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health insurance

Health Insurance

Health Insurance Plans

Health insurance is a type of medical insurance policy which covers medical expenses, pre-and post-hospitalisation, daycare facilities, surgeries, etc. Insurance providers extend cashless treatment facilities at network hospitals or reimburse the cost of the medical expenses incurred by the insured individual at other places medical insurance.
There are various health insurance plans available in the market such as family insurance plans, health insurance for senior citizens, group health insurance, maternity insurance, and the insurer extends various benefits based on the policy one opts for. Therefore, individuals must compare the policies online and choose the ones that suit their health requirements.

Key Features & Benefits of Health Insurance

Features Specification
Sum Insured Rs. 5 lakhs to Rs. 50 lakhs
Maternity Cover Covered* (Depends on the plans)
Pre & Post Hospitalisation Available
OPD Cover Available
ICU Charges Covered
Tax Benefits Available
Pre-existing Diseases Available
Day Care Procedures Available
Ambulance Cover Available
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What are the Benefits of Health Insurance Policy?

Here's a look at some of the benefits of choosing a health insurance plan:

  • Cashless treatment

    With health insurance, you can stop worrying about arranging funds for treatment, thanks to their cashless facilities. You can visit any network hospital to access this benefit.

  • Pre- and post-hospitalisation expenses

    Medical insurance include both pre-and post-hospitalisation charges. You can have coverage of up to 60 days before admission to a hospital and 90 days following the discharge. Many health insurance policies also cover daycare expenses if required for the treatment.

  • Ambulance charges

    Health insurance plans also include ambulance expenses for taking the policyholder to the hospital, if and when needed.

  • Medical check-up

    A mediclaim policy often includes covering the expenses of routines and periodic health check-ups. Certain insurance policy providers also provide free health check-ups to their customers.

  • Income tax deductions

    As per the Income Tax Act of 1961, you can get tax exemptions on premiums paid for managing medical insurance plans

  • Dedicated health app

    Bajaj Finance enables its policyholders to access their medical insurance policy through the Bajaj Finserv Health App.

  • Reimbursement of different tests

    You can now get reimbursed for all the lab and radiology tests as prescribed by your physician

  • Types Of Health Insurance Plans

    In addition to helping you find the best treatment for your health problems, these best insurance plans also take care of your expenditures. Buying the right mediclaim policy can be a bit complicated as there are different types of Health Insurance plans available in India, have a look and choose accordingly.

  • 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

    You can cover all your family members with a family floater health insurance policy 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 multiple people in the active policy year.

  • Group/employee medical insurance

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

  • Senior Citizen Health Insurance Policy

    Health Insurance For Senior Citizens

    Individuals 60 years and above can avail a medical insurance for senior citizens plan designed to cover 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 usually lower than usual.

  • Critical Illness Insurance

    A critical illness policy will protect you against expenses arising from treating severe or life-threatening 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. best critical illness insurance policies offer a considerable amount as compensation to the policyholder for expenses that fall in the ambit of this plan.

  • Top-up health insurance plans

    A top up mediclaim plan lets you scale up your insurance coverage at an affordable cost. This plan covers expenditure arising from a single illness when the existing policy threshold is insufficient.

  • Personal accident insurance plan

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

  • Maternity health insurance

    Maternity Insurance provide complete health and maternity care coverage to expecting mothers and their newborn babies. From the hospitalisation of the pregnant woman to normal or C-section delivery costs and vaccination of the newborn, this plan covers you all against any medical.

Health Insurance Plans In India

There are numerous insurance companies offers various mediclaim plans. Below is a list of best health insurance plans in India.

Health Insurance Plans Maximum Sum Insured Network Hospitals
Aditya Birla Activ Assure Diamond Up to 50 lakh 8,000+
Aditya Birla Group Activ Health (ABCD) Up to 10 lakh 8,000+
Aditya Birla Super Top-up Up to 50 lakh 8,000+
Bajaj Allianz Health Guard Plan Up to 50 lakh 6,500+
Bajaj Allianz Extra Care Plus Up to 50 lakh 6,500+
Bajaj Allianz Global Personal Guard Policy Up to 2 crore 6,500+
eBH Complete Health Solution (Silver and Platinum) Up to 10 lakh 6,000 (IPD)
450+ (OPD)
Niva Bupa Health Companion Up to 1 crore 7,000
Niva Bupa Health Assurance Up to 50 lakh 7,000
Niva Bupa Health Recharge Up to 95 lakh 7,000
Niva Bupa Health Plus Up to 10 lakh 7,000
Manipal Cigna Pro-health Retail 5 lakh 6,500+
Manipal Cigna Pro-health Group Up to 30 lakh 6,500+
Manipal Cigna Super Top-up Up to 1 crore 6,500+
Manipal Cigna Super Top-up Retail Up to 30 lakh 6,500+

