Types and Benefits of Health Insurance Policies in India

With the rise in health-related issues, there is an extreme increase in the treatment costs too. Moreover, there is an increase in the demand for Health Insurance Plans. Therefore, several types of Health Insurance Policies in the market help you save that extra burden on your pocket. These insurance plans just not let you find the best treatment for your health problems but also keep you stress-free from the expenditure point of view. Buying the right insurance plan can be a bit complicated as there are different types of Health Insurance plans in India. Health insurance plays a huge role in financial planning, offering protection against unexpected medical expenses. With various health insurance products available, it’s essential to understand the options to choose the right plan. In India, health insurance policies are designed to cater to diverse healthcare needs, ensuring that individuals and families have access to quality medical care. To help you out, we have listed all 11 types of plans and have described all significant elements of a health insurance policy so that you may buy a plan that is best for you.  

Types of Health Insurance Plans	Suitable For
Individual Health Insurance	Individual
Family Health Insurance	Entire Family- Self, Spouse, Children, and Parents
Critical Illness Insurance	Used for funding expensive treatments
Senior Citizen Health Insurance	Citizens of age 65 and above
Top Up Health Insurance	This insurance plan is beneficial when the sum insured of the existing policy gets exhausted.
Hospital Daily Cash	Daily hospital expenses
Personal Accident Insurance	It can be used in case of any loss or damage to the owner or driver.
Mediclaim	In-patient expenses
Group Health Insurance	For a group of employees
Disease-Specific (M-Care, Corona Kavach, etc.)	Suitable for those who are suffering from pandemic-manifested conditions or prone to one.
ULIPs	The dual benefit of insurance and investment

Types of Health Insurance in India

Individual Health Insurance

An Individual Health Insurance plan is meant for a single person. As the name suggests, it can be bought by a single individual. The individual who gets himself insured with this plan is compensated for the expenses incurred for illness and medical expenses. Such types of medical insurance plan cover all the hospitalisation, surgical, pre and post medication expenditures till the insured limit is reached. The premium of the plan is decided on the basis of the buyer’s age and medical history. Moreover, the insured individual can cover his spouse, his children, and parents, too by paying an extra premium under the same plan. However, if you get insured for any existing illness, there is a waiting period of 2-3 years for claiming the benefits.

Family Health Insurance

Popularly known as the Family Floater Plan, Family Health Insurance Policy secures your entire family under a single cover. Health insurance plans for family covers all the members of your family including your spouse, kids, and elders. Only one member of the family has to pay the premium, and the entire family gets insured in a single premium. In case two family members are getting simultaneous treatment, you can claim the insurance for both of them till the limit is reached. The premium is decided on the basis of the age of the eldest member to be covered up in the plan. So, try to avoid adding the members who are above 60 years in your family health insurance plan as they are more prone to illness, and thus, the premium will get impacted.

Critical Illness Insurance

The Critical Illness Insurance plan insures the person by offering a lump sum amount of money for life-threatening diseases. At the time of buying the insurance, the chosen health problems are included, and if you get affected by any of the pre-selected conditions, you can claim your insurance. Hospitalisation is not required to file a claim under this type of insurance policy. Only the diagnosis of the disease can make you avail the benefits of the critical illness insurance. The amount to be paid is pre-decided irrespective of pre and post-hospitalization expenses. Below is a list of all the critical diseases that are covered up in the Critical Illness Insurance.

• Major organ transplant
• Cancer
• Aorta graft surgery
• Kidney failure
• Stroke
• Multiple sclerosis
• Paralysis
• First heart attack
• Coronary artery bypass surgery
• Primary pulmonary arterial hypertension

Senior Citizen Health Insurance

As indicated by the name, such types of Health Insurance in India provides coverage to people who are 65 years and above. So if you are planning to buy an insurance policy for your parents or grandparents, then this is the best insurance policy for you. The Senior Citizen Health Insurance will offer you coverage for the cost of hospitalisation and medicines, whether it arises from a health issue or any accident. It covers hospitalisation expenses and post-treatment costs too. On top of this, some other benefits like Domiciliary Hospitalization and Psychiatric benefits are also being covered. The upper age limit has been marked at 70 years of age. Also, the insurer can ask for a complete body checkup before he sells the Senior Citizen Health Insurance. Moreover, the premium for this plan is comparatively higher as the senior citizens are more prone to illness.

Top Up Health Insurance

An individual can buy the Top Up Health Insurance plan if he seeks coverage for higher amounts. But there is a “Deductible Clause” added to this policy. Therefore, when the claim is made, the payment done is over and above the pre-defined limit that is mentioned in the policy. Moreover, there is also a Super Top-Up plan available for the individual. It provides additional coverage over the regular policy to increase the amount of sum insured. The Super Top-Up plan can only be used once the insured sum of the regular policy gets exhausted.

