What is Health Insurance?
Health insurance is a financial safety net that helps cover your medical expenses if you get sick or injured. By paying a premium, you receive coverage for a variety of healthcare needs, including hospital stays, daycare procedures, and treatment for critical illnesses. This means you won't have to worry about paying large medical bills out of pocket.
Many health insurance plans offer additional benefits like free medical check-ups and cashless hospitalisation, allowing you to get the care you need without upfront payments at certain hospitals. These features ensure that you can focus on your health and recovery, while your insurance takes care of the financial aspects. One of the advantages of health insurance is the tax benefit under Section 80D of the Income Tax Act. You can claim a deduction on the premium paid for yourself, your family, and even your parents. This helps you reduce your taxable income while ensuring financial protection for medical needs.
What is Medical Insurance?
Medical insurance, also known as health insurance, is a type of insurance policy that covers medical expenses for illness or injury. Medical insurance plans offer coverage for hospitalisation expenses, pre-and post-hospitalisation expenses, and other medical expenses. There are different types of medical insurance policies available, such as individual, family, senior citizen, and group medical insurance plans. It is important to note that medical insurance are used interchangeably, but health insurance covers preventive care, whereas medical insurance covers medical expenses due to an illness or injury.
Is Health Insurance truly valuable?
1. Financial protection against high medical costs
Health insurance safeguards you from unexpected medical expenses. It covers costs for hospitalisations, surgeries, and treatments, ensuring that you are not burdened by hefty bills that can disrupt your financial stability.
2. Access to quality healthcare
With health insurance, you gain access to a network of hospitals and healthcare providers. Insured individuals can receive timely and effective medical care, ensuring better health outcomes without the anxiety of financial constraints.
3. Preventive care benefits
Many health insurance plans offer free preventive services, such as vaccinations and health screenings. This encourages proactive health management, helping you catch potential health issues early before they become serious.
4. Medical inflation rate
The medical inflation rate has surged, driving up healthcare costs significantly. This escalation underscores the critical need for health insurance to protect against rising medical expenses and ensure financial security.
5. Gender and health in India
In India, gender disparities in health access and outcomes persist. Health insurance is vital for women, offering financial protection, promoting preventive care, and addressing unique health needs, thereby enhancing overall well-being.
Key Features Of Health Insurance Plans
Here are some key features to check before buying any Medical and Health Insurance policy:
Features |
Specifications |
Premium starts |
Rs. 9.3/day* |
Sum insured (medical coverage) |
Rs. 5 lakh to Rs. 50 lakh |
Cashless treatment |
10,000+ hospitals |
Pre-and post-hospitalisation expenses |
Covered |
Tax benefits |
Included |
Ambulance expenses |
Included |
Pre-existing diseases |
Covered (according to the plan terms and conditions) |
Daycare procedures |
Up to 527 daycare treatments |
OPD cover |
Covered |
ICU charges |
Covered |
Maternity cover |
Covered (depending on the plan you choose) |
| AYUSH treatment | Covered (depending on the plan you choose) |
Difference between health insurance and medical insurance
Here’s a quick overview of the key differences between Health Insurance and Medical Insurance plans:
Features |
Health insurance |
Medical insurance |
Scope of coverage |
Health insurance covers both preventive care and medical treatment. This includes regular check-ups, screening tests, vaccinations, as well as hospitalisation expenses and medical procedures. |
Medical insurance covers expenses related to accidents or illnesses, including hospitalisation, diagnostic tests, surgeries, and medication. |
Number of claims |
There is usually a limit on the number of claims per year. |
Medical insurance may have a limit on the total value of claims or a limit on the number of days of hospitalisation. |
Premium |
Health insurance comes at a higher premium than medical insurance as it covers a broader range of services. The premium depends on the age, health condition, and coverage required. |
Medical insurance policy premiums depend on the policy coverage and whether it is an individual, family, or group policy. |
Sum insured |
Depends on the health insurance coverage chosen. |
For medical insurance too, the coverage amount depends on the policy chosen. |
Add-on covers |
Available |
Available |
Types of Health Insurance plans
Buying the right medical insurance 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
Employee or Group 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.
