Kolkata, Chennai, Hyderabad, Bangalore, etc. will have high premiums due to the high quality and cost of medical facilities.

Some important covers:

Indoor patient cover (Hospitalization cover): If a person is admitted to a hospital (IPD - In-Patient department) for more than 24 hours or as prescribed in the policy, expenditure on doctor’s consultation fee, diagnostic tests, room rent, medicine cost, surgery/procedure cost, ICU charges, etc. will be covered in the policy as per terms and conditions. Once again it is reiterated that the area of cover will vary from plan to plan. Pre and Post hospitalization cover: As per the terms and conditions of the policy, expenses for a few days before hospitalization and for a few days after the discharge from the hospital for follow-up treatment like physiotherapy, medicine cost, lab tests, follow-up consultation, etc. are covered in the policy. The number of days for pre and post-hospitalization cover varies from plan to plan. It may be 30/60, 60/90, or 60/180 days etc. Some of the medical treatments require a lot of money to be spent before or after hospitalization (surgery/procedure). Therefore, if your policy covers this facility, it will be better. Inclusions and exclusions: War, civil war, and breach of law are excluded from the policy. Some costly treatments, Fatal diseases, long-term diseases, Critical care diseases like Cancer, Renal failure, Heart surgery, implant, transplant, and dental may not be included or partially included.  Please check thoroughly and minutely what is included or what is not included in your policy. Minor ignorance may trouble you in the future. OPD expenses cover: Some of the insurers provide cover for OPD (Outpatient Department - non-hospitalization treatment, medicines, medical tests, etc.) expenses. It will be beneficial to the policyholder subject to the terms and conditions, load of increased premium, etc. Domiciliary treatment cover or home health care cover: Sometimes it happens that the bed is not available in the hospital, or the patient is unable to move to the hospital. The Hospital facility and treatment are arranged at home under the guidance of a prescribed doctor. It is called a homecare service. Some plans may provide this cover. Under this cover home care expenses (nursing, equipment rent, medicines, diagnostic tests, consultations, etc.) will be borne by the insurer but the facility, terms, and conditions of the cover varies plan to plan.    Pre-existing diseases (PED) cover: Diseases already existing at the time of starting the policy are called Pre-existing diseases. After completing the waiting period as prescribed in the policy, expenses incurred on pre-existing diseases will be covered in the policy. The waiting period varies from one policy to another. Daily cash allowance cover: Some of the insurers provide the daily cash allowance for the days admitted in the hospital to compensate for the loss of your earnings.    Preventive health check-up cover: Most of the insurers provide this facility. Annual medical checkups for important parameters like: CBC (Complete Blood Count). LFT (Liver Function Test). KFT (Kidney Function Test). TFT (Thyroid Function Test). Lipid Profile (Cholesterol, HDL, LDL, Triglyceride etc.). Vitamins and minerals. Iron. Diabetes Screening (HBA1C, FBS- Fasting Blood Sugar). ESR (Erythrocyte Sedimentation Rate) & CRP (C reactive protein) tests to detect inflammation in the body. Cancer. HBsAg screening (Hepatitis B Virus B - HBV). Total Ige (for allergy). Peripheral smear examination (for blood diseases or parasites). lipase (for digestion). Urine (routine/microscopic/culture - to find out symptoms of any disease). Electrolyte (level of Sodium=Na, Chloride=Cl, Potassium =K). Advanced Cardiac risk meter (level of some specific proteins in blood, to judge the heart health), etc. Insurers may arrange your similar test free of cost, if some are left, then with the help of health care providers/specialists, as per the age and health condition, an annual health medical checkup is a must to diagnose serious diseases at an early stage. Ambulance or transportation charges by road or by air (domestic): The cover of Ambulance charges or transport charges is an additional benefit of the scheme. If it is medically needed to transport the patient for a long distance by air or by road. The Cost of the transportation charges matters. Daycare cover: Some of the insurers provide this cover. Due to the advancement of technology, some of the procedures, susurgeriesor treatments require hospitalization for less than 24 hours. In such a case this cover provides the free treatment, else you have to pay for such expenses. Critical illness cover: In this cover, some life-threatening diseases, high-cost treatment of fatal diseases like cancer, Heart surgeries, implants, transplants, Strokes, renal failure, etc. are covered. Please check carefully the coverage with terms and conditions. If it is not sufficient as per your need. Take a rider or top-up or another policy or plan.

Maternity cover or maternity Rider cover : Maternity cover or maternity rider comes with a waiting period of a minimum of 9 months or more. It will include the following expenses but varies from plan to plan: Delivery expenses (Normal or C-section). Hospitalization expenses. Pre and post-natal expenses. Childbirth cover. Newborn baby cover. Medically necessary Pregnancy termination. Child vaccination.   Pregnancy-related problems. Preservation of Stem Cells. Infertility treatment. Surrogacy, etc. Exclusions in the maternity cover: The following expenses may not be included in the maternity cover and varies plans to plan. Ectopic pregnancy: In this case, a fertilized egg implants and grows outside the uterus, usually in a fallopian tube. It cannot proceed normally. It can cause bleeding, pain, and complications. It may be life-threatening if left untreated. Pre and post-hospitalization expenses. Routine checkup. Hospital cash allowance. Caution for maternity cover:  Before buying the maternity cover, Please properly and thoroughly check the terms and conditions & especially the waiting period. Normally, these covers come with a very long waiting period. Only after the expiry of the waiting period, the policy will be activated.