Hospital Daily Cash

Another segment is the different types of health insurance policy providing an innovative solution is the Hospital Daily Cash. If you feel insecure about buying an insurance policy, then you should go further with this plan and learn about how these health insurance policies work. This plan can help you to protect yourself from unexpected expenses during your hospitalisation. Once a person gets hospitalised, the routine hospital expenses are not fixed, and they tend to change as per the condition. In such a situation, the Hospital Daily Cash works the best for an individual. In this plan, the individual gets a daily cash benefit of Rs. 500 to 10,000, as per the coverage amount selected at the time of insurance. Convalescence benefits are also offered in some of the plans if the individual gets hospitalised for more than seven days. Other add-ons include Parental accommodation and wellness coach.

Personal Accident Insurance

The number of road accident cases have increased over the years, and that is why today, there are dedicated types of health insurance in India to protect the citizens. Thus, people end up losing their life or getting disabled, and bearing the treatment expenses can be a bit traumatising. So, availing of the personal accident insurance policy is a wise idea. This policy provides a lump sum amount to the victim or his/her family as support. Some of the plans also offer education benefits and orphan benefits meant to cover the expenses of the children. Moreover, Bajaj Allianz also provides add-on coverage like temporary total disablement, assistance service, worldwide emergency, and accident in-patient hospitalisation with personal accident plans. Other than this, if the insured suffers from an accident and has any loan obligations, it will also be taken care of by the insurance provider.

Mediclaim

Illnesses and accidents do not come with a pre-notification. The same goes for the expenses that one has to bear once the person gets hospitalised for any of these. Therefore, one should go for buying a Mediclaim Policy. The Mediclaim Policy ensures compensation for your hospitalisation expenses in case of any illness and accident. It provides coverage for the in-patient expenses that include surgery expenses, doctor’s fees, nursing charges, oxygen, and anaesthesia. The Mediclaim Policy is available in the market as group mediclaim, individual medical insurance, overseas medical insurance, etc.

Group Health Insurance

Group Health is one of the up and coming types of health insurance plans trending these days. Many medium and large-scale enterprises are offering this insurance policy to the employees. This type of health insurance is bought by the employer of the company for its employees. The premium of this policy is comparatively lower than the Individual Health Insurance Policy. It is offered to the group of employees to meet the financial crisis and prudence in the company.

Disease-Specific (M-Care, Corona Kavach, etc.)

Nowadays, people are prone to get infected by an array of illnesses, and one of them is Covid-19. Thus, treatment for such infections can be a bit heavy on your pocket. Therefore, to make it easy for the people to avail treatment Bajaj Allianz has introduced some disease-specific insurance policies. Therefore, you must think of buying a health insurance policy that helps you in such severe health problems. Disease-Specific comes under the situation-oriented types of medical insurance policy that provides you coverage for specific diseases. One of the insurance policies is Corona Kavach that provides a fund of Rs. 50,000 to Rs. 5,00,000 to the person insured. The age limit is set between 18 to 65 years. It is a type of Family Floater Policy. If we talk about M-Care Health Insurance Policy, it provides insurance to the insured person against the diseases caused by mosquitoes. There are different types of mosquito-borne diseases that include Dengue Fever, Malaria, Chikungunya, Zika virus, etc. Thus, M-Care offers you coverage for these diseases.

ULIPs

ULIPs expands to Unit Linked Insurance Plans. In these plans, a part of your premium is invested, and the other remaining part is used for buying health covers. Therefore, this plan helps you earn a return besides providing you a safety net. Your savings can run short with the ever-rising cost of health facilities. So, it is always better to have more money at your disposal. ULIPs don’t assure you a fixed amount as it is subjected to market risks. And the returns that are earned from ULIPs are paid to the buyer at the end of the policy term.

Indemnity vs Fixed Benefit Plans

Indemnity

Indemnity plans are those types of health insurance plans where the policyholder can claim the hospital expenses up to a fixed limit.  The policyholder can make multiple claims only till the maximum limit is reached. There are two different ways by which your insurance provider will provide you with your medical expenses:

1. Reimbursement Facility- The bills are first paid by you, and then the insurance provider reimburses those bills.
2. Cashless Facility- Where you do not have to pay any bills as the insurance provider pays them directly to the hospitals.

The types of medical insurance policy that fall in the category of Indemnity plans are as under:

• Individual Health Insurance
• Family Floater Plan
• Group Health Insurance
• ULIPs

Fixed Benefits

Fixed Benefits offers you a definite amount of money for specific health issues caused due to accidents or illness. It covers those health conditions that are listed at the time of buying the policy. The popular Health Insurance Policies that are covered in the fixed benefits are listed below;

• Personal Accident Plan
• Critical Illness Plan
• Hospital Cash Plan

Benefits of Health Insurance

• Health insurance provides financial security by covering hospital health insurance costs, ensuring medical emergencies don't drain your savings
• Coverage varies between plans, with different inclusions and exclusions. Some policies might not cover all hospitalisation expenses or may have specific limits.
• Comprehensive health insurance plans often cover pre- and post-hospitalisation, day-care procedures, and ambulance charges. However, not all policies offer these benefits; some might have exclusions or limits.
• Many plans offer cashless treatment options at network hospitals, reducing upfront payments. However, treatment at non-network hospitals requires the policyholder to pay first and seek reimbursement.
• Tax benefits are available under Section 80D of the Income Tax Act. The amount depends on the policyholder's age and the premium paid:
• Up to INR 25,000 for individuals below 60 years.
• Up to INR 50,000 for senior citizens.

