Health Insurance

Health insurance is the best way by which one can get a cover against medical expenses and protects their savings. A health insurance policy is a form of medical insurance cover that provides complete protection against the cost of medical treatment and emergency hospitalization. It covers medical expenses and hospital bills in case of an accident, medical emergency or illness.

Be it for you, your parents or your entire family, every individual can be covered at the cost of an affordable premium. In addition, you can also purchase a COVID19 specific health cover plan .

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Mediclaim Plans starting @ Rs 350 / month

What does Health Insurance offer?

As mentioned above, a health insurance coverage plan is designed to provide financial protection in case you, your parents or any one of your family members require planned or emergency hospitalization.

The cost of medical treatment is covered under your health plan that is provided by a general insurance company. In addition, you can avail of cashless as well as reimbursement mode of payment at a nearby/network hospital.

Importance of Health Insurance Plans

  • In the wake of an ever-increasing demand for quality healthcare services, medical treatment has become expensive, particularly in private hospitals, the hospital bills are efficient enough to drain one’s savings.
  • A health insurance plan is the only way as it provides coverage to the insured, his parents and his other family members against the huge medical treatment expenses which become payable due to an accident or illness.
  • Besides the medical coverage, a health insurance plan also offers tax benefits on premium paid upto Rs. 75000/- under section 80D of the Income Tax Act, 1961.

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Best Health Insurance Plans 2021 in India

Here is a comprehensive list of top health insurance plans.

Health Insurance Plans Sum Insured (Rs.) NETWORK HOSPITALS NETWORK HOSPITALS
HDFC ERGO my:Health Suraksha Min-3Lakh - Max- 50 Lakh
69.01
10,000+
HDFC ERGO General Insurance Optima Restore Min-3 Lakh - Max- 50 Lakh
73.69%
10,000+
Star Family Health Optima Plan Min-1 Lakh - Max- 25 Lakh
65.91%
4,500+
Care Health Care Plan Min-4 Lakh - Max- 6 Crore
59.13%
5,000+
United India UNI Criticare Health Plan Min-1 Lakh - Max- 10 Lakh
104.24%
7,000+
Bajaj Allianz Individual Health Guard Plan Min - 1.5 Lakh - Max - 50 Lakh
81.96%
6,500+
Chola Healthline Plan Min-2 Lakh - Max- 25 Lakh
40.67%
7,240+
ManipalCigna Prohealth Plus Min-2.5 Lakh - Max- 1 Crore
61.64%
6,500+
Aditya Birla Active Assure Diamond Plan Min - 2 Lakh - Max - 2 Crore
49.08%
8,200+
SBI Arogya Premier Policy Min-10 Lakh - Max- 30 Lakh
NA
NA
Digit Health Insurance Plan Min- Lakh - Max- 25 Lakh
NA
NA
Future Generali Criticare Plan Min-5 Lakh - Max- 50 Lakh
NA
NA
IFFCO TOKIO Health Protector Plus Plan Min-2 Lakh - Max- 25 Lakh
95.66%
6,400+
Royal Sundaram Supreme Policy Min-5 Lakh - Max- 50 Lakh
63.55%
5,000+
Universal Sompo Individual Health Plan Max- 10 Lakh
76.68%
4,000+
Bharti AXA Health Insurance Min - 3Lakh - Max - 5 Lakh
77.50%
4,500+
Oriental Individual Mediclaim Policy Min-1 Lakh - Max- 10 Lakh
104.97%
4300+
Max Bupa Health Companion Min-3 Lakh - Max- 1 Crore
53.51%
7,000+
Reliance Critical Illness Plan Min-5 Lakh - Max- 10 Lakh
89.36%
7,300+
Liberty Health Connect Supra Top-up Plan Max- 1 Crore
NA
NA
National Parivar Mediclaim Plus Policy Up to 50 Lakh
103.30%
6,000+
Tata AIG MediCare Plan Min-2 Lakh - Max- 10 Lakh
66.61%
6,000+
Edelweiss Health Insurance Plan Min-5 Lakh - Max- 1 Crore
NA
NA
Raheja QBE Health Plan Min-1 Lakh - Max- 50 Lakh
85.07%
5,000+

Disclaimer: The above table has been compiled by sourcing information from the insurance company’s website. The Incurred Claim Ratio has been sourced from IRDAI Annual Report 2018-19. Last Updated 15-04-2021.

Key Benefits of Health Insurance Plans

Here are some important advantages of buying a health insurance plan:

• Cashless Claim Facility

    Now no more worrying about how you will arrange money in case you or your loved ones get hospitalized to face a medical emergency. Health Insurance Plan provides you cashless facility by which you can avail treatment at network hospital without spending anything from your pocket.

• Pre and Post-Hospitalisation Cover

    All the expenses incurred before getting hospitalized for a period of 60 days and after getting discharged from a hospital for a period of 90 days are covered.

