Health Insurance

Falling sick is bad enough, what’s worse is the medical bills that follow after. You might not be able to avoid unforeseen health issues, you can definitely protect yourself from financial losses incurred from it. A health insurance policy offers you protection against medical expenses when you fall ill. There are a variety of health insurance plans offering different coverages. In this article, we will delve into every aspect of health insurance. Read on to know all about these policies.

What is health insurance?

Insurance policies are generally designed to protect you from financial losses incurred from certain unforeseen incidents in life. Similarly, a health insurance policy offers protection against medical bills when you fall ill. Hefty medical bills are the last thing one would want to worry about after recovering from an illness. Health insurance guarantees peace of mind by taking care of your medical expenses.

Most health insurance plans cover pre and post-hospitalization expenses in addition to other medical-related expenses. Most policies also offer cashless claims which ensures you do not have to worry about arranging cash to close your bills. A comprehensive health insurance policy is a saviour in times when you fall ill.

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.

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What is the importance of a health insurance policy?

Unless you’ve been living under a rock, you are probably aware of the rising costs of medical care. A simple outpatient procedure can make your wallet considerably lighter. A health insurance policy will help you get the best medical care and you don't have to worry about expenses. A good health insurance plan ensures you don’t have to dig into your savings in the time of a medical emergency.

It also helps cut down the cost of medical expenses in cases such as daycare procedures & routine check-ups. At the cost of a small premium every year, you can protect yourself and your family from huge financial losses in the time of a medical emergency. Here are some of the reasons why you should get a health insurance policy:

  • Protects against financial losses - Buying Health insurance is one of the most clever financial decisions one could make. Even the simplest medical procedures can cost lakhs. When you have a health insurance policy, the insurer will pay the medical bills. By paying a small annual premium, you will protect yourself against huge financial losses in the future.
  • Modern Lifestyle - The modern lifestyle is definitely not the healthiest. Lack of sleep coupled with bad eating habits and stress takes a toll on one’s body. Young people in their 20’s and 30’s are falling prey to serious health issues such as diabetes, high blood pressure, heart ailments, and more. This is another compelling reason as to why you should get a health insurance plan.
  • Inexpensive - A small annual premium can save you from a huge financial liability during medical emergencies. There are a variety of health insurance plans but even the one with the highest coverage will cost you less than an outpatient procedure at a hospital. A basic health insurance plan will cost you less than a night out with your friends.
  • Best way to protect your loved ones - With a health insurance plan, you can also protect your family against medical emergencies. These policies are especially crucial for those who have large families, elders in the family, or are the sole breadwinner.
  • Tax benefits - Most health insurance policies can be used as a tax-saving tool. You can claim tax deductions up to Rs. 25,000 or more depending on the policy you choose. While this is not the main reason why you should invest in a health insurance policy, it’s definitely an added benefit.

Type of health insurance plans

There are a variety of health insurance plans in India. Listed below are some of the popular plans:

    Individual health insurance plan

    As the name suggests, an individual health insurance plan offers cover for the individual only. This plan covers your medical expenses for hospitalisation, injury, room rent, and more. This policy offers sum insured which can be used by only one person i.e. the individual covered under the plan.

    Family floater insurance plan

    Under a family floater plan, you can cover your entire family under a single policy. The sum insured for these policies are usually higher than regular individual health insurance plans. The sum insured is available for all the family members insured under the plan. The best part about this plan is that you can get cover for your entire family for a small premium amount.

    Group health insurance plans

    Group health insurance plans are highly popular in the corporate sector. Medium and large-sized enterprises use this insurance policy to offer cover for their employees in time of a medical crisis. It is a benefit that most employees expect when joining a company and this helps the employer retain their employees.

    Critical illness health insurance plan

    Critical illness health insurance policy offers cover specially for critical illnesses such as stroke, kidney failure, organ transplant, cancer, and more. Treating critical illnesses can get expensive and a policy like this can save a lot of money if you ever were diagnosed with a critical illness. The insurance pays a predetermined amount towards the treatment when the insured is diagnosed with a critical illness.

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24+ Best Health Insurance Plans in India - August 2021

Here is a comprehensive list of top health insurance plans.

Health Insurance Plans Sum Insured (Rs.)

