Individual Health Insurance Plans

Individual Health Insurance Plans

Understand the features and benefits of individual health insurance. Check plans and coverage details.

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3 mins
10-May-2023

An individual health insurance plan is a basic medical insurance plan that is a must-have for everyone. Since every individual is different with varied medical needs, one must choose individual insurance that perfectly suits their needs.

What is Individual Health Insurance?

Individual health insurance plans are designed to offer comprehensive coverage for medical-related expenses. These include expenses hospitalisation expenses, ambulance charges, consultation fees, treatment costs, and more. It helps to keep one financially secure in the event of any medical emergency.

Features

Specification

Network Hospitals

8000+

Expenses Covers

Covered

Tax Benefit

Covered

Free Health Checkup

Covered

Pre-existing Diseases

Covered (depending on plan chosen)

Pre & Post Hospitalization

Covered

Day Care Procedures

Covered

OPD Cover

Covered


Features of individual health insurance

Some of the key features of health insurance plans for individuals are as follows:

· Reinstatement of sum insured

If the base sum insured and the cumulative bonus get exhausted due to claims, you can get the sum insured reinstated on the health policy. This goes a long way to give you the necessary backup for medical emergencies.

· Medical tests are optional for up to 45 years

Considering you are fit and healthy at an early age, you do not have to undergo any medical test before buying individual health insurance policy.

· Cumulative bonus

You get a cumulative bonus for every claim-free year. You can benefit from this bonus by increasing your sum insured without paying extra premiums. Some insurers may offer discounts on renewal premium. Hence, check with your insurer when availing the benefit.

· Lifetime renewability

Some individual health insurance plans come with the option of lifetime renewability. You can renew the health plan at any time after it gets expired.

· Additional coverage

Some individual health insurance plans for individuals also offer additional coverage in the form of critical illness coverage, maternity benefit and more.

What are the benefits of individual health insurance plans?

Here are some key benefits of buying individual health insurance plans.

· Extensive coverage

Individual medical insurance offers comprehensive financial coverage that helps one cope with sudden expenses due to medical emergencies. Get coverage for pre-and post-hospitalisation expenses, daycare treatments, and in-patient hospitalisation charges. Also covers organ donor expenses, treatment for mental illness, AYUSH therapy costs and more.

· Cashless treatment option

One can opt for a cashless claim during any medical emergency that requires urgent hospitalisation. The insurance company will settle the bill directly with the hospital. However, the hospital should be on the list of the network hospitals of the insurer.

· Recovery benefit

There are many individual health plans that offer financial assistance to the insured individual’s family during treatment. In case, the individual stays admitted to the hospital for more than 10 days, the family is eligible for compensation.

· Tax benefits

As per Section 80D of the Income Tax Act, you can claim a tax deduction for the total premium paid for individual health insurance plans. The total deduction limit stands at Rs.25,000.

Things to keep in mind when you buy individual health insurance

· Coverage

It is essential to assess the coverage that the health plan offers. Make sure you get comprehensive coverage to meet all your needs comfortably.

· Affordability

If you find the premium high for your budget, you have the option of choosing to co-pay the claim. This means that you will pay a share of your final bill yourself. With the co-pay option, you can expect to pay lower premiums.

· Network hospitals

It is wise to check if the insurer has a vast chain of network hospitals. One can get a cashless claim settlement facility at any of these hospitals.

· Waiting period

The insurance benefits will not come into effect until the waiting period is over. One should look for individual insurance plans that have lower waiting periods for critical illness.

· Sub-limit

Sub-limit is a cap placed on the claim amount for hospital room rent, post-hospitalisation charges, and others. It is wise to choose a plan having a lower sub-limit.

What makes health insurance plans for individuals necessary?

Considering the increasing healthcare expenses, and changing lifestyle, individual health insurance becomes a crucial investment that secures you during medical emergencies. Health insurance policies for individuals ensure you can access high-quality medical care when required.

Here is why health insurance plans for individuals are necessary.

· Skyrocketing medical inflation

The cost of medical treatment has been on a drastic rise over the last few years. Individual health insurance lets you stay financially secure against any sudden expense caused due to medical emergencies.

· Lifestyle-related diseases on the rise

Increasing lifestyle-related diseases due to stress, pollution, device addiction, and unhealthy eating habits make personal health insurance a must.