Importance of Health Insurance Policies

Health insurance plans provide you with financial security, considering the rising healthcare expenses. With rapidly changing lifestyle habits, increasing pollution, the evolution of new diseases, and expensive healthcare facilities, it has become crucial 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 per the individual's needs, providing coverage for 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 plan your future better financially.

Below are some of the important reasons why you should buy a health insurance policy:

Financial security

Financial security is one of the main reasons for opting for a health insurance policy. It offers substantial financial coverage against any medical emergency. As a result, it safeguards a policyholder's financial interest.

Rising medical costs

Due to the rising inflation, health care expenses have increased significantly. Therefore, owning a medical insurance plan has become necessary to safeguard policyholders, families, and finances against these rising medical costs. These policies extend necessary access to medical treatment and customise a policy per an individual's requirements.

Changing lifestyles

Lifestyle changes are the primary reason behind the soaring popularity of health insurance. The rising pollution level, stress, etc., are some factors that lead to unanticipated medical conditions. Therefore, health insurance policies can be an effective option to counter such health-related issues.

Savings protection

Medical emergencies can take place at any time in life. If one is not financially prepared to cover such expenses, it will increase one's burden. Therefore, having a health insurance policy in place will let you meet the cost of the required treatment with ease.

Eligibility Criteria

Eligibility criteria for buying a health insurance plan

The eligibility criteria for every policy depend on the insurer's terms and conditions. A few factors like age, pre-existing diseases, and pre-medical screening are considered while evaluating if you are eligible to buy a medical insurance policy or not. Here are some of the common eligibility criteria you must know.

Eligibility Criteria Specifications
Age (Adults) 18 – 65 years
Age (Children) 90 days – 25 years
Pre-medical screenings Depends on the insurer
Pre-existing diseases Waiting period of at least 2 years, depends on the insurer

List Of Documents Required To Apply For Health Insurance

Generally, health insurance policies require minimum documentation, including the application form, accurately filled and signed. However, you may be asked to produce the following documents:

Proof Of Age Proof Of Identity Proof Of Address
Rate of interest 17% p.a. onwards 17% p.a. onwards
Birth certificate Aadhaar card Aadhaar card
Passport Telephone bill Voter’s ID
10th or 12th mark sheet Electricity bill Passport-size photograph
Aadhaar card Passport Driving licence
Driving licence Ration card Passport
PAN Card Driving licence PAN card
Voter ID Card Voter’s ID -

How To Apply For Health Insurance

Follow these seven steps to buy health insurance policies from Bajaj Finance.

Step 1: Click on Get Quote to visit our online application form.
Step 2: Fill in the proposer’s name, gender, mobile number, date of birth and residential pin code.
Check the terms and conditions and click on Get Quote.
Step 3: A list of policies will appear based on the insured amount, policy period (tenure), the person you’re insuring for and plan type (comprehensive/top-up). Select your preferred plan by clicking Buy Now.
Step 4: Choose the preferred policy tenor and click on Next. Review and validate the details of the proposer. Check the terms and conditions and click Next to proceed.
Step 5: Since this is a health insurance product, enter a few more details to proceed. Enter the proposer’s height, weight, nationality, marital status, address, and nominee details (if applicable).
Step 6:Answer a list of questions about the proposer’s health and lifestyle by clicking the relevant checkboxes. Click on the Next button to proceed.
Step 7: Review the filled details carefully and make the payment through any preferred online payment modes: Netbanking, UPI, debit or credit card.

Why choose insurance plans from Bajaj Finance?