**Tax benefits are subject to change in prevalent tax laws.

How Health Insurance Works?

Understanding how health insurance works can help you make better choices. When you purchase a policy, you pay a premium to the insurance company. In case of hospitalisation or treatment, you can opt for cashless treatment at network hospitals or reimbursement at non-network hospitals. The waiting period for pre-existing conditions typically ranges from 2 to 4 years, but this can vary by insurer and policy. It's important to clarify that not all plans have the same waiting periods, so it's essential to choose a plan accordingly. Most health insurance products come with a waiting period for pre-existing conditions, so it's vital to choose a plan accordingly. Bajaj Allianz General Insurance Company offers a wide range of health insurance products tailored to meet different needs, providing comprehensive coverage and ensuring peace of mind. Whether looking for individual coverage or family protection, choosing the right health insurance from other health insurance companies can make all the difference in managing healthcare costs effectively. Additionally, familiarising yourself with health insurance names can help you select a suitable plan. Investing in the right health insurance products is necessary and an intelligent decision if you want to protect your financial health against unforeseen medical emergencies.

Why is Health Insurance Important?

• Financial Assistance - The Health Insurance Policies offer the insured individuals financial assistance during any sort of medical emergencies.
• Tax Benefits - Buying a Health Insurance Policy will help you in tax deductions as it is listed under Section 80D of the Income-tax.
• Investment plus savings - Once you buy the Health Insurance Policy worrying about the treatment expenses is not a concern anymore. That’s because the expenses will be covered by the insurance company.
• Annual health checkups - Bajaj Allianz provides you with the coverage benefits of annual health check-ups. Hence, the company looks after the expenses that incur in the insured person’s annual health check-ups.
• Deal with Medical Inflation - Investing in Health Insurance Policies will help you to deal with medical inflation in a much easier and a better way without putting any burden on your pockets.
• Covers complex procedures - Health Insurance Policy provides coverage benefits for the complex procedures such as Bariatric surgery.
• Benefits for organ donors - buying a health insurance policy will provide coverage benefit in case you are donating any organ. It offers coverage up to the sum that is insured.
• Coverage for alternative treatments - when you purchase a health insurance policy from Bajaj Allianz, it offers you coverage for alternative treatments such as Ayurveda, Homeopathy, and Yoga.

Things to Consider While Buying Health Insurance

Deductibles

Before buying any types of health insurance policy, it is essential to look into the deductibles involved in that policy. A deductible is an amount that is to be paid by the insured as a part of a claim whenever it arises, and the rest of the amount is paid by the insurance company.

Your Age

The buyer needs to understand the importance of the age factor while buying the Health Insurance plans for oneself or for family members. There are various plans that depend upon the age of a buyer, and their premiums, waiting periods and renewability also play a role.

Medical History of Family Members

At the time of buying a Health Insurance Policy, one must consider and discuss the medical history of the family members as it can impact the premium of the policy. If any of the family members is already suffering from a health problem, then the possibility of claiming the insurance rises.

Exclusions

An exclusion in terms of policy is a provision that eliminates coverage for some type of risk. A few common exclusions in most of the Health Insurance Policies include pre-existing diseases, pregnancy, cosmetic treatment, medical expenses to treat injuries, alternative treatments, lifestyle-related diseases, limitations on hospital costs, and diagnostic tests. Therefore, the buyer has to discuss these exclusions with the insurance provider while buying any Health insurance.

Sum Assured/Insured

The sum assured is referred to as the amount of money that the insured individual will receive at the end of the Insurance term. The sum insured is the amount that is provided to the insured in an unforeseen event such as a medical emergency, theft, vehicle damage, etc.

Waiting Period

In the case of Health Insurance Policy, the waiting period refers to the amount of time you have to wait to benefit your insurance policy’s benefits. The waiting period varies from plan to plan.

Lifetime Renewability

The different Health Insurance Plans offer different renewability options. So, you must be watchful before buying one for yourself or your family member.

Network Hospitals

While buying any Insurance Policy, a buyer must choose the insurance company that covers the widest network of hospitals in their list.

Claim Settlement Ratio

The individual should pick up the insurance company that provides a fast claim settlement ratio.

Conclusion

The progressively rising costs in medical treatments have made it mandatory for people to buy Health Insurance Policies for themselves and for their family members too. Bajaj Allianz offers comprehensive health insurance policies in India, covering every type of ailment, condition, and incident. Therefore, it requires a buyer to put in his efforts and time to learn thoroughly about what is health insurance  and all types of health insurance policy available in the market. And it becomes equally important to compare all the insurance companies and their terms and conditions. Many individuals complain about paying an extraordinary amount of premium and getting less in return. This happens when a person does not gather the required information about all the insurance plans and companies. Hence, one needs to understand the ins and outs of all types of medical insurance policy to ensure that you choose the plan that fits well. *Standard T&C apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.