health insurance

Health Insurance

Health Insurance

Medical emergencies demand immediate action and access to finances. With increasing medical inflation, having health insurance has become more important. A health insurance policy provides financial security to individuals at critical times. A good health insurance policy covers doctor consultation fees, medical test costs, ambulance charges, hospitalisation costs, and even pre and post-hospitalisation recovery expenditures to some extent.

By procuring the right health insurance policy, one can receive the right medical treatment without worrying about finances. This is precisely why Bajaj Finance partners with some of the top insurance companies to bring you health insurance plans that have your best interest in mind. As a corporate agent, Bajaj Finance offers a selection of health insurance policies for individuals, families, and senior citizens to provide adequate cover.

 

Benefits of Health Insurance

 

Here’s a look at some of the benefits of choosing a health insurance plan.

  • Cashless transactions

    Cashless medical insurance helps you avail treatment facilities at network hospitals without worrying about access to immediate fund.

  • Pre-and post-hospitalisation coverage

    A medical insurance plan covers the cost incurred for required treatment before hospitalisation and after hospitalisation, depending on the policy taken.

  • Ambulance charges

    Most medical insurance plans also cover the transportation costs for commuting the insured person to the hospital, if required.

  • Medical check-ups

    These health insurance plans also cover routine or periodic health examinations, with some insurance providers offering free medical check-ups to the policyholders.

  • Tax saving benefit

    Premium paid towards health insurance plans is deductible under taxable income, as per the sections 80C and 80D of the Income Tax Act, 1961.

  • Types of Health Insurance Policies


    Here are the different categories of health insurance:

  • Individual health insurance policy

    Only the individual/insured person under the individual health insurance plan is entitled to the benefits and can claim the sum assured under the policy.

  • Family floater health insurance policy

    A family floater health insurance policy covers all the family members under a single plan. The sum insured under the chosen plan applies to all the insured family members in the policy. It can be used entirely by one member or by multiple people in the active policy year.

  • Group/employee health insurance policy

    Group/employee health insurance policies cover the expenses of the employees against unforeseen medical emergencies. The premium of group health insurance plans is generally lower than average and offers wide coverage for medical expenses.

  • Senior Citizen Health Insurance Policy

    Senior citizen health insurance policy

    Individuals who are 60 years and above can avail a senior citizen health insurance plan designed exclusively for them to cover the medical care expenses. Such health insurance plans generally need you to undergo a medical check-up before you can avail of the plan. The premium for this plan is generally lower than usual.

  • Critical illness health insurance plans

    This provides coverage against life-threatening or serious diseases. It is taken as a standalone insurance policy or as a rider for treatments of critical illnesses like - cancer, kidney failure, heart attack, etc. Critical illnesses insurance policies offer a huge amount as compensation to the policyholder for expenses that fall in the ambit of this plan.

  • Top-up health insurance plans

    A top-up health insurance plan lets you scale up your insurance coverage at an affordable cost. This plan covers expenditure that arises out of a single illness when the existing policy threshold is not enough.

  • Personal accident insurance

    Personal accident insurance protects you and your family from expenses incurred as the result of an accident that may lead to death, disability, injury, and other unforeseen situations. Personal accident Insurance can be purchased independently or as a rider to an already existing policy.

List of Health Insurance Plans

Here’s a list of health insurance plan offered by us

Insurance companies Health Insurance Plans Sum Insured (Rs.) Network Hospitals
Aditya Birla Health Insurance Aditya Birla Activ Assure Diamond Up to 50 Lakh 8,000+
Aditya Birla Health Insurance Aditya Birla Group Activ Health (ABCD) Up to 10 lakh 8,000+
Aditya Birla Health Insurance Aditya Birla Super Top-up Up to 50 lakh 8,000+
Bajaj Allianz Health Insurance Bajaj Allianz Health Guard Plan Up to 50 lakh 6,500+
Bajaj Allianz Health Insurance Bajaj Allianz Extra Care Plus Up to 50 lakh 6,500+
Bajaj Allianz Health Insurance Bajaj Allianz Global Personal Guard Policy Up to 2 crore 6,500+
Bajaj Finserv Health Limited (eBH) eBH Complete Health Solution (Silver and Platinum) Up to 10 lakh 6,000 (IPD)
450+ (OPD)
Max Bupa Health Insurance Max Bupa Health Companion Up to 1 crore 7,000
Max Bupa Health Insurance Max Bupa Health Assurance Up to 50 lakh 7,000
Max Bupa Health Insurance Max Bupa Health Recharge Up to 95 lakh 7,000
Max Bupa Health Insurance Max Bupa Health Plus Up to 10 lakh 7,000
ManipalCigna Health Insurance Manipal Cigna Pro-health Retail 5 lakh 6,500+
ManipalCigna Health Insurance Manipal Cigna Pro-health Group Up to 30 lakh 6,500+
ManipalCigna Health Insurance Manipal Cigna Super Top-up Up to 1 crore 6,500+
ManipalCigna Health Insurance Manipal Cigna Super Top-up Retail Up to 30 lakh 6,500+
Tata AIG Health Insurance Tata AIG Medicare Plan Up to 20 lakh 6,700+
Tata AIG Health Insurance Tata AIG Accident Shield Plan Up to 25 lakh 6,700+