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Cancer insurance plan
Cancer insurance plans cover the medical expenses for cancer treatment. It covers chemotherapy, diagnosis costs, and other related expenses. These plans come at a higher premium because of the risk coverage. Some health insurance policy also come with cancer add-on cover at slightly higher premium.
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Health insurance for parents
Parents health insurance is essential for securing medical coverage, safeguarding against high healthcare costs, and ensuring timely access to treatments, which ultimately promotes peace of mind and family well-being.
Health insurance buying checklist
There are a few things that one must keep on their checklist when looking to buy a health insurance plan. Refer to a few common things suggested below:
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Co-payment
You should choose a health insurance plan with no co-payment. This way, you won't incur any out-of-pocket expenses for each claim. Review the policy documents to check for any co-payment terms before purchasing.
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Health check-up benefit
Select a health insurance plan with annual free preventive health check-ups. This benefit covers yearly exams. Verify policy benefits for preventive check-up facilities before purchasing.
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Grace period
Choose a health insurance policy with a maximum grace period for more renewal time. Check policy wordings for the exact grace period.
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Restore benefits
Choose a health insurance plan with 100% restore benefits. This feature fully restores your sum insured after it’s exhausted following a claim. Verify the availability of this benefit in the policy documents.
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Waiting period
The waiting period refers to the duration before the policyholder can claim benefits for specific medical conditions. Ensure you understand the waiting periods for pre-existing diseases, maternity benefits, and specific treatments. Choosing a policy with a shorter waiting period can provide quicker access to coverage.
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No Claim Bonus
No Claim Bonus (NCB) is a reward given by insurers for not filing any claims during a policy year. This bonus usually results in a discount on the renewal premium or an increase in the sum insured. Look for policies that offer a significant NCB to maximise your benefits over time.
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Sub limits
Sub-limits are the maximum amounts that insurers will pay for certain treatments or services within your policy. It’s essential to review these limits for critical areas like hospitalisation, surgeries, and room rent. Choosing a plan with higher sub-limits ensures adequate coverage without financial strain during medical emergencies.
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Network hospitals
Network hospitals are those that have a tie-up with your insurer, allowing for cashless treatment. Check the list of network hospitals and their specialties. Ensuring access to quality healthcare providers within your locality can enhance your overall experience and expedite the claims process.
What are the benefits of buying health insurance plans?
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Medical coverage
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
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 illness 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-existing diseases coverage
Buy health insurance plans with medical coverage for pre-existing diseases. Pre-existing disease refers to a medical condition, disease, or injury that is diagnosed before purchasing the insurance policy.
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HealthReturns™ benefit
Get up to 30% of your premium as HealthReturns™ with Aditya Birla Activ Assure Diamond policy. You can use the benefit to pay for renewal premiums, medicine, or diagnostic tests. You will get it in the digital cash form on the Activ health app.
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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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Road ambulance expenses coverage
Get coverage for ambulance expenses incurred for transporting the insured to the hospital.
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527 daycare treatment coverage
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 check-ups
Buy medical insurance policies that cover the cost of your routine and periodic health check-ups. Some policies may also offer free health check-up facilities.
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100% digital process to buy insurance policy online
Buy health insurance online with zero paperwork. No need to visit a branch or contact any agents. Compare policies and buy the health plan you need online.
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Income tax benefit
Get tax exemptions on premiums paid for health insurance policies as per the applicable tax laws.
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Covers AYUSH treatment
Health insurance often covers AYUSH treatments, including Ayurveda, Yoga, Unani, Siddha, and Homeopathy, providing a comprehensive approach to health care that embraces traditional and alternative medical systems.
Things To Consider Before You Buy Health Insurance Plans
You need to consider certain crucial factors before buying a medical health insurance policy. Here's the list:
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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.
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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.
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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.
