Health insurance plans cover the insured for several healthcare expenses as per the sum insured opted for and the premium paid. Some best health insurance plans in the market are offered by popular insurance companies which have an impressive claim settlement ratio.
*Standard Terms and Conditions Apply.
**Tax benefits are subject to changes in Income Tax Act.
Having health insurance is very important these days as an adequate insurance policy provides you with much-needed financial assistance in case of any medical emergency. It covers treatment expenses incurred on pre and post-hospitalization, room rent, ambulance services, doctor's fees, ICU charges, medicine costs, and so on.
Thus, medical insurance protects your savings from any unexpected expenses due to medical treatments.
Check out the list of best health insurance plans in India below with their Incurred Claim Ratio (ICR) and the number of network hospitals facility:
Health Insurance Companies |
Health Insurance Plans |
Network Hospitals |
Incurred Claims Ratio (2018-19) |
Maximum Sum Insured Amount |
Universal Sompo Health Insurance | Essential Privilege Plan | 4,000+ | 92% | Rs. 10 Lakhs |
Bajaj Allianz Health Insurance | Health Guard Plan | 6500+ | 85% | Rs. 50 Lakh |
Star Health Health Insurance | Family Health Optima | 9,900+ | 63% | Rs. 25 Lakhs |
HDFC Ergo General Health Insurance | My: health Suraksha | 10,000+ | 62% | Rs. 75 Lakhs |
HDFC Ergo Health (Apollo Munich) | Optima Restore | 10,000+ | 62% | Rs. 50 Lakhs |
ManipalCigna Health Insurance | Prohealth Plus | 6,969+ | 62% | Rs. 50 Lakhs |
Royal Sundaram Health Insurance | Lifeline Supreme | 5,000+ | 61% | Rs. 50 Lakhs |
Aditya Birla Health Insurance | Activ Assure Diamond | 5,700+ | 59% | Rs. 2 crores |
Care Health Insurance(Religare) | Care Health Insurance formerly Religare Health Insurance Plan | 7,400+ | 55% | Rs. 6 Crores |
Max Bupa Health Insurance | Health Companion Individual | 4,500+ | 54% | Rs. 1 Crore |
Updated - 13th July 2021
Health insurance plans / medical insurance reimburse the insured individuals for their medical expenses that include costs related to surgeries, hospitalization, treatments, and the like arising due to injuries, illnesses, or even accidents. In case of a health insurance claim settlement, the insurer, that is the insurance company, pays the benefits to the insured as per the terms and conditions of the policy document.
In other words, a medical insurance policy is an agreement between an insurance company and the insured where the former agrees to provide the specified payment/compensation for medical expenses in case the latter is ill and requires hospitalization. In most cases, health insurance companies have tie-ups with hospitals, known as network hospitals where the insured can avail of treatment without paying even a single penny.
Buying best health insurance online is easy only when the buyer is aware of the different types of plans available in the market. Health insurance companies in India offer 7 types of health insurance plans that cater to the varied needs of people in different age groups and with different health conditions. Explained below are the types of health insurance plans that one can opt for as per their requirements:
Individual health insurance plans cover only one individual, the policyholder, who gains all the coverage benefits offered under them. Under an individual health insurance plan, the insurance company covers the medical expenses of the insured as per the sum insured opted and premium paid. Some common coverage benefits offered under these plans include in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, daycare expenses, domiciliary hospitalisation expenses, organ donor expenses, etc. Best suited for people with higher health risks, individual health insurance plans generally come without any limit on the maximum age for policy renewal. This means that the plan offers lifetime renewability benefits to the insured. Also, one can include their parents and immediate family members under the policy, on an individual sum insured basis. Individual health insurance plans cover people on an individual sum insured basis, hence there is no restriction on the number of claims made during a policy term.
