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With medical inflation in India at an all-time high, opting for a health insurance plan is a must so as to avoid burning a hole in your pocket. When you opt for health insurance of ₹ 5 Lakhs, you can rest assured that all most of your expenses pertaining to hospitalisation, treatment, surgery, and recovery shall be covered by the insurer. 

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024.


The Master Circular on Health Insurance Business 29052024 circular is available here -

Premiums for ₹5 Lakh Medical Insurance Plan

Whenever you opt for a health insurance policy, you must gauge, beforehand, how much the premium works out to, in addition to reading the fine print of the policy. By doing so, you can plan your finances better, and in a more structured manner. For example, when it comes to the premium for ₹ 5 Lakhs health insurance, there are a number of factors that help determine the same. Some of these factors include your current age, your medical and illness history, your lifestyle habits, and your area of residence. Additionally, when it comes to ₹ 5 Lakhs health insurance premium, each insurer offers slightly different quotations for the same. In general, the premium for such a health insurance policy stands at approximately ₹ 6,000 per year.

Features and Benefits of ₹ 5 Lakh Health Insurance

When you opt for a ₹ 5 Lakhs Mediclaim policy, you can benefit from the following:

  • Flexibility in Tenure

Holding true with most insurers, when you purchase health insurance of ₹ 5 Lakhs, you can opt for a flexible tenure, anywhere between 1 and 3 years. By doing so, you can avoid the process of renewing your health insurance policy on a yearly basis.

  • Free Health Check-Up

With every health insurance policy you purchase, you can undergo one free health check-up per year – which will be fully reimbursed by your insurer. 

  • Tax Benefits

When you make premium payments towards your health insurance coverage, you can avail of tax benefits. As per Section 80D of the Income Tax Act, any contribution towards the same is eligible for tax deductions and benefits. 

  • Additional Covers

If you opt for health insurance of ₹ 5 Lakhs, all your medical and hospitalisation-related costs will be taken care of by the insurer. Whether it is consultation fees, the cost of medication, surgery fees, or even ICU fees, everything is covered by the insurer in question.

  • Additional Benefits

In addition to your healthcare plan covering all your medical expenses, certain health insurance of ₹ 5 Lakhs also offers you additional compensation benefits. These can include expenses towards Wellness Coaches, Chronic Pain Management Programs, and the like.

Who Needs a ₹5 Lakh Health Cover?

In today’s day and age, critical illnesses are more common among people, of all ages. This includes cancer, cardiovascular illnesses, diabetes, tumours, and so on. This, coupled with steep medical inflation, has rendered the common man powerless. In such a situation, to avoid paying a steep price from your own pocket when there is a medical emergency, a ₹ 5 Lakhs Mediclaim policy will help you avoid burning through your hard-earned savings.

Eligibility & Documents Required to Buy ₹5 Lakh Medical Insurance

When it comes to a ₹ 5 Lakhs Mediclaim policy, there are specific eligibility rules in place. If you wish to apply for the same, you must be at least 18 years old, and should not be over 65 years old. Additionally, if dependent children/grandchildren are included in the policy as beneficiaries, they must be at least three months old, and not more than 25.


In addition to meeting the prescribed eligibility criteria, when opting for health insurance of ₹ 5 Lakhs, you must furnish the following documents:


  • Age Proof

  • Address Proof

  • Identity Proof

  • Requisite Medical Reports

  • Passport-size photographs

What's Covered Under ₹5 Lakhs Health Plan?

If you have opted for a health insurance plans for ₹ 5 Lakhs, keep in mind the following inclusions:


  • All costs related to the hospital room you are admitted to are covered under the policy.

  • The policy will compensate you for all in-patient expenses - tests, surgery, medication, and practitioner’s fees.

  • Both pre and post-hospitalisation costs will be covered by the insurer.

  • Ambulance fees will also be covered.

  • If in case you require an air ambulance, this cost too will be incurred by the insurer (at no extra premium).

What's Not Covered Under ₹5 Lakhs Health Plan?

When opting for health insurance plans for ₹ 5 Lakhs, the following exclusions will apply to the policy:


  • Generally, insurers do not cover pre-existing illnesses (especially if they are not disclosed when you purchase the policy).

  • In most cases, insurers also refrain from offering compensation for infertility treatments, as well as birth control.

  • Hospitalisation charges relating to pregnancy are not covered by the ₹ 5 Lakhs Mediclaim policy.

  • You cannot claim reimbursement for dental expenses under your health insurance policy.

  • In the incident of a suicide attempt, hospitalisation charges pertaining to the same are not covered by the health insurance policy.

How to Buy a ₹5 Lakhs Health Insurance Policy?

Once you have made up your mind to purchase health insurance of ₹ 5 Lakhs, follow the steps below:


  • Step 1: Start the process by visiting the official website of the insurer whose insurance policy you wish to purchase.

  • Step 2: Proceed by entering all requisite details asked - such as name, age, gender, area of residence, and so on.

  • Step 3: Next, browse through all the policies listed, and choose a policy that best suits your needs and budget.

  • Step 4: After this, choose any add-on covers you wish to purchase.

  • Step 5: Finish the whole process by making the payment.

How Much Sum Insured Coverage Works for You?

When it comes to deciding how much insurance coverage you actually need, you must factor in the following:


  • Whether your work environment is hazardous or risky.

  • Family history of critical illnesses.

  • Your desire to secure your investments and finances in the case of a medical emergency.

Which Type of Health Plan Will Work for You?

In addition to your health insurance of ₹ 5 Lakhs, if you wish to, you can also choose a critical illness cover, and if not, opt for a standalone critical illness plan. In the unfortunate event that you are detected with a critical major illness, you can then opt for a lump sum benefit, which can be used to avail the best treatment possible.


With ever-burgeoning medical costs in the country, and a steeply augmented rise in critical illnesses, having health insurance of ₹ 5 Lakhs can help safeguard your future, while also protecting your finances.  

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