10 Best Health Insurance Plans In India 2022
The best health insurance policy could be picked up based on your requirement:
Best Health Insurance in India for an individual
Best Health Insurance Plans for your family in India
Best Health Insurance Plan for your Parents or any senior citizen
Top Up/Super Top Up Health Insurance Policy
Some important factors you should consider before taking a health insurance.
What is Claim Settlement Ratio or CSR?
It is the ratio of the total number of claims settled by the insurance company to the total number of claims received in the same duration of time.
Important to know: A high CSR indicates that the company is more likely to settle a claim without any hassles.
what is Incurred Claim Ratio or ICR?
It is the ratio of the total amount of all claims received by a company to the total premiums collected in the same duration of time.
A high ICR indicates that an insurance company is more likely to accept new customers, more likely to have a less waiting period for pre-existing illnesses,
and more likely to issue policies to people with pre-existing illnesses.
Network Hospitals: An insurer should have a good number of hospitals in its network in each city, which cater to various classes of people. Network
hospitals should include nursing homes, day-care centers, and multi-specialty hospitals.
Waiting Period for Pre-existing Illnesses: A longer waiting period for pre-existing illnesses can mean that you cannot make a claim for hospitalization,
even though you are paying the premium.
Important to know: 2 years is the waiting period for pre-existing illness to be covered. However, there are some insurers who specify the waiting period to be 4 years.
What is cost of Premiums?
The premiums no doubt varies across insurers, but what matters is – the benefits that you are going to get for the premium you pay.
The premium should cover an acceptable room rent in any city, medical & surgical costs and also cover common treatment costs such as cataract, knee surgery and dialysis.
Note: The insurer should have different types of plans as per requirement, for example family floater plans, individual health plans, senior citizen health
plans and plans which are suitable for people with specific health conditions such as heart disease, cancers etc.
Let’s see what fits into our requirements from the list of best health insurance companies in India 2022.
1. Star Health Insurance
Star Health Insurance company provides a wide range of health insurance policies for families, individuals, senior citizens, they also provide insurance for specialized care like cancer or heart patients.
Star Health has a high claims settlement percentage of 98% and ICR of 60.52% with a whopping 9800+ hospitals are on its network.
2. ICICI Lombard Health Insurance
ICICI Lombard has a network of 6400+ hospitals where you can avail cashless facilities.
As per IRDA, it is supposed to have settled 98.30% of the claims received. It has a very high ICR of 80.39% which indicates that people are making claims and renewing their policy.
3. Care Health Insurance
Care Health Insurance was earlier known as Religare health insurance.
Care Health Insurance is one of the best health insurance in India 2022, It offers coverage for personal accident, critical illness, maternity, top-up coverage, international travel insurance along with group health insurance.
The CSR or claim settlement ratio of Care health insurance is 92% and has over 4850 hospitals in its network.
4. Max Bupa Health Insurance
Max bupa health insurance offers coverage for a number of diseases, cashless claims.
Claim settlement ratio of Max Bupa is 91% and a high ICR of 51.95%. Max has over 4900+ hospitals in its network.
5. Tata AIG Health Insurance
Tata AIG Insurance is a trusted 21-year-old with AAA rating by ICRA.
The company has access to 5700+ network hospitals.
Best Health Insurance Plans for your family in India 2022
1. CARE Advantage 1 Crore Health Insurance Plan
CARE Advantage health insurance (earlier known as Religare health insurance) is one of the best family floater plans in India. Care has launched the 1 Crore health plan with a motive to provide a higher health cover of Rs. 1 crore at a premium of regular plans. The floater combinations can be up to 2 Adults + 4 Children.
In the case of a claim-free year, the sum insured is increased by 10% as a No Claim Bonus. The increase is limited to a maximum of 50% in 5 consecutive years.
Highlights of Religare Care Advantage 1 Cr Plan
Ambulance in Emergency
Pre and post hospitalization expense cover
Higher coverage at a lower premium
Coverage for Organ donor
Coverage for daycare treatment
Up to 50% no claim bonus
Features & Benefits
Pre-Existing disease wait period – 48 months
Pre-hospitalization Medical expenses incurred up to 30 days before hospitalization is covered.