Health Insurance Rider: If your normal policy does not cover a few important benefits, in such cases you may add on the health insurance rider cover to make it more perfect. Suppose you are a frequent traveler in foreign and your normal policy does not cover the emergency treatment in foreign, then it may be good to take the rider cover to get such facilities.     AYUSH cover: AYUSH is the abbreviated form of Ayurvedic, Yoga and Naturopathy, Unani, Siddha, and Homeopathy systems of treatment. Some insurers provide this cover in addition to standard allopathic treatment. Bariatric surgery cover: It is one type of surgery to reduce the weight of an obese person.  Some insurers provide this additional cover. Organ donor expenses cover: Organ harvesting and transplantation expenses are covered if the recipient is the policyholder. The limit may be the sum insured. If the hospitalization claim for organ donation surgery is accepted, then this cover is applicable. Automatic Restoration: If the medical expenses exceed the limit of the sum insured by the policyholder. Automatically, this cover restores 100% of the sum insured when it exhausts fully or partially. But please go through the terms and conditions of its reuse in the same year. Consumable items cover: Some non-medical items which are directly consumed by patients are generally not covered in the health insurance plan. For example, dietary supplements, bandages, syringes, etc. are not covered in a normal policy. However, some health insurance plans provide this coverage. So, if you are getting this cover. It is an additional benefit. Top-up Cover: If your policy has a top-up cover or add-on benefit facility and your existing plan does not adequately cover your needs, then by availing of this cover, you can enhance your coverage area, sum insured, or other things that suit you. Super top-up cover: It is an additional plan that is purchased for enlarging your cover. It will cover more broadly and financially to your needs.

Some important tips:

Waiting period: Entitlement to cover the expenditures on treatment will start only after the end of the waiting period. Therefore, it should be zero or minimum. Because if the waiting period is too long, you will not be entitled to claim the expenditure for such a waiting period. Most of the plans have some waiting period except for medical emergencies or accidents. No copayment: Yes, opt it for no copayment. In this case, you are not required to pay any amount for expenses. Otherwise, You may be asked to pay some prescribed part of the expenditure from your pocket. Grace period: A grace period is given for renewal of the policies after the expiry date. It should be maximum to have plenty of time for better choices. Deductible: It is the amount fixed by the insurer which has to pay for presenting the claim. For example, if the claim is being presented for INR 1 Lakh, you have to deposit INR 10,000. Free look period: If you have purchased a policy but want to cancel it subsequently within some fixed days, you will not be charged any penalty. Such a period is called the Free Look Period. Roughly it may be 15 days. Diseases covered: We should carefully check the Diseases covered in the policy. Make a checklist of important diseases, emergencies o, and costly treatments. If most of them are covered, then it is ok. For example, Heart, cancer, fatal diseases, fatal accidents, and costly treatment or expensive medicines or costly tests, etc. Terms and conditions: We should carefully check the terms and conditions. Ceiling on expenses, long waiting periods, tough terms and conditions, etc. make the policy unsuitable. Please keep in mind to select the best policy which has suitable terms and conditions for you. Claim support: Always check and cross-check the claim support from the official website, third-party unbiased website, customer reviews, etc. Select the best. 24x7x365 assistance especially on WhatsApp or mail to keep a record. Relationship manager. 30 minutes claim facility. Importance of Reviews: Before purchasing the policy, we should go through the review of the customer from reliable sources. If customer satisfaction is excellent, and the selected policy is best suited to you, please go ahead with the policy. Claim settlement ratio: It will be checked and cross-checked from third-party independent websites, reliable sources, official websites, and reviews. If the claim settlement ratio is near 100%, it will be better to choose such a policy. Claim settlement is done by TPA (Third party Administrator). It is a separate organization between the policyholder and insurer for claim settlement. Some insurers have an in-house settlement unit or team, and they directly settle the claims. In the house, the team is considered better, but please go through the reviews and official website for cross-checking. The claim settlement ratio of HDFC Ergo is shown on the internet at around 99%. Please crosscheck it.  Lifelong renewability facility: Lifelong renewability facilities must be available without any age bar. Because in old age, you will be more prone to disease, and health insurance coverage is much needed at that time. Tax benefits: Income Tax benefit is allowed on the premium paid by the policyholder.

Networks of   hospitals for cashless treatment: Cashless everywhere facility:  It provides us tension-free treatment.   Every insurer company has a network of hospitals where you can get cashless treatment. We should carefully watch the list of such network hospitals. Some of the best network hospitals should be located near your residential region to avail of the cashless facility in case of emergency. Under this scheme, any emergency or planned medical treatment can be taken cashless in any hospital of choice. It is required to inform the insurance company within 48 hours of admission for emergency medical treatment. For planned medical treatment, it is required to inform the insurance company well before 48 hours of hospitalization. Terms and conditions may be different for various policies or plans. The benefit of this scheme is that you are not required or require a small amount to pay to the hospital.

