What is health insurance?
Health insurance covers medical expenses related to illness or injury in exchange of a premium amount. It allows the insurance company to provide financial assistance for hospitalisation, daycare, critical illness, etc. Other advantages of a health plan include free medical examinations and cashless hospitalisation.
Key features of health insurance plans
Features |
Specifications |
Sum insured |
Rs. 5 lakh to Rs. 50 lakh |
Maternity cover |
Covered (depending on plan chosen) |
Pre-and post-hospitalisation expenses |
Covered |
OPD cover |
Covered |
ICU charges |
Covered |
Tax benefits |
Covered |
Pre-existing diseases |
Covered (according to the plan terms and conditions) |
Daycare procedures |
Covered |
Ambulance Cover |
Covered (depending on plan) |
Benefits of Health Insurance plans
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Health coverage up to Rs. 50 lakh
Buy health insurance plans offered by our partners offering maximum coverage of up to Rs. 50 lakh. Premiums starting at Rs. 1,469*.
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Cashless treatment at 10,000+ hospitals
Our health insurance partners offer the convenience of cashless hospitalisation and treatment through a wide network of 10,000+ hospitals. Find your nearest network hospital here.
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Critical illnesses coverage
Buy health insurance policies that provide coverage for ABCD illnesses. These include chronic illnesses like asthma, blood pressure, cholesterol, and diabetes.
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Pre- and post-hospitalisation expenses coverage
Medical expenses coverage for up to 60 days before hospitalisation and 90 days after discharge. The number of days may vary as per the policy chosen.
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Covers road ambulance expenses
Get coverage for ambulance expenses incurred for transporting the insured to the hospital.
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527 daycare treatments covered
Get coverage for up to 527 daycare treatments that require hospitalisation for less than 48 hours. The number of treatments may vary depending on the policy.
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Coverage for medical checkups
Buy health policies that covers the cost of your routine and periodic health checkups. Some policies may also offer free health checkup facilities.
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Income tax benefit
Get tax exemptions on premiums paid for health insurance policies as per the applicable tax laws.
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. The top insurance providers extend a range of coverage. They include pre-and post-hospitalisation expenses, daycare facilities, ambulance charges, doctor consultation, and more.
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. They range from senior citizen, family floater plans, to critical illness cover. Additionally, there are group health plans, top-up health plans, and more.
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 arranging the money during medical emergencies.
Claim settlement ratio
The claim settlement ratio is the ratio of claims settled to 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 cannot raise a claim against your existing medical insurance plans. It can be between 3 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.
Types of Health Insurance plans
Buying the right mediclaim policy can be a bit complicated. This is because there are different types of Health Insurance plans available in India. Have a look below and choose accordingly.
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Individual health insurance policy
Only the individual/insured person under the individual health insurance plan can avail of the benefits and can claim the sum assured under the policy.
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Family floater health insurance policy
You can cover all your family members with a family health insurance policy under a single plan. The sum insured under the chosen plan applies to all the insured family members in the policy. One member or multiple people in the active policy year can use this policy.
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Group/employee medical insurance
Group/employee health insurance policies cover your employees' expenses against unforeseen medical emergencies. The premium of group mediclaim policy is generally lower than average and offers comprehensive coverage for medical expenses.
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Senior citizen health insurance policy
Individuals 60 years and above can avail a medical insurance for senior citizens plan designed to cover medical care expenses. Such or as a rider to an already existing policy.
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Maternity health insurance
Maternity Insurance provides complete health and maternity care coverage to expecting mothers and their newborn babies. From hospitalisation of the pregnant lady to normal or C-section delivery fees and newborn vaccination, this plan covers all medical expenses.
Step-by-step guide to buy Health Insurance plans on Bajaj Finance Insurance Mall
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Step 1
Click here to open our online application form.
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Step 2
Fill out the application form with basic details for you or the person you want to insure. These details include name, gender, mobile number, date of birth, and residential PIN code.
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Step 3
Now click on ‘Get Quote’ to proceed.
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Step 4
From the list of policies shown, choose your preferred Health Insurance plan by clicking the ‘Buy Now’ button placed under each plan. You can further modify the insured amount, policy term, and plan-type to get a list of policies tailored to your preference.
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Step 5
Based on the plan you choose, you may get the option to select the health policy term and premium amount.
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Step 6
Enter your email ID and check if all personal details shown are correct. Click ‘Next’ to proceed.
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Step 7
Enter some additional details, such as height, weight, nationality, marital status, address, and nominee details (if applicable).
