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These days, health insurance is not just a luxury but has become a necessity for most people. With the rapidly rising cost of healthcare, even a few days of hospitalisation at a private hospital can burn a hole in your pocket. As a result, more and more people are opting for health insurance to protect themselves and their families against rising medical costs. In this article, we’ll take a look at the important health insurance requirements and prerequisites you should keep in mind. 

Health Insurance Prerequisites

Health Insurance prerequisites refer to specific requirements or rules you need to know about before you set out to buy a health insurance plan. Here are some of the most important health insurance prerequisites that can help you make the right decision when buying health insurance:


  • Medical Tests: One of the major prerequisites of a health insurance policy is a medical test or check-up. If you plan to buy a health policy, you have to undergo a mandatory medical test. The medical test helps the insurance company to quantify the risk associated with your medical condition. The assessment of your health helps the insurance provider determine the insurance premium for your policy. Moreover, a health check-up before buying health insurance will ensure that your claims do not get rejected for reasons such as not disclosing pre-existing conditions.

  • Mandatory Hospitalisation:Generally, to get health insurance benefits, the insured must be hospitalised for at least 24 hours to be eligible to make an insurance claim. When you are hospitalised for at least 1 day, your room and boarding charges and/or ICU costs will be covered by insurance. Apart from this, for certain procedures, medical expenses incurred during 60 days immediately before hospitalisation and during 90 days after hospitalisation are covered by the policy, which are known as pre and post-hospitalisation expenses. Make sure you buy a health policy that offers these features.

  • Cashless Network Hospitals: Most insurance companies these days have a large network of hospitals where you can get cashless medical treatment. The network hospitals settle the medical bills directly with your insurance company. At the time of buying health insurance, make sure the insurance company you are going with has a wide network of hospitals across the country.

  • Exclusions: Most health insurance plans have a set of pre-defined exclusions that are not covered by the insurance policy such as dental or vision treatments, cosmetic treatments, treatment for conditions caused due to smoking or drinking. Moreover, if you have a pre-existing condition like diabetes or heart problems, they will only be covered after a certain waiting period. All these factors must be kept in mind when buying a health insurance plan.

  • Documents Required for Health Insurance; At the time of applying for a health insurance plan, the insurance company will ask you to submit several documents in order to buy the policy. Following is a list of documents you need to keep in handy at the time of buying health insurance:

  1. Proof of Age: Birth Certificate/Aadhar Card/PAN Card/Driving licence, etc.

  2. Identity Proof: Aadhar Card/Passport, Voting ID, Driving Licence, etc

  3. Address Proof: Electricity Bill, Voting Card, Passport, Aadhar Card, etc.

  4. Passport size photographs

  5. Duly filled application form for health insurance

  6. Other relevant documents that may be required by the insurance company

    Read More: Difference Between Copay, Deductible and Coinsurance

Final Thoughts

Buying health insurance for the first time may be a complicated process for someone who does not understand the technical jargon. However, an understanding of the above health insurance requirements and prerequisites can help you make the right decision on which health insurance policy to buy. If you are looking to buy health insurance online, you can check out the various health insurance plans available at Bajaj Markets and choose a plan that suits your requirements. 

Health Insurance Plans Available at Bajaj Markets

FAQs for Health Insurance Prerequisites You Should Know

What are the common exclusions in a health insurance policy?

The common exclusions in a health insurance policy include:

  1. Cosmetic treatments

  2. Dental and eye treatments

  3. Medical conditions as a result of smoking and drinking

What are health insurance requirements?

At the time of buying health insurance, you may have to undergo a medical test and submit all the documents as required by the insurance company. 

Is health insurance a legal requirement in India?

No, health insurance is not a legal requirement in India. However, a health insurance policy can protect you financially in case of any unexpected medical expenses. 

Is health insurance provided by the employer enough?

Generally, health insurance provided by employers is a group health insurance that has lower coverage. It is recommended that you buy a personal health insurance plan for yourself and your family. 

How much health insurance coverage do I require?

Most experts recommend that health insurance coverage of at least 50 lakh is required for individuals living in metro cities and around 1 crore for families. 

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