A health insurance policy is a written agreement between a policyholder and an insurance company where the insurer provides financial coverage to the insured for medical expenses such as hospitalisation, surgical treatments, and other healthcare-related expenses. A typical medical insurance policy in India works in two different ways- Cashless health insurance and Reimbursement health insurance.
A medical insurance policy is an important financial tool for a variety of different reasons. For instance, the best health insurance in India that has access to a wide range of network hospitals can offer the policyholder the quality treatment they need for any medical emergency. Here is a list of some important reasons why health insurance plans are a must:
Managing medical expenses is the top reason to buy medical insurance. Healthcare costs across the country have risen by a large margin over the past few years. With the best medical insurance, you will be able to financially deal with unforeseen health emergencies and treatments, and rest assured that healthcare costs will not eat away your entire savings.
While prevention is better than cure, one should always be prepared for emergencies. Hectic work schedules and unhealthy eating habits have led to an increase in diabetes and cardiovascular-related illnesses. The best medical insurance plan will ensure that you can get the best treatment for any health conditions at reputable hospitals.
Buying medical insurance in India also provides tax benefits to the policyholders, as they can claim maximum tax deductions of up to ₹75,000 as premiums paid for health insurance plans under Section 80D of the Income Tax Act, 1961.
Health emergencies can arise anytime and anywhere. With family health insurance plans, you can get the best treatment for yourself as well as your loved ones, all under a single policy and save money at the same time.
Most health insurance companies offer their customers the choice to choose the extent of financial cover they require. The cost of the insurance premiums also depends on the amount of coverage selected. This allows people from all financial backgrounds to get the level of coverage that they are comfortable paying for.
When you buy health insurance, you also have the choice to buy add-on covers on top of your health policy. These add-on covers offer specific coverages such as personal accident cover, room rent waiver, etc. You can choose and purchase the specific add-on covers that you may need to enhance your health insurance plans.
Under cashless health insurance, you can directly go to a network hospital affiliated with your insurer and get medical treatment for no cost. The hospital directly settles the treatment bills with your insurer. Under a reimbursement policy, you pay for the treatment out of pocket and then get the medical expenses reimbursed from your insurer. Now that you understand the meaning of health insurance, let’s take a look at the various components of a health policy in detail.
Check out the best health insurance options available on Bajaj MARKETS from different insurance companies like Bajaj Health Insurance, Aditya Birla Health Insurance, and Care Health Insurance:
Disclaimer: Premiums rates mentioned above for the above health insurance plans are not constant and subject to change over time.
Understanding the types of health insurance plans and their features will help you make the right choice when buying a health plan for yourself:
Medical emergencies may strike and catch you off-guard anytime. This is why it becomes critical for you to secure yourself with an Individual Health Insurance plan. This plan is designed to offer adequate coverage for medical treatment, to deal with such emergencies or unforeseen risks. With benefits like cashless treatments, pre and post hospitalisation expense coverage, cover of day care treatments and more, the individual health insurance plan is a great choice.
Moreover, when it comes to buying medical insurance, it is recommended that you buy the plan when you are young. This is because the premium payable is comparatively less when one is young, and the benefits to be reaped by the policyholder over the long run are very attractive. Hence, millennials should definitely consider buying individual health insurance.
When it is about our loved ones, we always want to go for the best treatment, especially when it comes to securing their health. While you can definitely go for individual health insurance plans for each of the family members, family health insurance seems a better choice.
With this plan, a defined sum insured coverage amount is split among the family members for treatment costs. Being a single plan that offers coverage for the entire family, you need to pay a single premium amount, making it a cost-effective choice.
Senior citizen health insurance plans are specifically desired for people above the age of 60 years. You can buy the policy for your parents or in-laws. It usually covers a wide range of critical illnesses, pre- and post-hospitalisation treatment, in-patient costs, daycare procedures, and more. Besides, if you have a senior citizen health insurance plan for your parents, you can claim tax deductions under Section 80D of the Income Tax Act, 1961.
In case you have already purchased a health insurance plan with lower coverage but wish to increase the coverage limit in the future, the most cost-efficient way to do it is by getting a health insurance top up plan. Top-up health insurance is a very valuable add-on that can help you extend your total coverage amount by a large margin while you only pay a small portion of the original cost of the health plan.
Offering group health insurance is one of the perks that employers offer their employees these days. Just like any other health insurance policy, the group health insurance plans offer coverage for medical treatment costs and more.
A large number of services have moved online over the past few years. Now, you have the option of buying or renewing your medical insurance while sitting in the comfort of your home:
Step 1: Head on to the health insurance page of the insurance company that you wish to purchase your plan from.
Step 2: Provide the necessary details about whom you wish to insure, along with your personal information.
Step 3: Pick from the list of available health insurance plans. You can also enhance your coverage by selecting the add-on covers.
Step 4: Upload the necessary documents and make your health insurance premium payment online.
