Getting a health insurance policy is key to securing quality treatment without worrying about its impact on your finances. On Bajaj Markets, you can get coverage of up to ₹2 Crores with affordable premiums starting at just ₹160 per month from leading insurers.

 

Different plans offer coverage for different expenses, so choose the best one for you by researching and comparing your options. The ideal policy is the one that offers an adequate sum insured at premiums that fit your budget.

What is Health Insurance?

This type of insurance plan reimburses you for certain expenses related to healthcare in return for an annual/monthly premium. It helps to protect your finances in the event that you are hospitalised, undergo treatment or require medicines, check-ups, or consultations with doctors.

Health Insurance Plans Available at Bajaj Markets

Insurance Partner
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Health Insurance Plan
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Premium Price
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Claim Settlement Ratio
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Aditya Birla Health Insurance

Group Activ Health

₹575/month

99.41%

4.4
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Aditya Birla Health Insurance

Base Policy

₹683/month

99.41%

4.2
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Aditya Birla Health Insurance

Enhanced Policy

₹732/month

99.41%

3.9
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Aditya Birla Health Insurance

Super Top Up

₹433/month

99.41%

3.9
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Bajaj Allianz General Insurance

Family Health Care Gold

₹266/month

98%

4.1
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Bajaj Allianz General Insurance

Extra Care Plus

₹160/month

98%

3.8
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Bajaj Allianz Health Insurance

Health Guard Silver

₹333/month

98%

3.9
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Bajaj Allianz Health Insurance

Health Guard Gold

₹492/month

98%

4.3
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Bajaj Allianz Health Insurance

Health Guard Platinum

₹546/month

98%

3.9
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Care Health Insurance

Care Health Insurance

₹672/month

87.1%

4.0
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TATA AIG

TATA AIG

₹612/month

96.43%

4.5
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Our Partners

With great expertise in the insurance sector, Bajaj Allianz General Insurance Co. brings to you, extensive insurance plans that are designed to fit your diverse needs. Their insurance expertise marrying Bajaj Markets' digital approach further offers you convenience, & great value for money!

We understand your needs and priorities. When it comes to protecting your valued assets, health is always on the top of the list. That’s why we bring you, health insurance by Aditya Birla Health Insurance, only on Bajaj Markets. With an extensive product portfolio of unique offerings like incentivized wellness and critical care, you need not look any further.

Staying healthy is not a choice! But health risks can knock at your door, anytime! Worried that such scenarios could put a burden on your pocket? Not anymore! With Care Health Insurance now available on Bajaj Markets, you can take care of your family's health, especially in times of need, without worrying about healthcare costs.

The Tata AIG General Insurance Company Limited is a joint venture between the American International Group (AIG) and the Tata Group. One of their key offerings is the Tata AIG Health Insurance, which has an outstanding claim settlement ratio of 96.43% for FY 2020-21.

Benefits of Buying Health Insurance Plans Online

Most insurance providers offer online facilities enabling you to choose an insurance plan in a few clicks. Here are some of the top reasons why it is smart to get health insurance online:

1. Plenty of Choices and Easy Comparison

You have easy access to more options in terms of plans and insurers online. With all the required details at your fingertips, you can compare them conveniently too. This facilitates informed decision-making and ensures you secure adequate coverage for the right price.

2. Cost-Effective 

Buying a policy offline usually involves an agent, while getting one online eliminates this middleman. By eliminating a commission for agents, you can get the policy more affordably online. 

 

The quick digital process also lowers other administrative costs of the insurer, which helps keep the premium amount low. You can thus get the same coverage and benefits at a reduced price.

3. Instant Access to Policy

Verification and other processes are faster when you choose the online mode. As soon as you submit the form and pay the premium, you will receive the health insurance policy on your email ID. There is less delay as you do not need to wait for it to be delivered to your home. 

4. Convenient and Simple

When you sign up for health insurance online, you are not bound by typical working hours. You can get it whenever you want, no matter where you are. 

