11 Best Health Insurance Plans in India 2023 (Plan Reviews)

I have categorized different health insurance plans into 4 categories depending on different requirements. You can pick the best health insurance policy based on your requirement.

• Best Family Floater Health Insurance Plans in India
• Best Health Insurance in India for Individual
• Top Up/Super Top Up Health Insurance Policy
• Best Health Insurance Plan for Parents (Senior Citizen)

Before moving to the list of best health insurance policies in India 2023 let’s look at the important factors that you should know while getting health insurance.

5 Factors You Should Consider Before Buying Health Insurance Plan in India

#1. Claim Settlement Ratio (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.

Expert tip: A high CSR indicates that the company is more likely to settle a claim without any hassles.

#2. Incurred Claim Ratio (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.

#3. 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.

#4. 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.

Expert Finding: 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.

#5. 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.

The insurer should have different types of plan available that is suitable for different sections of people such as individual health plans, family floater plans, senior citizen health plans, top-up plans and plans suitable for people with certain health conditions such as cancer and heart disease.

Top 5 Best Health Insurance Companies in India 2023

Let’s see what fits into our requirements from the list of best health insurance companies in India.

#1. 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 which offers coverage for health insurance, critical illness, personal accident, top-up coverage, international travel insurance, and maternity along with group health insurance.

The claim settlement ratio of Care health insurance is 92.3% and has over 4900 hospitals in its network.

#2. Tata AIG Health Insurance

Tata AIG Insurance is a trusted 20-year-old joint venture between Tata & AIG Group that carries a AAA rating by ICRA for ability to pay claims and policy holder obligations in a timely manner. The individual death claim ratio for 2018-19 was 96.12%.

The company has access to 5800+ network hospitals.

#3. Max Bupa Health Insurance

Max bupa insurance offers coverage for a number of illnesses, access to hospital networks and cashless claims.

Claim settlement ratio of Max Bupa is 91.2% and a high ICR of 51.96%. Max has over 5000+ hospitals in its network.

#4. ICICI Lombard Health Insurance

ICICI Lombard has a network of 6500+ hospitals to avail cashless facilities.

According to IRDA, it is supposed to have settled 98.32% of the claims received. It has a very high ICR of 80.38% which indicates that people are renewing the policy and also making claims.

#5. Star Health Insurance

Star Health Insurance company provides a wide range of health insurance policies for individuals, families, senior citizens and for those who need specialized care like heart patients and cancer patients.

Star has a high claims settlement percentage of 98.72% and ICR of 60.51% with a whopping 9900+ hospitals are on its network.

Best Family Floater Health Insurance Plans in India 2023

#1. CARE Advantage 1 Crore Health Insurance Plan

Care Health Insurance was earlier known as Religare health insurance.

CARE Advantage 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 (NCB). The increase is limited to a maximum of 50% in 5 consecutive years.

Highlights of Religare Care Advantage 1 Cr Plan

• Higher coverage at a lower premium
• Pre and post hospitalization expense cover
• Up to 50% no claim bonus
• Organ donor cover
• Daycare treatment cover
• Emergency ambulance

Features & Benefit

Minimum age for cover	Individual – 5 years and Child – 91 Days (floater policy with 1 person above 18 years)
Maximum age for renewal	Lifelong renewability
Waiting period to cover pre-existing illness	Named ailment wait period – 24 months 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.
Restoration benefit	Recharge of sum insured at no extra cost. But not for ailment already claimed during the same year.
Room Rent / ICU Charges	No sub-limits for Room Rent charges or ICU Charges.
Exclusions	Self-inflicted injuries (suicide), injuries caused by alcohol or drug use, congenital disease, Infertility and sterility, change of gender treatments and expenses related to any admission primarily for diagnostics and evaluation purposes only.

Advantages

• 1 Crore cover an affordable price
• No capping on Ambulance charges
• No cap on Room rent & ICU charges
• No maximum entry age

Disadvantages

• 20% Co-payment if the age of the eldest member insured at the time of the first policy is 61 years or above
• 4 years of continuous coverage required to cover pre-existing illness

You can check out the different care insurance plans for different requirements like family floater, insurance for parents or insurance for any specific disease.