Importance of Health Insurance Policies

Health insurance plans provide you financial security, especially when healthcare inflation is on the rise. With rapidly changing lifestyle habits, increasing pollution, the evolution of new diseases and expensive healthcare facilities, it is important to have a health insurance policy. These plans prevent you from out-of-pocket-expenditures in times of sudden emergencies. Health insurance policies are customised as per the individual’s needs, providing coverage for all kinds of health issues. The plans enable you to avail timely and quality health solutions without worrying about the expenses. Having a health insurance plan also helps you keep your savings intact and financially plan your future better.

Eligibility for Health Insurance and Documents Required

Eligibility criteria for every health insurance policy may differ as per the insurer’s terms and conditions. Here are some common eligibility criteria mentioned in insurance policies:

  • Individuals between the age group of 18 to 65 years can avail a health insurance policy.
  • Dependent children under the age bracket of 90 days and 25 years are covered under different policies.
  • Individuals above the age of 60 years are covered under the policies tailored for senior citizens.

Note: Generally, health insurance policies require minimum documentation including the application form, accurately filled and signed. However, you may be required to take a medical test if you are over a certain age.

Why Choose Insurance Plans from Bajaj Finserv?

Bajaj Finserv is a trusted brand that has your best interest at heart. Maintaining high credibility and transparency at all levels, we offer unbiased guidance to ensure that you choose the right insurance plan for your family. Bajaj Finserv works with reliable insurance partners to offer plans that best suit your requirements.

Why do our customers love us?

Here’s why our customers prefer us:

  • Our partners collectively have over 1.5 crore happy customers
  • 6,500+ pan India network hospitals offered our health insurance partners
  • Average claim settlement ratio of 98% across our partners
  • Quick claim settlement

Things to Consider before you Buy Health Insurance Plans

Here are a few tips to help you choose the right insurance plan for you and your family.

  • Know about the different types of health insurance policies like individual, family floater or senior citizen and coverages provided under these plans to choose the one that suits you best.
  • Know about the sum insured under the plan and the add-on features if any, you would want to opt-in for.
  • Know about the applicable sub-limits (capping amount of expenses for room rent, doctors’ fees, medical tests etc.)
  • Check all the inclusions and exclusions mentioned in the policy carefully.
  • Know about the claim settlement procedures (cashless, reimbursement).
  • Know about medical check-ups required before policy acceptance.

How to choose the right health insurance plan

Here are a few tips to help you choose the right health insurance plan for you and your family

Evaluate different policies

When looking for health/medical insurance, the first step is to compare different insurance company offerings. It helps you in understanding the benefits available as well as determining your needs. Pay close attention to the mentioned inclusions and exclusions. Also, don't make your pick just based on the premium you need to pay. Instead, concentrate on the policy's terms and conditions.

Know about the different types of health insurance policies like the individual, family floater, or senior citizen and coverages provided under these plans, and then choose the one that suits you best.

Compare add-on features

Know about the sum insured under the medical insurance policy and the add-on features, if any, you would want to opt-in for.

Check your eligibility

Check the eligibility criteria before buying a health insurance plan. The minimum age to apply is 18 years, and the maximum age is 65 years.

Look up the network hospitals that are part of your plan

Check to see if your preferred hospitals are empaneled with the insurer chosen. It is best to go with an insurer that has a large network of hospitals. This way, your treatment options will not be confined to a small number of hospitals and doctors. Giving you access to better medical facilities.

Consider things like:

• What’s covered and what’s not covered in the policy carefully
• The claim settlement procedures (cashless, reimbursement)
• Know about medical check-ups required before policy acceptance
• Applicable sub-limits, expenses for room rent, physicians' fees, and medical tests etc.

How to raise a claim for a health insurance policy

Health insurance claims can be claimed in two ways.

Planned hospitalisation

  • One can opt for cashless treatment at any of the partner’s network hospitals.
  • The health insurance company has to be intimated two days before a planned hospitalisation.
  • A form would have to be filled and submitted to the third-party administrator counter at the hospital, along with the insurance card and KYC documents.
  • It is advisable to ask for a copy of the records as well.
  • One should also keep all the documents of medical bills incurred during pre-and post-hospitalisation.
  • When the time of billing arrives, the hospital will settle the bills directly with the insurance company.

Reimbursement claim

A reimbursement claim can be made when the policyholder has taken treatment from a non-network hospital. In such a case, all the bills including tests, hospitalisation, and medicines should be collected from the hospital and submitted to the health insurance company. After thorough verification, the insurer will reimburse the claim amount up to the sum insured.