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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.
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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.
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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.
Top reasons to buy Health Insurance plans
Health insurance plans provides financial security against the medical expenses that arise due to any unforeseen events. It ensures that you receive quality medical care without any financial burden. Here are the top reasons to buy a health insurance plan:
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Financial protection
Health insurance plans offer financial protection to you and your family against the high cost of medical treatments.
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Wide coverage
Health plans cover a wide range of medical expenses such as hospitalisation, daycare procedures, ambulance charges, organ donor expenses, and more.
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Cashless treatment
Health insurance policies provide cashless treatment facilities at network hospitals. This is especially convenient when you require urgent medical help.
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Quality healthcare services
This encompass comprehensive medical care, including preventive, diagnostic, therapeutic, and rehabilitative treatments. They are characterised by skilled professionals, advanced technology, and patient-centric approaches that prioritise safety, effectiveness, and accessibility for all patients.
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Coverage for critical illness
Coverage for critical illness provides financial protection against severe health conditions like cancer, heart attack, or stroke. This insurance offers a lump-sum payout upon diagnosis, enabling access to necessary treatments and alleviating financial burdens during challenging times.
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Tax benefits
You can claim deduction under section 80D of the Income Tax Act for the premium paid towards your policy.
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Peace of mind
Health insurance plans provide peace of mind. They ensure that you are prepared financially to handle medical emergencies.
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Affordable premiums
Health insurance policies come with a range of premium and coverage options. This makes having a health insurance policy accessible for everyone.
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Preventive health check-ups
Some health insurance policies cover preventive health check-ups, which help in early detection of any health issues.
Step-by-step guide to buying 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 of health insurance plans
Here’s a quick look at what’s covered and what’s not covered in 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 health insurance 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 for Health Insurance |
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 |
Does your health insurance policy cover COVID-19 treatment?
Yes, most medical insurance plans now include coverage for COVID-19 treatment, addressing the rising healthcare needs during the pandemic. These policies typically cover hospitalisation, medication, and post-treatment expenses related to COVID-19. It's crucial to review the specifics of your health insurance policy to understand the extent of coverage. With the evolving nature of the pandemic, insurers have adapted their medical insurance plans to ensure comprehensive protection against the financial burden of COVID-19 treatment.
Factors that affect your health insurance premium
Health insurance premiums are calculated based on several factors. These include the age of the insured, type of plan, sum insured, habits and lifestyle, and medical history. The older you are, the higher your premium is likely to be, as the risk of mortality, hospitalisation, and medical expenses increases with age. The type of plan you choose, such as an individual health policy or a family floater plan, also affects your premium. Here are some of the factors that affect the 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 their age increases. For instance, someone over 50 years old 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 types of 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 (NCB) 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.
How to choose the best health insurance plan in 2025?
Here are some tips to choose the best health insurance plans for you and your family.
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Analyse the plan type
Understand your requirement, whether you need an individual health insurance or a health insurance for family.
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Affordable premium with maximum coverage
Consider your budget and coverage required on the policy, and for how many people if buying a family health insurance.
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Coverage details
Check the coverages offered like pre-and post-hospitalisations expenses, hospitalisation expenses, daycare procedures, and more.
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Easy claim process
You must also consider the claim settlement ratio of the health insurance company. This will help you know the insurance company’s efficiency to resolve the claims.
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Based on these requirements, choose a health insurance that fits your requirements.
What is the Ideal Coverage for Health Insurance
A good health insurance plan should provide coverage that is tailored to an individual's medical needs and circumstances. A common guideline is to purchase a plan with a sum insured amounting to at least half of your annual income. With rising medical costs, experts recommend a minimum coverage of Rs. 10 lakh. However, determining the ideal coverage isn't straightforward and depends on several factors:
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City of residence
Coverage requirements can vary significantly between tier-1, tier-2, and tier-3 cities due to different medical costs.
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Age or life stage
Younger individuals typically need less coverage compared to older individuals who may have more health issues.
