Health Insurance

These plans come in different forms, each offering diverse benefits and coverage options. Knowing the types of health insurance policies can help you choose the one that best suits your needs and budget.

• Individual Health Insurance

These plans offer comprehensive coverage for you and your family. These policies cover various medical expenses, including hospital stays, outpatient procedures, and room charges. Each individual has their own coverage limit.

• Family Floater Health Insurance

They provide coverage for multiple family members under a single policy. Everyone in the family shares the same coverage limit. Family health insurance plans are generally more cost-effective than individual plans because of the shared coverage.

• Maternity Insurance

This plan provides financial protection for the medical expenses associated with pregnancy. Maternity insurance covers prenatal and postnatal care, delivery, and newborn expenses.

• Senior Citizen Health Insurance

These plans cater to the unique medical needs of older individuals. Due to the increased risk of health problems among seniors, senior citizen health insurance could be more expensive.

• Critical Illness Health Insurance

You can purchase these policies as an add-on to your regular or separate plan. They provide coverage for specific critical illnesses and often offer a lump sum payment upon diagnosis.

• Group Health Insurance

These plans are designed for large groups of individuals like employees of a company. Group health insurance is generally more affordable but may have limited coverage compared to individual plans.

• Top-up Health Insurance

As its name suggests, it offers extra coverage on top of your existing health insurance policy. Top-up health insurance plans cover medical expenses beyond your primary policy's coverage limit.

To select the right policy, consider what exactly it covers. The following are some of the main inclusions and exclusions in health insurance:

Choosing the right plan can be overwhelming with so many options available. Consider the following factors when selecting a health insurance policy:

• Know the Sum Insured

Determine the appropriate sum insured based on your family size, age, and potential medical expenses

• Look for Network Hospitals

Identify hospitals within your preferred geographical area that are part of the insurer's network

• Read the Fine Print

Carefully read the policy documents to understand the terms and conditions

• Check Additional Benefits

Look for additional benefits such as maternity coverage, dental care, or outpatient treatments

• Understand Policy Exclusions

Be aware of any pre-existing conditions or specific illnesses that the policy may not cover

Due to their online availability, comparing plans online has become easier than ever. Follow this simple process to compare various health insurance plans:

1. Visit the official website of the insurance company

2. Click on the ‘Buy Insurance’ or ‘Get Quote’ button

3. Enter basic details about the person who you want to insure

4. Choose the sum insured and include additional coverage

5. Note down the quote along with reviews of the plan

6. Follow the same process across different insurers

The premiums that you will have to pay for a policy vary depending on several factors. You can use a health insurance premium calculator to get an estimate of the cost of a policy. Follow these simple steps to calculate premium costs:

1. Visit the official website of the insurance provider or Bajaj Markets

2. Locate the ‘Health Insurance Premium Calculator’ facility

3. Enter the basic details of the person for whom you want to get the insurance

4. Select the number of people you want to insure

5. Click on the ‘Calculate’ button once you have entered all the relevant details to get an estimate

Several elements influence the cost of your policy. Understanding these key factors enables you to make informed decisions when purchasing a policy.

• Age

Older individuals have higher premiums due to increased health risks associated with age

• Health Status

Pre-existing medical conditions can significantly impact your premiums, as individuals with chronic illnesses may have to pay higher premiums

• Tobacco Use

Tobacco users typically have higher premiums due to the increased risk of health problems associated with smoking

• Location

Geographic location can also influence premiums, as areas with higher healthcare costs may have higher premiums.