• No Claim Bonus

    Had a claim free year! congratulations you will receive a No Claim Bonus in the form of an increment in the sum insured at the same premium or a discount on the premium cost.

• Ambulance Cover

    The ambulance charges for transferring the patient to the hospital are covered upto a specified amount say Rs. 5000/- or upto a certain limit like 1% of the sum insured capped with a maximum amount.

• Tax Benefits of Health Insurance Plans
SCENARIO DEDUCTIONS
Health Insurance Plan for Self
Rs. 25,000/-
Health Insurance Plan for Self and Spouse
Rs. 25,000/-
Health Insurance Plan for Self, Spouse, dependent children up to age 25
Rs. 25,000/-
Health Insurance Plan for Parents
Rs. 25,000/-
Health Insurance Plan for Senior Citizens
Rs. 50,000/-
Health Insurance Plan for Self, Spouse, dependent children up to age 25 and Parents
Rs. 50,000/-

(Rs. 25,000/- + Rs. 25,000/-)
Health Insurance Plan for Self, Spouse, dependent children up to age 25 and Parents
Rs. 75,000/-

(Rs. 25000/- + Rs. 50,000/-)
Health Insurance Plan for Self and Parents (All Senior Citizens)
Rs. 1,00,000/-

(Rs. 50,000/- + Rs. 50,000/-)

    *The tax benefits are subjected to changes in tax laws.

Free Health Check-ups

    You and your family members also become eligible for free health checks at the nearest network hospital of the insurance company.

• Pre-Existing Disease Cover

    If you or any of your loved ones are already suffering from any medical condition you need not worry, you can still buy a health insurance plan. The existing diseases and medical condition will be covered post a waiting period which ranges from 24 to 48-months depending upon the disease, insurer and insurance plan.

Is Coronavirus Covered by Your Existing Health Insurance?

    The answer is yes, your existing health insurance policy covers the expense of COVID-19 treatment.

  • Apart from this IRDAI has directed insurance companies to launch two special standard health insurance products, namely Corona Kavach and Corona Rakshak, were launched.

  • • Corona Kavach Policy

  • It covers coronavirus hospitalization (minimum 24 hours) cost, home treatment expenses, and AYUSH treatment bills up to Rs 5 Lakh. The cost of consumable items like gloves, masks, ventilators, oxygen cylinders, PPE kits is also covered.
  • The benefits provided under the Corona Kavach policy shall remain the same across all the insurance providers.
  • Eligibility Specification
    Entry Age 18-65 years
    Coverage Type Individual/Family floater
    Sum Insured (Rs.) 50,000-5,00,000
    Discount on Premium 5% for health workers and doctors

    • Corona Rakshak Policy

  • On being diagnosed with Coronavirus during the policy term It gives a lump sum payment on hospitalization (for a minimum period of 72 hours) The policy duration is minimum of 3.5 months and a maximum of 9.5 months.
  • Eligibility Specification
    Entry Age 18-65 years
    Coverage Type Individual
    Sum Insured (Rs.) 50,000-2,50,000
    Discount on Premium 5% for health workers and doctors

    Its Simple and Instant

    Health Insurance Inclusions

    Here are some common health insurance plans inclusions:

    • In-patient hospitalization expenses
    • Pre and post hospitalization expenses
    • Pre-existing diseases, illnesses and medical conditions
    • In the case of organ transplantation, donor expenses are covered
    • During injuries requiring overnight hospitalization
    • Ambulance Cost
    • Maternity Expenses and Newborn Medical expenses
    • Health check-ups
    • Daycare procedures
    • Domiciliary hospitalization i.e. Treatment taken at Home

    Health Insurance Exclusions

    Following are common health insurance plans exclusions:

    • A waiting period of 2 to 4 years for pre-existing illnesses
    • Injuries caused by war/terrorism/suicide attempt/nuclear activity
    • Clear exclusion of costs incurred for maternity/newborn unless a maternity rider has been added on
    • Terminal illnesses, AIDS, and any other similar diseases
    • Plastic/cosmetic surgery, sex change, replacement of hormones, and more
    • Eye or dental surgery
    • Hospitalization and rehabilitation/bed rest, common illnesses, etc.
    • Non-allopathic treatment
    • Treatment/diagnostic tests and post-care procedures
    • Getting treatment abroad or by an under-qualified medical professional

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    Factors to Consider Before Buying Health Insurance Plans

    There are some factors that need to be considered closely to make the right decision:

    ● Caps and Sub-limits

    ● Cover offered

    ● Life-Long Renewability

    ● Network Hospitals

    ● Claim Record

    ● In-house Claim Settlement Team

    ● Restore Benefit

    ● Waiting Period

    Which Health Insurance Policy Should You Buy?

