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Reliable Health Insurance Partner for you and your family

 99% claim ratio

99% claim ratio

Find your ideal premium

No. of Adult (Max 2)

-

1

+

Age : 18 - 70 yrs

No. of Children (Max 2)

-

0

+

Age : 3 month - 17 yrs

Age of eldest member

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Age of eldest member in the policy is directly proportional to the premium you pay

Age : 18 - 70 yrs

Sum Insured

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This represents the maximum amount the insurer will provide for your medical expenses. Your premium is directly proportional to the sum insured

Existing Cover

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Choose the Sum Insured of your existing insurance or the amount you are comfortable to pay from pocket on hospitalization

Prioritize your loved ones and secure your future with Apollo's user-friendly premium calculator. Estimate insurance premiums seamlessly for transparent and informed financial planning. Trust us for peace of mind and a more secure future.

How to calculate premium

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Health Insurance Buying Guides

Zero Underwriting
Zero Underwriting

There is no process of submitting any additional details to get your insurance policy document. Insurance underwriting is a process by which the insurance company evaluates various details like medical records, and body mass index of the insurer to determine if the policy document can be issued.

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Restoration Benefits
Restoration Benefits

Let's assume you had a health insurance cover of Rs. 5 lakhs, which you exhausted last month when you were admitted to the hospital for a heart complication. But your wife and your children are also part of your plan, and in the future, if any of them fall ill, the insurer won't pay the dues. But with an unlimited restoration benefit, your insurance could reset to Rs. 5 lakhs after each claim, ensuring coverage for future hospitalisations.

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Deductibles
Deductibles

Think of it as an initial hurdle you need to cross before your health insurance kicks in. You pay this fixed amount out-of-pocket first (and only once), and then the insurance company will pay for the medical expenses.

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Waiting Time
Waiting Time

This clause specifies the time when you cannot claim your health insurance plan. It can be applicable for specific coverage like maternity benefits, for pre-existing conditions like diabetes, high blood pressure, thyroid, etc., or specific illnesses like cataracts, arthritis, etc. The waiting period can range anywhere from 12 months to 48 months, depending on the insurance company and your chosen plan.

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Co-Payment
Co-Payment

This is a payment you share with the insurance company for your medical expenses. Unlike deductibles, co-payments are smaller, fixed amounts. They apply even after you meet your deductible and are payable every time you make a claim

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Network Hospitals
Network Hospitals

Hospitals affiliated with the insurance company are network or partner hospitals where you can make a cashless claim. If you receive treatment at non-network hospitals, you will have to make the payment first, and the insurance company will reimburse the dues later. Choose a health insurance plan with a vast network covering hospitals of your choice or those in your vicinity.

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Preventive Health Check-Ups
Preventive Health Check-Ups

Many plans offer preventive health check-ups, which can help you identify health issues early and prevent costly treatments later. Moreover,regular health screenings for cardiovascular diseases, cancer, and lifestyle-related ailments can be expensive. Confirm that your insurance policy covers the examination of these conditions.

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Maternity Coverage
Maternity Coverage

If you are planning to start a family, ensure your health insurance policy covers maternity expenses, including prenatal and postnatal care, delivery charges, and newborn care. Consider the coverage amount, waiting period, and sub-limits for these expenses.

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Inclusions & Exclusions
Inclusions & Exclusions

Thoroughly review the inclusions and exclusions of your health insurance policy. Inclusions specify the medical services and treatments that will be covered, while exclusions list the ones not covered. Understand the extent of coverage provided and any limitations or exclusions that may affect your healthcare needs.

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Claim Settlement Ratio
Claim Settlement Ratio

The claim settlement ratio indicates the insurance company's ability to handle claims. A high health insurance can offer coverage for AYUSH treatments for specific conditions or up to a certain limit. One essential factor to remember is that the costs of AYUSH treatment will be covered.

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Benefits covered by a Health Insurance plan

In-patient Hospitalisation Expenses

Hospitalisation costs include room rent, doctor's consultation fees, nursing care, medicines, diagnostic tests, ICU charges, and surgical procedures due to accidents or illnesses. Remember that health insurance policy terms and limits vary. Carefully review your medical insurance policy to understand covered expenses, sub-limits, and exclusions.