The basic requirements to purchase a health policy: The basic requirement to purchase a policy varies from one policy to another. A basic idea is given below: Age of policyholder:  18 to 65 years. Age of Dependent children: 91 days to 25 years. Medical test: at the age of 45 or more. Declare pre-existing diseases at the time of purchase. You should have KYC documents like an Aadhaar card, PAN card, etc. Note: The best Health insurance policy may cover the maximum expenses for the treatment, yet you are required to have some money in your pocket to meet additional expenses or expenses which are not covered under the policy.

Types of Health Insurance Plans in India: Plenty of options are available in India for different categories. Some are listed below: Health insurance plan for Individuals: As the name is self-explanatory this policy is for the benefit of a single person. Family Health Insurance plan: It covers all family members like spouses, children, Parents, etc. A single Policy is sufficient for it. The sum insured will be divided equally among all family members and one or more policyholders can take the benefits of cover for their share in the sum insured. Health Insurance plan for Senior Citizens: Age limit: 60 years and above. Some of the benefits: Income tax benefit. OPD, IPD, Pre and Post hospitalization, Day care treatment cover, etc. Health Insurance plan for children: Newborn baby health Insurance plan Maternity Health Insurance Plan Women's Health Insurance Plan Critical care Health Insurance Plan: If any critical disease Kidney or Heart failure, Paralysis, stroke, Cancer, etc. is detected, then a predefined lump sum amount will be paid to the policyholder. It may be a separate policy or rider, etc. Health Insurance plan for parents: As we know Parents are pillars of the family and when they grow old, chances of becoming victims of various diseases increase. They are prone to Heart failure, stroke, paralysis, cancer, Orthopedic problems, diabetes, critical illness, renal failure, etc. Therefore, parents must be covered by a suitable health insurance plan.  Health Insurance plan for Diabetic Patients: If anyone is a diabetic patient or prone to diabetes due to heredity or some other reasons. A special cover for diabetics should have to meet the expenses of this illness. Personal Accident Health Insurance plan: Such types of policies cover the cost of hospitalization due to accidents. The insurer also pays a predefined lumpsum amount in case of death or disability due to an accident. Group Health Insurance Plan: This type of insurance plan is provided by the employer. The Central Government of India is providing this facility under the name of CGHS. (Central Government Health Scheme).   Similarly, Private companies are also providing similar facilities to their employees. But we should always have a separate health insurance policy. Whenever you switch over the job, your Group health insurance provided by the employer may not be continued. For lifelong health insurance, we should have a comprehensive health insurance policy at an early age. Self Employed Health Insurance Plan Top-up or rider plans:      These are the add-on plans which may be added to the existing policy to make it more comprehensive with a high sum insured. Super Top UP Plan It is an additional plan to make your existing plan more comprehensive in cover and sum insured. Mediclaim Policy: Mediclaim policy generally provides very restrictive or limited coverage, and Health insurance policies have a very large horizon of coverage. We can say that a Mediclaim policy is a subset of a Health Insurance Policy. Pradhan Mantri Suraksha Bima Yojna Rashtriya Swastha Bima Yojna

Some examples of health insurance plans in India:

Acko 1 Crore Platinum Health Plan: It covers most of the preexisting diseases and most of critical care illnesses. Cover limit: INR 1 Crore as the name suggests. Hospital in networks: more than 7,000 Age limit: 18 years and above.

Aditya Birla Health Insurance Company Plans: Aditya Birla Activ Assure Diamond Plan: Cover limit: INR 2 lakh to 2 crores. Empaneled cashless Hospitals:  more than 9,000 Some of the benefits: Affordable premium and wider cover. Pre (60 days) and post (180 days) hospitalization cover. IPD (In Patient Department) Hospitalization cover. Free preventive health checks once a year. AYUSH cover: as explained earlier in this blog. The second opinion covers consultation regarding critical illnesses from the listed hospitals of the network. Personalized health professional coaching cover: For the guidance of some specific diseases like diabetes, asthma, BP, etc. Domestic and international emergency help services. Restore benefit: If the sum insured, no claim bonus, and super no claim bonus are exhausted, policyholders will get 150% (maximum INR 50 lakhs) additional sum insured for hospitalization cover against different unrelated diseases. Aditya Birla Activ Fit Health Insurance for individuals. Aditya Birla Activ Health plus Multiply fit combo. Aditya Birla Activ Fit Preferred Maternity Plan: Waiting period :3 years. Delivery expenses limit:  INR 40,000 to 60,000 Premium: Around INR 17,000 Limited to 02 pregnancies including delivery and termination. Aditya Birla Group Active Health Plan

Arogya Sanjivani Health Insurance Plan: It is a simple and affordable health insurance plan approved by IRDA and most of the health insurance companies issue this policy.