 

Digital processes also do away with the need to take prints and carry physical copies of documents. Simply upload basic paperwork by following clear instructions and you can get a policy hassle-free. 

5. Safer 

Health insurance providers ensure their digital payment gateways are secure, which helps make sure your details are safe. Before you proceed, ensure that you are on the official website and that your connection is secure so you can pay stress-free.

Checklist for Choosing Health Insurance

Inadequate coverage can lead to financial stress as you will have to bear medical costs out of pocket. To avoid this, consider these factors before getting a health insurance policy:

1. Type of Policy

Insurers offer different types of plans that offer different coverage at different premiums. For instance, getting a family floater policy may be more suited to secure your loved ones than getting an individual policy for each member. 

 

If you want to cover only hospitalisation expenses, mediclaim insurance may be ideal. For all-around protection, consider a comprehensive policy. Based on these and other features, choose the right policy.

2. Sum Insured

This refers to the maximum financial assistance that the insurer will offer during your policy period. It affects the premium you will have to pay.

 

Being underinsured could translate to higher out-of-pocket expenses. To choose the right cover, evaluate your medical expenses in the past and forecast future needs. Consider your or your family members’ medical conditions and the care they require.

3. Premium and Tenure 

Most insurers offer basic health insurance policies at different costs. Some may offer a discount if you choose a longer term. Compare the options thoroughly to get the most cost-effective one.

4. Inclusions and Exclusions

All your medical expenses are not covered by a health plan. Insurers have terms and conditions in place about what is considered and what isn’t covered, which dictate what you can claim. This varies across insurers and policies, so comparing them is crucial.

5. Co-payment Clause

Some insurers and policies require you to pay a part of the claim amount, known as the co-pay or deductible. With a higher co-pay, the premium will be lower and vice versa. However, a higher co-pay will also mean that you will pay more out of pocket. Assess your needs and choose accordingly.

6. Waiting Period 

This refers to the period after which the insurer will cover certain medical conditions. Some may have a 2-year period, while in others, it may extend to 4 years. Since you will need to cover health costs yourself during this time, choose a policy with the shortest period after some research. 

7. Network Hospitals

Insurance providers offer the cashless claim facility through tie-ups with medical institutes. Choosing an insurer who has more partners, or partners that you are more likely to visit, is beneficial. You can find the list on the official website.

 

However, the General Insurance Corporation (GIC) recently initiated the ‘Cashless Anywhere’ facility. Under this, you can benefit from the cashless facility even if a hospital or medical facility is not in your insurer’s network. Follow the guidelines listed by the GIC to take advantage of this initiative. 

8. No Claim Bonus (NCB)

Almost every insurance provider will give you a bonus for a claim-free year. This is known as NCB, and it is rewarded in the form of increased coverage without any increase in premium. 

 

It is often a percentage of the sum insured. Try to select a policy that comes with the highest percentage to get the best value.

9. Complimentary Check-ups

Many insurers offer a few health screenings for free every year. This helps doctors heed warning signs and treat diseases in early stages. Look for this benefit in your health insurance policy to save more in the long run. 

10 . Claim Settlement Process and Ratio

The financial assistance you get from the insurer is through the claim you will file. Check the process in advance to ensure that it is simple and quick. 

 

In addition, check the settlement ratio and choose an insurer with a higher one. A high ratio indicates that the insurer approves more claims, so the chances of you getting a hassle-free settlement are higher.

11. Other Terms and Conditions

Insurance providers have many conditions that outline when they are liable to pay for your medical costs. Allocate some time to read through them as they vary depending on the policy and the insurer. By understanding these terms, you can pick the best health insurance policy for your unique needs.

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Reasons to Buy a Health Insurance Plan

Rather than delaying your purchase, get a health plan right away. Here are some of the benefits of acting fast:

1. Comprehensive Cover

Sourcing sufficient funds to finance timely treatment can be a strain. A health insurance policy comes in handy as the insurer covers medical costs as per the terms and up to the sum insured. 