    An ideal health insurance plan for you is the one that offers you the desired coverage, here we have compiled a few health insurance plans based on some of your needs:

    Your Requirement Health Insurance Policy you Should Get
    Cover for In-patient hospitalization expenses, inclusive of surgical bills Health insurance providing cashless and reimbursement claim facility
    A constant amount daily while you are hospitalised Hospital Cash Plan
    If diagnosed or hospitalised with a critical illness or if the disease is leading to loss of income Critical Illness Plan
    When an accidental disability leading to the loss of income Personal Accident Insurance
    Coverage for expenses in the event of cesarean and normal delivery Maternity Insurance
    Insurance coverage for the whole family in a single plan Family Floater Health Plan
    Coverage for senior citizens Senior Citizen Health Insurance

    Health Insurance Eligibility Criteria

    Health insurance policy eligibility criteria depend on pre-existing illnesses (if any), current medical conditions, the customer’s age, etc. The health insurance companies also conduct a medical test to check if the applicant already has some health diseases or not. Commonly these eligibility criterion needs to be met:

    • Age Criteria:
    • The entry age for Adults: 18 to 65 years (70 and above, depending on the plan and the insurer).
    • The entry age for Children is 90 days to 18 years, and in some plans, it goes up to 25 years.
  • Pre-medical Screening: In most cases, the applicant’s age has to be above 45 years, but it might vary depending on the insurer and the kind of medical insurance plan. Most senior citizen health plans need pre-medical tests to determine if the applicant meets the eligibility criteria for insurance cover. The criterion for an individual and family floater health plans might vary according to the policy terms and conditions.
  • Pre-existing Diseases: While buying a health insurance policy, you must inform the insurer about the health diseases you have or any pre-existing illness that you or your family members have. It would be best if you did not keep it a secret as it can create problems at claim settlement time. It can even lead to the rejection of your claims.</p>
  • Most health insurers question the applicant if they have any medical conditions such as blood pressure, diabetes, kidney problems, cardiovascular diseases, and other diseases. You also have to inform about your smoking or alcoholic habits (if you have the habit); based on these factors, the insurance company will decide if you are eligible to get medical cover or not.

    If one insurer rejects your application, you can also check with another or buy a specific health plan as per your medical conditions. Check the policy for terms and conditions to have a better understating of the eligibility criteria.

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    Why Compare Health Insurance Plans?

    A comparison of health insurance policy can be difficult, we completely understand. That is why we have created our platform which specializes in making insurance simple for you.

    There is no point in comparing something of which you know nothing about. With Coverfox on board, just sit back and relax. Let us do the hard work for you. Comparing Health Insurance on our platform is very easy. We have a detailed page that explains you the importance, benefits of comparison. You also get to know how you can perform quickly.

    How to Compare Health Insurance Plans?

    With over 25 insurance companies and more than 200 health insurance products available in India, performing a comparison of various benefits, features of health insurance plans and finding the best quote becomes a daunting task. Here are some important tips to make an informed decision:

    • Select the Appropriate Sum Assured
    • The country’s healthcare inflation is rising and is increasing at the rate of 17% to 20% annually. To take care of growing expenses in health care, it is essential to select the maximum available sum insured at the best possible premium rate.

    • Provide Complete & Right Details
    • Provide correct information about your health in the proposal form, as any inaccurate information can make the insurer reject your claim form.

    • Remember the Factors That Influence the Premium
    • Some elements that influence a health insurance plan’s premium include the sum insured, proposer’s age, medical history, family health history, lifestyle, smoking habits, etc. These factors are considered before the premium amount is determined.

    • See the Credibility of the Health Insurance Company
    • Check the history of the health insurance company from where you are planning to buy your health insurance plan. It is best if you select the health insurance company based on the following parameters:

      • ICR: Incurred Claim Ratio or ICR falls under one of the most important parameters to check while comparing India’s health insurance companies. Considering the ICR of a health insurance company, look for the average ICR of all the health insurance companies online on Coverfox.com and go for the one closest to this average for few years.
      • Customer Experience: You should always consider the mass opinion. Look for customer reviews online.
      • Know about the Claim Process: Although a health insurance claim process is the same across most insurance providers, knowing the process can help save much hassle at the eleventh hour.

    Benefits of Comparing Health Insurance Plans Online

    Due to busy schedules these days, it has become challenging to visit different health insurers’ offices or branches to compare various medical insurance policies.

    You don’t have to worry as Coverfox understands the dilemma of the customers and hence, has a tech-enabled platform that helps you compare different health insurance quotes online.