Post-hospitalization Covers expenses like doctor consultations, diagnostic tests, medications up to 60 days post-hospitalization.
Min age for cover Individual – 5 years and Child – 91 Days (floater policy with 1 person above 18 years)
Max age for renewal Lifelong renewability
Waiting period to cover pre-existing illness Named ailment wait period – 24 months
Restoration benefit Recharge of sum insured at no extra cost. But not for ailment already claimed during the same year.
Exclusions Self-inflicted injuries (suicide), injuries caused by alcohol or drug use, congenital disease, Infertility and sterility, change of gender
Room Rent / ICU Charges No sub-limits for Room Rent charges or ICU Charges. treatments and expenses related to any admission primarily for diagnostics and evaluation purposes only.
Advantages
No capping on Ambulance charges
No cap on Room rent & ICU charges
No maximum entry age
1 Crore cover in affordable price
Disadvantages
If the age of the eldest member insured at the time of the first policy is 61 years or above 20% co-payment,
4 years of coverage required to overcome pre-existing illness
2. Tata AIG Insurance
This health insurance represents AAA rating by ICRA, This is for paying claims and policyholder obligations on time. The individual death claim ratio for 2019-20 was 96%.
One can avail a long-term premium discount of 5% and 10% for the policy with tenure of 2 and 3 years respectively.
The policy covers medical expenses incurred outside India which makes this one special. But the initial diagnosis should have been made in India.
Type of Tata AIG Medicare health plans – Medicare, Medicare Protect and Medicare Premier.
Medicare – The sum insured ranges from Rs. 3 Lakhs to Rs. 20 Lakhs.
Medicare Protect – the sum insured under Medicare protect plan covers the basic pre and post hospitalization expenses, i.e can range up to Rs. 5 Lakhs
Medicare Premier– The sum insured ranges from Rs. 5 Lakhs to Rs. 50 Lakhs.
Features & Benefits
Initial Policy issued for the period 1/2/3 years with life long renewal option
Policy Coverage Individual or on a family floater basis. Maximum 7 members
Waiting Period Specified disease waiting period – 24 months
Pre-hospitalization Medical expenses incurred up to 60 days immediately before hospitalization is covered.
Post-hospitalization Medical Expenses incurred in the 90 days immediately after the discharge
Min Age for cover Dependent children between 91 days and 5 years, only when both parents are getting insured
Max Entry Age 65 years
Pre-existing disease waiting period – 36 months
Day Care Procedures 541 daycare procedures are covered
Domiciliary Hospitalization The plan covers medical expenses incurred during treatment at home
No-Claim Benefits 50% increase in cumulative bonus for every claim-free year
Restoration Benefit An additional amount equivalent to the base Sum Insured will be restored once during the policy period
Preventive Health Checkup expenses Up to 1% of the previous sum insured subject to a maximum of Rs. 10,000/- per policy
Alternative Treatments – AYUSH Medical Expenses incurred for In-patient treatment taken under Ayurveda, Unani, Sidha or Homeopathy.
Exclusions Injuries caused by alcohol or drug use, mental disorders, weight control, congenital disease, treatment for correction of eyesight,
maternity, abortion, self-inflicted injuries (suicide), an act of war, riots, strike and nuclear weapon induces hospitalization, hazardous or adventure sports.
One can have a family floater discount on premium as under:
2 members – 20%
3 members – 28%
>3 members – 32%
The unique coverage under the policy includes:
Vaccination cover
Health Check-up (max Rs. 10,000)
Bariatric Surgery cover,
Medical and surgical expenses for organ donor
OPD dental treatment
What you may like
5700+ Network hospital
Global medical cover
1,2, and 3-year policy
Up to 32% family floater discount on premium
What you may not like about
Cover for individuals aged 5 years onwards
Limit on ambulance cover
3. Max Bupa Heartbeat Family Floater Health Insurance Plan
Max Bupa Heartbeat family is comprehensive health insurance plan could be best options for family needs international emergency coverage.
Types or variants of plan – Silver, Gold, and Platinum.
Silver variant – It is a basic health insurance plan which covers inpatient care, pre and post hospitalization expenses and day care procedures. It also offers maternity benefits for 2 kids and covers the newborn baby also.