 

Apart from hospitalisation costs, most plans cover diagnostic expenses, OPD, ambulance charges, and more. Most insurers charge nominal premiums so you can get comprehensive protection affordably. 

2. Superior Quality Treatment

Since the insurer pays for most medical expenses, you don’t have to rely on your savings. This eliminates finances from the equation and allows you to focus on choosing the best facilities for excellent treatment.

3. Tax Benefits

You can claim a deduction u/s 80D on health insurance premiums you pay for yourself and your family. The amount varies and can go up to ₹1 Lakh, which adds to your savings.

Ideal Coverage Amount for Health Insurance

Your policy’s sum insured determines the maximum amount that your insurer will pay. If the amount is inadequate, you will have to pay out of your own pocket. So, choosing the right amount is crucial. 

 

However, since individual needs are different, the ideal coverage amount varies. Experts suggest that you should get medical insurance for at least 50% of your annual income. So, if you earn ₹15 Lakhs a year, your sum insured should be approximately ₹7.5 Lakhs.

 

Due to rising medical inflation, experts also suggest that if 50% is too low, your health insurance cover should be a minimum of ₹5 Lakhs. However, these are just general estimates. Consider the following to determine the ideal coverage for your needs:

  • Medical history

  • Age

  • Family health history

  • Preferred hospitals

  • Lifestyle

Types of Health Insurance Plans

Your coverage depends on the policy and customisations as well as the insurer. Here are the different types of health policies that most insurers offer: 

1. Individual Health Insurance Plans

These policies cover the costs only for one individual, and the premium depends on the age and medical history. The policy generally covers pre- and post-hospitalisation expenses, day care treatments, and more.

 

You can get this plan for yourself, your spouse, children, or your parents. Since it is an individual plan, everyone will have a separate sum insured, and each policy will require the payment of a separate premium. 

 

On Bajaj Markets, you can get an individual health insurance policy with premiums starting at ₹333 per month.

2. Family Health Insurance Plans

These policies are ideal to cover the entire family under one policy. These are also known as family floater policies, and the sum insured is shared among the insured. 

 

As the coverage amount is split, you only have to pay one premium. Since the coverage in this plan is similar to the individual plans, it is a more cost-effective solution. You can buy family health insurance policies starting at ₹708 per month on Bajaj Markets.

3. Senior Citizen Health Insurance Plans

When you are over 60 years old, you require different health coverage as your needs vary significantly from those of a younger individual. To ensure that you are adequately covered, insurers offer policies that are specially curated for them.

 

Along with standard cover for hospital expenses, OPD, and more, these plans may cover domiciliary hospitalisation, psychiatric benefits, and more. Since this group of individuals is more likely to have health issues, which can lead to more claims, insurers often require a medical check-up.

 

The possibility of higher claims also results in higher premiums. On Bajaj Markets, you can get a senior citizen plan with a minimum cover of ₹2 Lakhs starting at just ₹1,868 per month.

4. Group Health Insurance Plans

Generally, employers get this type of health insurance policy as an added perk for the employees. The cover offered under it is generally related to basic health needs, unlike that of individual and family floater policies. 

 

On Bajaj Markets, you can get a group insurance plan starting at ₹853/month with a minimum cover of ₹5 Lakhs.

5. Top-Up Health Insurance Plans

These plans are ideal for when you want to want to restore your sum insured up to a certain limit once it is exhausted. Its premium is comparatively lower than regular health insurance policies and provides an affordable way to extend your total coverage.

 

On Bajaj Markets, top-up health plans start at a premium of ₹160 per month with a basic cover of ₹5 Lakhs.

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Inclusions in a Health Insurance Plan

The insurer does not pay for all medical expenses. It’s important to know what’s covered under your health insurance policy to ensure you have the right coverage. Here are some standard inclusions:

1. In-Patient Hospitalisation

 

This refers to the expenses that you incur when you are hospitalised for 24 hours or more. The majority of insurance plans cover this cost. Common expenses covered are ICU treatment, OT charges, diagnostic tests, nursing care, doctor’s fees, room charges, and medicines.