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Future hospitalisation costs
Consider the potential increase in medical expenses due to inflation.
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Below is a table to help determine the ideal health insurance coverage based on different types of plans and city tiers:
Types of Health Insurance plans
Tier-1 City
Tier-2 City
Tier-3 City
Individual Health Insurance Plan
Rs. 15 lakh & above
Rs. 8-15 lakh
Rs. 7 lakh
Family Floater Health Insurance Plan
Rs. 40 lakh & above
Rs. 25 lakh & above
Rs. 12 lakh & above
Senior Citizen Health Insurance Plan
Rs. 25 lakh & above
Rs. 18 lakh & above
Rs. 12 lakh & above
People can consider purchasing a Rs. 1 crore health insurance policy, which has become more affordable. This is particularly useful for long-term critical illness treatments or treatments abroad.Disclaimer: The above sum insured is suggestive and may vary according to the age and medical needs of individuals.
Steps to calculate health insurance premium online
Here are things you need to calculate health insurance premium online.
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Step 1
Enter the value of number of people you want to cover under the policy.
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Step 2
Provide your mobile number and date of birth.
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Step 3
Enter information like the sum insured, plan tenure, and add-on covers if any.
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Step 4
You need to also enter your health conditions and lifestyle habits.
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Once you fill in all the above information, you will receive the health insurance policy quotes on your registered number or email address.
Health insurance riders
Health insurance riders are additional benefits that policyholders can add to their base health insurance plans for enhanced coverage tailored to specific needs. Here are some common health insurance riders explained in a descriptive and pointers format:
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Critical illness rider
Provides a lump-sum benefit upon diagnosis of specified critical illnesses such as cancer, heart attack, or stroke, supplementing treatment costs.
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Hospital cash rider
Offers a daily cash benefit during hospitalisation to cover incidental expenses like transportation or caregiver costs.
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Maternity and newborn rider
Covers maternity expenses including prenatal care, delivery, and postnatal care. Some plans extend coverage to newborn care.
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Personal accident rider
Pays a lump sum or ongoing benefits in case of disability or death due to accidents, complementing health insurance coverage.
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Waiver of premium rider
Waives future premiums if the policyholder becomes permanently disabled or critically ill, ensuring continuous coverage without financial burden.
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Top-up and super top-up riders
Super Top Up Health insurance Provides additional coverage beyond the base sum insured once the threshold limit is reached, offering cost-effective enhancement of coverage.
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Choosing the right riders depends on individual needs and health risks, offering flexibility and comprehensive protection against unforeseen medical expenses.
How to reduce the health insurance premium?
Here are tips to reduce the health insurance premium.
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Compare premiums
Compare health insurance premiums online. Look for different health insurance policies online from different insurance companies.
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Reasonable
Compare the coverages offered and premiums. Go for the health insurance policy that provides maximum coverages at reasonable premiums.
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Age
Buying a health insurance policy at an early age can help you save on premiums, as you are less likely to have health issues when you're young. Pre-existing conditions or health issues can lead to higher premiums because the coverage amount would increase.
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Top-up benefits
You can look for top-up health insurance policies that come at an affordable premium. You can choose a basic health insurance plan and enhance the policy with a top-up health plan that gives extra coverage.
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Avoid claims for smaller expenses
Do not make claims for small medical expenses. Health insurance companies offer a cumulative bonus for every claim-free year. You can use this bonus to increase your sum insured without increasing the premium on health insurance renewal.
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Co-pay feature
You can opt for co-pay as well. Co-pay in health insurance means the insured and the insurance company both share the medical expenses. For instance, if you opt for 20% co-pay on your sum insured of Rs. 10 lakh, then you may have to pay Rs. 2 lakh. The insurance company will pay Rs. 8 lakh. The higher the co-pay you choose, the lesser premium you will pay.