HDFC ERGO my:Health Suraksha

Min-3Lakh - Max- 50 Lakh

HDFC ERGO General Insurance Optima Restore

Min-3 Lakh - Max- 50 Lakh

Star Family Health Optima Plan

Min-1 Lakh - Max- 25 Lakh

Care Health Care Plan

Min-4 Lakh - Max- 6 Crorev

United India UNI Criticare Health Plan

Min-1 Lakh - Max- 10 Lakh

Bajaj Allianz Individual Health Guard Plan

Min - 1.5 Lakh - Max - 50 Lakh

Chola Healthline Plan

Min-2 Lakh - Max- 25 Lakh

ManipalCigna Prohealth Plus

Min-2.5 Lakh - Max- 1 Crore

Aditya Birla Active Assure Diamond Plan

Min - 2 Lakh - Max - 2 Crore

SBI Arogya Premier Policy

Min-10 Lakh - Max- 30 Lakh

Digit Health Insurance Plan

Min- Lakh - Max- 25 Lakh

Future Generali Criticare Plan

Min-5 Lakh - Max- 50 Lakh

IFFCO TOKIO Health Protector Plus Plan

Min-2 Lakh - Max- 25 Lakh

Royal Sundaram Supreme Policy

Min-5 Lakh - Max- 50 Lakh

Universal Sompo Individual Health Plan

Max- 10 Lakh

Bharti AXA Health Insurance

Min - 3Lakh - Max - 5 Lakh

Oriental Individual Mediclaim Policy

Min-1 Lakh - Max- 10 Lakh

Max Bupa Health Companion

Min-3 Lakh - Max- 1 Crore

Reliance Critical Illness Plan

Min-5 Lakh - Max- 10 Lakh

Liberty Health Connect Supra Top-up Plan

Max- 1 Crore

National Parivar Mediclaim Plus Policy

Up to 50 Lakh

Tata AIG MediCare Plan

Min-2 Lakh - Max- 10 Lakh

Edelweiss Health Insurance Plan

Min-5 Lakh - Max- 1 Crore

Raheja QBE Health Plan

Min-1 Lakh - Max- 50 Lakh

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.

Benefits of health insurance

Health insurance comes with a plethora of benefits that are not just limited to offering financial cover during medical emergencies. Listed below are some of the most popular benefits of health insurance:

• Comprehensive cover

    Health insurance policies offer a comprehensive cover, meaning you are protected against a myriad of health issues. In addition to that, you also get cover for pre and post hospitalisation expenses, medications, and more. All this at the cost of a small annual premium.

• Cashless treatment

    Most health insurance companies have tie-ups with hospitals and medical centres. If you get admitted to one of these network hospitals, you will not have to pay anything. The insurer will handle all the bills and all you have to do is mention the policy number. This not only saves you from the hassle of arranging money in an emergency but also saves you a lot of time running around filling forms while you can be focusing on what’s important.

• Quality medical care

    This is one of the most underappreciated benefits of health insurance. One of the things that stop many people from opting for quality healthcare during emergencies is the rising cost of medical care. But with health insurance by your side, you can opt for quality medical care instead of settling for cheaper options. Many health plans also offer cover for health check-ups which will help you keep your health in check.

• 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.

• Health Insurance Tax benefits

    Health insurance policies offer tax benefits under section 80D of the Income Tax Act, 1961. The tax deduction offered depends on the age of the insured, premium amount, and other factors. Depending on these factors you can claim tax deductions from anywhere between Rs.25,000 to Rs.50,000.

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.

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• Portability

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

• Financial security

    Without health insurance, it takes just one serious medical emergency to deplete your life savings. A health plan not only offers you peace of mind but also offers financial security. With the right health insurance policy, you can avail quality medical treatment without having to break into your savings

• Convenience

    Unlike old times, you do not have to go from one insurance provider to another to find the right plan. You can compare, assess, and purchase health insurance plans online from the comfort of your home. What’s even better is that you can even get discounts when you purchase policies online.

Main factors to choose the best health insurance policy

There is no one-size-fits-all health insurance plan. The right insurance policy not only fits your budget but covers all your needs. So how do you choose the right health insurance plan? Here are some things to consider before purchasing a health insurance plan:

• Ensure you have the right coverage

    The first thing you need to check with any health insurance policy that you are considering. Ensure that your prospective plan offers cover against a wide range of medical expenses. We also suggest taking into account your family medical history while choosing a policy. For instance, if there is a history of diabetes or heart issues in your family, ensure you have adequate cover for the same in your policy.

• Check if it is affordable

    What many people fail to understand is that health insurance policies come with a financial commitment. You will have to pay the premiums for your policy diligently to maintain the policy. So when choosing a policy, make sure that the premiums are affordable and you can continue paying it for a long-term.

• Look for flexibility

    Another thing to look out for when purchasing a health insurance policy is flexibility. Ensure that your policy can be customised with additional riders.