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In-patient Hospitalisation Expenses
Pre-existing Illnesses or Diseases

Pre-existing conditions or diseases are diagnosed before purchasing a health insurance plan. Its coverage varies across insurance companies while some insurance plans offer immediate coverage for pre-existing illnesses, others may ask you to wait for a specified period. Be transparent about your medical history when choosing a plan to avoid coverage disputes later.

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Pre-existing Illnesses or Diseases
Pre and Post-Hospitalisation Expenses

Medical health insurance typically covers your pre-hospitalisation expenses incurred within a specific period before admission (90 days) and post-discharge expenses up to a certain period after discharge (180 days). It shall include consultations, diagnostics, physiotherapy, follow-up treatments, and medicine costs beyond your hospitalisation bill.

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Pre and Post-Hospitalisation Expenses
Ambulance Charges

Emergency ambulance services can be expensive. However, many health insurance plans cover ambulance charges for transporting the insured individual to the hospital in case of an emergency. Check your policy document for coverage details and any kilometre restrictions.

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Ambulance Charges
Maternity Cover

Maternity coverage is crucial for expecting parents. It covers expenses related to pregnancy, childbirth, and newborn care. This can include prenatal check-ups, delivery charges, baby nursery expenses, and vaccination costs. The eligibility criteria, waiting period, and sub-limits associated with maternity coverage may vary across health insurance plans.

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Maternity Cover
Preventive Health Check-ups Coverage

Regular health check-ups help in early disease detection and prevention. Some health insurance plans offer complimentary preventive health check-ups, including full-body check-ups, specific screenings for certain diseases, vaccinations, and consultations. This benefit can help you stay proactive about your health and avoid medical complications in the future.

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Preventive Health Check-ups Coverage
Daycare Procedure

Daycare procedures are medical treatments that don't require overnight hospitalisation and are covered by health insurance. Examples of these treatments include minor surgeries, diagnostic tests, etc. Understanding the list of covered daycare procedures and any exclusions mentioned in the policy is essential.

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Daycare Procedure
Home Treatment Cover

Most health insurance plans offer discounts on various medical services at their network hospitals home under medical supervision might be recommended. Health insurance with this coverage offers home treatment

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Home Treatment Cover
AYUSH Benefit

AYUSH is India's traditional system of medicine, including Ayurveda, Yoga, Unani, Siddha, and Homeopathy. In addition to allopathic treatments,health insurance can offer coverage for AYUSH treatments for specific conditions or up to a certain limit. One essential factor to remember is that the costs of AYUSH treatment will be covered.

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AYUSH Benefit
Mental Healthcare Cover

Mental illness is often considered taboo, but mental health is critical to a person's well-being. Recognising its need, health insurance companies now offer coverage for mental healthcare, including consultations with psychiatrists, psychologists, and therapists, hospitalisation for mental health conditions, and specific treatments.

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Mental Healthcare Cover
Organ Donor Expenses

Organ donation is a noble act that can save many lives. Health insurance offers coverage for expenses incurred during organ donation procedures including donor surgery, hospitalisation, medications, and post-operative care. This benefit can ease the financial burden for families considering organ donation.

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Organ Donor Expenses
Latest Treatments

Advanced medical procedures, including immunotherapy, deep brain stimulation, stem cell therapy, and robotic surgery, can be costly. Confirm if these contemporary treatments are covered when choosing a health insurance plan. If not, add them as an extra cover to prevent unexpected expenses.

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Latest Treatments

What our customers are saying about the product

"I recently switched to Apollo 24|7 for my health insurance after my previous provider hiked their premiums significantly. It was a smooth online process, and I ..."

Maya Sharma, 26

Maya Sharma, 26

"I had a few existing health insurance plans. I also added Apollo 24|7 as they offered a senior citizen plan with good coverage for pre-existing conditions like ..."