2. Pre- and Post-Hospitalisation Expenses

Insurers also cover the expenses you incur before and after hospitalisation. This may include diagnostic test charges, doctor consultation fees, medicines, physiotherapy, and more. 

 

Generally, expenses incurred up to 90 days before and up to 180 days after hospitalisation are covered.

3. Preventive or Annual Health Check-ups

You may also get coverage for the health screenings that help you monitor your health. This may include tests done to evaluate renal function, blood sugar, ECG, and more. Some insurers may also offer a complimentary annual package of such tests. 

4. Organ Donor Expenses

Most health insurance policies also cover the costs of harvesting an organ, should you need a transplant surgery. They may also cover compatibility tests, post-operative care, and hospitalisation.

5. Day Care Procedures

These are treatments for which you do not need to stay in the hospital for more than a day. Some treatments covered under this include chemotherapy, dialysis, cataract surgery, and radiotherapy.

6. AYUSH Treatment

Most health insurance plans today also cover the costs for alternative treatments like Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy (AYUSH). There are certain conditions you need to adhere to, such as getting treatment at a government hospital.

 

Your treatment may also be done at an institute recognised or accredited by the National Accreditation Board for Hospitals & Healthcare or the Quality Council of India. It must also be an in-hospitalisation treatment.

7. Mental Healthcare

IRDAI has mandated that all insurance providers must offer coverage for the treatment of mental illnesses. This includes anxiety, depression, dementia, bipolar disorder, schizophrenia, and others.

8. Pre-Existing Diseases (PEDs)

These are medical conditions that you have while in the process of getting a health insurance policy. While the insurer will cover the expenses for the treatment of these conditions, it will be after the waiting period. Generally, insurers have a waiting period of 2 to 4 years.

9. Maternity Expenses

Insurers will cover the prenatal and postnatal expenses along with other maternity-related costs. However, it is covered only after the waiting period, just like PEDs. The waiting period may be between 9 months and 6 years.

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Exclusions in a Health Insurance Plan

1. Corona Rakshak Policy

This plan covers various needs related to COVID-19. In the event of a 72-hour hospitalisation due to COVID-19, you can claim the sum insured from the insurance company. You can also claim benefits that cover various protective items such as: 

  • Personal Protective Equipment

  • Ventilators

  • Oxygen cylinders, etc. 

     

Each premium payment can help you subscribe to the Corona Rakshak policy for up to 9.5 months. You can claim its benefits and coverage if you are diagnosed with COVID-19 within that policy term.

2. Corona Kavach Policy

This benefit-based plan offers you wholesome coverage for hospital treatments, at-home COVID-19 care and AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) treatments. Under this policy, you can also claim coverage for protective items and other equipment used for COVID-19 treatment. 

Here are some common medical expenses that fall under the category of what’s not covered  under your health insurance:

1. Cosmetic Surgery

The insurer is not liable to cover the costs of plastic or cosmetic surgery unless it is required due to an accident.

2. Specific Illnesses

There are some specific medical conditions that the insurer will not cover. These include hernia, STIs, joint problems, and more. The list will be mentioned in the policy document.

3. Self-Injury

Insurance providers are not liable to pay for treatment that arises due to any self-inflicted injuries. 

4. Dental Expenses

These expenses are generally outpatient procedures, meaning they do not need hospitalisation. As such, the health insurance plans do not cover them.

5. War and Related Perils

Any insurance policy will not cover the expenses related to the treatment of diseases or injuries resulting from war or other related circumstances.

6. Injuries Inflicted Due to Dangerous Activities

Your health insurance will not cover expenses for treatment of injuries resulting from dangerous activities, such as racing, adventure sports, and more.

7. Emergencies Led by Substance Abuse

Misuse of substances such as alcohol, drugs, or other addictive substances leading to medical conditions or emergencies is also not covered by insurance.

