Individual health insurance provides personalised coverage based on your chosen sum insured. With rising healthcare costs in India, being financially ready for medical emergencies is more important than ever. This insurance helps you handle unexpected health expenses by covering hospitalisation, pre- and post-hospitalisation care, daycare treatments, and even critical illnesses—protecting your savings while giving access to quality care.
You also benefit from cashless treatments across a wide hospital network, tax deductions under Section 80D, and optional add-ons like OPD cover and wellness perks for all-round protection.
What is Individual Health Insurance?
Individual health insurance is a personal medical policy that provides exclusive coverage to one insured person. Whether it’s for yourself, your spouse, your child, or a dependent parent, this plan ensures dedicated financial protection for each member, separate from others.
It typically covers hospitalisation, daycare procedures, ambulance charges, AYUSH treatments, organ donor expenses, and more. Since it isn’t shareable like a family floater, the entire sum insured is reserved for one person, offering peace of mind when it matters most.
Premiums vary based on factors like age, pre-existing conditions, and lifestyle, and you can personalise your plan with add-ons for maternity, critical illness, or room rent waivers. All policies are regulated by IRDAI, ensuring transparency and consumer protection.
Why wait for a health crisis to act? Secure yourself or your loved one with an individual health plan. Get quotes, compare benefits, and buy online in minutes.
Features |
Specification |
Network Hospitals |
10000+ |
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 |
ICU charges |
Covered |
AYUSH treatment |
Covered (depending on the plan you choose) |
Why should you choose Individual Health Insurance?
Individual health plans provide personalised coverage, ensuring financial protection during medical emergencies. They offer tailored benefits, flexibility, and a choice of healthcare providers, making them an ideal solution for securing your health and financial well-being.
- Flexibility: Individual health insurance offers flexibility by allowing you to choose coverage options that suit your specific needs. Whether you need basic coverage or a more comprehensive plan, you can select the best policy for your health requirements and budget.
- Choice of providers: With individual health plans, you can choose from a wide network of healthcare providers. This allows you to access quality medical care from preferred hospitals and specialists, giving you greater control over your healthcare decisions.
- Employment status: Unlike employer-based health insurance, individual health plans provide coverage regardless of your employment status. This ensures that you remain insured even during job changes, self-employment, or retirement, offering continuous health protection.
- Portability: Individual health insurance policies are portable, meaning you can carry your coverage with you when switching jobs or relocating. This ensures uninterrupted protection, eliminating the need to reapply for insurance during transitions.
- Family coverage: Many individual health plans offer the option to include family members under the same policy. This allows you to protect your loved ones with comprehensive healthcare coverage, ensuring the whole family is financially secured during medical emergencies.
- Early start: Starting an individual health insurance plan early provides long-term benefits such as lower premiums, access to better coverage, and no waiting periods for pre-existing conditions. Early coverage helps you stay financially prepared for future health needs.
- Tailored benefits: Individual health plans offer tailored benefits, allowing you to customise your policy according to your unique health requirements. This personalized approach ensures that your plan provides coverage for specific treatments, medications, and preventive care you may need.
- Control over coverage: With individual health insurance, you have complete control over your coverage. You can choose the level of protection, add-ons, and specific benefits that match your lifestyle and health needs, providing a personalised healthcare experience.
- Access to specialised care: Individual health plans often grant access to specialised care, allowing policyholders to consult with top-tier specialists and receive advanced treatments. This ensures that you get the best possible care for complex or chronic health conditions.
- Peace of mind: Having an individual health insurance plan offers peace of mind, knowing that you're financially protected against unexpected medical expenses. It helps reduce stress during emergencies, allowing you to focus on recovery without worrying about high healthcare costs.
What are the 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 tests before buying an 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 expires. Health insurance renewal is a completely online process and you can easily renew your policy online with minimum documentation.
- 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.
- No Claim Bonus (NCB): Many insurers reward your healthy lifestyle! If you don’t make any claims during the policy year, you’re eligible for a No Claim Bonus—which can be either a discount on premium or an increase in sum insured at no extra cost. Over time, this significantly enhances your coverage.
- Tax benefits: Under Section 80D of the Income Tax Act, premiums paid for individual health insurance policies are eligible for tax deductions of up to Rs. 25,000 (and up to Rs. 50,000 for senior citizens). This means you’re not only protecting your health but also saving more on taxes.
- Preventive health check-ups: Many individual health plans offer annual preventive health check-ups either free or at discounted rates. These screenings help detect health issues early, enabling timely treatment and better outcomes.