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Step 8
Answer a few questions about your health and lifestyle by clicking the relevant checkboxes. Click on the ‘Next’ button to proceed.
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Step 9
Verify if the previously filled details are correct and click on the ‘Proceed’ button to visit the payment page.
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Step 10
Make the payment through net banking, UPI, debit, or credit card to buy the policy.
After successful payment, your policy document will be available for you to download instantly. You will receive the policy document on your registered email address within 5-7 business days.
You will also receive an SMS confirmation immediately after the payment process is completed.
You can also access your policy details through the My Account section within 5-7 days after purchase.
Key inclusions and exclusions
Here’s a quick look at the inclusions and exclusions of Health Insurance policies:
- Key inclusions
- Key exclusions
| Key inclusions | Description |
|---|---|
| In-patient hospitalisation expenses | Get coverage for hospitalisation expenses incurred due to illness or accidental injuries sustained during the policy period |
| Pre- and post-hospitalisation expenses | Covers medical costs incurred due to an illness or injury from 60 days before hospitalisation |
| Critical illnesses | Get coverage for critical illnesses such as Asthma, Cholesterol, Diabetes, and high blood pressure |
| Road ambulance charges | Get coverage for road ambulance charges up to the amount mentioned in the policy details. The ambulance coverage is applicable for transporting the policyholder to the hospital |
| Domiciliary hospitalisation | Get coverage for availing of hospital-like treatment at home |
| Daycare procedures | Get coverage for daycare procedures that require less than 24 hours of hospitalisation |
| Key exclusions | Description |
|---|---|
| War | Losses arising due to an act of war/terrorism/invasion |
| Breach of law | Criminal intent, intentional self-injury, or attempted suicide while sane or insane |
| Substance abuse | Abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol |
| Cosmetic surgery | Cosmetic, aesthetic, and re-shaping treatments and surgeries |
Eligibility criteria for buying a health insurance plan
The eligibility criteria for every policy depend on the insurer's terms and conditions. Medical insurance eligibility depends on age, pre-existing conditions, and pre-medical screening. Here are some of the common eligibility criteria that you must know.
Eligibility criteria
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
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Factors that affect your health insurance premium
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Medical history
Every insurance provider considers the applicant's and sometimes family's medical history. Before getting health insurance, you must report any pre-existing conditions. This determines the insurer's coverage and premium.
To receive coverage for pre-existing diseases without a waiting period, you can pay more or buy an add-on. -
Age
Age affects premiums for health insurance policies. Younger applicants have to pay less, and premiums increase as the age increases. For instance, someone over 50 years may need significant coverage due to heart, blood pressure, or serious sickness. In such cases, the premium will also get higher.
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Lifestyle
Your lifestyle choices could significantly affect how much you pay for your health insurance. This is because you become more susceptible to lifestyle disorders like obesity, diabetes, high blood pressure, and heart disease.
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Type of health insurance chosen
The coverages of various health insurance plans, such as individual and family health insurance policies, vary. Hence, the range of coverages you select will determine your premium.
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No claim bonus
Check your health insurance plan's "no claim bonus" before renewing. You can receive a no-claim bonus of up to 50% for each year you do not make a claim. This amount reduces your coverage or premium.
Why choose insurance plans from Bajaj Finance?
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Convenient online process
To make purchasing and renewing policies online simpler, Bajaj Finance offers a quick, basic process, with minimal documentation.
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Online account management
Policyholders can manage their medical insurance using Bajaj Finance's improved customer experience. Users can search nearby doctors, book appointments, lab testing, and teleconsultations, and buy health insurance.
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Additional sum insured
You can choose from senior citizen, group, and family floater plans, as well as low-cost supplemental coverage. These policies also pay for pre- and post-hospitalisation expenditures, consultation fees, the price of medical tests, etc.
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COVID-19 coverage
You can opt for health insurance plans that pay for the costs of treating COVID-19. This can assist policyholders in obtaining coverage for costs related to hospitalisation and quarantine.
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Wide network of affiliated hospitals
Partnering with top health insurance providers in India, Bajaj Finance is enabling policyholders to access cashless care at more than 10,000+ network hospitals.
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Comprehensive coverage
These health insurance plans include pre- and post-hospitalisation costs, reimbursement for prescribed testing, costs associated with organ donation, childcare services, etc. Additionally, it provides a selection of health insurance plans at reasonable premiums.