Key Factors to Consider Before Getting Health Insurance

1. Health Insurance Riders 

These additions help you extend the coverage of your policy. Different insurers offer different types of riders, but here are some common ones:

2. Personal Accident 

With this rider, you get coverage for unintentional damages resulting from accidents or other conditions specified in the policy document. It is a compensation-based add-on, meaning you will get compensation in case of permanent, partial, or total disability. 

 

In the unfortunate event of death, your immediate family member or nominee will receive compensation. The amount depends on your policy terms.

3. Critical Illness 

Conditions like cancer, stroke, heart attack, kidney failure, and more are generally not covered under insurance, and can strain your finances. 

 

With this rider, you can get coverage and receive funds to get the required treatment. Insurers generally give a lump-sum amount, regardless of the treatment cost.

4. Maternity Cover 

This rider helps you get coverage for maternity expenses from pregnancy to childbirth. The extent will depend on the insurer. Most insurers cover prenatal and postnatal expenses, such as hospitalisation, ambulance charges, and childbirth. 

 

Some insurers may also extend the cover to the newborn child till the policy term. Most insurers only offer it after a waiting period. Read the terms and conditions carefully before adding this rider. 

5. Room Rent Waiver 

Your policy may offer room rent of ₹1,500 per night at a hospital. If your chosen room costs more than this, you will have to bear the additional costs. But with this add-on, you do not have to worry about that. This rider allows you to choose the best room for a comfortable and convenient recovery. 

6. Hospital Cash 

Also known as daily cash allowance, this rider helps you get coverage for the daily expenses you bear during hospitalisation. This includes transportation, food, medicines, and more. 

 

Its aim is to cover the loss of pay you will face during hospitalisation. The amount offered depends on the insurer and your policy terms.

7. Restoration of the Sum Insured

Adding this rider to your health insurance allows you to get coverage even if you have exhausted your sum insured before the policy term. It will help restore your sum insured entirely or partially, depending on the terms. 

 

Some other riders you may consider include the following:

  • Global coverage

  • OPD care

  • Air ambulance

  • Zone upgrade

  • Second opinion

  • Home healthcare

 

Check with the insurer at the time of getting insurance to know your options better. This will help you choose suitable riders and get the best health insurance policy.

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Coronavirus (COVID-19) Treatment Coverage in Health Insurance Policies

Covid-19, or coronavirus, is not a pre-existing disease. As such, basic hospitalisation expenses resulting from it are covered by most insurers. However, if you get health insurance after testing positive, the insurer may not cover the expenses.

 

Additionally, the insurer is not liable to pay for the treatment cost during an active waiting period. To ensure you have coverage, opt for special policies exclusively designed to cover expenses arising out of treating it.

Eligibility Criteria to Get a Health Insurance Plan

Most insurers focus on your age and your health when determining your policy terms. Here is an overview of some crucial eligibility factors:

1. Age

The majority of insurers offer coverage to infants as old as 15 days and late adolescents up to 18 years. The maximum age is 65 to 70 years, depending on the insurer and policy you choose.

2. Medical Test Results

Most insurers require you to undergo tests to determine your health if you are aged 40 to 45 and above. Based on the results, your insurance cover and premiums are decided. 

 

Some insurers may also assess pre-existing diseases to determine if you qualify for coverage. While most providers offer coverage with a waiting period, some even add a co-payment clause.

Reason to Compare Health Insurance Plans Online

Evaluating different plans is crucial because it helps you make an informed decision that prioritises your health and finances. Here are some reasons why you should do it online:

  • It is easier as you need to visit a few websites instead of physical branches

  • You do not pay anything to compare different policies online 

  • The facilities are available around the clock, so you can do it at any convenient time 

  • Online comparisons are quicker because you do not have to travel or wait for anyone

  • The options you can compare online are more extensive, giving you the power of choice, which helps you choose the best health insurance policy suited to your needs

How to Calculate Health Insurance Premiums

An easy way to calculate the premium of your health insurance policy is to use a premium calculator available online. This automated tool is easy to use and requires minimal details. 