Amit Kumar, 40

Amit Kumar, 40

"I opted for the Apollo 24|7 family floater plan to cover myself, my wife, and our two children. Knowing their network of hospitals and clinics reduced my stress..."

Rajeev Singh, 42

Rajeev Singh, 42

"My previous insurance company denied my claim. So, I switched to Apollo 24|7. Their customer service team patiently guided me through the process and addressed ..."

Lakshay Malhotra, 26

Lakshay Malhotra, 26

"As a person with diabetes, finding an insurance plan that covers pre-existing conditions is challenging. Apollo 24|7 offered a plan with reasonable premiums and..."

Sunita Mishra, 42

Sunita Mishra, 42

"As I'm still studying, I needed an affordable health insurance plan. Apollo 24|7 offered a basic plan with essential coverage at a budget-friendly premium. Thei..."

Vikas Verma, 25

Vikas Verma, 25

"My family has a history of chronic illnesses, so I needed a reliable plan with wider coverage. Apollo 24|7's health insurance plan provided me with wide coverag..."

Rahul Verma, 28,

Rahul Verma, 28,

Benefits not covered by a Health Insurance plan

Self-Inflicted Injuries

Injuries caused intentionally by yourself, including attempted suicide or self-harm, are excluded from the coverage of health insurance.This stems from the principle of insurability, where the insurer cannot compensate for actions within the policyholder's control. The intention behind this exclusion is to deter such actions and encourage responsible behaviour.

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Self-Inflicted Injuries
Adventure Sport Injuries

Activities classified as adventure sports, like skydiving, rock climbing, or bungee jumping, carry inherent risks. As they are considered voluntary, they are outside the purview of standard medical coverage. Any injuries sustained during such activities are not covered by health insurance plans.

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Adventure Sport Injuries
Sexually Transmitted Diseases (STDs)

Treatment for STDs, including HIV/AIDS, is not covered by standard health insurance plans. They are often viewed as preventable conditions arising from personal choices and excluded due to public health considerations and the potential for misuse of coverage. However, some specialised plans or riders might offer limited coverage for specific situations, like HIV/AIDS treatment.

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Sexually Transmitted Diseases (STDs)
Dental Treatments

These are considered cosmetic procedures. Hence, aside from routine dental check-ups and cleanings, most health insurance plans do not cover dental treatments like root canals, fillings, or extractions unless necessitated due to accidental injuries and requiring hospitalisation. However, some plans offer add-on covers primarily designed for dental care at an additional cost.

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Dental Treatments
Treatment of Obesity or Cosmetic Surgery

Expenses for procedures for weight loss treatment or solely for cosmetic purposes, such as liposuction or breast augmentation,are typically excluded. Health insurance prioritises medically necessary treatments, and these procedures don't fall under that category. However, some reconstructive surgeries following accidents or burns may be covered under special conditions.

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Treatment of Obesity or Cosmetic Surgery
Medical Aids

This includes spectacles, hearing aids, dentures, orthopaedic shoes, artificial limbs, and other assistive devices. While essential for managing certain medical conditions, their costs are usually considered personal expenses and not covered by health insurance.

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Medical Aids
War Injuries

Medical expenses incurred during war or in any situation declared an act of war are excluded from health insurance. This is because such events are unpredictable and pose significant challenges to delivering healthcare services.

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War Injuries
Participation in Defence Operations

Injuries or medical conditions sustained while actively participating in military or defence operations are outside the ambit of health insurance. This exclusion stems from the inherent risks associated with such activities, which fall outside the scope of standard medical coverage.

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Participation in Defence Operations

Claim your Insurance in 4 steps

Show the ID & Health Card

step 1

Show the ID & Health Card

Fill pre-authorization form & submit to the hospital

Approval from the insurer

step 2

Approval from the insurer

Hospital requests cashless treatment approval

Reviewal of the documents

step 3

Reviewal of the documents

Insurer authorizes cashless treatment upon reviewal

Obtain cashless treatment

step 4

Obtain cashless treatment

Hospital sends the bills to the insurer for settlement

Different types of Health Insurance

Individual Health Insurance
Individual Health Insurance

This is the most common health insurance plan available in India. As the name suggests, this policy is for a single person only.