BajaJ Allianz Health Insurance Company Plans: Bajaj Allianz Health Guard Plan: Cover limit: INR 1.5 lakh to 1 crore. Empaneled hospitals for cashless treatment: More than 7,500 Some of the benefits: Free preventive health checkups once a year. Pre, Post-hospitalization, and in-patient hospitalization cover. Maternity expenditures cover. Convalescence benefit: A lump sum amount is given by the insurer to the policyholder in addition to medical and other costs. It is given to compensate for the loss of earnings during a stay in the hospital with some terms and conditions. Bajaj Allianz Criti Care Policy: Suitable for critical care plans. Cover limit: INR 1 Lakh to 50 Lakhs. Age limit:  Adult: 18 years to 65 years Child: 91 days to 30 years. Bajaj Allianz Life Group Insurance Plan

Care Health Insurance Company General features: Cover limit: INR 1 Lakh to 6 Crore. Empaneled hospitals: more than 19,000 Pre-, post, and inpatient hospitalization. Preventive health checkups once a year. Maternity expenses. International cover. Plans: Care Supreme Direct Plan: Cover Limit: INR 7 Lakhs. Maternity cover: INR 25000 from day 1. No hospital room rent limit. Renewal bonus: INR 10.5 Lakhs. Network of cashless hospitals: roughly 250 Starting premium: >1000 per month. Care Health Insurance supreme plan: Minimum cover: INR 10 Lakhs Minimum premium:  INR 750/month approx. Room rent: No Limit No claim bonus: 50% Restoration benefit: unlimited Pre-existing diseases (PED)  Waiting period: 04 years. Care Plus Youth Health Insurance Plan (especially for youth): Cover limit: INR 3 Lakhs to 25 Lakhs. Age limit: 18 to 35 years. A 91-day-old child is eligible under the family floater plan. CareJoy, tomorrow's maternity plan: Delivery expenses limit: INR 50,000 Waiting period: 02 years. Premium: INR 30,000 (for a sum insured of INR 5 Lakhs). Coverage for maternity expenses and newborn baby treatment.

Cholamandalam MS Health Insurance Company Plan: Cholamandalam Flexi Health Supreme Plan: Cover limit: INR 5 lakh to 5 crores. Empaneled hospitals:  more than 11,000 Inpatient hospitalization expenses are covered. Ambulance charges cover. Maternity cover. International cover. Consumable cover.

Digit Health Insurance Company Plan: Digit Health Insurance Plan: Cover limit:  INR 2 Lakh to 2 Crore. Empaneled hospitals for cashless treatment: More than 16,000 Annual free check-up. Covers expenses for : Inpatient treatment. Maternity. International treatment. Psychiatric treatment.

Future Generali Health Insurance Company Plan: Future Generali Health Total Policy: Cover limit: INR 3 Lakh to 1 Crore. Empaneled hospitals for cashless treatment: More than 8,000 Some of the benefits: OPD (Outpatient Department):  medical cover Maternity cover. IPD (In Patient Department): hospitalization cover. International medical cover. Roadside ambulance assistance.

HDFC Ergo Health Insurance Company: Note: Apollo Munich Health The insurance company is now merged with HDFC ERGO. Apollo Munich Optima Restore Health It is a health insurance plan for families and applies to spouses, dependent children & parents, and parents-in-law. As the name of the policy suggests, it will automatically be restored annually for the basic sum insured if the total sum insured (base) has been exhausted from a family member's treatment. In-patient hospitalization cover. Pre and Post-Hospitalization Cover: 60 days before the hospitalization and 180 days after the discharge from the Hospital. Special steps count discount on renewal: On the mobile phone app the insurer, if you are active on the steps count option. After getting the target, you are entitled to get a discount at the time of renewal. Multiplier benefit: You will get a 50% to 100% bonus of the sum insured for claim-free years at the time of renewal. HDFC Ergo plans come with 4X coverage:  Explanation: 1X means select a plan as per budget and requirement. 2X means secure benefit. As soon as we purchase the plan. The base amount of the sum insured will be doubled automatically without any request for a claim. This means the 1 Cr sum insured will be 2 Cr. 3X means Plus benefit: On the first renewal, base cover increases by 50%, and on the second renewal base cover will be increased by 100%.  So, if your sum insured was 1 Cr, after 1x it became 2 Cr. Now after 3x, it became 3 Cr (three times of 1 Cr). 4X means Restore benefit:  Any claim made partial or complete, 100% of the base cover will be restored for the same year. In this way, your base cover has been increased to 4 times of initial base cover. == Some other benefits: Pre and post-hospitalization cover a Wider range: It covers the expenses for 60 days before hospitalization and 180 days after the discharge from the hospital. Includes hospitalization expenses for the treatment of mental illnesses. Comprehensive health checkup. Daycare treatment cover. Cashless home health care:  If treated by the prescribed doctor. Protect benefit: On listed nonmedical expenses, there will be no deductions. The sum insured rebound claim amount (max. Base sum) will be added to the sum insured for subsequent hospitalization. Organ donor expenses: it covers the medical and surgical expenses of organ donors for harvesting the major organ from the donor body. Recovery benefit (daily allowance): In case of hospitalization for more than 10 days continuously, it provides some amount to cover the financial loss due to long stay. AYUSH cover: As explained earlier in this blog. Wide networks of hospitals for cashless treatment: More than 13,000 Claim settlement ratio: 99% Please cross-check all parameters, terms, and conditions thoroughly and minutely before purchase. Note: Individual and family floaters both plans are available in HDFC Ergo. HDFC Ergo My Health Suraksha Plan: Cover limit: INR 1 Lakh to 5 Crores. HDFC Ergo My (Health Women Suraksha) (especially for women) Cover limit: INR 1 Lakh to 1 Crore. Age limit 18 to 65 years. HDFC Ergo Optima Secure Plan: Minimum cover: INR 05 Lakhs. Minimum Premium: INR 1300/month approx. Hospital room rent limit: No No Claim Bonus: 50% Restoration benefits: 100% Pre-existing diseases (PED) cover. Waiting period: 03 years.     HDFC Ergo Optima Secure Global HDFC Ergo Critical illness insurance