Gold variant – The Gold plan covers up to Rs. 50 Lakhs and has all features of the Silver plan. You have higher room rent coverage up to the sum insured and maternity benefits covered up to Rs. 1 Lakh.
Platinum variant – Offers insurance coverage up to Rs. 1 crore and all features of the Gold plan with additional features as below:
Covers international treatment for specified illnesses like cancer.
Charges for OPD treatment and diagnostic services if required.
Emergency medical evacuation & hospitalization facility.
Second medical opinion.
Higher maternity benefit coverage of up to Rs. 2 Lakh.
Vaccination expenses for children up to the age of 12 years.
Features
Pre-hospitalization Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.
Post-hospitalization Expenses up to 90 days post-discharge is covered.
Min Age for cover Entry age for adults is 18 to 65 years. The entry age for dependent children is from 91 days to 21 years.
Max Age for Renewal Lifelong renewal is allowed.
Refill Benefit In case the base sum insured is exhausted, you can have 100% of the base sum insured refilled.
Day Care Procedures 536 daycare procedures are covered.
Domiciliary Hospitalization Provided only if there is no bed available in the hospital and a minimum of 3 days treatment is taken at home.
Waiting Period to cover pre-existing illness 2 years for gold and platinum variants and 4 years for the silver variant.
No-Claim Benefits Irrespective of claim status, you will get a 10% per annum increase in the Sum Insured, up to a maximum of 100% of the Sum Insured for Gold and Platinum plan and 50% in case of the Silver plan.
Alternative Treatments – AYUSH Covered in all the variants
Exclusions Eyesight, and optical services, suicide, illnesses due to alcohol & drug abuse, IVF treatment, cosmetic & plastic surgery, robotic assisted surgery and AIDS
Advantages
Different relations including children, spouse, parents, parents-in-law, dependent sisters/brothers are allowed to be covered in the policy.
Maternity Benefits for delivery of up to 2 children.
A newborn is covered immediately without any additional premium
International treatment is covered in the platinum plan. Also, sub-limit for OPD and diagnostic services expenses are available.
AYUSH treatments are covered for all the plans.
Vaccination expenses are covered in the Platinum plan
Disadvantages
Waiting period for pre-existing illness is 2 years for Gold and Platinum plan but 4 years for the basic Silver plan.
OPD treatment and diagnostic services are available only under the Platinum plan.
4. Bajaj Allianz Health Guard Family Floater Plan
Health guard is a comprehensive family floater plan from Bajaj Allianz. The Sum Insured under the floater policy can be used to meet hospitalization or other permitted expenses for any of the insured members under the policy.
The best facility or advantage one can get from this policy is that the common surgeries like hernia, piles, cataract and sinusitis are covered after a waiting period of 2 years for aged-people.
Health guard family floater - type of plans
Silver plan with the option to have a sum insured up to Rs. 2 Lakh
Gold plan where you can have a sum insured up to Rs. 50 Lakh
Platinum plan with the sum insured up to Rs. 1 crore
Features
Min Entry Age Adult – 18 to 65 years
Dependent children/ grandchildren – 3 months to 30 years
Max Age for Renewal Renewable for lifetime
Waiting Period to cover pre-existing illness 3 years
Pre-hospitalization Expenses for consultation, medical tests, and medicines incurred up to 60 days immediately before hospitalization are covered.
Post-hospitalization Expenses incurred during the 90 days immediately after discharge are covered.
Reinstatement Benefit 100% of the sum insured specified under inpatient hospitalization treatment cover
Day Care Procedures 130 daycare procedures covered.
No-Claim Benefits For every claim-free year, you will get a 10% per annum increase in the base Sum Insured, up to a maximum of 100% of the base Sum Insured.
Domiciliary Hospitalization Not covered.
Alternative Treatments – AYUSH Ayurvedic and Homeopathic hospitalization covered under the Gold & Platinum plan only.
Exclusions Attempted suicide, pregnancy, childbirth, fertility & infertility treatment, dental treatment and any treatment received outside India
Advantages
No restriction on room rent under the Gold & Platinum variant.
