Individual Health Insurance Plans

What is Individual Health Insurance?

Individual Health Insurance, also known as Personal Health Insurance, is coverage that a person purchases independently rather than through an employer or a government program. Unlike group plans offered by employers or government schemes, individual plans cater to your specific needs and provide financial protection in case of hospitalisation, illness, or accidents. You can choose the coverage level, sum insured, and riders that best suit your and your family's health requirements and budget.

Key Features of Individual Health Insurance Policy

Our Individual Health Insurance policy features provide a holistic health insurance solution. Read on to know more about our individual medical insurance policy and its key features:

Platinum Plan

Super cumulative bonus of 50% per claim free year

Recharge Benefit

To take care of claims where the claim amount exceeds your sum insured

Multiple Sum Insured

Enjoy the flexibility to choose between 3 Plans variants along with the Sum Insured options ranging from 1.5 Lakh to 1 crore.

Covers Extended Family

This policy covers extended family members including parents, in-laws and siblings, on an individual basis.

Covers Ayurvedic and Homoeopathic Treatment

As per the Gold & Platinum Plan of the policy, in-patient hospitalisation expenses up to Rs 20,000 incurred in a recognised Ayurvedic/homoeopathic hospital are covered if the admission period is not less than 24 hours.

Covers Daycare Procedures

This policy covers medical expenses incurred during the treatment of listed daycare procedures or surgeries.

Convalescence Benefit

You will be eligible for a benefit payout of upto Rs 7500 annually, in case of continuous hospitalisation for a period of 10 days or more and provided that your hospitalisation claim is admissible.

Bariatric Surgery Cover

Bariatric surgery is covered under medical advice, subject to certain terms and conditions.

Sum Insured Reinstatement

If you completely exhaust your sum insured along with the cumulative bonus (if any) during the policy year, we will reinstate the same.

Covers Pre and Post Hospitalisation

This policy covers pre and post hospitalisation expenses up to 60 days and 90 days respectively.

Covers Road Ambulance Expenses

This policy covers ambulance expenses incurred upto Rs. 20,000 during per policy period

Covers Organ Donor Expenses

This policy covers expenses towards organ donor’s treatment for harvesting of the donated organ.

Daily Cash Benefit

A daily cash benefit of Rs 500 per day, for up to 10 days, during each policy year is provided as accommodation expenses for one parent/legal guardian to stay with a minor insured under the policy, for an admissible claim.

Maternity/New Born Baby Cover

Under the Gold & Platinum Plan, maternity expenses and medical expenses towards treatment of a newborn baby are covered, subject to certain terms and conditions.

Documents Required for Reimbursement Claim

- Original pre-numbered hospital payment receipt duly sealed and signed.

- Original prescriptions and pharmacy bills.

- Original consultation papers (if any).

- Original investigation and diagnostic reports along with original bills and payment receipt for the investigation done within and outside the hospital.

- If you availed a cashless claim but did not utilise it, a letter from the hospital stating so.

- A letter from the treating doctor mentioning incident details (in case of an accident).

- Hospital registration certificate and hospital infrastructure on the letterhead.

- A cancelled cheque bearing IFSC code and name of the insured.

- Indoor case paper copy attested from the hospital from the date of admission to the date of discharge with detailed medical history and doctor’s notes with temperature, pulse and respiration charts.

- X-ray films (in case of a fracture).

- Obstetric history from treating doctor (in maternity cases).

- FIR copy (in accident case).

- Additional requirements for some special cases:
            - In case of a cataract operation, lens sticker with a bill copy.

            - In case of a surgery, implant a sticker with a bill copy.

            - In case of a heart-related treatment, a stent sticker with a bill copy.

All original documents need to be submitted to the following address: Bajaj Allianz House, Airport Road, Yerawada, Pune-411006. Mention your Policy Number, Health Card Number and Mobile Number clearly on the face of the envelope. Note: Keep a photocopy of the documents and courier reference number for your records.

Benefits of Buying Personal Health Insurance Policy Online

Buying a Personal Health Insurance policy online offers several advantages:

- Convenience: Shop and compare plans from multiple insurers at your own pace, anytime, anywhere.

- Comparison Tools: Use online comparison tools to assess coverage options, features, and premiums quickly.

- Time-Saving: Skip lengthy agent visits and complete the application process efficiently.

- Potentially Lower Premiums: Online purchases can sometimes lead to lower premiums due to reduced administrative costs for insurers.

- Paperless Process: Enjoy a faster, more eco-friendly experience with digital applications and policy documents.

Additional benefits with your Individual Private Health Insurance Our Individual Health Insurance plan provides extensive coverage with multiple benefits:

Wellness Benefit 

Maintain good health & get rewarded with wellness benefit discount upto 12.5% on your renewal

Renewability

You can renew your Individual Health Insurance policy for your entire lifetime.