 

Here are the steps to follow on Bajaj Markets:

  1. Visit the ‘Health Insurance Premium Calculator’ page

  2. Enter the necessary details of the person to be insured, like age, address, and mobile number

  3. Click on ‘Get Quote’ and see the plans available to you

  4. Pick one that best suits your requirements and add riders too

  5. Based on your choices, the premium amount you are liable to pay will be displayed

 

You can modify your choices to compare the premiums and select the most suitable plan.

Factors Affecting Health Insurance Premium

The premium you pay in exchange for health coverage depends on various factors. Understanding them will help you optimise your plan and get the best health insurance policy as per your financial and medical needs:

1. Your Age

If you are young, the premium will likely be lower and vice versa. In general, older people are more susceptible to health issues and will likely make more claims.

2. Pre-Existing Diseases

Insurers will likely charge a higher premium if you have any PEDs because of the increased possibility of filing a claim.

3. Type of Plan

There are different types of insurance plans which come with different coverage and terms. The policy you choose influences the premium you will pay.

4. Add-on Covers

Enhanced coverage comes at a price, and the type and number of riders you choose affects the cost of your insurance policy. 

5. Sum Insured and Policy Duration 

When you choose a higher coverage amount, the insurer will charge a higher premium. Additionally, if the term of your policy is longer, the insurer will likely charge a lower amount. Keep this in mind to choose ideal terms that make your policy pocket-friendly while fulfilling your needs. 

6. Lifestyle 

Your lifestyle affects your health and, therefore, your insurance premium. If you lead a risky life, such as holding a dangerous job or indulging in frequent smoking, the premium will be higher. 

 

The more vulnerable you are to health issues, the higher your likelihood of filing a claim, and thus, the higher your premium will be.

Steps to File a Health Insurance Claim

There are two types of claims you can file, cashless and reimbursement. Here is a guide to filing both these claims:

  • Cashless Claim Process

  1. Choose a network or non-network hospital 

  2. Inform your insurer in advance for planned treatment or within 48 hours for unplanned treatment

  3. Fill out the cashless claim form

  4. Submit your medical and policy details to your insurer or third-party administrator 

 

The insurer will review your request and directly pay for the expenses covered under your policy if approved. If rejected, you can file a reimbursement claim or shoulder the expenses yourself. 

  • Reimbursement Claim Process

  1. Settle all the bills at the hospital during the time of discharge

  2. Inform the insurer of your admission and begin the claim process

  3. Fill out and submit the reimbursement form

  4. Submit the form and required documents

 

Once the insurer approves the claim, the settlement amount will be transferred to your account. 

 

When filing either claim, make sure you begin the process as per the timeline provided by the insurer. For instance, most insurers require you to notify them of treatment 3 days in advance in case of planned treatment. 

 

In case of an emergency admission, inform them as soon as possible. For reimbursement claims, you generally need to start the process within a week of discharge. You can find the exact timeline in your policy documents or by contacting the insurer.

Documents Required for a Reimbursement Claim

When filing a reimbursement, you will likely have to submit extensive paperwork as compared to a cashless claim. Here is an overview of the documents you will need to furnish: 

  • Signed claim form

  • Identity proof

  • Diagnosis and treatment documents (x-rays, blood tests, sonography, etc.)

  • Prescriptions and bills

  • Ambulance receipts

  • Discharge card or report

  • FIR, if required

  • Policy details

 

The insurer may ask for additional documents to review and process your claim, in which case you will be notified. Be sure to submit them on time to avoid delays.

Documents Required for Getting Health Insurance

The list of documents varies depending on the insurer. However, most require you to furnish some basic paperwork, which includes:

  • Identity proof

    • Passport

    • Voter ID

    • PAN card

    • Aadhaar card

    • Driving license

  • Age proof

    • Passport

    • Birth certificate

    • Driving license

    • PAN card

    • Voter ID

    • Aadhaar card

  • Address proof

    • Utility bills (telephone, electricity, etc.)