Diseases like hernia, piles, cataract and sinusitis are covered after a waiting period of 2 years.
Complimentary health checkup for every 3 continuous policy years for Silver & Gold plan / 2 years for Platinum plan.
Children/ grand children, up to 30 years of age can be covered.
Known for smooth and quick processing of claims.
Disadvantages
20% co-payment if you avail treatment in Zone A cities but pay Zone C premium.
Alternative treatment covered under the Gold & Platinum plans only
Domiciliary treatment not allowed.
Lower (only 130) daycare procedures covered as compared to other insurers.
Best Health Insurance in India for an Individual
5. HDFC ERGO (My: Health Suraksha Plan)
An individual can avail benifits like Air ambulance cover, infertility cover along with other benefits with My:health Suraksha insurance plan that is normally not covered with other insurers.
Types of my:health Suraksha plan – Silver Smart, Gold Smart and Platinum Smart Plans.
Silver Smart Plan – with a basic sum insured up to Rs. 5 Lakhs covering basic hospitalization expenses, daycare procedures and domiciliary hospitalization expenses.
Gold Smart Plan – with a basic sum insured up to Rs. 50 Lakhs with air ambulance cover and higher road ambulance limit.
Platinum Smart Plan – with a basic sum insured up to Rs. 75 Lakhs with a cover similar to Gold Smart plan but with a higher limit.
Features
Pre-hospitalization Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.
Post-hospitalization Medical expenses incurred up to 180 days immediately after you are discharged from the hospital are covered.
Restoration Benefit An amount equivalent to claim amount is added, subject to a maximum of the basic sum insured
Day Care Procedures Covered.
Minimum entry age for cover
Maximum entry age Adult – 18 years/ Child – 91 days
Adult – Lifetime entry/ Child – 25 years
Maximum Age for Renewal Renewable for life
Waiting Period to cover pre-existing illness 48 months for pre-existing disease
24 months for the specified disease
No-Claim Benefits (NCB) For every claim-free year, you will get a 10%/ 25% per annum increase in the Sum Insured, up to a maximum of 100% of the Sum Insured.
Domiciliary Hospitalization Covered
Alternative Treatments – AYUSH Covered provided that the treatment is carried out on outpatient basis.
Exclusions Treatment for alcoholism, drug or substance abuse, obesity & weight control, attempted suicide, sterility & infertility treatment like IVF, and dental treatment & surgery.
Advantages
Air ambulance cover with Gold & Platinum Smart plan
Organ Donor expenses covered
AYUSH treatments are covered.
180 days of post-hospitalization cover
Disadvantages
Per-policy checkups for Platinum Smart plan for sum insured over Rs. 25 Lakhs
20% co-payment terms if treatment availed in higher-tier cities
48 months waiting period for pre-existing disease
6. Manipal Cigna ProHealth Plus Insurance Plan
Manipal Cigna ProHealth plan offers the typical benefits of individual health policy and also offers protection up to the full Sum Insured in case of emergency hospitalization worldwide.
The plan also covers the cost of expert opinion on listed critical illnesses.
Features
Minimum Entry Age for cover Child – 91 days
Adult – 18 years
Pre-hospitalization Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization are covered.
Post-hospitalization Expenses incurred up to 180 days after hospitalization is covered.
Restoration Benefit Unlimited restoration of 100% of the Sum Insured for a policy year.
Day Care Procedures 546 types of daycare procedures covered.
Maximum Age for Renewal Lifelong renewable
Waiting Period to cover pre-existing illness 3 years
No-Claim Benefits For every claim-free year, you will get a 10% per annum increase in the Sum Insured, up to a maximum of 200% of the Sum Insured.
Domiciliary Hospitalization If you need to be treated at home due to a bed shortage at the hospital or even if your doctor prescribed home care, it will be covered up to the sum insured.
Alternative Treatments – AYUSH Inpatient hospitalization under Ayush covered up to the sum insured.
Exclusions Dental treatment, birth control procedures, routine medical checkup & diagnostics, AIDS/HIV, ailments arisiong due to alcohol or drug abuse,
non-allopathic treatment, and robotic or remote surgery.