• Compare between plans

    As we have already mentioned, a health insurance plan is a serious long-term commitment. So it is wise to not choose the first policy you chance upon. We suggest comparing between different health plans before zeroing in on the best policy.

Types of Coronavirus 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

    What does health insurance cover?

    While every health insurance policy is unique, most of them have the same cover. Listed below are some of the most common inclusions under medical insurance plans:

    • Hospitalisation expenses
    • Pre-hospitalisation expenses
    • Post-hospitalisation expenses
    • Outpatient procedures
    • Health checkups
    • Ambulance charges
    • Donor transplant expenses
    • Preventive services
    • Critical illness
    • Chronic illness treatment
    • Prescription medication
    Its Simple

    Health Insurance Exclusions

    While health insurance offers cover for most health ailments and diseases, there are still some exclusions under the policy. Listed below are some of the common exclusions under health plans:

    • Cosmetic procedures
    • Dental procedures
    • Pre-existing conditions
    • Congenital diseases
    • Injuries incurred from war, terrorism, & suicide
    • Non-prescription drugs

    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

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    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

    Who is the eligible to get health insurance?

    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.

    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 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.

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    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, 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
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    Buy Top Health Insurance Plans Online from Coverfox

    Buying health insurance can be hassle-free if you approach the right channel. Having said this, 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

    Buying health insurance can be hassle-free if you approach the right channel. Having said this, 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?

    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

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    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

    FAQ about Health Insurance

    Q. How to get the best coverage with health insurance?

    Ans: The best way to get the highest coverage with health insurance without splurging is through additional riders. You can add riders as per your needs and enhance your policy coverage.

    Q. At what age can I get a health insurance policy?

    Ans: The minimum age to purchase a health insurance plan is 18 years.

    Q. What happens if I don’t pay my health insurance premium?

    Ans: Your policy will lapse or get terminated if you fail to pay your premiums.

    Q. How many health insurance policies can I have?

    Ans: There is no limit on how many health insurance plans you can purchase.

    Q. What is cashless treatment?

    Ans: Cashless treatment under health plans ensures that you do not have to pay anything when you get admitted to one of the network hospitals of your health insurance provider.

    Q. Is health insurance in India expensive?

    Ans: No, health insurance is quite affordable. For instance, under a basic health plan with a sum insured of Rs. 5 lakh, you might have to pay a premium of Rs. 5,000 - Rs. 10,000 per year. The premium depends on your age, type of policy, and other factors.

    Q. Can you get cover for family members under one insurance policy?

    Ans: Yes, you can add family members like your spouse, children, parents or parents-in-law under a family floater which offers cover for the entire family.

    Q. Define Health Insurance?

    Ans: 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. When can I use my health insurance policy?

    Ans: Every policy comes with a waiting period after which your cover gets activated. The waiting period for most health policies is 30 days but we suggest checking with your insurance provider on the same.

    Q. Will I still be covered if I get admitted to a non-network hospital?

    Ans: Yes, your health insurance policy will still cover you if you are admitted to a non-network hospital. The only difference is that you will have to pay the bills and then file for reimbursement as opposed to getting cashless treatment.

    Q. Explain the working of a health insurance plan?

    Ans: 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. Which is the best health insurance policy?

    Ans: When it comes to health insurance, there is no one policy that fits all. The best health plan for you is one that suits your needs and budget.

    Q. What is the importance of health insurance?

    Ans: 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?

    Ans: 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?

    Ans: 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. Is it mandatory to undergo a medical test to buy a health insurance policy?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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. What is the meaning of pre-existing diseases or conditions?

    Ans: 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?

    Ans: 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 or by email on or by calling on Toll-Free No. 155255 or 1800 4254 732.

    Q. What is a Health Insurance Card?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: Read our detailed article on “All You Wanted to Know About Health Insurance Portability” ( 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?

    Ans: 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 ( It explains the importance of comparing a health insurance plan.

    Q. How can I file a reimbursement claim?

    Ans: You can go through the detailed claim settlement process ( to know how to make a reimbursement claim.

    Q. How much health insurance coverage is enough for me?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: Click on this link to find out the best health insurance plans (

    Q. Can Health Insurance Policies be Ported?

    Ans: Yes, health insurance plans can be ported to another insurer.

    Q. What is Co-Pay?

    Ans: 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?

    Ans: 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?

    Ans: 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?

    Ans: Yes. Mostly, health care and health insurance is referred to as the same thing.

    Q. Are children covered in Health Insurance Plans?

    Ans: 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: 2nd Sep 2021
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