Bajaj Finance offers you a most of benefits through various medical insurance plans. Below are some of the top reasons to select a bajaj health insurance:

  • Convenient online process


    Bajaj Finance offers a simple, straightforward process requiring minimal documentation to make purchasing and renewing policies online convenient.
  • Online account management


    Bajaj Finance offers enhanced customer experience through the Bajaj Finserv Health mobile application, allowing the policyholders to manage bajaj medical insurance efficiently. Through this app, one can search for doctors nearby, book appointments, lab tests, and teleconsultations, and purchase health plans, among other things.
  • Additional sum insured


    Individuals can avail of bajaj health insurance with additional coverage at a nominal cost and a range of policies involving senior citizens, group plans, family floater plans, etc. Moreover, these policies cover pre-and post-hospitalisation expenses, consultation fees, medical test costs, etc.
  • COVID-19 coverage


    The company provides health insurance plans that cover the medical expenses incurred for COVID-19 treatment. This can help policyholders get coverage against expenses incurred during quarantine and hospitalisation.
  • Wide network of affiliated hospitals


    Bajaj Finance has partnered with top health insurance companies in India through which policyholders can avail of cashless treatment at 6,000+ network hospitals across the country. In addition, they can get treatment in several multi-speciality hospitals and enjoy attractive deals and offers.
  • Comprehensive coverage


    These bajaj health insurance come with comprehensive coverage that includes pre-and post-hospitalisation expenses, reimbursement of prescribed tests, organ donor expenses, daycare facilities, etc. Besides, it offers a range of health insurance policies at an affordable premium.

Save Tax with Health Insurance Policy

You can now get income tax deductions with premiums paid on health insurance plans. As per the Income Tax of India, 1961, these health insurance deduction in income tax are available under Section 80D. Following are the details:

  • For self and family (everyone below 60 years): Rs. 25,000
  • For self, family and parents (everyone below 60 years): Rs.25,000 + Rs. 25,000
  • For self and family (everyone below 60 years) and senior citizen parents: Rs. 25,000 + Rs. 50,000
  • For self and family (eldest member above 60 years) and senior citizen parents: Rs. 50,000 + Rs. 50,000

A health insurance plan covers your medical costs and offers tax reductions so you can save up to Rs. 75,000^ under Section 80D of Income Tax Act 1961. Buying a Mediclaim policy can help you manage your finances even better.

Note: The tax benefit amount can vary based on the premium of different policies.

Reasons To Buy a Heath Insurance Plan Online

Here are some of the reasons for purchasing a health insurance policy online.

  1. Contactless Application Process
  2. Secured Payment Methods
  3. Instant Policy Issuance
  4. Make Comparison
  5. More Covenient
  6. Time Saving
  7. Abundance Of Choices
  8. No Middlemen
  9. Instant Coverage
  10. Attractive Offers

Mediclaim Insurance

Mediclaim insurance is the most fundamental sub-type of medical insurance policy that reimburses all your medical expenditures when you need them. These insurance policies cover domiciliary expenses, hospitalisation expenses, daycare expenses, etc. The bill amount is settled per the sum insured offered by this policy.

Mediclaim Policy

The term 'Mediclaim' is synonymous with health insurance in the current world. However, people often get confused when they hear Health Insurance Policy, unaware that they are the same thing.

The coverage of a Mediclaim policy, add-on benefits, claim settlement process, etc., are similar to a health insurance policy. Additionally, flexible add-ons for adding family members are available (the sum insured can be increased accordingly). Certain Mediclaim policies are also available with co-payment options.
Certain mediclaim policies are also available with co-payment options. Henceforth, when you come against the mediclaim policy, don't get confused.

Why do our customers love us?

Here’s why our customers prefer us:

  • Our partners collectively have over 1.5 crore customers
  • 6,500+ pan-India network hospitals offered our health insurance partners
  • We offer a seamless purchase journey to buy and renew policies
  • You can easily purchase policy online through our website or App
  • Average claim settlement ratio of 98% across our partners
  • Quick claim settlement process

Things to consider before you buy health insurance plans

You need to consider certain crucial factors before buying a medical insurance policy. Here's the list:

  • Policy coverage


    One of the essential factors to consider when purchasing a medical insurance is the financial coverage offered by the insurer. Top health insurance providers extend a range of coverage such as pre-and post-hospitalisation expenses, daycare facilities, hospitalisation and ambulance charges, doctor consultation, etc.
  • Type of policy


    Before considering medical insurance plans, one must go through the types of policies offered by the lender. Reputed insurers offer a range of policies such as senior citizens, family floater plans, critical illnesses cover, group plans, top-up health insurance cover etc.
  • Sum insured


