Health Insurance FAQs

Frequently asked questions

What is health insurance?

Health insurance is a type of insurance that allows the insured for medical expenses reimbursements up to the coverage amount for their medical expenses in case of illness or accident, it may include doctor's fees, medication, diagnostic tests, and hospitalisation expenses.

How much does a health insurance plan cost per month?

The premium value of health insurance plans differs from insurer to insurer, sum insured, and the plan you choose. It also depends on several factors like age, medical history, lifestyle habits, and occupation. The premium may likewise increase if you choose to get add-on covers along with your regular health insurance plans. The premiums for individual and family health insurance plans also varies.

Bajaj Finance Limited offers health insurance plans that will cost you Rs. 17.5/day* for a coverage of Rs. 5 lakh. We have plans for you, that offer coverages right up to 50 lakh or more and the premiums are calculate depending on your chosen plan. Check the plans here.

How do I get a health insurance policy?

You can buy a health insurance policy online or offline. With digitalisation, now the majority of the insurance companies offer health insurance plans online. You can visit the Bajaj Finance Insurance Mall to compare and buy health plans as per your needs.

How many times can medical insurance be claimed?

You can raise a claim on your health insurance policy multiple times through your policy tenure. You must check with your insurance provider on the terms and conditions related to the claim process. Claims can be raised up to the total sum insured on the policy mentioned at the policy inception. Many insurance providers offer up to 100% sum reinstatement option, which helps restore the sum insured amount if it gets exhausted in a policy year.

Can I add my family members to my existing policy?

Adding family members to an existing policy is only allowed if the health insurance plan has the provision to cover family members. Usually, you can cover your family members up to a certain age limit while buying the policy. This depends on the terms and conditions of the policy.

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

Health insurance providers usually cap the entry age limit for dependent children from the age of 90 days to 25 years. Check the entry age limit on the specific plan that you are interested in before you purchase.

What is the benefit of buying health insurance at a young age?

Buying a health insurance policy at a young age will help you save on the premiums. The premium value of health insurance policies increases with age. So, buying a health plan at a younger age is preferred. Another advantage is that many health insurance policies have a waiting period of one month to 2 to 3 years for certain health conditions, which may pass if you buy the health policy early. Because usually, people at a young age may not have developed diseases or health conditions.

Nonetheless, you can gain a cumulative bonus on claim-free years that is passed over to you as a discount on the premium at the time of policy renewal.

Can a person have more than one health insurance policy?

Yes, a person can have more than one health insurance policy. Many choose to buy top-up health insurance plans to stay adequately covered during medical emergencies.

What does a 'free look period' mean?

Free look period is a term of 15 to 30 days (if the policy is acquired online) from policy receipt during which an individual can decide if the policy's benefits and terms and conditions meet their needs. During this period individuals have the right to cancel insurance without penalty. The refund of your premium shall be processed as per the applicable process and procedure followed by the insurer.

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

There is no right age for buying a health insurance policy. However, doing it at an early age enables you to unlock better benefits like availing of a health plan with a low premium, gaining a cumulative bonus for claim-free years, and passing the waiting period on certain health conditions.

How can I claim if admitted to a non-network hospital?

You can make a reimbursement claim after discharge from a non-network hospital. You need to submit the hospital bills, doctor's prescriptions, summary reports, and a claim form to the insurer.

What is a cumulative bonus?

It is a reward given to the policyholder for having claim-free years. The insurer may either increase your sum insured without charging you extra premiums or give you a discount on the premium.

Does the premium amount vary from insurer to insurer?

Yes, every insurer may charge a different health insurance premium, depending on your age, health conditions, requirements, lifestyle habits, occupation, and product benefits & features.

What is a co-payment clause?

A co-payment clause requires the policyholder to pay a percentage of medical treatment costs for each claim. Because the policy holder agrees to share a part of the claim amount, they pay a lower premium in case of the co-payment option.

Can I get admitted to a non-network hospital?

Yes, you can. But you will have to clear the hospital bills from your pocket and later claim for reimbursement. The option of cashless claims is available at the insurer's network hospitals only.

How much does an individual need to pay for a health insurance plan?

The health insurance premium of a policy will be determined by several factors – the type of coverage, age of the proposer (applicant), medical history of the proposer, and more such factors. Besides add-on covers are an addition to your regular premium. You should choose a health insurance plan that adequately covers all your medical needs to be financially equipped to handle any medical emergency. Bajaj Finance offers various health insurance plans from leading insurers with varying coverage and premium amount. Click here to access the health insurance plans.

I have my employer's group policy; do I need to buy a separate health insurance plan?

An employer's group policy will acquire a group health insurance plan from an insurer and enroll you as a member. 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, as it allows the individual to get substantial coverage and benefits like, no claim bonus, customisation options, and more such facilities offered by the policy.

What are deductibles?

A deductible is an amount a policyholder must pay in any medical emergency before the insurer begins paying up the claim amount. The insurance 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 are pre-existing diseases in health insurance?

Pre-existing diseases refer to one's medical history of illnesses, such as heart disease, asthma, cholesterol, thyroid, diabetes, or cancer, that one is already diagnosed with and suffering from before enrolling for any medical insurance plan.

Does health insurance cover pre-existing health conditions?

Many health insurance providers do not cover pre-existing diseases under their plans. It also depends on the insurance provider and the 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.

What is a 'waiting period' in health insurance?

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 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, whereas a few policies require one to wait for around 2 to 4 years. Policies that cover pre-existing conditions especially have a longer waiting period. You need to know about the waiting period offered by your policy provider at the time of purchase to avoid any confusion in the future.

Can I avail of tax benefits against premiums paid towards a health insurance policy?