Advantages
Health Maintenance benefit of up to Rs. 2,000
Free comprehensive health checkup at every renewal.
Ambulance cover of Rs. 3,000 for every time you get hospitalized.
Organ transplant costs including donor hospitalization is covered.
Reimbursement up to the Sum Insured in case of emergency hospitalization worldwide.
Add on benefits such as voluntary co-pay benefit, deductible option, and critical illness cover are available.
Disadvantages
Maternity expenses coverage normally available after a waiting period of 4 years.
20% co-pay in respect of claims for insured above 65 years and above.
7. HDFC Ergo Optima Restore Health Plan
Optima Restore health plan was initially launched by Apollo Munich health insurance. Post take over of Apollo Munich health insurance HDFC Ergo renamed the plan.
You can be benefited by having a 100% cover restored instantly after the first claim. The benefit will restore the amount equal to your base sum insured on both partial & complete utilization. The restoration can be used once in every policy year for a lifetime
HDFC Ergo Optima Restore is an individual plan with cover up to Rs. 50 Lakh with affordable premium rates as compared to the other plans on this list with
over 10,000+ network hospitals for cashless treatment.
Features
Pre-hospitalization Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization are covered.
Post-hospitalization Expenses for consultation, investigations, and medicines incurred up to 180 days after to hospitalization are covered.
Restoration Benefit 100% Basic Sum Insured will be reinstated only once in a policy year.
Day Care Procedures All daycare treatments covered.
Min Age for cover Adult – 18 years
Child- 91 days
Max Age for Renewal Lifelong renewable
Waiting Period to cover pre-existing illness 3 years
No-Claim Benefits For every claim-free year, you will get a bonus of 50% of the Basic Sum Insured, up to a maximum of 100%. However, the Cumulative
Bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal.
Domiciliary Hospitalization If you need to be treated at home due to a bed shortage at the hospital or the condition of the patient is such that he/she
cannot be removed to a hospital, it will be covered up to the sum insured.
Alternative Treatments – AYUSH Covered
Exclusions Attempted suicide, war, self inflicted injuries, adventure sports, IVF treatment, treatment of obesity & cosmetic surgery and AIDS/ HIV.
Advantages
No sub-limit on room rent
50% bonus as no-claim benefits
Organ transplant costs including hospitalization is covered.
180 days of post-discharge expenses
Complete cover for AYUSH treatments
10,000+ network hospitals to avail cashless facility
Disadvantages
50% reduction in bonus in case of claim.
3 year waiting period for pre-existing disease
8. ICICI Health Booster Super Top Up Policy
ICICI Health Booster is a super top-up policy that is similar to other health insurance policies except that it comes with a deductible amount. The greatest advantage of such policies is getting high health cover at a low premium.
With this policy, you have to bear the hospitalization expenses which is equal to the deductible amount. All hospitalization expenses over and above the deductible amount will be covered by this policy.
For example, you have bought this policy with a Sum Insured of Rs.10 Lakh and a deductible amount of Rs. 3 Lakh.
Assume you get hospitalized and the total expenses are Rs. 5 Lakh. Since the deductible amount is Rs. 3 Lakh, you have to bear the expense of Rs. 3 Lakh and the policy will give you Rs. 2 Lakh.
It is important to note that you need not have to bear the deductible amount from your pocket. If you have an individual or family floater policy, then it can be used to pay the deductible amount.
So, a super top-up policy is good in case you already have a health insurance policy and you want to increase the sum assured at a lesser cost.
Features
Pre-hospitalization Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization are covered.
Post-hospitalization Expenses for consultation, medical tests, and medicines incurred up to 90 days after hospitalization is covered.
Restoration Benefit For plans with deductible of Rs. 3 Lakh and above – reset up to 100%of the sum insured once in a policy year
Day Care Procedures 150 types of daycare procedures covered.
Minimum Age for cover Under Individual policy – 6 years
Under floater plan – 91 days onwards
Maximum Age for Renewal Lifelong renewability
Waiting Period to cover pre-existing illness 2 years
No-Claim Benefits For every claim-free year, you will get a 10% per annum increase in the Sum Insured, up to a maximum of 50% of the Sum Insured.