    Listed below are some of the advantages of buying a health insurance plan online:

    • Access to Right Information: Provides easy access to every medical insurance policy available in the market, saving the buyers from the pain of dealing with the agents who are known to provide unreliable and biased information most of the time.
    • Time Efficient and Convenient: This process saves the user’s time. You no longer have to keep meeting agents to compare and choose the best plans. Additionally, paying premiums, renewing the health insurance plans, etc., are also more accessible via online mode.
    • Pocket-Friendly: If a customer buys a health plan online, he/she can then compare the premium and choose the one that fits in the budget with no brokerage or agent fees, saving a significant amount of money.
    • Availability of Provider/Plan Reviews: Reviews will aid in getting an overall idea of an insurer’s reputation, assisting in making an informed decision.

    Arogya Sanjeevani Policy: A Health Insurance for All

    Arogya Sanjeevani is a health insurance policy offered by every Indian health insurance company. Arogya Sanjeevani policy covers your primary health insurance needs. It is a good option for those who do not have medical insurance cover, particularly in smaller towns.

    As mandated by the IRDAI, the Arogya Sanjeevani policy offers health cover ranging from Rs. 1 lakh to Rs. 5 lakhs. A primary waiting period of 30 days is applicable from the date of policy issuance. The waiting period for specific illnesses ranges from 24 months to 48 months, depending on the disease.

    Benefits of Buying Arogya Sanjeevani Policy:

    • The policyholder under Arogya Sanjeevani gets coverage for Coronavirus related hospitalization expenses.
    • It reduces the complications that crop up while selecting from several health plans with varied inclusions, exclusions, and sum assured. Therefore, it is easier for ordinary people to buy a health cover without any difficulty to understand the policy terms and conditions.
    • Lifelong Renewal facility, No Claim Bonus (NCB), Cashless hospitalization is provided.
    • Easily portable from one insurer to another.

    Features available under an Arogya Sanjeevani Plan:

    • Arogya Sanjeevani plan provides cover for people aged 5 months and 65 years.
    • It has a minimum sum insured of Rs. 1 lakh, and the maximum sum insured is Rs. 5 lakhs. It is an ideal health plan for people who live in rural areas and cannot pay a larger premium.
    • Cover for in-patient hospitalization expenses, daycare treatments, ICU expenses, Ayush treatment, Ambulance charges, Cataract treatment etc.
    • 5% co-pay is applicable irrespective of the age of the policyholder.

    How to Port a Health Insurance Policy?

    You don't have to continue with your current health insurance provider if you do not want to since IRDAI now allows you to change your insurer without losing any existing or accumulated benefits.

    Now IRDAI allows you to switch from one insurer to another while the new insurer will have to consider the credits you have gained from your previous insurer, where the credits refer to the completed waiting period in pre-existing conditions. The same thing applies if you switch from one plan to another within the same insurance company.

    • What can you do
    • Switch from health insurance companies.
    • Family floater/individual policy can be switched.
    • Get insurance cover by your new insurer up to the sum assured as the old policy has.
    • Both insurers should mutually complete the formalities as per the IRDAI timeline.
    • Criteria
    • A policy can be ported at the time of renewal only.
    • There must not be any break between policy renewals.
    • You need to submit a formal porting request to your current insurer at least 45 days before the renewal’s due date.
    • With a new policy, the terms and conditions and the premium are at the new insurer’s discretion.
    • You must mention the name of the new insurer you are willing to switch to.

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    Some Myths about Health Insurance

    Before believing the information, it is imperative to check the facts and then buy a health insurance policy. Here are a few popular myths that most people believe about health insurance policies:

    I am Healthy; therefore, I Don’t Need a Health Insurance

    Even if you are healthy, there are many unforeseen circumstances like seasonal illnesses, malaria, dengue, or an accident that can hit anyone at any time. These days, hospitalization expenses are not easy to pay. Even 2-days of hospitalization would cost you between INR 60,000 to INR 1 lakh and even more (depending on the illness).

    My Health Insurance will provide for all the Medical Expenses

    According to the IRDAI regulations, all health insurance plans come with a set of exclusions/limitations. You must check all the policy details mentioned in the plan. The insurer will only cover the expenses covered in the policy and up to the specified limit only.

    Declaration of Pre-existing Diseases

    You must declare all the pre-existing diseases in the proposal form before buying a health insurance policy. Inadequate information can lead to claim rejection and can cost you more than the expected amount.

    Smokers can not Buy a Health Insurance Plan

    According to the survey, almost 49% of the applicants who consume alcohol or smoke are perplexed to buy a health insurance policy. But some health insurance companies give medical insurance coverage to them. But considering the risks, alcohol consumers and smokers will have to undergo a stringent pre-medical examination process and pay a higher premium to get health insurance coverage.

    Medical Insurance will only Include Hospitalization Expenses

    Although most of the health insurance plans cover medical expenses towards hospitalization for more than 24-hours, some plans have a capping on the duration of hospitalization. But most of the insurers cover daycare procedure where you don’t have to be hospitalized for 24-hours. It includes cataract surgery, varicose vein surgery, and similar medical procedures.