ICICI Lombard (old name - Bharti AXA) Health Insurance Company Plans: ICICI Lombard AdvantEdge Policy Restore benefit cover: explained in this blog on another page. Cumulative Bonus:  At the time of renewal of the policy for a claim-free year, a 20% extra sum will be added to your base sum insured. However, the maximum limit will be 100 % of the base sum insured. 24x7 Audio Visual assistance. Convalescence benefit: Explained in the blog on another page. Health reward: If you participate in health-related activities and achieve the target, Some discount will be given in premium, etc. Pre-existing disease cover: Please check the terms and conditions. Domiciliary hospitalization cover: Home care service is explained in this blog on another page. Transportation by air:  By air domestic transportation to a hospital for the required treatment which is not available at the parent's place. Personal accident cover. Bariatric treatment/surgery cover: Explained at another place in this blog. Add on maternity cover. Hospitalization cover, Pre and post-hospitalization cover: (subject to Compilation claim acceptance). Daycare cover: Explained at another place in this blog. AYUSH cover: For Inpatient only in the Government hospitals or government-recognized institutes, etc. The term AYUSH is explained at another place in this blog. Redemption of Wellness points: Wellness points earned through various wellness and fitness activities may be redeemed in OPD expenses like Consultation fefeeslab tests, dental treatment, etc. Annual Health check-up cover: 0.5% of the sum insured and a maximum of Rs.10,000 Organ donor cover: Already explained in this blog. Emergency services cover: By road ambulance, teleconsultation (Audio/Video) 24x7 round-the-clock with doctors, surgeons, etc. covered here. NO COPAYMENT OPTION: Opt for no copayment. Already explained it on another page. Lifelong renewability is available without any age bar. Please go through the terms and conditions of the policy for the exclusions and inclusions of the diseases, etc. ICICI Lombard- Complete Health Insurance Policy: (especially for comprehensive coverage) Cover limit: INR 1 Lakh to 50 Lakhs Hospitals in networks for cashless treatment: more than 6500 Age Limit: 91 days to 18 years. ICICI Lombard Group Mediclaim Insurance Policy

IFFCO Tokio Health Insurance Company Plans: IFFCO Tokio Individual Health Protector Plan: Cover limit: INR 50,000 to 20 Lakh. Impaneled hospitals: more than 7,500 Some of the benefits: In the hospital, Domiciliary hospitalization is covered. Ayushman policy cover. It covers critical illness also. Emergency support services. IFFCO Tokio Family Health Plan: Suitable plan in economic premium for a family. Cover limit: INR 30 Lakhs. Age Limit: 18 years and above.

Kotak Mahindra Health Insurance Company Plan: Kotak Mahindra Health Primer Policy: Cover limit: INR 2 Lakhs to 2 Crores. Impaneled hospitals for cashless treatment: more than 9,000 Some of the benefits: In-patient, maternity, and homecare cover. Convalescence cover: In addition, you are entitled to get a lump sum amount for the stay period in the hospital to compensate for the loss of earnings during hospitalization. Preventive health checkups once a year.

Liberty Health Insurance Company Plan: Liberty Health Prime Connect Policy: Cover Limit: INR 10 Lakhs to 1 Crore. Empaneled hospitals for cashless treatment: More than 6,000 Some of the benefits: It covers Hospitalization, Obesity treatment, Maternity and Childcare, Infertility treatment, Daily cash allowance during hospitalization, etc.

Magma HDI Health Insurance Company Plan: Magma HDI One health Insurance Plan: Cover Limit: INR 02 Lakhs to 1 Crore. Empaneled hospitals for cashless treatment: More than 8,000 Some of the benefits: Outpatients Department (OPD) - Hospitalization expenses are covered. Inpatient Department (IPD) - Hospitalization expenses cover. Cover for maternity expenses. Psychiatric treatment cover. Free preventive measures health checkup once in a year.

Manipal Cigna Health Insurance Company Plans: Manipal Cigna Prohealth Prime Advantage insurance plan: (if opted for Prime enhancer rider) Maternity cover. Delivery expenses limit: INR 1 Lakh. Waiting period: 3 years. Limited to 02 deliveries or terminations. Premium: INR 25,000 approximately with Prime Enhancer Rider. Manipal Cigna Prohealth Insurance Plan: Cover Limit: INR 2.5 Lakh to 1 Crore. Empaneled hospitals for cashless treatment: More than 8,000 Some of the benefits: IPD treatment cover. Already explained in this blog. AYUSH cover: already explained in this blog. International Emergency treatment cover: If you are traveling abroad and have fallen sick all of a sudden. Reimbursement of medical expenses abroad will be limited to the terms and conditions of the policy. Maternity cover. Free annual medical check-up. Manipal Cigna TTK Prohealth Plus Affordable premium with comprehensive covers. Cover limit: INR 4.5 Lakhs to 10 Lakhs (04 options). Pre (60 days) and Post (180 days) hospitalization cover. International reimbursement cover:  If the policyholder takes the emergency treatment during the trip abroad. He will be reimbursed the maximum limit of the sum insured. OPD cover limit: INR 2000 annually.