#2. Tata AIG Insurance

Tata AIG carries an AAA rating by ICRA for its ability to pay claims and policyholder obligations in a timely manner. The individual death claim ratio for 2018-19 was 96.12%.

Tata AIG Medicare is a comprehensive “Health Insurance” plan initially offered for 1,2 or 3 years. One can avail a long-term premium discount of 5% and 10% for the policy with tenure of 2 and 3 years respectively.

The best part is that the policy covers medical expenses incurred outside India. However, the initial diagnosis should have been made in India.

Tata AIG Medicare health plans come in three variants – Medicare, Medicare Protect and Medicare Premier.

• 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 – The sum insured ranges from Rs. 3 Lakhs to Rs. 20 Lakhs.
• Medicare Premier– The sum insured ranges from Rs. 5 Lakhs to Rs. 50 Lakhs. 

Features & Benefits

Minimum Age for cover	Dependent children between 91 days and 5 years, only when both parents are getting insured
Maximum Entry Age	65 years
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-existing disease waiting period – 36 months
No-Claim Benefits	50% increase in cumulative bonus for every claim-free year
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
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
Day Care Procedures	541 daycare procedures are covered
Domiciliary Hospitalization	The plan covers medical expenses incurred during treatment at home
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:

• Bariatric Surgery cover,
• Medical and surgical expenses for organ donor
• OPD dental treatment
• Health Check-up (max Rs. 10,000)
• Vaccination cover

What I Liked

• Global medical cover
• 5800+ Network hospital
• 1,2, and 3-year policy
• Up to 32% family floater discount on premium

What I didn’t like

• Cover for individuals aged 5 years onwards
• Limit on ambulance cover

#3. Max Bupa Heartbeat Family Floater Health Insurance Plan

Heartbeat family is comprehensive health insurance best-suited to a family’s needs with international emergency coverage.

There are 3 variants in this 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:

• Emergency medical evacuation & hospitalization facility.
• Covers international treatment for specified illnesses like cancer.
• Charges for OPD treatment and diagnostic services if required.
• Second medical opinion.
• Vaccination expenses for children up to the age of 12 years.
• Higher maternity benefit coverage of up to Rs. 2 Lakh.

Features

Minimum 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.
Maximum Age for Renewal	Lifelong renewal is allowed.
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.
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.
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.
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

• 19 different relations including spouse, children, parents, parents-in-law, dependent brothers, dependent sisters 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
• Vaccination expenses are covered in the Platinum plan
• 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.

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 policy 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 biggest advantage of this policy is that the common surgeries that are carried out for aged-people such as hernia, piles, cataract and sinusitis are covered after a waiting period of 2 years.

Health guard family floater has three variants

• 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

Minimum Entry Age	Adult – 18 to 65 years Dependent children/ grandchildren – 3 months to 30 years
Maximum Age for Renewal	Renewable for lifetime
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 base Sum Insured, up to a maximum of 100% of the base Sum Insured.
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.
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

• Children/ grand children, up to 30 years of age can be covered.
• 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.
• 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.

You would like to read – best term insurance plan in India

Best Health Insurance in India for Individual

#5. HDFC ERGO My: health Suraksha Plan

You get covers like Air ambulance cover, infertility cover along with other benefits with My:health Suraksha insurance plan that is normally not covered with other insurers.

There are 3 variants 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

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.
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.
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

• 180 days of post-hospitalization cover
• Air ambulance cover with Gold & Platinum Smart plan
• Organ Donor expenses covered
• AYUSH treatments are covered.

Disadvantages

• 48 months waiting period for pre-existing disease
• 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

#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
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.
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.
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

• 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.
• Health Maintenance benefit of up to Rs. 2,000
• Free comprehensive health checkup at every renewal.
• 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 benefit 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

Minimum Age for cover	Adult – 18 years Child- 91 days
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 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.
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.
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

• Organ transplant costs including hospitalization is covered.
• 180 days of post-discharge expenses
• No sub-limit on room rent
• 50% bonus as no-claim benefits
• 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

Top Up/Super Top Up Health Insurance Policy

#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

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.
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.
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