Step 5: And that’s it! Your policy will be emailed to you shortly.
Health insurance renewal online in India is just as easy as buying a new plan. Check out the simple steps given below:
Step 1: On the main health insurance page of the insurer of your choice, click on the type of health insurance plan you wish to renew, i.e., individual, family, or top-up.
Step 2: Now, click on the ‘Renew Plan’ option that shows up on the screen.
Step 3: Enter your existing policy details on the page along with other necessary details and check the renewal quote.
Step 4: Upload the necessary documents and make your renewal premium payment.
Step 5: Your plan will be renewed shortly and details will be sent to your registered email.
Calculating the insurance premiums you will have to pay for any plan is really easy with the help of a health insurance premium calculator. All you need to do is enter relevant information like your age, gender, weight, location, amount of coverage needed and other necessary data. The premium calculator uses your data to provide an accurate estimate of the amount you will need to pay in the form of health insurance premiums.
Inclusions refer to the variety of diseases and medical conditions for which the treatment/hospitalisation costs are covered by the health insurance policy. On the other hand, exclusions are those medical conditions or situations for which the health insurance policy does not provide any coverage for medical treatments. Let’s take a look at the common inclusions and exclusions under medical insurance in India.
Coverage for treatment costs incurred during pre & post-hospitalisation procedures so you need not worry about your hospital bills.
Expenses incurred for day care treatment and procedures that require short-term hospitalisation are also covered.
Expensive organ donation procedure treatments are taken care of by health insurance plans.
The daily hospital cash benefit takes off the burden of the sudden hospitalisation expenses, so you need not face the last minute hassle of arranging additional cash.
Avoid an unexpected ambulance bill while you go to or return from a hospital in times of an emergency with ambulance cover.
Pre-existing diseases without the completion of the waiting period (which is typically 2-4 years) are not covered under the policy. However, check with your insurer for the same before raising any claim requests.
Treatment cost for injuries caused due to war-like scenarios, nuclear activity, suicide attempts, and terrorism is not covered.
Dental procedures unless arising due to an accidental injury are not covered.
Medical emergencies arising due to consumption of intoxicants and/or addictive substances like drugs, alcohol, etc. are not covered.
Injuries when participating in naval, military or air force operations or dangerous sports like racing and driving are not covered.
Health insurance is one of the most powerful tax-planning instruments. With health insurance plans, you can avail several tax benefits under Section 80D of the Income Tax Act, 1961. Here’s a quick walkthrough of the same.
Description |
Tax Deduction on Premiums for Self, Spouse and dependent children |
Tax Deductions on Premiums for Parents |
Persons below the age of 60 years (Section 80D, Income Tax Act,1961) |
Up to ₹25,000 |
Up to ₹25,000 |
Senior citizens/People above the age of 60 years (Section 80D, Income Tax Act, 1961) |
Up to ₹50,000 |
Up to ₹50,000 |
Note: The deduction for parents is over and above the maximum deduction allowed for an individual and his/her family.
Additional Deductions: You can claim an annual deduction of up to ₹5,000 on expenses incurred for health check-ups. This includes the check-up expenses of all members of a family – self, spouse, children and parents.
Understanding the claim settlement process is also important before you buy the best health insurance policy for you. Knowing your plan’s claim details is critical so that you can make the most of your medical coverage. Here’s how to file both cashless health insurance claims and reimbursement claims:
Step 1: Visit your provider’s network hospital. Submit policy details and take the pre-authorisation form.
Step 2: The insurer verifies the form and the hospital is notified about the details of the policy.
Step 3: Once discharged, the hospital will send the bill along with discharge papers to the insurer.
Step 4: The claims are then directly settled with the hospital, after reducing the co-payment, if any.
Step 1: Submit all original medical documents and hospital bills and insurance claim form to the insurer.
Step 2: The insurer evaluates the details and may ask for any additional information, if required.
Step 3: On receiving all the documents, your claim decision is made.
Step 4: You will receive the claim amount based on the policy terms and conditions.
You will need to submit the following documents to the insurer in order to make a health insurance claim:
Duly filled the claim form
Medical Certificate
Original copy of hospital discharge summary or card
Prescription and cash invoice from pharmacies and the hospital
Investigation report by the doctor
FIR or Medico Legal Certificate (MLC), in case of an accident
With the Bajaj MARKETS app, you can now apply or renew health insurance from the comfort of your house. It is an effortless process. Follow the below steps to get started:
Step 1: Enter the personal details of the individual
Step 2: Get a quote from the representative about the various options available
Step 3: Choose a plan that suits your requirement and budget. Enhance the coverage by selecting add-on covers
Step 4:Upload the necessary documents and pay the health insurance premium online
That’s all. The policy will be emailed shortly after you make the payment.
One way you can increase your health insurance coverage is by buying a health insurance top-up plan.
Yes, you can buy Bajaj Health insurance plans and health insurance from other companies online.