Save tax with health insurance policy
Health insurance premiums are available with tax benefits. Section 80D of the Income Tax of India, 1961 allows health insurance deductions. Given below are the details for tax exemption:
- 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
- Health insurance covers medical expenses and reduces taxes, saving you up to Rs. 75,000* under Section 80D of Income Tax Act 1961.
*Note: The tax benefit amount can vary based on the premium of different policies.
Documents required for raising a claim request
Here is the list of documents that you need to raise a claim request against your health insurance policies.
- Claim form (part A and B)
- Cashless card or health card issued by the insurer
- Valid ID proof (PAN, voter ID, passport)
- Original discharge summary
- Original hospital bills and payment receipts
- All doctor consultation papers
- FIR copy or post-mortem report in case of an accident or death
Frequently asked questions
Several factors determine the health insurance premium of a policy. It depends on the type of coverage, age of the proposer (applicant), medical history of the proposer, and more. Besides, if you take add-on covers, your premium will increase. Choose a health insurance plan that adequately covers all your medical needs so that you can handle any medical emergency . Bajaj Finance offers various health insurance plans from top insurers with varying coverage and premium amount.
Pre-existing diseases refer to one's medical history of illnesses, such as heart disease, asthma, cholesterol, thyroid, diabetes, or cancer. These are diseases that one is already diagnosed with and suffering from before enrolling for any medical insurance plan.
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. Depending on your health insurance provider, the waiting period may vary between 2-4 years.
The duration from buying the health insurance policy until you can claim the benefits is called a waiting period. The insurance company does not accept policy claims made during this block time.
Every insurance company has a waiting period. Different policy providers have different waiting periods. It also depends on the health insurance policy and may vary according to your health conditions, such as pre-existing diseases or critical illnesses. Some health insurance plans have a waiting period of 30, 60 or 90 days. Few policies may require you to wait for around 2 to 4 years. Policies that cover pre-existing conditions especially have a more extended waiting period. Understand the waiting period of the policy at the time of purchase to avoid any confusion in the future.
A deductible is an amount that a policyholder must pay in any medical emergency. The insurance provider will settle the remaining amount. For instance, if your policy's deductible is Rs. 10,000 and the policyholder claims Rs. 40,000, then the insurance company will pay only Rs. 30,000.
Yes, the premiums paid towards health insurance policy offer tax benefits. All health insurance plans, from individual to family floater plans, 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 is up to Rs. 75,000. Individuals paying premiums towards their parent’s health insurance policy who are above 60 years old can avail of tax benefits of up to Rs. 50,000.
Under an employer's group policy, the employer will purchase a group health insurance plan. The premium will depend on the number of members and the coverage offered. However, the employer's group medical insurance policy does not allow customisations, such as coverage for high-end medical expenses, expensive hospital beds, and more.
As such, purchasing a separate health insurance plan is recommended. It allows the individual to get substantial coverage, no claim benefits, customisation options, and more.
Health insurance is a type of insurance that allows the insured to claim compensation for their medical expenses. It may include doctor's fees, medication, diagnostic tests, and hospitalisation expenses.
Almost all health insurance providers have designed and incorporated COVID-19 health insurance policies, including coverage for hospitalisation expenses under their offerings. Medical insurance companies also cover pre- and post-hospitalisation, in-patient and out-patient treatment, and home isolation treatment from the day one is diagnosed. Check with your health insurer or go through the terms and conditions regarding the COVID-19 health insurance policy and how you can claim it.
Yes, most health insurance policies covering COVID-19 have a waiting period, depending on your policy'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, you will not be able to claim your policy. You can claim COVID-19 coverage after the waiting period is over. To know about the duration of your waiting period, you must contact your insurer.
Many medical insurance providers cover expenses for home care or home quarantine treatment if the doctor has advised home isolation. However, you must check with your insurer to know the terms and conditions of the policy chosen.
You can get individual health insurance online through the official website of your preferred insurance provider.
Yes, you can pay for health insurance monthly. But check with your insurance provider regarding the availability of this facility.
Whether or not you want a separate health insurance policy apart from a group policy depends on your preference. However, decide based on the coverage of your group policy. You can skip to a separate policy if it offers substantial coverage for major diseases and includes other benefits.
Cashless hospitalisation means that if you visit any network hospitals registered with your insurance provider, you need not pay anything for receiving treatment.
Yes, if the policy you are purchasing requires you to go through any medical checkup, you need to complete that to be eligible for it.
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:
1. Individual medical insurance policies that cover each family member individually.
2. 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.