Some popular individual health insurance plans available in the market are:
Unlike individual health insurance plans, a family floater health insurance plan extends coverage to the entire family, on a floater sum insured basis. One of the best advantages of family floater health insurance plans is that it allows an individual to cover him/herself as well as their family members under a single health insurance plan, thereby making it easier for the insured to manage. When it comes to covering your parents under a health insurance policy, a family floater health insurance policy is an affordable option as compared to a senior citizen health insurance policy. A family floater health insurance policy covers your family members including legally wedded spouse, dependent children, parents, parents-in-law, brother, sister, and other relations varying from plan to plan, at affordable premiums. These plans are recommended for young families as then the chances of making more than one claim are lesser. This allows the member making a claim to get greater coverage at lesser premiums.
Some popular family floater health insurance plans available in the market are:
Senior citizen health insurance plans are tailor-made for people aged between 60 years and 75 years to cater to their respective insurance-related needs. It is recommended to get a senior citizen health insurance policy as most individual or family floater health insurance plans do not offer coverage to people aged above 65 years. Beyond 65 years, they only allow renewals. Some of the unique coverage benefits of senior citizen health insurance plans include daycare expenses, domiciliary hospitalisation expenses, cashless hospitalisation, cover for pre-existing diseases, and cover for specific diseases.
Some popular senior citizen health insurance plans available in the market are:
Critical illness plans cover the insured for life-threatening illnesses that are serious and long-term in nature like heart attack, stroke, paralysis, cancer, renal failure, etc. These plans provide the insured a lump sum amount on the first diagnosis of the critical illnesses covered under the plan. The insured can use the amount received not only to avail of the required treatment in India but outside India as well. The insured can also utilise the amount to pay for debts if any, for the child's education, or in any other way as per the requirement. It is recommended to be covered under a critical illness policy as the treatments of critical illnesses are expensive. If someone is diagnosed with a critical illness, it may hurt their pocket in case one has to bear the expenses on his/her own.
Some popular critical illness health insurance plans available in the market are:
Women-specific health insurance plans are especially designed to meet the insurance-related requirements of women in different stages of their lives. For instance, these plans protect women from healthcare expenses at the time of retirement, maternity expenses, cover for newborn baby, cover for child's education, etc. they also cover women for specific diseases which they are prone to, after a specific age. Even if a woman has an individual health insurance policy provided by her employer, it is still recommended that she should be covered under a women-specific policy. This is because sometimes an individual health insurance policy, unlike a women-specific health insurance plan, does not cater to the specific needs of women and hence they miss out on coverage benefits. Also, these plans come at affordable premiums and generally offer lifetime renewability benefits to the insured.
Some popular specific health insurance plans available in the market are:
Top-up and super top-up health insurance plans let the insured enhance the sum insured of their base health insurance policy to cover the shortfall, in case the hospital bills exceed the limit. A top-up health insurance policy kicks in when the amount of claim exceeds the deductible value and the sum insured of the base health insurance policy during a policy term, in case of single hospitalisation. All claims are treated individually in these plans. Whereas, in super top-up plans, the insured gets paid for claims for cumulative healthcare expenses within a policy term when it exceeds the deductible and sum insured limit of the base health insurance plan. A super top-up policy covers you for expenses that are not covered under your top-up or base policy. The only difference is that the super top-up policy takes into account multiple hospitalisations. One can purchase a super top-up insurance policy from any insurance company irrespective of which insurance company's base policy one has.
Some popular top-up and super top-up health insurance plans available in the market are:
Disease-specific health insurance plans cater to a particular disease such as cancer, diabetes, heart diseases, etc. It is suitable for people looking for wide coverage for a particular disease. One can choose this plan even if they are already covered under a corporate health insurance plan or any regular health insurance plan. This is because those plans may not always offer sufficient coverage for specific diseases. Disease-specific health insurance plans eliminate the waiting period, which otherwise you are required to complete if covered under a regular health insurance plan. The plan is best suited for people with a family history of a particular disease like hypertension, diabetes, etc.