Contact details of our Health Insurance Partners
Brand Name |
Aditya Birla Health Insurance |
Niva Bupa Health Insurance |
Manipal Cigna Health Insurance |
Bajaj Allianz General Insurance |
Contact number |
8828800035 |
18005008888 |
18001024462 |
18002090144 |
Email address |
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Know more |
Why compare health insurance plans online?
Comparing health insurance policies online offers several significant advantages:
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Comprehensive comparison
Easily compare multiple health insurance policies side-by-side to identify the best coverage options.
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Cost efficiency
Find the most affordable premiums and comprehensive coverage, helping you save money in the long run.
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Feature evaluation
Evaluate additional benefits, such as wellness programs, cashless hospital networks, and preventive care services included in each health insurance policy.
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User reviews
Access real customer feedback and ratings, providing valuable insights into the performance and reliability of different insurers.
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Convenience
Save time and effort by comparing policies from the comfort of your home, without the need to visit multiple insurance offices or agents.
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By comparing health insurance policies online, you can make an informed decision that best suits your healthcare needs and budget.
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 Bajaj 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 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 Bajaj 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:
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For self and family
Everyone below 60 years: Rs. 25,000
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For self, family, and parents
Everyone below 60 years: Rs. 25,000 + Rs. 25,000
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For self and family
Everyone below 60 years and senior citizen parents: Rs. 25,000 + Rs. 50,000
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For self and family
Eldest member above 60 years and senior citizen parents: Rs. 50,000 + Rs. 50,000
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Health Insurance covers medical expenses and reduces taxes, get deduction 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.
How to raise a claim for a Health Insurance policy?
Raising a claim for medical insurance policies in India might seem complicated, but it is a simple process if you follow the right steps. Here's a quick guide on how to raise a claim for your medical insurance plans:
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Inform the insurer
As soon as you or your family member is admitted to the hospital, inform the insurance provider to start the claim process.
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Fill out the claim form
Submit the duly filled claim form along with other documents such as hospitalisation bills, discharge summary, doctor's prescription, and diagnostic reports.
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Pre-authorisation
In case of a planned hospitalisation, pre-authorisation from the insurance provider is necessary. Submit all the relevant documents to get pre-authorisation.
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Cashless treatment
If your policy provides cashless treatment, then after pre-authorisation, the insurer will directly settle the medical bills with the hospital.
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Reimbursement
If cashless treatment is not available, then you can opt for medical reimbursement where you pay the hospital bills first, then file a claim with the insurer, and get reimbursement for the medical expenses.
Raising a claim for your health insurance policy is a simple process. Make sure you submit all the relevant documents to avoid delays and ensure a smooth claim process. Knowing the process will make it easier for you at the time of medical emergencies.
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
Why buy a Health Insurance plan at an early age?
Buying medical insurance plans at an early age has numerous benefits. Here are a few reasons to consider buying health insurance plans when you are young:
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Low premiums
Health insurance premiums are determined based on your age. So, the younger you are, the lower the premiums.
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Lesser health issues
Typically, you experience fewer health issues compared to those in their thirties, which increases your likelihood of obtaining comprehensive coverage. With minimal or no pre-existing conditions, securing a strong medical policy becomes easier, giving you an early advantage in insurance planning.
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Avoiding the waiting period
Most health insurance policies have a waiting period of 2-3 years for pre-existing illnesses. Buying a health insurance plan at an early age ensures you have coverage when you need it.
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Comprehensive coverage
Buying a health insurance plans earlier ensures you get comprehensive coverage. So, you stay protected against unforeseen medical emergencies.
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Tax benefits
You can claim deductions under section 80D of the Income Tax Act for the premium paid towards your health insurance policy.
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Financial security
A health insurance policy offers financial security and protects you against high medical bills that can cause a significant financial burden. Check health insurance tax benefit.
Myths About Health Medical Insurance
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Health insurance is only for older people
Many believe that health insurance is only necessary for the elderly. However, medical emergencies can occur at any age. Buying insurance early offers lower premiums and comprehensive coverage when needed most.