National Health Insurance Company

National Mediclaim Policy (Individual): Cover Limit: INR 01 Lakh to 10 Lakhs. Empaneled hospitals: more than 6,000 Some of the benefits: IPD Hospitalization including psychiatric treatment cover. Sports injury and modern method treatment cover. Ambulance charges cover.

Navi Health Insurance Company

New India Health Insurance Company Plan: New India Assurance Mediclaim Policy: Cover Limit: INR 1 Lakh to 15 Lakhs. Empaneled hospitals: More than 8,000 Some of the benefits: IPD hospitalization including Psychiatric treatment cover. Congenital diseases cover - the diseases coming with Birth are called congenital diseases. Cash allowance for hospital stay. Day 1 Baby Cover.

Niva Bupa Health Insurance Company Plans: Niva Bupa (old name - Max Bupa) ReAssure 2.0 (Platinum+) Plan: Cover Limit: INR 5 Lakhs to 1 Crore. Empaneled hospitals for cashless treatment: more than 8500 Some of the benefits: Pre-existing diseases (PED) waiting period: 3 years. Inpatient hospitalization and day care cover. Free medical checkup once a year. Booster+  benefit- Unused amount of sum insured may be carried forward for next year subject to a maximum of 5 to 10 times of sum insured. No claim bonus: 50% increase in sum insured if there is no claim in the preceding year, maximum 100%. Later on, if there is any claim, it will be reduced by 50%. No hospital room rent limit. Unlimited restoration benefit. ReAssure+ benefit - unlimited reinstatement up to the base sum insured in a year. Niva Bupa Health Pulse Policy (especially for affordable plans) Cover Limit: INR 3 Lakhs to 25 Lakhs. Niva Bupa Health Companion Policy: Comprehensive health insurance policy. Individual or family floater options. Customized health insurance plan: so it is customer friendly. Cover limit: INR 2 Lakhs to 1 Crore (three options are available). In-patient hospitalization cover. Pre and post-hospitalization cover: 30 days before the hospitalization and 60 days after the discharge from the hospital. Hospitalization accommodation without an upper ceiling in the entitled category. AYUSH Cover. Refill benefit: If the sum of the insured amount has been finished then by paying a premium for the base sum insured, you can avail of that for different and unrelated treatments only. Niva Bupa Health Premia plan: Maternity cover is available with a family floater or family first plans. Cover: maternity expenses and newborn baby treatment. Delivery expenses limit: INR 60,000 Waiting period: 2 years. Premium: INR 30,000 approx. Niva Bupa Aspire maternity plan: Waiting period: 9 months to 4 years (depending on different options of the policy) Premium: varies from 15000 to 20,000 Niva Bupa Aspire Gold+ direct plan: Cover limit: INR 5 Lakhs Maternity cover: INR 5,000 (waiting period 4 years) Room rent limit: No No claim bonus: INR 5 Lakhs. Number of cashless hospitals: roughly 270.

Oriental Health Insurance Company Plan: Oriental Happy Family Floater Policy: Cover limit: INR 1 Lakh to 50 Lakhs. Impaneled hospital for cashless treatment: more than 3,000 Some of the benefits: OPD cover for Eye and Dental problems. IPD hospitalization covers including Psychiatric treatment and maternity cover. Teleconsultation benefit.

Raheja QBE Health Insurance Company Plan: Raheja Health QBE Insurance Policy: Cover Limit: INR 1 Lakh to 50 Lakhs. Impaneled hospitals for cashless treatment: More than 5,000 Some of the benefits: IPD hospitalization cover and Domiciliary (home care including medicines, nursing, equipment charges, etc.) cover. Organ donor benefits and nonmedical expenses are covered. Medical checkups are free once a year.

Reliance Health Insurance Company Plans: Reliance Health Infinity Insurance Plan: Cover Limit: INR 3 Lakhs to 5 Crores. Empaneled hospitals for cashless treatment: More than 8,500 Some of the benefits (COVERS): Ambulance, Transportation, AYUSH, Daycare, IPD hospitalization cover, etc. Maternity cover: INR 1 to 2 Lakhs. Waiting period -1 or 2 years, Premium INR 70,000 (varies) Reliance Health Gain Plan:   (especially for families) Cover limit: INR 3 Lakhs to 3 Crores. Age limit: 18 to 65 years. Reliance Health Gain Plus Plan: Minimum cover: INR 5 Lakhs. Minimum Premium: INR 450/month approx. Room rent limit: No No claim bonus: 33% Restoration benefits: 100% Pre Existing Diseases (PED) waiting period: 03 years.