However, the Cumulative Bonus is reduced by 10% of the Sum Insured once a claim is made.
Domiciliary Hospitalization If you need to be treated at home due to a bed shortage at the hospital or even if your doctor prescribed home care, it will be covered up to the sum insured.
Alternative Treatments – AYUSH Covered without any sub-limit
Exclusions Attempted suicide, routine medical, alcohol & drug abuse, dental treatment, AIDS, birth defect treatment, adventure sports, and treatment
received outside the country.
Advantages
Tax benefits can be claimed under Section 80D just like other health insurance plans.
Organ transplant costs including donor hospitalization is covered.
Deductible applicable on aggregate basis per policy year.
Complimentary health check coupons are issued every year.
AYUSH treatment is covered without any sub-limit.
Can be bought as an individual or family floater policy.
Disadvantages
Once the insured crosses 60 years of age, 20% of the amount above deductible is applicable for every claim as co-payment.
Best Health Insurance Plan for Parents (Senior Citizen)
9. Star Senior Citizen Red Carpet Health Insurance Plan
Star Senior Citizen Red Carpet plan is exclusively for senior citizens aged between 60 years to 75 years. The policy covers pre-existing diseases from the
second year onwards and carries lifelong renewals.
Star Senior Citizen Red Carpet plan is available both as an individual and floater policy.
Features
Pre-hospitalization Medical expenses incurred up to 30 days prior to the date of hospitalization is covered.
Post-hospitalization A sum equivalent to 7% of the hospitalization expenses incurred comprising of Nursing Charges, Surgeon / Consultant fees, Diagnostic
charges, Medicines and drugs only subject to a maximum amount per occurrence as under
Min Age for cover 60 years up to a maximum of 75 years
Max Age for Renewal Lifelong renewable
Waiting Period to cover pre-existing illness After 12 months of continuous coverage
No-Claim Benefits At the discretion of the company
Sum Insured up to Rs. 7.5 Lakh – Rs. 5,000.
Sum Insured of Rs. 10 Lakh and 15 Lakh – Rs. 7,000.
Sum Insured of Rs. 20 Lakh and 25 Lakh – Rs. 10,000.
Co-payment terms Sum Insured – 1 Lakh to 10 Lakh – Co-pay 30% for Non-PED (pre-existing disease) claims and 50% co-pay for PED claims
Sum Insured – 15 Lakhs to 25 Lakhs – Co-pay 30% for both PED and Non-PED claims
Day Care Procedures All daycare procedures covered.
Domiciliary Hospitalization Not applicable.
Medical Screening No pre-aceptance medical screening
Exclusions Attempted suicide, dental treatments, Laser surgeries for the eye, adventure sports and for treatment of disease by system of medicine other than allopathy
Advantages
Covers pre-existing disease from second year onwards
Outpatient consultations in networked hospitals.
Pre-insurance medical test is not required
Disadvantages
Sub-limits applicable for specific diseases.
Non-Allopathic system treatments not covered.
Room rent limits
ICU charges up to 2% of the Sum Insured per day.
Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees subject to a maximum of 25% of the sum insured per hospitalization.
10. Bajaj Silver Health
This policy can be bought by anyone who is between the age of 46 – 70 years of age and can be renewed lifelong.
This is available as an individual policy only.
Features
Pre-hospitalization 3% of admissible hospitalization expenses.
Post-hospitalization 3% of admissible hospitalization expenses.
Restoration Benefit Not available.
Day Care Procedures 130 types of daycare procedures covered.
Min Age for cover 46 years up to a maximum of 70 years
Max Age for Renewal Lifelong renewable
Waiting Period to cover pre-existing illness 12 months
No-Claim Benefits For every claim-free year, you will get a cumulative bonus of 10% of the Sum Insured, up to a maximum of 50% of the Sum Insured.
However, the Cumulative Bonus is reduced by 10% of Sum Insured once a claim is made.
Domiciliary Hospitalization Not applicable.
Alternative Treatments – AYUSH Not covered.
Exclusions Attempted suicide, dental treatments, obesity & weight control, refractive error for the eye less than 7.5 diopters, and treatment received out of India
Advantages
Free health checkup at designated centers after 4 consecutive claim-free years.