    I am Covered by a Group or Corporate Health Insurance Plan!

    Most people depend on the health insurance plan that their employer provides. You should be well aware of the fact that a group health insurance policy comes with limitations. Group health insurance policy will not offer coverage to all your family members in most cases; the sum assured will generally not be sufficient, and it will not cover critical illnesses.

    How to Calculate Health Insurance Premium

    It is essential to pay a fixed premium regularly in order to keep the policy in force. Have you ever wondered how this premium is calculated? Certain factors affect health insurance premiums like your family’s medical background, your personal medical history, and so on.

    Depending on that, you might want to calculate your premium to know how much you would have to pay for the policy. It can be done via a health insurance premium calculator. A premium calculator is an online tool that calculates the premium to be paid as per your information. At Coverfox.com, you can calculate your health insurance premium easily.

    Factors Affecting Health Insurance Premium

    As the medical facilities are advancing, so are the health care costs. The primary benefit of health insurance is that it takes care of healthcare costs. It gives financial security to you and your family if any unanticipated serious illness or accidental injuries draining all your savings. Learn how the cost of your insurance premium is determined:

    • Medical History: Medical history is a major determinant of the health insurance premium. Pre-medical tests are mandatory by almost all health insurance provider in India (after a certain age) before buying a health insurance policy. While a few insurance companies don’t make medical screening mandatory, they consider your current medical conditions, lifestyle-related health risks, and the medical history of your family. That is the reason why medical insurance premium for smokers is higher than other people.
    • Gender and Age: Age is an important aspect of determining the medical insurance premium. The premium differs based on the age of the insured person. That is why it is suggested to buy a policy at a young age because the premium cost is low for young applicants. Older adults are vulnerable to cardiovascular diseases and other critical illnesses like kidney problems, cancer, etc.; thus, senior citizen medical insurance premium is generally higher. Additionally, the cost of the premium for women’s health insurance is lower than the male candidates due to the lower risk of stroke, heart attack, etc.
    • Policy Term: The premium for a health insurance plan for 2-year will be more than a 1-year plan. However, nearly all insurance companies offer a discount on long-term medical insurance plans.
    • Type of Health Insurance Plan: The kind of health insurance policy you choose also changes the cost of the premium. The higher the risks, the higher will be the premium and vice-versa. An online health insurance premium calculator will help you compare the premium for different health insurance plans.
    • No-Claim-Discount: If no claims are made from your end in your policy term, you can earn NCB or No-claim-bonus from 5 to 50 per cent. This is also considered to be one of the most important factors that are considered while calculating the cost of the premium.
    • Lifestyle: If you regularly drink or smoke, the chances are high that you will be charged a more premium amount. In that case, the insurer can even reject your medical insurance policy request.

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    Health Insurance Claim Procedure

    Health insurance plans have additional benefits of cashless treatment and expense reimbursement by the insurer. You can check out the entire claim settlement process in detail and know about the documents required for making a claim on our dedicated page, " Health Insurance Claims "

    Documents Required for Health Insurance Claim Reimbursement

    If the policyholder is hospitalization he/she needs to submit certain documents as mentioned below for making a reimbursement claim:

    • Discharge card provided by the hospital
    • In-patient hospitalization bills signed by the hospital for authenticity
    • The doctors’ prescriptions, along with medical store bills
    • Claim-form signed by the insured
    • A valid investigation report
    • Doctor's prescribed consumables and disposables with complete details
    • Doctor's consultation bills
    • Copy of the previous year insurance policy and the current year/copy of ID Card of TPA
    • Any other document(s) needed by the TPA

    Buy Top Health Insurance Plans Online from Coverfox

    Buying health insurance can be hassle-free if you approach the right channel. Having said this, Coverfox.com provides you with a tech-enabled platform where you can compare the best health insurance and then can choose the one the suits your requirement. Well, visit Coverfox and get expert advice along with an informed, unbiased opinion that will clear all your doubts and help you buy the perfect plan. Moreover, enjoy the attention of a service manager who will assist you with all your post-sale requirements- from claims processing to renewals! What more can you hope for?

    How to Buy Health Insurance Plan Online from Coverfox

    Now buy health insurance online in no time from Coverfox. Here are the steps to buy medical insurance:

    • Step 1: First select gender (Male/Female) and enter your full name
    • Step 2: Feed in your correct phone number, and then click on view plans and select your age
    • Step 3: Now click on continue and enter your city where you are living in along with the pin code
    • Step 4: Select Yes or No if you take any medications
    • Step 5: Choose the best health insurance plan from the options that are displayed.
    • Step 6: Now select and compare the different health insurance plans on Coverfox. You can also choose the personalized plans options
    • Step 7: Once you select the plan, you can pay the premium or speak to our customer care representative to take you through different options
    • Step 8: Do make an informed decision and pay the premium. Once all the steps are done, the policy will be emailed on your registered email-id

    Its Simple and Instant

    List of Health Insurance Companies in India

    To ensure the best and convenient buying experience for you, we have made a list of General Insurance Companies in India. This list is created based on the Incurred Claim Ratio (ICR) and the overall health insurance policy benefits that they are offering:

    Let’s go through these Health Insurance Providers in detail.