Some popular critical illness health insurance plans available in the market are:
You can consider the following tips to select the best medical insurance policy:
Select a medical insurance policy that offers cover against expenses arising due to many health issues and provides various health care facilities such as daycare expenses, pre-hospitalisation expenses, post-hospitalisation expenses, ambulance cover, etc. In case you opt for health insurance for your entire family, then make sure to check if the health plan meets the requirement of each member. Compare the plans on the basis of the benefit offered and reasonable cost before making a decision.
While purchasing a health insurance policy do not forget to check the duration for which the plan is offering you coverage or if it comes with a lifetime renewability option or not. It is always recommended to buy an insurance plan that offers a lifetime renewability option.
Compare various health insurance policies online to make sure that you purchase a health plan that meets all your requirements. Also, you can get quotes for various different plans online by providing the necessary details to get an estimated premium of different policies. Gather best quotes and compare in order to make an informed decision. So, all those wondering how to choose the best health insurance plan online must read the things to consider:
A claim settlement ratio is the total number of settled claims over by the insurer over the total number of claims received. Therefore, while buying a health insurance plan make sure to check the claim settlement ratio and always opt for the insurance provider that has a high claim settlement ratio.
After selecting medical insurance plans, make sure to check if your preferred hospitals or doctors are there in the list of network hospitals provided by your insurance provider. Choose an insurance company that has a wide range of network hospitals across India.
People who do not have a family to support should choose Individual health plans. However, if you are purchasing a health insurance plan keeping your family in the picture, then opt for a family health plan to avail more benefits at a reasonable cost.
While purchasing a medical insurance policy, it is important to select a plan that caters to your requirements. However, you should select a health plan that fits within your budget but make sure to consider the benefits before going for the cost. Compare the plans thoroughly to make a wise decision and to ensure an overall protection against health issues at an affordable cost. Also, you can enhance your coverage with time after considering important factors such as size of family, rise in income and needs of the family members.
There are several benefits of comparing health insurance plans online. It not only allows you to choose the best one to meet your healthcare requirements but also helps you make an informed decision. But there are various health insurance companies in the market that offer various health insurance plans, so sometimes one may end up buying a health insurance policy that comes at a low premium, but may compromise on the coverage benefits. On the contrary, it may also be the case that someone pays a higher premium for a health insurance policy but still does not get the features as required. Keeping into consideration the increasing healthcare costs of treatment, a health insurance policy protects a medical emergency from becoming a financial emergency, and hence should be chosen wisely.
Listed below are some common benefits of comparing health insurance plans online:
1. Access to Accurate Information: All the information about different health insurance plans in the market is easily accessible online. So, comparing health insurance plans online saves you from dealing with agents who are known to provide biased and unreliable information most of the time and help you access accurate information.
2. Time Efficient And Convenient: Comparing health insurance plans online helps you save time, which is not the case when you meet agents and discuss policies. Also, it is comparatively easy to pay health insurance premiums or renew health insurance plans online. So, the process is transparent and does not take much of your time.
3. Pocket Friendly: When you buy health insurance plans online, you compare them in terms of premium, benefits, etc, thereby shortlisting the most affordable one as per your budget. So, in this case, you end up buying a health insurance policy that fits your budget. But if an agent is involved, then he/she might trick you into buying a policy that you do not actually require or is out of your budget.
4. Customer Reviews: At InsuranceDekho, you will find several customer reviews of different health insurance plans. When shortlisting a policy, you can go through the reviews to be certain of your decision.
Under health insurance plans, you can make a claim in two ways, i.e. cashless claim and a reimbursement claim. A cashless claim is when you do not pay anything at the hospital for the treatment availed. Whereas in reimbursement claim, you will be first required to pay for the treatment taken, at the hospital, and the insurance company pays to you later. The claim processes for them are mentioned below:
Cashless Claim
To make a cashless claim, you will be required to follow the steps given below:
Reimbursement Claim
To avail reimbursement treatment, you must follow the steps given below:
You will be required to submit the following documents to the insurance company in case of reimbursement claim:
Health insurance plans protect your savings from getting ruined in case of serious health conditions that result in hospitalisation during the policy period. But most of the people believe that health insurance plans only cover them for hospitalisation expenses, which is not true. The key purpose of health insurance plans is to provide comprehensive coverage to the insured, which they do so by offering protection for various healthcare expenses. Some of these include cover for in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, daycare expenses, domiciliary treatment expenses, organ donor expenses, etc. Apart from coverage benefits, health insurance plans also offer other benefits. To understand them in detail, read below:
Health insurance companies, generally, have tie-ups with hospitals wherein the insured can avail the required treatment without paying anything except the non-medical expenses or the expenses that the policy does not cover. Network hospitals are present across India and you can avail treatment in any of them, provided the treatment availed is in accordance with the terms and conditions mentioned under your health insurance plan.