• Family History

A family history of certain diseases or conditions can affect your premium costs

• Coverage Amount

The higher the sum insured, the higher the premium and protection you can enjoy

Before getting a plan, it is crucial to understand the prerequisites to qualify. While these may vary, the following are the basic eligibility criteria:

• Most plans allow you to get a plan when you turn 18 years old
• Some policies may put forth some conditions if you have pre-existing conditions
• Most policies also require you to undergo medical tests

On Bajaj Markets, you can compare and get a health insurance plan with ease. Follow these simple steps to get a policy of your choice:

1. Click on the ‘CHECK PLANS’ tab at the top of the page

2. Fill in the relevant information, such as your name, date of birth, contact details, etc.

3. Click on ‘GET QUOTE’ after you check the terms and conditions box

4. Select a plan and include add-ons if you require any

5. Make online payment for the premium to receive the policy

Before filing a claim, informing the insurer about hospitalisation within a specified time is crucial. If you fail to notify them within the specified time, they may reject your claim. Once you inform the insurance company, a representative will guide you through the health insurance claim process.

1. Cashless vs Reimbursement Claims

You have two primary options when it comes to filing claims for your health insurance policy. These include – cashless claims and medical reimbursement. Each has its own benefits and drawbacks.

2. Cashless Claims

It allows you to get treated at a network hospital without paying upfront. Follow these steps to file cashless claims:

• Inform your insurer and submit the required documents

• Provide the pre-authorisation forms to the insurer 

• The insurer will settle bills directly with the hospital

3. Reimbursement Claims

This process lets you choose your preferred hospital for treatment. Follow these simple steps:

• Pay bills upfront after your treatment

• Submit a claim with the required documents

• The insurer will reimburse you within 10-15 working days, subject to verification and policy terms

We can avoid using the word diverse here. You can compare multiple health insurance plans offered by different insurers on Bajaj Markets. These are designed to protect you and your loved ones from the financial burdens in times of medical emergencies.

• Trusted Platform

It is a reliable and trusted platform for purchasing insurance policies

• Diverse Options

The extensive network of insurance providers offers a wide range of health insurance plans to cater to various needs and budgets

• Quick Online Process

You can compare plans, customise coverage, and get your policy in just a few clicks, saving you time and effort

Having the right paperwork can significantly streamline the health insurance claim process. The following are some of the documents you may need when filing a claim:

• Duly filled claim form from the insurance company
• Discharge summary of the insured
• Prescription from the doctor, along with the receipts
• Hospital bills duly signed and stamped by the hospital authorities
• Medical reports, such as blood tests, urine tests, X-ray films, and others
• Prescription bills from the pharmacy
• Any other essential document related to the treatment

You can claim tax benefits on health insurance plans bought for yourself, your spouse, children, and dependent parents. You can claim the following deductions under Section 80D of the Income Tax Act of 1961: 

• You can claim a deduction of up to ₹25,000 if you are below 60 years old
• For senior citizens, the maximum deduction allowed is ₹50,000
• If you do not reach the above-mentioned deduction limit, you can also claim the Preventive Health Check-up (PHC) allowance
• You can get a PHC allowance of ₹5,000

The Union Government has implemented various health insurance schemes to provide access to affordable healthcare. Check details of some of such schemes below:

1. Ayushman Bharat

The Union Government launched this scheme in 2018 to achieve Universal Health Coverage (UHC). The following are some of its notable features:

• It is the world’s largest health insurance scheme, with over 55 crore beneficiaries
• You can enjoy coverage of up to ₹5 Lakhs per year per family for secondary and tertiary healthcare treatment

2. Central Government Health Scheme (CGHS)

The Union Government provides this insurance policy to the Central Government employees. Check out some of its features:

• It covers expenses incurred on hospitalisation and domiciliary care
• This scheme provides coverage for Allopathy and Homeopathy treatment 
• It is available in 71 cities, which will be expanded in the years to come

3. Pradhan Mantri Suraksha Bima Yojana (PMSBY)

This scheme offers accidental cover to citizens. The following are some of its features:

• You can benefit from this scheme if you are aged between 18 to 70 years and have a bank account
• It offers an annual cover of ₹1 Lakh for partial disability and ₹2 Lakhs for total disability or death
• The premium cost of this policy is ₹12