Tax benefits of an individual health insurance policy
Investing in health insurance not only ensures financial security during medical emergencies but also provides significant tax savings. Here’s how you can avail of the health insurance tax benefit:
- Deduction under Section 80D – Premiums paid for an individual health insurance policy are eligible for tax deductions under Section 80D.
- Tax savings for family – You can claim additional deductions for premiums paid for your spouse, children, and parents.
- Higher deductions for senior citizens – If you insure parents above 60, you can claim up to Rs.50,000 in deductions.
- Preventive health check-up benefits – Get additional deductions of up to Rs.5,000 for preventive health check-ups.
What is covered under individual health insurance plans?
- 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.
- Preventive health check-up at no cost: Many insurers offer complimentary annual health check-ups to encourage preventive care and early detection of health issues.
- Emergency air ambulance coverage: Provides financial support for emergency air evacuation during life-threatening situations, ensuring timely medical access even in remote areas.
- Daily hospital cash benefit: A fixed daily allowance is paid during hospitalisation to cover non-medical expenses like food, travel, and attendant costs.
- E-opinion for 51 critical illnesses: Access to expert second medical opinions through online consultations for critical illnesses like cancer, heart disease, and neurological disorders.
- Alternative treatments coverage: Some policies include coverage for AYUSH treatments (Ayurveda, Yoga, Unani, Siddha, and Homeopathy), offering flexibility in healthcare choices.
- Lifelong renewability option: Health insurance plans can be renewed for life, ensuring continued financial protection against medical expenses regardless of age.
What is not covered under individual health insurance plans?
Here are some of the key exclusions under the individual health insurance plans.
- Cosmetic surgeries: Cosmetic or aesthetic procedures like facelifts, liposuction, and Botox treatments are generally not covered, as they are not considered medically necessary. However, reconstructive surgeries following accidents or trauma may be covered under certain conditions.
- Dental treatment: Routine dental treatments, such as cleanings, fillings, and orthodontic procedures, are usually excluded from coverage. Only specific dental treatments required due to accidents or injuries may be included in some policies.
- Self-inflicted injuries/suicide: Medical expenses resulting from self-harm or suicide attempts are typically not covered under individual health insurance plans. This exclusion is intended to prevent intentional misuse of health insurance benefits..
- Treatment for any ailment due to drug abuse: Health issues arising from substance abuse, such as drug or alcohol addiction, are not covered. Treatments for illnesses or injuries directly caused by drug abuse are also excluded from coverage.
- Deaddiction treatment: Costs related to rehabilitation or de-addiction programs for substance abuse are excluded. This includes both inpatient and outpatient services aimed at overcoming addiction to drugs, alcohol, or other substances.
- HIV/AIDS: Most individual health insurance policies do not cover the treatment of HIV/AIDS or related conditions. Some newer policies may offer partial coverage for HIV/AIDS treatments, but this remains an exclusion in many traditional plans.
- Injuries or illness due to war: Injuries or health conditions arising from participation in war, acts of terrorism, or civil disturbances are not covered. This exclusion also applies to injuries sustained during participation in military activities or riots.
What are the types of Individual Health Insurance claims?
Individual health insurance claims are generally categorised into two types: cashless claims and reimbursement claims. Both processes help policyholders manage medical expenses, offering flexibility in settling hospital bills based on the treatment received.
Cashless claims
- Available at network hospitals partnered with the insurance provider.
- No upfront payment is required; the insurer directly settles the bill with the hospital.
- Requires pre-authorisation from the insurance company, usually before hospitalisation.
- Ideal for planned treatments or emergencies at designated healthcare facilities.
Reimbursement claims
- Applicable when treatment is received at non-network hospitals.
- Policyholders pay the medical bills upfront and then file for reimbursement from the insurer.
- Requires submitting necessary documents, such as hospital bills, discharge summary, and prescriptions.
- The insurer evaluates and reimburses the eligible amount as per the policy terms.
What is the difference between Group and Individual Health Insurance?
Aspect |
Group Health Insurance |
Coverage |
Offered through employers or organisations, covering multiple people |
Premiums |
Typically lower due to group rates |
Flexibility |
Limited options for customisation |
Portability |
Coverage often ends with employment or organisation membership |
Eligibility |
Generally guaranteed for all members of the group |
What are the 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 tests before buying an 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 expires. Health insurance renewal is a completely online process and you can easily renew your policy online with minimum documentation.
Additional coverage
Some individual health insurance plans for individuals also offer additional coverage in the form of critical illness coverage, maternity benefit and more.