Health Insurance in India

  Health Insurance in India



Health Insurance in India, As the name suggest, it basically insured about your Health in India. It takes care of your medical expenses such as hospitalization cost, doctor consultation cost, medicine cost etc. Due to second Largest Population of the world, we have a large market and scope in terms of Health Insurance.


Basic Terms used in Health Insurance

  • Agent:– He is a person appointed by the company (Health Insurance company) to work on behalf of the company.
  • Assignee: In basic, He is also called Policy holder. He is the person who gets the benefit of the policy.
  • Claim: – It is a request filed by the policy holder to the insurance company to pay for services obtained from health care professional.
  • Certificate of Insurance: – It is the description of the benefit and coverage mentioned in a document between the company & policy holder. It discloses what illness is covered and what is not and also the cash limit.
  • Co-Payment: – When the policy holder (insured) files a claim, there is a certain claim amount, the insured (the policy holder) has to pay before the insurer (company) steps in. This fractional amount paid by the insured (policy holder) is called Co-payment. Co-payment is shown as the percentage of the total claim amount.
  • Cumulative Bonus: – Here In every claim free year (The year when you do not claim from the insurance company), The sum insured will progressively increased by 5%.  However, The Cumulative Bonus can never be increased more than 50% of the Capital Sum Insured and that the policy was renewed continuously.
  • Deductible: The amount of loss borne by the policy holder/insured. The Loss can be certain amount or percentage of the claim amount. Larger the deductible, Lower is the premium.
  • Dependents: Spouse and/or dependent children (either natural, adopted or step) of the policy holder/insured.
  • Exclusions: There are certain conditions or circumstances that the policy holder/insured does not get any benefits.
  • Insurer: The Insurance companies who take responsibilities for the risk issues insurance policies and receives premiums.
  • Long term care policy: Insurance policies that cover specified services for a specified period of time. Long term care policies and their prices vary significantly. The policy that covered service include nursing care, home health care services, and custodial care.
  • Long term disability insurance: It basically pays the policy holder/insured a percentage of their monthly earnings if they became disabled.
  • Premium: The monthly amount paid by the insured/policy holder or their employer in exchange for insurance coverage.
  • Policy: It is a legal document that acts as a contract between the insured/policy holder and the insurer/insurance company. It basically contains conditions of the insurance.
  • Pre-existing condition: The medical condition of an individual is excluded from coverage if the condition is believed to have existed prior to obtaining the policy from a particular insurance company.
  • Network: It is basically a group of doctors, hospitals and other health care providers are contracted to provide services to the customers of the insurance companies for less than the usual fees.
  • Sum Insured: Sum Insured is the amount payable by the insurance companies to the insured/policy holder in case of eventuality. For e.g.: The Sum Insured is Rs, 4 lacs under health insurance and if the policy holder/insured gets hospitalized and his expenses come Rs. 3 lac, then the insurance companies is liable to pay him Rs. 3 lacs.
  • Waiting Period: When an individual signs a new health insurance policy, then there is a fixed period of time to wait after which certain benefits of the policy comes into effect. For e.g. The usual waiting period for Pre-existing condition is 4 years.

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Why Health Insurance is Important?

We have definitely heard from our elder that “Health is Wealth”. As we safeguard our wealth through various investment or deposit in bank, It is equally important to safeguard our health expenses through health insurance policies. Time fluctuates and no one knows about the health emergencies, so  it is wise to take health insurance according to our requirement and safeguard our health expenses which is very expensive now a days. Health insurance pay maximum amount of money during acute illness, accident etc. to individual or family depending upon your insurance.