Health insurance plans offer comprehensive coverage by protecting you from several healthcare expenses. These include the following:
Another benefit of health insurance is that it offers flexibility to port from one health insurance policy to another in case you are not satisfied with the benefits offered under the existing one. Apart from giving the customers flexibility, it also saves them from being taken for granted by the insurance companies.
A health insurance plan helps you in combating financial stress in case of an emergency even during rising healthcare expenses. It offers you wide coverage even in times of inflation. Therefore, it is recommended to buy a suitable health insurance policy.
The government of India promotes health insurance by offering tax deductions on the premium paid for the plans, under Section 80D of the Income Tax Act, 1961. To understand the tax benefits in detail, refer to the table below:
Situations | Premium Paid (Self, Family, Children) | Premium Paid (Parents) | Deduction under Section 80D of the Income Tax Act |
When Policyholder and Parents are below 60 years | Rs. 25,000 | Rs. 25,000 | Rs. 50,000 |
When Policyholder and family members are below 60 years with parents above 60 years | Rs. 25,000 | Rs. 50,000 | Rs. 75,000 |
When Policyholder, family members and parents are above 60 years | Rs. 50,000 | Rs. 50,000 | Rs. 1,00,000 |
Members of HUF | Rs. 25,000 | Rs. 25,000 | Rs. 25,000 |
Non-resident Individuals | Rs. 25,000 | Rs. 25,000 | Rs. 25,000 |
The utility of health insurance plans not only depends on the features and benefits offered under them but also on how the insured is able to make the most of it. So, if you don't want your health insurance policy to be underused, you must thoroughly understand its benefits as well as the process to avail of them.
The pandemic declared coronavirus has impacted the lives of many in India. During times like these when medical emergencies can arise any time, having a health insurance policy comes in handy. Whether you are married, single, have children, are young, old, or do not have any children, you must have a reliable health insurance policy that protects you in case of serious illness, sickness, disease, or an accident. Whether you choose individual health insurance plans or family health insurance plans, remember that the choice will not only affect the quality of healthcare but also affect your wallet.
During coronavirus times, the policyholders are often confused if the policy under which they are covered protects them from hospitalisation expenses arising due to coronavirus or not. The answer is 'YES'. All new health insurance plans in the market will cover the insured for coronavirus cases after 30 days i.e. the initial waiting period. COVID-19 related claims will follow the normal processes and will be treated as a normal illness like chikungunya, pneumonia, or any other virus. The good news is that so far there is no exclusion.
So, if you still have not insured yourself and your family, then you should get coronavirus health insurance as soon as possible.
It is an agreement between an insurer and a policyholder where former promises of bearing the medical expenses of the latter subject to the limits of the plan. To own this coverage, the policyholder is required to pay premiums to the insurer for getting the coverage without any break.
With age, the probability of falling prey to diseases increases. Therefore, a senior citizen health insurance plan is an excellent option, as in older age, the lesser or no income enhances the trouble. These plans are designed to cover senior people aged 60 years and above and provides coverage for diseases, critical illnesses, accidents, etc.
Treatment of critical diseases is never easy. The procedures related to critical illnesses are highly expensive and prolonged that lead to the loss of a significant amount of savings. These plans provide cover for diseases like kidney failure, heart attack, cancer, muscular dystrophy, and many others.