    Aditya Birla Health Insurance

    Bajaj Allianz General Insurance

    Bharti AXA General Insurance

    Chola MS General Insurance

    Digit General Insurance

    Edelweiss General Insurance

    Future Generali Insurance

    HDFC ERGO General Insurance

    Its Simple and Instant

    What Affects the Price of Your Health Insurance Policy?

    To begin with, let us understand what premium is all about. A health insurance premium is the annual cost of the insurance plan. It is the cost of providing health cover (an amount you pay to buy your coverage).

    For example, suppose you buy a new health insurance policy for Rs. 1500 per year for a cover of Rs. 5 lakhs. As per this plan, Rs. 1500 is the premium amount which you have to pay every year and Rs. 5 lakhs is the financial cover you get by paying Rs. 1500 as premium for a single year.

    Check our page on Health Insurance Premium Calculator to know in detail factors that affect your health insurance premiums.

    Tips to Decide Which Health Insurance Policy to Buy?

    Your Requirement What you Should Get
    Protection from hospitalization expenses, inclusive of surgical bills Health insurance plan with the cashless facility and claim reimbursement.
    Protection from medical bills and hospital expenses for the whole family. Family Floater Health Plan
    Coverage for senior citizens Senior Citizen Health Insurance
    Daily amount to meet hospitalization expenses Hospital Cash Plan
    Financial aid to fight a critical illness Critical Illness Plan
    Help in meeting Maternity and New Born Baby medical expenses Maternity Insurance

    Its Simple and Instant

    Frequently Asked Questions

    • Q. Define Health Insurance?
      • Health Insurance, in its simplest term, is an arrangement between you and the insurance company. The insurance company provides a financial safety net to your savings by taking care of all your medical expenses in return for a small amount paid by you called a premium.

    • Q. Explain the working of a health insurance plan?
      • Under a health insurance plan, when you make a claim, the insurer checks the illness for which claim is made against the illnesses covered under the plan. If the illness is covered, the insurer accepts the request for a cashless claim at a network hospital or reimburses the treatment expenses upto the sum insured amount.

    • Q. Name the best health insurance plan in India?
      • We have compiled a list of the best health insurance plans available in India for you. Click here to check the same. (https://www.coverfox.com/health-insurance/)

    • Q. What is the importance of health insurance?
      • Health insurance protects your savings from the cost of medical treatment expenses. It helps you get good quality health care services at the best hospitals and medical treatment facilities without worrying about huge bills. It also helps reduce your tax liability.

    • Q. How much does an individual have to pay annually for a health insurance plan?
      • The premium for a health insurance plan for a 30-year-old male for a sum insured of Rs. 4 Lakhs residing in Mumbai starts from Rs. 3425/-. The cost for a health insurance plan varies from person to person and insurer to insurer. It depends on factors like sum insured, family members, covered, age, etc. You can check the premium applicable by using our free calculator.

    • Q. At which age should one buy a health insurance plan?
      • Yesterday was the right time to buy a health insurance plan. You should purchase health insurance at the earliest possible. This way, you can get a high sum insured at the cheapest rate. Buying a health insurance plan early also helps you complete the applicable waiting period when you are healthy.

    • Q. Am I allowed to buy more than one health insurance policy?
      • Yes, you can have multiple health insurance policies if you like. You can get an individual health insurance policy and at the same time also be covered with a group health insurance plan provided by your employer. You can also increase your health insurance cover with a Super Top-Up Plan or a critical illness plan.

    • Q. Is it mandatory to undergo a medical test to buy a health insurance policy?
      • NO, if you are below the age of 45 years, then undergoing a medical test for buying a health insurance plan is not mandatory for you. This requirement may vary from insurer to insurer, health insurance plan variant, sum insured, etc.

    • Q. How much does an individual have to pay monthly for a health insurance plan?
      • A 30-year-old single person residing in Mumbai can get a health insurance plan starting from just Rs. 300/- per month for a sum insured of Rs. 4 lakhs. The premium depends on the sum insured, health insurance plan chosen, insurer, age and other applicable factors.

    • Q. How many claims can I make under a health insurance plan?
      • Generally, there are no restrictions on the no. of claims you can make in a policy year. It is best to go through the policy document to know about the exact no. you are allowed in your health insurance plan.

    • Q. Which diseases are excluded or not covered in the health insurance plan?
      • Terminal illnesses, AIDS, Internal Congenital diseases, Diseases of the gall bladder including cholecystitis, all forms of Cirrhosis, and any other similar diseases are generally not covered under a health insurance plan. You can go through the policy document to check out the complete list.