Yes, the premiums paid towards a health insurance policy qualify for tax benefit under Section 80D of the Income Tax Act, 1961. Tax deductions are dependent on the prevalent tax laws. At present, one can avail 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. If an individual below 60 years is paying premiums towards the health insurance policy of their parent(s) who are 60 years or above, they can avail of tax benefits of up to Rs. 50,000.

Can I upgrade my health insurance at any time?

You need to check with insurer and the policy terms and conditions to upgrade your medical insurance plan. Some insurance providers enable upgrades under a special enrolment period. With growing healthcare inflation, it is wise to upgrade your health insurance plans per your and your family's needs to benefit from maximum coverage. You can look to upgrading your plan if you have a pay-hike or a new member added to your family or have a child.

Will my existing health insurance policy cover hospitalisation expenses during COVID-19?

Most health insurance providers offer COVID-19 policies that cover hospitalisation expenses under their offerings. Medical insurance covers pre- and post-hospitalisation, in-patient and out-patient treatment, and home isolation from the day of diagnosis. Check with your health insurer or read the policy terms and conditions for COVID-19 health insurance claims.

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

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, your claims will not be accepted by your insurer. 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.

Will the policy cover the expenses for home quarantine?

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.

Can health insurance premiums be paid monthly?

Yes, you can pay premium for health insurance monthly. But, check with your insurance provider regarding the premium payment options available.

How to check health insurance claim status online?

Here is the step-wise online process of checking the status of your health insurance plan:
Step 1: Visit the official website of your insurance provider.
Step 2: Select the login option on the website and enter the relevant credentials.
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 does cashless hospitalisation mean?

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

Can I claim medical bills in health insurance?

You can claim medical bills in health insurance only if your particular insurance policy has the provision.

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.

Do I have to undergo any medical examination before buying health insurance?

Yes, if the policy you are purchasing requires you to go through any medical checkup, you must complete that to be eligible.

How to check medical insurance claim status online?

You can check the health insurance claim status online on the insurer's website. Also, the insurance company sends notifications updating your health insurance claim status to your registered mobile number and email ID.

Which health insurance is the best?

Any comprehensive health insurance plan that covers all your medical-related requirements is best. Ensure that your health insurance plan offers adequate coverage for all kinds of medical expenses. This includes pre-, post-, and during hospitalisation period, daycare and domiciliary treatments, and modern and non-allopathic treatments. Some health insurance policies also include the cost of transport via road or air, room rent, and organ donor.

Bajaj Finance Limited offers a wide range of comprehensive health insurance plans, partnering with top insurance companies in India. Check the plans here.

What are the inclusions under maternity health insurance?

Maternity insurance covers pregnancy-related expenses. This includes delivery expenses, abortions up to two instances, and pre-and post-natal expenses. Many maternity insurance policies cover the newborn baby's medical expenses and vaccinations.

Do I have to pay GST on the health insurance premium?

Yes, GST is charged on health insurance premiums.

Can I still claim if hospitalisation is less than 24 hours?

Yes, you can claim the benefits if hospitalisation is less than 24 hours under daycare facilities as offered by your policy terms.

Check the health plans offered by Bajaj Finance Limited that cover over 500 daycare procedures. Click here to view the plans.

What should I do if I have a pre-existing health condition and want to buy health insurance?

If you have any pre-existing diseases, you must declare the health conditions while buying the health plan to the insurer. If you do not do so, you may end up paying more during a medical emergency. As the insurance company will reject the health insurance claim on grounds of non-disclosure of mandatory information.

What is the cheapest health insurance?

Health insurance premium value varies from insurer to insurer. Therefore, you need to look for a health insurance plan that suits your medical requirements.

Bajaj Finance Limited offers a range of comprehensive health insurance plans with premiums starting from Rs. 17.5 per day#. You can check the plans here.

What is the average premium for health insurance in India?

The premium of health insurance plans primarily depends on multiple factors like age of the insured, pre-existing illnesses, sum insured, etc. For example, with Bajaj Finance, individuals can get coverage for medical costs ranging from Rs. 5 lakh to Rs. 2 crore at premiums starting from Rs. 17.5 per day#. Individuals can get additional coverage for doctor consultations, ambulance services, treatment charges, etc. Hence premiums for health insurance can differ across India, given the wide selection of health insurance plans available.

How do I choose a health insurance plan?

There is a wide range of health insurance plans in India for individuals, families, and senior citizens. Tips to consider while choosing the right health insurance plan for yourself or your family members are mentioned below:
Tip 1: Look for sufficient 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.

How much does family health insurance cost per month?

The premium for health insurance plans for a family depends on multiple factors like the number of members, age of the oldest member, pre-existing diseases, if any, etc.

A family health insurance plan is ideal today, where even minor expenses can derail monthly expenses and savings.
With Bajaj Finance, you can choose comprehensive family medical insurance and get coverage for medical expenses for treatment, diagnostics, pre-and post-hospitalisation, etc., at affordable premiums.

Check the plans here.

Which 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:
1. Individual medical insurance policies that cover each family member individually
2. Family floater health insurance that covers the entire family under a single plan and premium.

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

Are the family health insurance plans cheaper than individual ones?

No, family health insurance plans are not cheaper than individual ones as they tend to offer more extensive coverage and come with features that cover the family as a whole. However, the premium value will depend on the policy chosen.

Why do I need family health insurance?

A family health insurance policy proves beneficial during medical emergencies and covers the entire family's major and minor health expenses. Given the rising healthcare costs, having your whole family covered for medical emergencies is significant. When buying a family health insurance plan, please check and understand the waiting period, primary inclusions and exclusions to make an informed decision.

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