• Deductible applicable on aggregate basis per policy year.
• Complimentary health check coupons are issued every year.
• Tax benefits can be claimed under Section 80D just like other health insurance plans.
• Organ transplant costs including donor hospitalization is covered.
• 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

Minimum Age for cover	60 years up to a maximum of 75 years
Maximum 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
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 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

• Outpatient consultations in networked hospitals.
• Pre-insurance medical test is not required
• Covers pre-existing disease from second year onwards

Disadvantages

• Non-Allopathic system treatments not covered.
• Sub-limits applicable for specific diseases.
• 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

Minimum Age for cover	46 years up to a maximum of 70 years
Maximum 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.
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.
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

• 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.
• Pre-medical test are mandatory

#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

Minimum Age for cover	10 years up to a maximum of 65 years
Maximum Age for Renewal	Lifelong renewable
Waiting Period to cover pre-existing illness	48 months
No-Claim Benefits	Not available.
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.
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

• 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.
• AYUSH treatments not covered.
• Organ transplant costs are not covered.

5 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

• Offers higher protection for each person rather than as a family.
• The policy can be renewed without any age restrictions.
• 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 Rely on Employer-Provided Health Insurance

One of the main reasons why people avoid taking health covers is because they get employer-provided group health coverage. But no matter how much health cover your employer provides, it has its own drawbacks.

Let’s understand why having your own health coverage 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 cover early in life will always help in the case, you are diagnosed with any illness. 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 exhaust in a single hospitalization. You must have a backup policy.
• Would you buy an expensive health cover post-retirement?

13 Practical Tips to Choose the Best Health Insurance Policy

Tip #1.

Always buy an individual policy at a young age. Otherwise, insurance becomes as expensive as you grow old.

Tip #2.

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.

Tip #3.

If you are buying health coverage for a family of 4 (2 adults and 2 kids), you can either

• 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.

Tip #4.

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.

Tip #5.

Choose a policy that offers lifetime renewability.

Tip #6.

Do not buy a policy that has sub-limits on per day expenses or room rent

Tip #7.

Your health plan should cover hospitalization expenses for critical illnesses also. 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.

Tip #8.

Check the waiting period for pre-existing illnesses. Most insurance policies have 2 years as the waiting period but some have up to 4 years.

Tip #9.

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.

Tip #10.

If you are buying health cover for aged parents, check the list of illnesses and medical procedures that are not covered. Your policy should provide cover for common surgeries required by aged people such as cataract and knee surgery.

Tip #11.

Buy the policy before you get any critical disease (health, lungs, cancer). Many policies have clear-cut clauses that the policies are to be bought before the onset of any such illness.

Tip #12.

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.

Tip #13.

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.

Glossary

AYUSH: stands for Ayurvedic, Unani, Siddha and Homeopathy. If a health insurance policy provides coverage for AYUSH treatments, it means that the insured can undergo treatments suggested by the AYUSH doctors and make a claim for it.

Restoration Benefit: It is a benefit that allows an insured to reinstate (refill) the entire sum insured in the policy year when it gets exhausted due to incurred claims. You can reinstate up to 100% of the sum insured in a year. But it costs slightly more than standard health insurance.

Daycare Procedures: A daycare procedure is a surgery or medical procedure that can be completed in less than 24 hours.

Domiciliary Hospitalization: It means medical treatment for a period exceeding three days for such illness/disease/injury which in the normal course would require care and treatment at a hospital but actually taken while confined at home under any of the following circumstances, namely:

i) The condition of the patient is such that he/she cannot be removed to the Hospital/Nursing Home or

ii) The patient cannot be removed to Hospital/Nursing Home for lack of accommodation therein.

Things You Should Know About Health Insurance

• It is always better to buy 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.
• You can actually bargain for less premium rates if you have healthy living habits such as maintaining a good BMI, exercising regularly and avoiding smoking.
• 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 applies to employer-provided health insurance 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.
• If 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.

Final Words

By now you have gauged that you and your family’s health insurance needs will be unique. You have to choose a policy based on various factors such as sum insured, co-pay, sub-limit clauses and network hospitals, and not just about quoting low premiums.

Always buy a health policy early in life as it works out cheaper and you will be covered if you fall ill later in life.