Royal Sundaram Health Insurance Company Plans: Royal Sundaram Health Lifeline Supreme Plan: Comprehensive health insurance policy. Annual health checkup. Health and wellness cover. Cover limit: INR 5 lakhs to 50 Lakhs.  Pre (60 days) and post (90 days) hospitalization reimbursement cover. NoNo-claimonus: At the time of renewal, you will get a NoAlaim bonus: of 20of % to 100% of the sum insured. AYUSH Cover limit: INR 30,000  Second opinion cover: For the expenses for the specified 11 critical illnesses.   Royal Sundaram Lifeline Insurance Plan: Cover Limit: INR 2 Lakhs to 1.5 Crore. Empaneled hospitals for cashless treatment: More than 11, 500 Some of the benefits (covers): OPD, IPD, International Emergency medical cover. Free Preventive health checkup once a year. Domestic emergency evacuation cover - Transport by road or by air Ambulance from a hospital (which does not have sufficient medical facilities for the treatment/recovery of the patient) to a better-equipped hospital. Royal Sundaram Family Plus Policy: Suitable for a large family. Cover limit: INR 2 Lakhs to 50 Lakhs. Age Limit: Minimum 18 years and maximum no limit. A dependent child of a minimum of 91 days is also eligible.

SBI Health Insurance Company Plan: SBI Arogya Supreme Policy: Cover Limit:  INR 1 Lakh to 5 Crores. Empaneled hospitals for cashless treatment: More than 16,000 Some of the benefits: IPD hospitalization covers including Psychiatric, Bariatric surgery, etc. Domestic medical emergency help. Free health checkup once a year. SBI Group Health Insurance Plan

Star Health Insurance Company Plans: Star Health Young Star individual Silver plan: Minimum cover: INR 5 Lakhs. Minimum premium: INR 450/month approx. Hospital room rent: Single AC private room. No claim bonus: 20% Restoration benefits: 100% Pre Existing Diseases (PED) waiting period: 01 years. Star Health Assure maternity insurance plan: Cover for delivery expenses: INR 1 lakh. Waiting period: 2 years. Premium: INR 20,000 approx. Star Woman Care Insurance plan: Delivery expenses limit: INR 25000 to 1 Lakh. Waiting period: 2 years. Premium: INR 18,000 approximately.  Star Health Young Star Gold maternity Plan: Delivery expenses limit: 30,000 Waiting period: 3 years. Premium: INR 13,500 approx. Star Comprehensive Insurance Policy: Cover Limit:  INR 5 Lakhs to 1 Crore. Network hospitals to avail cashless treatment: more than 12,000 Branches in India: >850 Lives covered since inception: 17 crores. Claims settled since inception: > 01 crore Some of the benefits: Room limit: Single AC room. Maternity cover: INR 30,000 to 50,000 (waiting period - 2 years), Premium - INR 18,000 approx. Outpatient Department (non-hospitalized) consultation cover. IPD hospitalization cover. Second opinion consultation cover. Free health check-up. No claim bonus: INR 2.5 Lakhs. Star health insurance policy for individuals: Good cover for unexpected medical expenses, Pre and post-hospitalization cover, Income tax benefit. Star Health Insurance policy for family: In this policy, all family members are covered at an affordable premium. It also covers Maternity and newborn baby expenses. Star Health’s Senior Citizens Red Carpet Health Policy:  It covers pre-existing diseases. Cover limit: INR 1 Lakh to 25 Lakhs. Age Limit: 60 Years to 75 years.

Tata AIG Health Insurance Company General features: Waiting period = 03 years. Network hospitals: More than 10000 cashless hospitals across India. Claim settlement ratio: Above 96% (very quick settlement).  Ambulance and emergency assistance: 24x7x365 means round-the-clock on WhatsApp and voice calls. Pre (30 to 60 days) and Post (60 to 90 days) hospitalization cover for a predetermined sum insured cover for some plans like Medicare and Medicare protect health insurance policy. Number of days and sum insured depend on various factors. Cumulative No claim bonus (Additional sum insured) for each claim-free year: In Medicare health insurance plans, 10 to 100% of the additional sum will be insured. Income tax benefits. Paperless online issues and renewal of policies. 5 to 10% discount if you plan to purchase the Medicare or Medicare Protect policies for 2-3 years. 20% to32% discount on family floater plan for 2, 3, or more family members. Consumable cover: It covers the non-music expenses like surgical pads, syringes, oxygen, etc. which are directly consumed by the patient. International cover: If you are diagnosed with some illness in India and opt to take treatment abroad.  This cover will provide you with financial help. Add on maternity cover: waiting period 4 years. This rider will provide cover of INR 50000 for a baby boy and INR 60000 for a baby girl. Newborn baby cover: If a Maternity claim is accepted, then only INR 10,000 cover will be provided for the treatment of newborn baby cover. OPD cover: waiting period  2 years and cover limit INR 5,000 per year. Automatic restoration benefit: If your sum insured is exhausted in a single financial year for medical emergency treatment. The sum insured will automatically be restored or refilled. No sub-limit for hospital room rent. NO Co-Pay cover. Cover for pre-existing diseases: will be activated after the waiting period. AYUSH cover Day care procedure cover. In-patient hospitalization cover. Not covered (medical exclusions and nonmedical exclusions): (Please check this  from official websites for all policies that you are comparing for purchasing purposes) : Example: Plastic surgery: If it is not part of the medical requirement.  Otherwise, it is covered if it is medically required due to an accident, burn, or cancer. Please go through the official website for full details. Plans: TATA AIG Individual health insurance plan. TATA AIG Family health insurance plan. TATA AIG Critical care health insurance plan. TATA AIG Personal accident insurance policy. Tata AIG Medicare Premier Policy: Cover Limit: INR 05 Lakhs to 3 Crores. Some of the benefits: Maternity cover: INR 1 Lakh for a boy child and INR1.2 Lakh for a girl child, waiting period - 4 years, Premium- INR 21500 approx. OPD, IPD, Maternity, International treatment cover. Accidental death cover. Tata AIG Medicare protects health insurance plans. Tata AIG Super Top-Up Policy: (especially for top-up plans) Cover limit: INR 3 Lakhs to 1 Crore. Age limit: 91 days to 65 years. TATA AIG Medi Prime Group Health Insurance Plan