    • Passport

    • Driving license

    • Voter ID

    • Aadhaar card

    • Ration card

  • Medical reports

  • Proposal form

  • Photographs (passport-size)

Common Health Insurance Terms

Knowing certain technical terms will help you better understand the policy and ensure that you choose the best one. Here are some must-know terms:

1. No Claim Bonus

This is a benefit that the insurer offers when you do not file a claim during the policy period. It is offered in the form of an increase in your sum insured without any increase in your premium amount. 

 

For instance, if your current sum insured is ₹5 Lakhs, the insurer may offer NCB up to ₹5 Lakhs. So, your new sum insured can be up to ₹10 Lakhs without any increase in premium amount, apart from the standard hike, if any.

2. Dependents

These are financially dependent family members that you want to cover under your insurance plan. It is generally limited to your spouse, children, and parents. 

3. Grace Period

This refers to the time during which you can renew your expired policy without losing your benefits. Simply put, your policy will not lapse if you renew during this period. It can range from two weeks to a month or more, depending on the insurer. 

4. Premium

This is the amount that you pay in exchange for the coverage and other benefits of a health insurance policy. It is generally a one-time payment, and the amount depends on various factors, including the insurer you choose. 

5. Pre-existing Disease (PED)

This refers to medical conditions that were diagnosed prior to you getting health insurance. Generally, insurers cover such conditions after a waiting period. Note that for the purpose of insurance, a condition is considered a PED if it is diagnosed two to four years before the date of purchase.

6. Portability

This is a facility through which you can switch insurers without losing any benefits like NCB. All insurance providers offer this option. However, you can opt for it only while your policy is active. Ideally, you should begin the porting process at least 45 days prior to the end of your policy term.

7. Waiting Period

In some cases, insurers cover the costs for medical conditions only after a certain period, which is known as the waiting period. It starts from the start date of your policy and can go up to 4 years, based on your policy and insurer. 

8. Exclusions

Insurers do not cover all medical expenses, which are referred to as exclusions. You must check this list before getting insurance to ensure you have the right cover and can have a stress-free experience when filing claims. 

9. Insurer

This is the company that provides insurance and covers the cost of your medical treatments. 

10. Network Hospital

Insurance providers have tie-ups with hospitals to settle cashless claims. The hospitals that they partner with are known as network hospitals. You must check this list to ensure that your preferred hospital is a part of the insurer’s network. Today, you can benefit from cashless claims even at a non-network hospital. 

11. Sum Insured

This is the maximum amount that the insurance provider will offer against a claim. For instance, if your expenses are ₹7 Lakhs and your sum insured is ₹5 Lakhs, you will only get ₹5 Lakhs from the insurer. 

12. Free Look Period

This is the time during which you can terminate the policy with the insurer without any penalties. It generally goes up to 30 days but can vary depending on the insurer. This facility enables you to take the time to go through terms and conditions before finalising a policy.

Health Insurance Partners Available at Bajaj Markets

FAQs and Support

How can I increase my health insurance coverage?

If you want to increase coverage in terms of the sum insured, you can contact the insurer and choose the plan. To widen the coverage, i.e., cover things not covered right now, you can get the appropriate add-ons. Note that both of these will increase the premium amount.

Can I buy health insurance plans online?

Yes. On Bajaj Markets, you can compare affordable plans from leading insurers and get one that fits your needs.

Are there any government health insurance plans that I could opt for?

Yes. Pradhan Mantri Jan Arogya Yojana (PM-JAY), Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY), and Aam Aadmi Bima Yojana (AABY) are some of the government schemes you can choose. However, these are curated for specific individuals so check your eligibility before you get it.

What is covered under my medical insurance plan?

Your coverage will depend on the type of policy you choose. Generally, a health insurance plan covers the cost of hospitalisation, surgeries, medicines, doctor visits, and more.