    • Q. Why should I buy Health Insurance?
      • There is a constant rise in health insurance costs. Today inflation in the health insurance sector has reached double digits. Getting treated at a private hospital means emptying your bank account. Health insurance is the best way of getting the best in class health service and keeping your savings intact at the same time.

    • Q. Is cancellation of a health insurance plan possible? If yes, will my premium be refunded?
      • Yes, you can cancel your health insurance plan during the free look period of 15 days. Suppose you cancel your policy during the 15 days free look period. In that case, you will get your premiums back after deduction of medical examination charges borne by the company and the stamp duty charges.

    • Q. What is the waiting period in a health insurance plan?
      • The waiting period is the no. of days mentioned by the insurance company during which a claim will not be accepted for the defined illness. There are 3 types of waiting periods applicable under a health insurance plan, i.e. Initial waiting period of 3 months, pre-existing diseases waiting period of 24 - 48 months, a disease-related waiting period of 24 or more months.

    • Q. Does a health insurance plan cover outpatient expenses?
      • Yes, health insurance plans offer cover for outpatient expenses like OPD charges for doctors consultation. Not all health insurance plans provide cover for these expenses, so it is wise to check the product brochure before buying the plan.

    • Q. When will I be allowed to make a claim on my health insurance plan?
      • You can file a health insurance claim in case of an accident or when any covered members require medical treatment. If the disease or treatment expenses are covered under the health insurance plan's scope, you can make a claim.

    • Q. What is a No-claim-bonus under a health insurance plan?
      • No-Claim Bonus is a benefit given by the insurance company to the policyholder for having a claim-free year, i.e. not claiming in the previous year. This benefit is in the form of an increase in the sum insured by 5% or 10% at the same premium.

    • Q. What is the cost of a health insurance plan?
      • The cost of health insurance depends on various factors like sum insured, age, geographical location, medical history, no. of members covered, morbidity rates, plan type and features, and insurance companies are some of the factors that determine the cost of a health insurance plan. As you are different from the person next to you, so the price would also be different.

    • Q. Explain what a sum insured is in a health insurance plan?
      • Sum insured is the maximum amount for a policy year upto which the insurance company will take care of all your hospital, treatment and medical bills. Any amount that becomes payable over this amount has to be paid by you.

    • Q. Name some riders available with a health insurance plan?
      • You can attach various riders like OPD, Cover Hospital Cash Rider, Critical Illness Rider to your base health insurance plan. Rider increases the coverage level of your health insurance plan by paying just a nominal amount.

    • Q. What is the meaning of pre-existing diseases or conditions?
      • A pre-existing disease or condition in health insurance refers to your medical condition, health issue, or medical complications that you are / or have been facing and for which you are / or have been taking medicines before buying a health insurance plan. Pre-existing diseases are covered after a waiting period of 24 to 48 months or permanently excluded depending upon the disease.

    • Q. How can I file a complaint against the health insurance company for not settling my claim? Or how can I complain against the insurer If I am not satisfied with the processed claim amount?
      • First, you must raise a complaint with the insurance company's in-house complaints/grievance redressal cell. If you are still unhappy with the insurer's resolution, you can approach IRDAI with your complaint. You can register your complaint on IRDAI Portal at https://igms.irda.gov.in or by email on complaints@irdai.gov.in or by calling on Toll-Free No. 155255 or 1800 4254 732.

    • Q. What is a Health Insurance Card?
      • A Health Insurance card is an identity document issued to you by the insurance company. This health insurance card enables you to get cashless services at network hospitals that are empanelled with the insurance company.

    • Q. At what age should a health insurance plan be bought?
      • It would be best if you bought a health insurance policy at the earliest possible. If you purchase a health insurance plan when you are young, you can get a large sum insured as coverage for a small premium amount.

    • Q. What do you mean by Personal Accident Insurance?
      • Personal Accident Insurance plan provides cover against accident-related risks like death and permanent disability. The amount paid depends on how severe the disability is due to an accident. Say, on losing a limb, 50% of the sum insured is paid and so on. On accidental death, 100% of the sum insured is paid.

    • Q. Is it essential to buy a critical illness cover?
      • A critical illness cover provides financial coverage against 34+ critical illnesses like cancer, kidney failure, heart ailments, organ failure, other life-threatening critical illnesses. This way, your health insurance plan will take care of your hospital bills, while a critical illness plan pays you a lump sum amount to overcome your critical illness.

    • Q. How can I port my current health insurance plan to another health insurance company?
      • Read our detailed article on “All You Wanted to Know About Health Insurance Portability” (https://www.coverfox.com/health-insurance/articles/health-insurance-portability-all-you-wanted-to-know/) gives you all the details required for porting your existing health insurance plan to a new insurance company.