    The sum insured can be a deciding factor in choosing a health insurance plan. Considering the rising cost of medical treatment across the country, choosing a policy with a maximum sum insured value is wise. A higher sum insured will ensure comprehensive coverage.
  • Network hospitals


    It is essential to check the availability of network hospitals before buying a health insurance policy.This will save you from the hassle of arrangingthe money during medical emergencies.
  • Claim settlement ratio


    The claim settlement ratio denotes the number of claims settled versus the number of claims made in a financial year. It further helps in gauging the capability of an insurance provider to handle customers' claims. So, it is better to check and choose an insurance provider with a higher claim settlement ratio.
  • Waiting period clause


    The waiting period denotes the duration of time during which you can't raise a claim against your existing medical insurance plans. It can be between three months and two years or based on the insurer's terms and conditions. Therefore, it is wise to check the applicable waiting period before applying for the policy.

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 company offerings. It helps you understand the benefits available and determine your needs. Pay close attention to the mentioned inclusions and exclusions. Also, don't make your pick 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 empanelled with the insurer chosen. It is best to go with an insurer with an extensive 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, medical tests, etc.

Factors that affect your health insurance premium calculation

Here are some of the factors considered to determine the premium amount.

Medical history

Every insurance company takes into consideration the medical history of the policy applicant and (in some cases) their family. You need to disclose your medical history or if you have any pre-existing diseases before buying a health insurance plan. Basis on this, the insurer will provide the coverage and calculate the premium.

Insurance providers also have a waiting period before covering the medical expenses incurred against the treatment of any pre-existing diseases. If you want to waive off the waiting period, you can also pay a bit extra or buy an add-on cover to get adequate coverage for pre-existing diseases.

Age

Your age is one of the important determinants for calculating the premium. The younger the applicant is, the lower the premium will be. Similarly, as the age increases, the premium amount goes higher. The reason is, for example, someone who is above 50 years may require extensive coverage, as they are prone to health conditions like heart diseases, blood pressure or critical illnesses. Therefore, their premium will be higher.

Lifestyley

Your lifestyle habits can also play a vital role in determining the premium amount of your health insurance plan. As you become more vulnerable to lifestyle diseases like heart diseases, blood pressure, diabetes, stroke, obesity etc.

Type of health insurance chosen

Different kinds of health insurance plans, such as individual or family health insurance plans have different coverages. So, your premium will be decided depending on the range of coverages you choose. Plus, the premium is likely to increase if you enhance your health insurance plan with add-on covers.

No claim bonus

If you already have a health insurance plan and are looking to renew the plan, you must check for the 'no claim bonus' applicable to the plan. This benefits as a discount when renewing the health insurance plan. Basically, if you have not made any claims in the previous year, you earn no claim bonus of up to 50%, depending on the number of no claim years. This amount is either adjusted to your coverage amount or deducted from the premium.

How to raise a claim for a health insurance policy?

One can claim health insurance in two ways.

 

Planned hospitalisation

 

  • One can opt for cashless treatment at any partner's network hospitals.
  • The health insurance company must be intimated two days before a planned hospitalisation.
  • A form would have to be filled out 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 to the sum insured.

Health Insurance FAQs

What is health insurance?

Health insurance is a type of insurance that covers medical expenses that occur due to an illness. Some individuals also choose to opt for the Mediclaim policy, which only provides compensation up to a fixed sum. However, health insurance can be better if you're looking for coverage for doctor's fees, medication, diagnostic tests, and hospitalization expenses.

What is mediclaim policy?

A Mediclaim policy is a type of health insurance plan in which the insurer reimburses the insured for medical expenses incurred for the treatment.

Can I get maternity insurance while pregnant?

Majority of compaines does not provide maternity health insurance in case of already pregnant position. Whereas nowadays some compaines started offers a maternity cover after the pregnancy also.

What is the difference between health insurance and mediclaim?

The primary difference between health insurance and medical insurance is that the former offers more comprehensive coverage than the latter. Moreover, Mediclaim only provides coverage for hospitalization whereas, health insurance includes a comprehensive plan that provides coverage for doctor's fees, medication, diagnostic tests, and hospitalization expenses.

How to check medical insurance claim status online?