What happens to the health insurance policy once I have filed a claim?

If the insurer accepts and settles your claim, the sum insured in your policy will be reduced by that amount. At the time of renewal, the amount will be restored or changed as per the policy you choose.

 

For instance, say your sum insured is ₹5 Lakhs, and you file a claim of ₹1.5 Lakhs. Once the insurer accepts and settles it, your sum insured for the remaining policy term will be ₹3.5 Lakhs.

What are the benefits I could enjoy by getting health insurance?

One major advantage of getting health insurance is that you do not have to worry about finances during a medical emergency or procedure. If it is covered in your plan, the insurer will pay for the costs. You can also benefit from the complimentary check-ups and tax benefits.

Do health insurance policies cover diagnostic expenses?

Yes. Most policies will cover these expenses. However, there may be specific conditions attached. For instance, some insurers will cover the costs only if it leads to treatment in a hospitalisation. 

 

On the other hand, some may cover only the costs incurred 30 days before hospitalisation. You can confirm this by reviewing your policy document or contacting your insurer.

Should I get health insurance at an early age?

Yes. Apart from the financial coverage for medical expenses, getting insurance at a young age is beneficial because the insurers will likely offer low premiums. Additionally, since you will be less likely to file a claim at a young age, you can benefit from the NCB.

Can I have multiple health insurance policies?

Yes. You can choose multiple insurers and policies. However, you cannot claim the same expenses under different policies. But you can split your claim between two policies. Here is an example: Say you want to claim ₹15 Lakhs and have two policies of ₹10 Lakhs each. 

 

In this case, you can claim ₹10 Lakhs from one insurer and ₹5 Lakhs from the other. You cannot claim ₹10 Lakhs from both. Remember to file the claim one after the other and not simultaneously. You must also inform the insurers about any other policies you have, as per the protocols specified by IRDAI.

Can I cancel my health insurance at any time?

Yes. You can cancel your insurance policy at any time. However, the insurer will provide a refund only under certain circumstances.

Can I claim health insurance at any hospital?

Yes. The recently launched ‘Cashless Anywhere’ facility by the GIC helps ensure you can get a cashless claim even in a non-network hospital. If the insurer does not approve the cashless claim, you can file for a reimbursement claim, regardless of the hospital you visit.

How many times can I claim health insurance in a year?

There is no cap on the number of times you can file a claim. You can file as many claims as you want until your sum insured is exhausted. For instance, if you have a policy of ₹5 Lakhs, you can claim ₹1 Lakh 5 times or ₹50,000 10 times, and so on.

Can I port my medical insurance policy after expiration?

No. You need to begin the porting process at least 45 days, or as specified by IRDAI, before the expiry date. If your policy has lapsed, the insurer can deny the application to port. Not renewing the policy can lead to loss of NCB and other such perks.

Which is better, Mediclaim or insurance?

It depends on what you need. With a Mediclaim policy, you can get coverage only for hospitalisation expenses. However, a health plan covers pre- and post-hospitalisation expenses, OPD, and more.

Is it good to get health insurance?

Yes. Having a health insurance policy is beneficial because it offers financial assistance during medical treatment. This reduces your financial burden and allows you to get quality treatment without any compromise.

Is health insurance only for 1 year?

No. While most insurers offer policies with a term of one year, some offer longer terms, going up to 3 years. Getting a longer-term policy can be more beneficial as many offer a discount on the premium.

Which health insurance is best in the market?

The best health insurance policy will depend on what you need. For individuals, the Aditya Birla Activ Fit Health Insurance plan is a popular option. For senior citizens and women, STAR Health’s Senior Citizens Red Carpet Health Policy and HDFC ERGO My: Health Women Suraksha are among the top options.

No Room Rent Capping | No Medical Check-up up to 55yrs | Tax Benefit up to Rs. 75,000 | Buy Health Insurance starting @ ₹160 pm Check Plans
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