· Savings

One of the most significant reasons to buy an health insurance plans for individuals is that it helps keep one’s savings intact in times of medical emergencies. There are no out-of-pocket expenses as the policy offers the necessary financial coverage.

· Secure your family

Having an individual health insurance plan for family members will ensure complete security for them. Ageing parents or growing children are most vulnerable to illnesses. A medical insurance plan will ensure they access the best quality healthcare services without worrying about funds.

What does individual health insurance plan cover?

· In-patient hospitalisation

Covers treatment costs during in-patient hospitalisation. This includes room rent, medication, doctor fees, tests, etc.

· Pre-and post-hospitalisation

Covers hospitalisation charges for up to 30 days before and 90 days after hospitalisation. The duration varies for different insurers.

· Daycare treatment

Get coverage for daycare treatment charges within the valid policy term. The individual health insurance includes the number and types of daycare treatments covered in the policy document.

· Organ donor expenses

Covers expenses incurred to harvest a major organ from a donor for an organ transplant procedure.

· Domiciliary hospitalisation

Health insurance plans provide coverage for domiciliary hospitalisation. You get coverage for treatment taken at home under the supervision of a medical practitioner. Usually, doctors prescribe home treatment if the patient’s condition does not permit to go to the hospital or due to the unavailability of hospital bed.

What does individual health insurance plan not cover?

Here are some of the key exclusions under the individual health insurance plans.

  • Cosmetic surgeries
  • Dental treatment
  • Self-inflicted injuries/suicide
  • Treatment for any ailment due to drug abuse
  • Deaddiction treatment
  • HIV/AIDS
  • Injuries or illness due to war

How to claim your individual health plan

At the time of an emergency, you can claim your individual medical insurance by following the set of steps given below:

Step 1: Fill up the pre-authorisation form at the network hospital to claim cashless approval at the time of hospitalisation.
Step 2: The insurer will approve the request and notify the hospital.
Step 3: Following which the hospital procedures will begin.
Step 4: The insurer will settle the bills directly with the network hospital at the time of discharge.

A similar set of steps can be followed to claim other individual health insurance plans.

How much coverage under individual health insurance should you have?

Usually, it is advised you must have 50% of your annual income value as health insurance coverage. This means if you earn Rs. 5 lakh per annum, get health insurance coverage up to Rs. 2.5 lakh. However, considering the medical inflation every year, you must have sufficient health coverage to stay adequately covered during medical emergencies. You get coverage up to Rs. 2 crore on health insurance plans for individuals. The premium for individual health insurance policies depends on the coverage chosen. Hence, buy an individual health insurance that fits your budget and requirement.

Frequently asked questions

Which is better a family floater or individual health insurance?

Family floater health plans cover the entire family in a single policy, whereas personal health insurance secures individuals. The premium varies for both types of health insurance plans as depends on the coverage offered. The best strategy would be to focus on ensuring all family members and getting maximum advantages from both plans. Choose a health insurance plan that suits your requirement and budget, giving you adequate coverage during a medical emergency.

When should I buy an individual health insurance plan?

The earlier you purchase, the better. Generally, you must buy a health insurance plan during your early twenties, when you have just begun working. You are less likely to fall ill or claim the benefits of health insurance policy at this age. This helps you get cumulative bonus, i.e., bonus accumulated for every claim-free year. You can use the benefit to increase the sum insured without paying any extra premium on policy renewal. Health insurance policies for individuals also aid in financial planning and provide comprehensive coverage at a lower price.

Is individual health insurance expensive?

The premiums of health insurance policies differ from insurer to insurer. You can compare and choose the right insurance plan that fits your requirements and budget. Bajaj Finance along with leading insurers offers a wide range of comprehensive health insurance plans at affordable premiums. With the growing medical inflation, it is imperative to have health insurance that keeps you financially secure.

What should I do if I cannot afford a health insurance plan for individual?

Digitalisation has boosted the health insurance sector. Most health insurers now offer health insurance policies online. You can simply visit your preferred health insurance provider’s website to check different policies and coverages offered. You will find multiple health insurance plans with extensive coverages at reasonable prices. Different insurers have different premium and coverage offerings. Many health insurance companies offer the option to pay the premium in instalments. Hence, compare and buy health insurance policies online. You can also choose a family health insurance plan that covers your entire family under one plan. Look for a wide range of health insurance plans available at affordable premiums on Bajaj Finance Insurance Mall.

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