If you are looking for the best cashless mediclaim family policies on Bajaj MARKETS, check out the plans offered by:
Bajaj Allianz Health Insurance
Care Health Insurance
Aditya Birla Health Insurance.
A health insurance policy protects the policyholder against the financial costs of medical treatments and hospitalisations. You can buy medical insurance online at Bajaj MARKETS or from other reputed insurance companies and aggregators.
The best medical insurance plans come in many types:
Individual health insurance
Group health insurance
Top-up health insurance
Senior Citizens' health insurance
Family Health Plans
You can compare the best medical insurance online on the basis of important factors such as the price, the amount of coverage offered, inclusions and exclusions, reviews, the reputation of the insurer, etc, and then decide the best health insurance for you.
The government has several state and national government healthcare schemes that you can apply for, such as:
Ayushman Bharat Scheme
Pradhan Mantri Suraksha Bima Yojana
Aam Aadmi Bima Yojana
Employee State Insurance Scheme
Rashtriya Swasthya Bima Yojana
Yes, of course. Not just you, but your family too needs the best health insurance in India. Medical expenses are increasing significantly, and it is hence sensible to invest in a health insurance plan, irrespective of your age.
Your health insurance premiums mainly depend upon the following factors:
The type of cover chosen
Amount insured selected
Amount limit (if selected)
Add-ons you choose (optional covers).
Your health insurance plans will cover the pre and post-hospitalisation expenses. These expenses include:
In-hospital expenses, hospital room rent and boarding expense
Cashless treatment in-network hospitals across India
Charges for medical examination
Physician fees and doctor’s consultation fees
Charges for the ambulance
A pre-existing disease is any ailment or health condition for which you have been diagnosed or received medical advice/treatment before buying your first health insurance plan with the insurer. These could be anything ranging from blood pressure to diabetes to cancer to any other disease/ailment.
The waiting period in a medical insurance plan refers to the duration after which you can make a claim on your health insurance plan for a pre-existing medical condition or disease.
A health card is a kind of identity card that comes along with your health insurance plan. This card will enable you to avail cashless hospitalisation facility at any of the network hospitals.
It is best to finish the health insurance renewal online process before its expiry date. In the best medical insurance plans, insurers usually offer a grace period of 30 days (after the expiry date of the plan), within which you can renew the plan without having to apply afresh. However, it is suggested that you pay your renewal premium while your plan is still in force so that you can enjoy uninterrupted coverage.
In the event of your policy getting rejected, you can avail premium reimbursements within the next seven working days. However, your medical check-up expenses will not get reimbursed.
When the claim is filed and settled, the coverage amount will be reduced by the amount that has been paid to you (claim). Your medical insurance plan will continue to be in existence with the remaining coverage amount.
Yes, there are tax benefits under the Income Tax Act, 1961. Every taxpayer can avail an annual deduction of up to ₹50,000 from their taxable income for health insurance premiums paid for self and dependent family members.
The right amount of health insurance coverage depends upon several factors like the type of hospital you prefer, your current age and health conditions, your affordability, etc. It is advised to have health insurance cover of at least 50% of your annual income.
Our partners have tie-ups with over 6,500 network hospitals across India and the details of those hospitals are available in the download section.
Read more:
Network hospitals for Bajaj Allianz Health Insurance
Network hospitals for Aditya Birla Health Insurance
Daycare medical treatments are those medical procedures (surgeries or treatments) that can be completed in less than 24 hours. In such cases, even though you are hospitalised, you do not need to stay in the hospital for more than 24 hours.
Pre and post hospitalisation medical expenses cover refers to the feature when the insured is covered against relevant medical expenses incurred for a certain number of days, both before and after the event of hospitalisation.
The best health insurance in India does cover the cost of diagnostics tests such as MRI, X-Ray and more, if the patient is admitted for more than 24 hours for a disease that is covered under the insurance policy. However, it is a good idea to check the policy details before buying.
Maternity cover is provided under the best health insurance in India. However, if you are already pregnant at the time of buying the medical insurance plan, it will be considered a pre-existing condition and will not be covered.
Yes, you can add a family member to your medical insurance plan as long as you have a family insurance plan or a plan where you have the option to add dependents. You cannot add a family member to your plan if you have an individual health insurance policy.
A mediclaim policy provides financial coverage only for hospitalisation, accident-related coverage and coverage for pre-determined diseases. On the other hand, health insurance is a much more comprehensive policy that also covers expenses such as pre and post hospitalisation charges, room rent, ambulance expenses etc.
As a general rule, financial advisors recommend that you should get health insurance coverage equal to at least 50% of your annual income, or a minimum health cover of at least ₹5 lakhs.
Ideally, it is better to get the main health insurance policy with a coverage of ₹25 lakhs and then purchase a top-up coverage of 20-25 lakhs as the top-up coverage policy will be cheaper than buying a ₹50 lakh health insurance plan.