No sub-limit on the room rent and surgery costs.
Enhancement of sum insured allowed at the time of renewal
Disadvantages
Pre-medical test are mandatory
20% co-payment clause would be applicable if you get treated at a non-network hospital.
In case of hospitalization for any of the pre-existing illnesses, the cover would be restricted to 50% of the Sum Insured in a policy year from the second year of the policy.
11. Star Health Cardiac Care insurance
Star Health Cardiac Care is for those who are existing heart patients. People who have undergone stenting (angioplasty) or Bypass surgery within 7 years prior to the policy purchase.
All the other features of this policy are similar to other health insurance plans.
Features
Pre-hospitalization Expenses for consultation, medical tests, and medicines incurred up to 30 days prior to hospitalization is covered.
Post-hospitalization Expenses for consultation, medical tests, and medicines incurred up to 60 days prior to hospitalization is covered.
Restoration Benefit Not available.
Day Care Procedures All daycare procedures are covered.
Min Age for cover 10 years up to a maximum of 65 years
Max Age for Renewal Lifelong renewable
Waiting Period to cover pre-existing illness 48 months
No-Claim Benefits Not available.
Domiciliary Hospitalization Not applicable.
Alternative Treatments – AYUSH Not covered.
Exclusions Attempted suicide, dental treatments, Laser surgeries for the eye, adventure sports and for treatment of disease by system of medicine other than allopathy
Advantages
Flexible cover for accident and non cardiac treatments also covered.
90 days waiting period for cardiac ailments
Disadvantages
AYUSH treatments not covered.
Co-pay of 10% of each claim of the insured beyond 60 years of age.
Post hospitalization expenses capped at 7% of the hospitalization expenses, subject to a maximum of Rs.5,000/- per hospitalization.
Organ transplant costs are not covered.
Type of Health Insurance Policies in India
1. Individual Health Plans
If you have an individual health insurance policy, you alone will be eligible to claim the benefit of the entire sum assured. All the benefits covered in the plan are available to you and cannot be transferred to anyone else.
The greatest advantages of individual health plans are
The policy can be renewed without any age restrictions.
Offers higher protection for each person rather than as a family.
Suitable for people with health risks.
No risk for other family members even if the cover gets exhausted in a single year.
2. Family Floater Health Insurance Policies
Family floater health policies are umbrella health cover tailored for the entire family. A single premium is paid to obtain a cumulative health cover for
the entire family and the amount of health coverage can be utilized for hospitalization expenses of any member of the family.
The advantage of a family floater insurance policy is that
You can get your entire family covered by single health insurance at a lesser cost.
You can cover 4 children for each policy along with 2 adults.
The biggest disadvantage of the family floater health policy is that
There is a high possibility of the entire cover getting exhausted due to the hospitalization of one family member.
If your family members have frequent illness then opt for individual plans.
3. Senior Citizen Health Insurance Policies
Buying health insurance at an old age is difficult or unaffordable. I suggest you buy a health insurance policy for your parents before they get too old.
The Senior citizen policies are similar to individual health policies but come with stringent medical checkups, high premiums, a higher waiting period for pre-existing illnesses and a greater number of exclusion clauses.
These policies are usually bought by people who have already crossed 60 years of age but do not have any health insurance with them.
4. Top-up and Super Top-up Insurance Policies
Top-up and super top-up policies are health policies that come with a ‘deductible’ clause. These policies come into effect after the amount specified as the deductible is incurred as hospitalization expenses.
For example, assume that you have bought a top-up/super top-up policy of Rs.20 lakhs with a deductible of Rs.5 lakhs. If you get hospitalized, you are eligible to claim from the top-up/super top-up policy for all your hospitalization expenses over Rs. 5 lakhs.
The biggest advantage of these policies is that you can get a large cover for a low premium. Even though there is a deductible clause applicable, you can take a basic health policy whose sum assured will be equal to the deductible.
5. Policies Covering Specific Illnesses Such as Cancer or Heart Disease
The biggest advantage is that these policies cover illnesses like heart disease or cancer, which are usually avoided by many insurers. The premiums for such policies are high as the risk is high for the insurer.