Pregnancy is a turning point in every woman's life. At this time, they require the utmost care. With time, medical technology has made delivery procedures safer, more comfortable, but expensive. Everyone wants that the mother and baby should get the most possible comfort during the delivery procedure. Thus, taking a maternity plan is a gesture of perfect planning.
The group health provides the insurance to eligible professionals of an organization. Under this segment of insurance plans, the employers purchase the health policies for their employees. The payment for it is made two ways, half of the amount is paid by the employer and the remaining by the employees. It is generally given to enhance the morale of the employees and also to retain the employees.
An accident is an unforeseen and unfortunate event that can happen to anybody and anytime. Also, its consequences may go disastrous and catastrophic. Therefore, a personal accident insurance plan is necessary for dealing with financial hardships during an accident.
Some of the parameters that you must consider in order to purchase the most suitable health insurance policy include waiting periods for pre-existing diseases, capping or sub-limits, waiting period for specific illnesses/diseases/procedures, co-payment clause, if any, exclusions under the policy, number of network hospitals and if your preferred hospital is a part of the network or not, claim settlement ratio of the insurance company, incurred claim ratio, premium, add-on benefits, if any, inclusions and exclusions, etc.
Health insurance plans do not offer cover for all healthcare expenses. Some common exclusions include expenses incurred on treatment due to self-inflicted injuries including suicide, expenses incurred due to participation in any adventurous sport, pre-existing conditions are not covered during the waiting period, venereal or sexually transmitted disease, cosmetic treatments, treatments related to dental, hearing, and vision, expenses incurred on treatment of obesity, and cover for accidents due to participation in defence operations.
Yes. Standard health insurance plans offer cover for expenses incurred due to positive diagnosis of COVID-19. The health insurance policy will cover you for in-patient and outpatient expenses arising due to treatment of COVID-19. You can also purchase health insurance plans especially designed for coronavirus. These include Corona Kavach Policy and Corona Rakshak Policy. These are short term policies that offer cover against the pandemic declared coronavirus. For more information about these policies, you can connect to the customer care executives at InsuranceDekho and they will help you understand them in detail.
A health insurance policy offers you a cashless treatment facility allowing you to get the required medical treatment at the network hospital without paying even a single penny. It offers you several benefits apart from cashless treatment, such as pre-hospitalisation and post-hospitalisation expenses, tax benefits under Section 80D of the Income Tax Act, 1961, daily hospital cash benefit in some plans, organ transplant expenses, No Claim Bonus, lifetime renewability benefit, automatic restoration of sum insured, etc.
If your sum insured amount gets exhausted under a health insurance insurance policy due to claims made in a policy year, then the insurance company will restore the amount automatically without having you to pay anything extra to avail the benefit. Health insurance plans that offer restoration benefits are generally available at higher health insurance premiums.
No. Health insurance plans come with multiple sub-limits which can be for specific treatments, doctor's consultation fees, pre-planned surgeries like cataract, joint replacements, pre-planned surgeries, etc. You cannot claim an amount that exceeds your sum insured limit. Many health insurance plans also come with room rent limits, ICU charges, surgery expenses, doctor's fees, lab test expenses, etc. for which the cover is offered proportionately.
Some popular health insurance plans that offer wide coverage and yet come at affordable premium include Essential Privilege Plan offered by Universal Sompo Health Insurance, Health Guard Plan offered by Bajaj Allianz Health Insurance, Family Health Optima offered by Star Health insurance, and My: health Suraksha offered by HDFC Ergo General Insurance.
There is not one, but many health insurance plans in India that offer great benefits to the policyholders. These include Prohealth Plus offered by ManipalCigna Health Insurance, Lifeline Supreme offered by Royal Sundaram Health Insurance, and Activ Assure Diamond offered by Aditya Birla Health Insurance.
Purchasing health insurance for yourself as well as your family is important in India because lifestyle diseases are becoming very common and healthcare expenses are skyrocketing, especially in private hospitals. So, if you do not have a suitable health insurance plan, it may burn a hole in your pocket.
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