Health insurance policies also helps in tax benefits under Section 80 D. At present, Tax deduction up to Rs. 25,000 is permissible under Section 80 D for health insurance premiums paid for the individuals below 60 years of age. If their parent age is more than 60 years, then additional Rs. 50,000 tax benefit is allowed. If you and your parents both are above 60 years then the limit is extended to Rs. 1 Lakh

 Benefits of Health Insurance

There are few Benefits of Health Insurance

  • Cashless Medical Treatment
  • Coverage of Pre & Post Medical Expenses
  • Ambulance Fee
  • No Claim Bonus: This Bonus is provided to the policy holder/insured if no claim has been filed for any treatment previous year. The reward is given either in terms of increment of Sum Assured or discount on the premium cost. You can take this advantage during Policy Renewal.
  • Medical Check-up Facility
  • Tax Benefit

 Health Insurance Companies in India

Some of the Important Health Insurance companies in India are as below:

  • Kotak Mahindra Health Insurance
  • SBI Health Insurance
  • Bharati AXA Health Insurance
  • HDFC Ergo General Health Insurance
  • Bajaj Allianz Health Insurance
  • Liberty Health Insurance
  • Aditya Birla Health Insurance
  • Digit Health Insurance
  • Future Generali Health Insurance
  • Oriental Health Insurance

Types of Health Insurance

We must know different types of Health insurance in order to take correct Health insurance plan according to our requirement.

Below is the types of Health Insurance

  • Individual Plans: This Plan is for Single or Individual. It offers insurance protection with benefits like Cashless, Hospitalization, Reimbursement, Compensation for expenses incurred on pre & post hospitalization expenses etc.
  • Family Plans: – As the name suggest, It covers an entire family in a Single Premium (Policy). Under this Plan, A certain amount of sum Insured is divided among the policy members equally which can be benefitted  either by one or all members of family for one or more claims during the tenure of the policy.
  • Senior Citizen Plans: This Plan basically covers the age group between 60 & above. It covers hospitalization expenses like In-Patient, OPD, Daycare Procedures, Pre & Post Hospitalization expenses along with tax benefit under Section 80 D.
  • Critical Illness Plans: This Plan offers a Lumpsum amount in case if a person/insured/policy holder is diagnosed with critical illness like Kidney Failure, Heart Attack, Paralysis etc. This policy is usually brought as a Stand-alone policy, whereas the Sum-Insured is Pre-defined and the Insured person has to survive a particular survival period after being diagnosed to avail the policy benefit.
  • Maternity Plans: This Plan covers the Maternity expenses during both pre and post-natal care, child delivery (normal or cesarean). Some Providers also include vaccination of new born baby in the Maternity plan. It covers the transportation fees for moving the mom to the nearest network hospital of her own choice.
  • Personal Accident cover: As the name suggest, This Insurance covers when you met with an accident leading to disability or death. It covers hospitalization and bears medical expenses during an accident. It also provides a fixed monetary benefit during loss of income during accident.
  • Group Plans: Many Employers provide Health Insurance to their Employees. The Health Insurance provided by Employers covers Hospitalization expenses of the employee and his/her family including spouse, children or parents. It comes under a Group Health Insurance Policy and the Premium is paid by the Employer, based on the group size and the benefits offered.
  • Coronavirus Plans: After the Corona Pandemic, the IRDAI  launched two Coronavirus Health Plans.

o   Corona Kavach Health Plan: – This Plan is for Family

o   Corona Rakshak: This Plan is for Individual coverage.

Both the Plan covers Hospitalization expenses including cost of consumable items like Masks, Gloves, PPE Kits, Oximeters, Ventilators etc.  If any Person has already  Health Insurance Plan, he can buy Coronavirus    Health Insurance Plans to safeguard his/her family during Pandemic.

  • Unit Linked Plans: This Health Insurance Plan is introduced recently. It provide a  combination of health insurance and investment. It means Apart from giving Health Insurance Protection, It also contribute to build a Corpus that can be used to meet expenditures that are not covered by Health Insurance Plans.

Some of the Companies that provide Unit Linked Health Insurance Plans are Birla Sun life Saral Health, LIC Health Protection Plus, ICICI Prudential Health Saver etc.


Now a days When the Life Style of human being has degraded and everything (Mostly Eatables & Products) is adulterated. It is high Chances of getting affected and trapped. So, it is a Clever Step to take Health Insurance, not only to protect yourself but your family from any mishappening (accident, acute illness, pandemic diseases) as it helps in covering hospitalization, medical etc. cost which is very expensive these days.


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