These policies are designed for people who are already diagnosed with certain diseases or are at high risk of getting certain diseases.
Don’t just Rely on Corporate Health Insurance
It is often observed that people avoid taking health insurance as they got one from their employer, It is advisable to have personal health insurance policy always.
Why having your own health insurance policy is important.
Employer-provided insurance benefits will end the moment you leave or change the job.
You can not carry forward the benefits of employer health insurance.
Having your own health insurance early in life will always help in the case, you are diagnosed with any disease. This is because the waiting period clause will not apply and any illnesses you catch at a later stage get covered.
Employer-provided insurance clauses can change at any time.
Employer-provided health coverage can complete with a single hospitalization. You should have a backup policy.
Would you buy an expensive health cover post-retirement?
How you can wisely choose the Best Health plan/policy for you and your family
Always buy an individual policy at a young age. Otherwise, insurance becomes as expensive as you grow old.
Choose the right amount of sum insured as per your family size. Smokers, obese individuals and people with inactive lifestyles have higher health risks and need higher cover.
If you are buying health coverage for a family of 4 (2 adults and 2 kids), you can either
Good to buy individual covers for each family member and buy an additional family floater to increase the cover.
The second option is to buy a family floater and then buy a top-up/super top-up policy whose deductible is equal to the sum insured of the family floater policy.
It is recommended to choose a policy with minimal exclusions. Buy a plan which covers 100% of the costs of hospitalization, common daycare procedures and a part of pre and post-hospitalization costs. Do not opt for plans which have a co-pay option.
Do not buy a policy that has sub-limits on per day expenses or room rent
Choose a policy that offers lifetime renewability.
Your health plan/policy should cover hospitalization expenses for critical diseases as well. There should be no “claim loading” in case you or your family are diagnosed with a critical illness. Claim loading is a feature in which the insurance company can keep increasing your premiums year on year if you are diagnosed with a critical illness.
Look at the the waiting period for pre-existing diseases. Most insurance policies have 2 years as the waiting period but some have up to 4 years.
Always check the clauses for getting treated at network and non-network hospitals. Many insurers reimburse only 70-80% of the costs if you get treated at a non-network hospital.
If you are buying health cover for aged parents, check the list of diseases and medical procedures that are not covered in the list. Your policy should provide cover for common surgeries required by aged people such as cataract, hernia, knee surgery etc.
Buy the health insurance policy before you get any critical disease ( lungs, cancer, heart). Many policies have clear-cut clauses that the policies are to be bought before the onset of any such illness.
Buy a top-up/super top-up policy at a very less premium to get a large cover if you want to increase your health cover.
It is good to buy separate individual policies for yourself and your spouse as you grow old. This is an important step because family floater policies are issued against the name of the oldest person listed in the group. If the oldest person passes away, the policy ceases and the remaining family members have to buy a new policy at higher premium rates.
Before we look at the best health insurance policies, let us understand some of the common terms used to describe the features, benefits and advantages of health policies.
Things You Should Know About Health Insurance
It is always advisable to buy a health policy from a reputed insurance broker. Verify the credentials of the insurance agent before you buy a health policy. If any claims get rejected, your agent may not be able to help you.
You can also buy health policies online at a lesser price than offline. You have to make sure that you declare all the requested data correctly and honestly.
Feel free to bargain for less premium rates if you have healthy living habits such as non smoker, maintaining a good BMI, exercising regularly.
It is important to know that, No insurer will provide cover for a person aged above 90 years. Any existing policies also cease to be effective once the insured crosses 90 years of age.
This is applicable for employer-provided health insurance and also for retirees also.
The family floater policies are issued with the eldest member as the policyholder. If the eldest in the family deceases, a fresh policy has to be taken by the surviving family members at prevailing premium rates.
Always declare every detail of your illness, if any, even if it seems insignificant. Insurers have experts to determine if you have not declared any pre-existing illness and may deny your claims.
In case you are not satisfied with your existing health insurance policy, you can always ‘port-out’ to another policy. However, you have to pay the applicable premium of the new policy. But the greatest advantage is that the waiting period for the pre-existing illness will not apply.
Source: Policy Bazaar, Cashoverflow
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