Checking the status of your health insurance plan is a convenient and hassle-free process. Policyholders can select online and offline modes to check their claim status.

Here is the step-wise process of checking the status of your medical insurance plan:

  • Step 1: Visit the official website of your insurance provider.
  • Step 2: Select the 'lodge a claim' option on the website.
  • Step 3: Choose the 'track claim status'.
  • Step 4: A new page will appear where you need to input the policy number, customer ID, claim number and date of birth.
  • Step 5: Select 'submit', and the status of your health policy will be displayed on the screen.

What are deductibles?

A deductible is an amount that a policyholder needs to pay in any medical emergency. The mediclaim policy provider will settle the remaining amount. For instance, if your policy's deductible is Rs. 10,000 and the claim by the policyholder is Rs. 40,000, then the insurance company will pay only Rs. 30,000.

What is premium in insurance?

A health insurance pemimum is the amount wich individual pays periodically to insurance company for for covering his/her risk against any kind of medical expenses.

What are pre-existing diseases in health insurance?

Pre-existing diseases conditions may be defined as an illness which is already existing. It refers to one's medical history or an illness, like heart disease, asthma, cholesterol, thyroid, diabetes, or cancer, that one is already diagnosed with and suffering through before enrolling for any medical insurance plan.

Which is the best health insurance policy?

Getting a medical insurance policy is not a hassle anymore with the availability of online application services. You can visit the official website of an best mediclaim policy provider to apply for one.

What does cashless hospitalisation mean?

Cashless hospitalisation or cashless mediclaim insurance means that if you visit any network hospitals registered with your insurance provider, you need not pay anything for receiving treatment.

How much time does it take to settle a mediclaim?

Typically, a Mediclaim is settled within 30 days. However, this period can change depending on the particulars of the claim or if there are issues regarding the filing of a claim.

Does health insurance require any medical examination?

Yes, if the medical insurance policy you are purchasing requires you to go through any medical check-up, you need to complete that to be eligible for it.

What are pre-existing diseases?

Pre-existing conditions may be defined as an illness which is already existing. It refers to one's medical history or an illness, like heart disease, asthma, cholesterol, thyroid, diabetes, or cancer, that one is already diagnosed with and suffering through before enrolling for any medical insurance plan.

What is the right age to buy a health insurance policy?

There is no right age for buying a mediclaim policy. But if you can afford then buy it once you turn 18 years. As, buying it at an early age enables you to unlock better health insurance benefits.

What is a 'waiting period' in health insurance?

A waiting period is the amount of time you need to wait before you start using your health insurance policy benefits. Wating period is also called as limination periods and qualifying periods.

Can I get medical insurance with pre-existing condition?

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 medical insurance plans provider.

Is health insurance covered in 80D?

Yes, the premiums paid towards mediclaim policy qualify for tax benefit under Section 80D of the Income Tax Act, 1961. All health insurance plans, from individual to family floater health insurance, qualify for the tax-deduction benefit, depending on the individual's age. One can avail of tax deductions up to Rs. 25,000 if the person is below 60 years of age. While for 60 years and above, the tax benefit provided is up to Rs. 75,000. If an individual below 60 years is paying premiums towards the mediclaim insurance policy of their parent(s) who are 60 years or above, they can avail of tax benefits of up to Rs. 50,000.

At what age can I include my children in the plan?

The specifications of when you can include children health insurance plan vary from one policy to another. Thus, you need to check particular policy details to learn more.

How do I choose a best health insurance plan?

There is a wide range of medical insurance policy in India for individuals, families, and senior citizens. Some tips to consider while choosing the right health insurance plan for yourself or your family members are mentioned below:

Tip 1: Seek adequate financial coverage
Tip 2: Look for affordable premium
Tip 3: Select a plan with lifetime renewability
Tip 4: Check network hospital coverage
Tip 5: High claim settlement ratio
Tip 6: Compare online health insurance quotes.

What is the best family insurance?

Usually, family health insurance plans cover the entire family’s health against illnesses and diseases. There are two types of health insurance plans in India:
 

  • Individual medical insurance policies that cover each family member individually
  • Family floater health insurance policy covers the entire family under a single plan and premium.

Any policy that meets your requirements offering the facilities mentioned above can be considered. But before making your purchase decision, consider aspects like sum insured, claim settlement ratio, lifetime renewability, network hospitals, etc.

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