Save tax with health insurance policy

Premium paid towards a health insurance policy is eligible for tax exemption under section 80D of the Income Tax Act, 1960.

• You are eligible for a maximum tax deduction of Rs. 25,000 per annum (if you are below 60 years).
• If you are a senior citizen (over 60 years old), you are entitled to a maximum tax deduction of Rs. 50,000. This is applicable if you pay health insurance premiums for your parents who are 60 years and above.

Health Insurance Frequently Asked Question (FAQs)

1. What is health insurance?

Health insurance is a type of insurance that allows the insured to claim compensation for his or her medical expenses. Some individuals also choose to opt for Mediclaim policy, which provides compensation up to a fixed sum only. However, if you’re looking for coverage of doctor’s fees, medication, diagnostic tests and hospitalization expenses, health insurance can be a better option for you.

2. What are pre-existing diseases?

Pre-existing conditions define illness which is already existing. It refers to one’s medical history or illness like heart disease, asthma, cholesterol, thyroid, diabetes, cancer among others that one is already diagnosed with and suffering through before enrolling for any medical insurance plan.

3. Does health insurance cover pre-existing conditions?

Many health insurance providers do not cover pre-existing diseases under their plans. However, it also depends on the insurance provider and policy you choose. Some insurance providers cover pre-existing conditions but with a waiting period. During this period, you cannot raise claims for any treatment of pre-existing conditions. The waiting period may vary between 2-4 years, depending on your health insurance provider.

4. What is ‘waiting period’ in health insurance?

The duration from when you buy the health insurance policy till the time you cannot claim the benefits is called a waiting period. Policy claims made around this block time is not accepted by the insurance company.
Every insurance company has a waiting period. Different policy provider has a different waiting period. It also depends on the health insurance policy you choose and may vary according to the health conditions such as pre-existing diseases, or critical illnesses you have. Some health insurance plans have a waiting period of 30, 60 or 90 days, whereas a few policies have to wait for around 2 to 4 years, especially pre-existing conditions have longer waiting period. You need to know about the waiting period offered by your policy provider at the time of buying one, to avoid any confusion in future.

5. Is health insurance tax-deductible?

Yes, the premiums paid towards health insurance policy qualifies for tax benefit under Section 80D of the Income Tax Act. All health insurance plans from individual to family floater plans qualify for the tax-deduction benefit, depending on the age of the individual. One can avail of tax deduction up to Rs. 25,000, if the person is below 60 years of age. While for 60 years and above tax benefit provided is up to Rs. 75,000. If an individual below 60 years is paying premiums towards the health insurance policy of their parent(s) who are 60 years or above, then he/she can avail tax benefit of up to Rs. 50,000.

6. Can I upgrade my health insurance at any time?

Yes, you can upgrade your medical insurance plan at any time. However, before planning to upgrade your policy, you must check with your insurer on the options and offers available. Some insurance providers enable up-gradation under a special enrolment period. With growing healthcare inflation, it is wise to upgrade your health insurance plans as per the needs of you and your family to benefit from maximum coverage. You can look for upgrading your plan if you have a pay-hike or new member added to your family or have a child.

7. Will my existing health insurance policy cover hospitalization expenses during COVID-19?

Almost all health insurance providers have designed and incorporated COVID-19 health insurance policy including coverage for hospitalisation expenses under their offerings. Medical insurance companies also cover pre-hospitalisation, post-hospitalisation, in-patient and out-patient treatment, home isolation treatment from the day one is diagnosed. You must check with your health insurer to understand the terms and conditions of the COVID-19 health insurance policy and how you can claim it.

8. Are any waiting periods applicable to claims under COVID-19?

Yes, almost all health insurance policies covering COVID-19 have a waiting period, depending on your insurer’s terms and conditions. The waiting period may vary from the first 15 days to 30 days of buying the COVID-19 policy. During this period, your claims will not be accepted by your insurer. You can claim for COVID-19 coverage after the waiting period is over. To know about the duration of your waiting period, you must contact your insurer.

9. Will the policy cover expenses for home quarantine?

Many medical insurance providers cover expenses for home care or home quarantine treatment if the doctor has advised for home isolation. However, you must check with your insurer to know the terms and condition of the policy chosen.

10. Can I transfer my health insurance to another company?

Yes, you can port your health insurance to another company. You can also do it without compromising on your existing policy benefits. Many health insurance companies provide a 15-30 days free look period depending on the policy chosen. This facility allows you to cancel and switch the policy in case you don’t find the policy terms and condition good. In case you are looking to change your medical insurance company during the renewal period, then you must do so 45 days before your health insurance plan expires. Intimate both the insurance providers—existing and the one you wish to transfer your plan to. Also, it is recommended that you contact both the insurers to know the terms and conditions of health insurance portability.