United India Health Insurance Company Plan: United India Individual Health Insurance Plan: Cover Limit: INR 2 Lakhs to 20 Lakhs. Impaneled hospitals for cashless treatment: More than 14,000 Some of the benefits: IPD including Ayurvedic treatment cover. Dar car and Domiciliary (home care) expenses cover. Medical checkup free.

Universal Sompo  Health Insurance Company Plan: Universal Sompo Complete Healthcare Insurance Policy: Cover Limit: INR 1 Lakh to 50 Lakhs. Impaneled hospitals for cashless treatment: more than 12000. Some of the benefits: OPD, IPD, Maternity cover. Emergency dental procedure. Free Health checkup.

Zuno (old name - Edelweiss) Health Insurance Company General features of a plan: Cover Limit: INR 1 Lakh to 1 Crore. Empanelled Hospitals for cashless treatment: More than 10,000. Some of the benefits: IPD, Pre and Post hospitalization, Daycare, Ambulance cover, etc. Maternity cover ( including Gold with Health 241 add-on): Delivery expenses limit: INR 50,000 with Gold plan and INR 2 Lakh with Platinum plan. Waiting period: 4 years. Premium: INR 18,000 to 25000 approx. (varies with different plans).

Online Purchase of Health insurance policies and its benefits: It is always better to purchase the policies online due to the following reasons: A Lot of options are available to purchase health insurance policies online. We can compare various policies in online purchases. Various third-party online platforms like www.policybazar.com are available to select the best option. Such types of platforms provide a comparison between various options and normally such platforms are not biased to force you into a particular plan. You may get some discount also when you purchase the policy online. However, it is very important to cross-check each and every plan from the official website of the insurers.

IRDA GUIDELINES 2024 The Insurance Regulatory and Department Authority (IRDA) of India is a government-controlled body to ensure healthy practice in the insurance sector. Some of the guidelines issued in 2024 in favor of policyholders are mentioned below: The entry age limit is removed. It is good for senior citizens. Pre-existing diseases (PED) waiting period is reduced to 3 years. Specific disease waiting periods like joint replacement, etc. are reduced to 3 years. The insurance company now can not refuse to issue the policy to a customer suffering from critical diseases like AIDS, Renal failure, Heart disease, cancer, etc. No sub-limit on AYUSH treatment: Policyholders now can avail full sum insured for such treatment. A customized plan and dedicated support channels for senior citizens. Moratorium period: It is reduced to 5 years. Now after 5 years of the policy life, the Insurer can not reject the claim based on non-disclosure or misinterpretation of the diseases. No option for Indemnity-based policies: Now, insurers cannot issue such policies that are not beneficial to the policyholder. Instead, now benefit-based policies will be issued so that the policyholder will get a lump sum amount after detecting a covered disease. Multiple claims across various insurers for benefit-based policies: it will give various options to policyholders to file the claim with all insurers to get the best deal.

Summary: The basic idea is given here for different types of policies available in the Indian market. Terms and conditions and other things about policies are subject to change from time to time. It is strongly felt to go through the information from reliable sources before purchasing a policy.  Health insurance policies cover a wide horizon of expenses for OPD, IPD, Pre and Post hospitalization, fatal diseases, fatal road accidents, Diagnostic tests, second opinion, Transportation cum ambulance charges by air or by road, long-life renewal, Daily care, domiciliary healthcare,  daily allowance, age and health conditions, listed networks hospitals for cashless treatment, geographical region of stay, No copayment option, etc. Take all the important points into consideration especially those related to high-cost expenses,  critical illnesses, your budget, etc. Read, study, and collect the information available from reliable sources. Collect the doubtful terms and conditions, terminology, and fatal diseases. Take the help of an adviser or from the internet for any doubt and clarification. First, select 5 plans. Then compare it and reduce it to 3. Then again compare it and select one. Go through the official website of the insurer and reconfirm all pros and cons. If any top-up, add-on, or rider is needed, consider adding it. Purchase the policy and live life tension-free.

Disclaimer: The best efforts are made to provide authentic and correct information here. A lot of study is made on the following and similar websites. However, I am not a certified adviser. The author does not have any guarantee /responsibility (legal or otherwise) for its correctness, completeness, and further consequences. The author does not recommend any specific policy. Before using the given information, it is strongly felt to analyze your needs and go through reliable sources of information. If in doubt, take the help of an expert and with your own decision purchase a good policy. https://www.forbes.com  https://www.acko.com https://www.policyx.com https://www.policybazaar.com https://www.starhealth.in https://www.1mg.com https://www.forbes.com https://www.hdfcergo.com https://www.icicilombard.com https://www.groww.in https://www.tataaig.com https://tjzuh.com https://www.mayoclinic.org https://www.insurancedekho.com =Health is wealth= ==The end==