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Only hospitalisation expenses are covered
A common myth is that health insurance only covers hospitalisation costs. In reality, most policies also cover pre- and post-hospitalisation, diagnostic tests, day-care treatments, and sometimes even preventive care, like health check-ups.
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Pre-existing conditions are never covered
While many think pre-existing conditions are excluded, most health insurance policies cover them after a waiting period. It's crucial to choose a policy with a manageable waiting period to ensure comprehensive protection.
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Claiming insurance is a hassle
Many believe that claiming health insurance is a complicated process. However, with cashless claims at network hospitals and digital claim processes, insurers have made it more convenient than ever to get timely reimbursements.
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.
You can claim your health insurance policy multiple times during a policy term as per the maximum sum insured offered by the policy.
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.
Calculating your health insurance premium online is a simple process. Here are the steps to calculate your health insurance premium online:
1. Visit the website of the health insurance provider or aggregator.
2. Look for the health insurance premium calculator.
3. Enter your age, gender, type of policy, coverage amount, and any pre-existing medical conditions that you may have. You may need to give additional information like your occupation, medical history, and family members to be covered.
4. The calculator then generates the premium amount as per your policy requirements.
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. The tax deductions are as mentioned below:
- 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. 31,200* under Section 80D of Income Tax Act, 1961.
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.
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 check-up, 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.
It depends on your age, health condition, and insurance provider. If you are young and healthy, you may not need to undergo a medical test to buy a health insurance policy. However, if you are older or have pre-existing medical conditions, the insurer may ask you to undergo a medical test before your policy gets approved. Medical tests depend on the insurer’s terms and conditions. Therefore, you must check with them before buying a health insurance policy.
Yes, many health insurance plans offer accidental death coverage as an add-on cover. This benefit provides financial compensation to the nominee in case of the policyholder's accidental death or disability. However, the terms and conditions for this coverage may vary for different insurance providers.
Several insurance providers offer mediclaim insurance policies in India. It is essential to research and compare the policies, premiums, coverage, and benefits offered by different companies. You can look for the mediclaim policies online. Go to your preferred insurance provider’s website and check for the premiums, coverages, and benefits available. Choose a plan that best suits your requirements and budget.
The cost of health insurance in India depends on several factors such as age, health condition, and coverage required. If choose to add a few add-on covers, the premium may go up. So, choose a policy that fulfils your needs and comes within your budget. Read the policy's terms and conditions carefully before purchasing.
There are various leading insurance providers in the country that offer health insurance policies. All policies are comprehensive and can be customised based on an individual’s requirement. One such portal that offers health insurance policies by leading insurance providers is the Bajaj Finance Insurance Mall. Here you can choose from multiple policies for individuals, senior citizens, family plans, and much more.
Pre-hospitalisation expenses cover medical costs incurred before hospital admission, such as consultations and tests. Post-hospitalisation expenses include follow-up treatments, medication, and therapies after discharge, ensuring comprehensive care.
If you already have a health insurance policy and want to increase your sum insured, you can opt for a top-up or super top-up plan to enhance your coverage without buying a new policy.
No, cashless benefits are typically not available at non-network hospitals. However, you can file for reimbursement of medical expenses incurred at non-network hospitals under your health insurance policy.
Bajaj Finserv offers a variety of health insurance plans, including individual health insurance, family floater plans, critical illness coverage, personal accident insurance, and senior citizen policies. These plans provide comprehensive protection tailored to different health needs and age groups.
The cost of a health insurance plan per month varies depending on factors like age, sum insured, coverage, and chosen riders. Typically, premiums can start as low as ₹300 per month and increase based on the selected plan and individual requirements.
Yes, you can get health insurance money back through plans offering a "return of premium" feature, or by opting for a No Claim Bonus (NCB), which rewards policyholders with lower premiums or increased coverage for not filing claims during the policy term.
To get a health insurance quote from Bajaj Finserv, you can visit their official website, fill out basic details such as age and coverage preferences, or contact their customer service. Instant online quotes and policy comparisons are available for your convenience.