    • Q. How can I select the best health insurance plan available in India?
      • You can use our health insurance premium calculator by visiting our home page to calculate and compare various health insurance plans. By comparing multiple health insurance plans, you can pick the best plan as per your requirements. Check out our page on health insurance premium calculator (https://www.coverfox.com/health-insurance/health-insurance-premium-calculator/). It explains the importance of comparing a health insurance plan.

    • Q. How can I file a reimbursement claim?
      • You can go through the detailed claim settlement process (https://www.coverfox.com/health-insurance/health-insurance-claim-settlement/) to know how to make a reimbursement claim.

    • Q. How much health insurance coverage is enough for me?
      • You must have a primary health cover of Rs. 5 to 10 lakhs in today's scenario. Apart from this base cover, you must also have a Super Top-up plan of Rs. 25 to 30 lakhs. This way, you and your family will be adequately covered.

    • Q. Is an individual health insurance plan more beneficial for me than a family floater health insurance plan?
      • This decision solely depends on your requirement. If you are looking to protect only yourself, then individual health insurance is the right choice. If you want to protect your entire family, then you must go for a family floater health insurance plan.

    • Q. Will smoking affect my health insurance premiums?
      • If you are a smoker or consuming tobacco in any other form, then you must get ready to pay a higher premium. A person who smokes has high chances of contracting diseases like heart problems, hypertension, breathing issues, cancer, etc. hence premiums are higher.

    • Q. What does a health insurance plan cover?
      • A health insurance policy takes care of all expenses related to In-patient hospitalization, Pre and post hospitalization, illnesses, organ transplantation, donor expenses, daycare procedures, Ambulance Cost, Domiciliary hospitalization and much more.

    • Q. What documents will be asked from me for purchasing a health insurance policy?
      • You need to provide primary KYC documents like Age proof, Address proof for buying a health insurance plan. If you are above the age of 45, you would be required to undergo a medical test.

    • Q. Is a medical checkup mandatory for buying a policy?
      • No, If you are below the age of 45, you are not required to undergo a medical checkup. If you are above the age of 45, you may be required to undergo a medical checkup before buying a health insurance policy.

    • Q. Define the minimum and maximum policy durations?
      • You can buy a health insurance plan for a minimum duration of 1 year and a maximum duration of 2 or 3 years. If you purchase a longer duration policy for 2 or 3 years, you can get a discount on the premium payable.

    • Q. Can my friend who is not an Indian National but living in India buy a health insurance policy?
      • Yes, foreign nationals living in India can buy a health insurance policy. The policy offered would provide cover only within the boundaries of India.

    • Q. Will my health insurance plan cover diagnostic charges like X-ray, ultrasound or MRI?
      • Yes, health insurance plans cover pre and post-hospitalization expenses, including diagnostic charges like X-ray, ultrasound, MRI, Blood Tests, and other tests required before hospitalization and after getting discharged from the hospital. If such tests are conducted on an OPD basis, these expenses are not covered under the health insurance plan.

    • Q. Will my policy be terminated after I file a claim?
      • The policy continues providing coverage even after a claim is filed. The coverage provided reduces by the amount of claim paid. So, if you have a sum insured of Rs. 10 lakh and a claim of Rs. 3 lakhs is paid, then the sum insured applicable becomes Rs. 7 lakhs.

    • Q. Can I buy a policy for my 3-year-old child?
      • Yes, you can include your 3-year-old child in your health insurance plan. You can also buy a family floater plan and have all your family members covered under a single plan. However, you cannot buy a standalone individual health insurance plan for your 3-year-old kid.

    • Q. Which health insurance policy is best for me?
      • Click on this link to find out the best health insurance plans (https://www.coverfox.com/health-insurance/)

    • Q. Can Health Insurance Policies be Ported?
      • Yes, health insurance plans can be ported to another insurer.

    • Q. What is Co-Pay?
      • Co-pay is a clause in the health insurance policy that underlines that the insured will have to share the claim burden and co-pay a pre-determined amount.

    • Q. Is Maternity covered under Health Insurance Plans?
      • Yes, maternity is covered under health insurance plans. In fact there are special health insurance plans by many insurers that take care of medical expenses related to maternity.

    • Q. What are Overseas Health Insurance Policies?
      • Overseas health insurance is covered under international travel plans. These plans usually cover bodily injuries caused, medical illnesses or diseases contracted during an international journey.

    • Q. Is health care and Health Insurance the same thing?
      • Yes. Mostly, health care and health insurance is referred to as the same thing.

    • Q. Are children covered in Health Insurance Plans?
      • According to the current law, your health insurance plan can cover your dependent children., You can now add or keep your dependent children included in your policy, until they turn 26 years old.

    Written By: Coverfox - Updated: 12th April 2021
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