Tax Saving

Tax saving Avail income tax benefit under Section 80D of the Income Tax Act.* *On opting for Individual Health Insurance policy for yourself, your spouse, children and parents, you can avail Rs 25,000 per annum as a deduction against your taxes (provided you are not over 60 years). If you pay a premium for your parents who are senior citizens (age 60 or above), the maximum health insurance benefit for tax purposes is capped at Rs 50,000. As a taxpayer, you may, therefore, maximise tax benefit under Section 80D up to a total of Rs 75,000, if you are below 60 years of age and your parents are senior citizens.  If you are above the age of 60 years and are paying a medical insurance premium for your parents, the maximum tax benefit under Section 80D is, then, Rs 1 lakh.

Hassle-Free Claim Settlement

Hassle-free claim settlement Our in-house claim settlement team ensures a quick, smooth and easy claim settlement process. Also, we offer cashless claim settlement at more than 18,400+ network hospitals* across India. This comes in handy in case of hospitalisation or treatment wherein we take care of paying the bills directly to the network hospital and you can focus on recovering and getting back on your feet.

Preventive Health Check-Up

At the end of every continuous period as mentioned in coverage during which You have held Our Health Guard Policy, You are eligible for a free Preventive Health checkup.

Portability Benefit

Portability benefit If you are insured under any other health insurance policy, you can switch to this policy with all accrued benefits (after due allowances for waiting periods) to enjoy all the benefits of the policy.

Long-term policy

This policy can be purchased for a period of 1, 2 or 3 years.

Discounts on Policy

Discounts on Policy Opt for our health insurance policy for more than a year to avail a discount. Avail various discounts such as family discount up to 15%, long-term policy discount up to 8%, co-payment discount and more.

Eligibility Criteria for Individual Medical Health Insurance

Eligibility criteria for Personal Health Insurance coverage can vary by insurer, but generally include:

- Age: Most plans cover individuals between 18 and 65 years old, with senior citizen plans available for those above 65.

- Location: You must reside within the geographical area serviced by the insurer.

- Medical History: Pre-existing conditions might require waiting periods or exclusions. Disclose all medical history accurately.

- Occupation: Certain high-risk occupations might have limited coverage options or higher premiums.

How Much Individual Health Insurance Coverage Should You Have?

The right amount of Personal Health Insurance coverage depends on several factors:

- Medical History: Consider any pre-existing conditions and potential future healthcare needs.

- Hospitalisation Costs: Research your area's average hospital room rates and surgical costs.

- Lifestyle: Healthy lifestyle choices can lower health insurance costs and improve coverage options.

- Financial Goals: Balance affordability with adequate protection. Consider how much you can comfortably afford as a premium.

Types of Individual Health Insurance Claims

Individual health insurance plans cover two main types of claims:

Cashless Claims

These allow you to avail of medical treatment at network hospitals without upfront payments. The insurer settles the bill directly with the hospital.

Reimbursement Claims

If you have not availed of the cashless facility due to the non-availability of the network hospital or for any other reason, you can submit the claim documents to your insurer. The insurer will process your claim and settle the claim with you.

How to File an Individual Health Insurance Claim?

The claim process for single health insurance plans can vary by insurer but generally involves:   - Intimation: Inform your insurer about the hospitalisation within the stipulated time frame.  

- Submit Documents: Provide necessary documents like claim form, medical bills, investigation reports, and discharge summary for processing your claim

Individual Health Insurance Premium Calculator

Many insurers offer online premium calculators that help you estimate the cost of an Individual Health Insurance plan based on your age, location, desired coverage, and sum insured. This allows you to plan your budget and compare policies before purchasing a policy.

Difference Between Group and Individual Health Insurance

Essential Considerations When Choosing an Individual Health Insurance Plan

Choosing the right Individual Health Insurance plan requires careful thought. Consider these factors:

- Coverage Needs: Assess your medical history, lifestyle, and future healthcare needs.

- Sum Insured: Choose an adequate sum insured to cover hospitalisation costs.

- Network Hospitals: Opt for a plan with a wide network of hospitals for cashless hospitalisation convenience.

Why Choose Bajaj Allianz Individual Medical Health Insurance?

Happiness is good health that is protected by a comprehensive health insurance policy. A health insurance plan is a must-have to guard yourself and your loved ones from sky-high medical bill expenses. Our Individual Health Insurance plan ensures that you are covered in case of a medical emergency, and proper care is available to you without exhausting your finances. You can also avail of our Health Insurance policy for each of your family members. We cover your medical expenses incurred due to hospitalisation. What’s more, you can also avail Cashless Treatment at over 18,400 + network hospitals* with a Bajaj Allianz health insurance plan.