For example, if you take individual health insurance of Rs. 5 lakhs, it can only be used for your medical expenses and will not include your wife, children or parents. If you want to cover them, you will have to buy a separate individual health plan.


It is the best health insurance plan for you if you:


  • Have higher health risks.
  • Uninsured, but your family members are insured.
  • Prefer a fixed-sum insured over a floating-sum insured.
  • Wish to renew your insurance policy regardless of your age.
  • Need more protection than a family floater plan offers.
  • Prefer cashless and prompt claim settlements.
  • Fall into categories such as students, self-employed individuals, or those aged between 18 and 26 years.

Under this policy, you will receive reimbursement for the expenses incurred during hospitalisation resulting from illness or injury. It will cover all the hospitalisation, surgical, room rent, and pre and post-medication charges until the insured limit is exhausted. The premium will depend on individual factors, such as your age and medical history.


As this health insurance policy promises financial aid for an individual's medical emergencies, you can customise it according to your medical needs. You can choose a comprehensive plan or consider extra coverage.

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Family Floater Health Insurance
Family Floater Health Insurance

Unlike individual health insurance plans, this plan covers your entire family in a single plan and premium. This shared approach reduces the risk of underinsurance for any family member and increases the utilisation of the sum insured.


For example, when you purchase family floater health insurance of Rs. 10 lakhs for yourself, your spouse, and your children, every family member can claim the sum insured until the insured limit is exhausted. For instance, if you get admitted to the hospital for an angioplasty costing Rs. 3 lakhs. The insurance company settles the claim. Later, in the same year, your family got into a minor accident, requiring them to be admitted. Collectively, all of you can claim the remaining Rs. 7 lakhs from the insurance policy. But if the hospital bill exceeds Rs. 7 lakhs, you need to bear the expenses from your pocket.


The benefits of a family health insurance policy include:


  • As it covers your entire family under one plan, it simplifies the process of managing the policies of different family members.
  • It shares the sum insured, ensuring each member can access sufficient coverage during medical emergencies.
  • The premiums are lower than individual policies (as you have to buy a single policy compared to 3-5), providing a cost-effective solution for families.

In this policy, the age of the eldest member determines the premium. So, consider taking separate individual policies for members over 60, as they are more prone to illness, which will affect the premium amount.

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Senior Citizen Health Insurance
Senior Citizen Health Insurance

As you age, there is increased vulnerability to various health issues. Due to slower recovery, long-term care and regular medications, you may strain or even exhaust your savings. This is where Senior Citizen Health Insurance comes into play.


As the name suggests, this plan is for individuals over 60 or 65, depending upon the policy's terms and conditions. If you, your parents, or your grandparents fall into this category, you can consider a senior citizen health insurance plan. It provides health check-ups and cashless hospitalisation at the insurer's network of hospitals. The coverage includes hospitalisation costs, critical illnesses, pre- and post-hospitalisation expenses, online consultations, modern and alternative treatments, daycare, and domiciliary treatment. Notably, the premium for this plan is also higher than other types of insurance.


Why choose a senior citizen health insurance policy?


  • Your retirement savings might not suffice due to rising medical costs, inflation, and unforeseen emergencies.
  • The plan offers critical illness coverage, which becomes necessary with age.
  • The policy, designed for illnesses like cancer, heart issues, and kidney failure, also includes age-specific and pre-existing conditions like blood pressure, diabetes, and cholesterol.
  • Most plans allow for free annual health check-ups, enabling early detection of diseases, and prompt treatment.
  • With the help of this policy (along with yours), you can claim a tax deduction of up to Rs. 75,000 under Section 80D of the Income Tax.

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Group Health Insurance
Group Health Insurance

This health insurance plan covers a defined group under a single policy. The group can comprise employees of a company, members of an association, or individuals belonging to a specific community. The premium is lower than that of an individual insurance plan, as this policy is taken collectively.


The policy covers the policyholder (employee or member) and their dependents, such as spouses, children, and sometimes parents. The inclusions and exclusions depend on the chosen plan and group agreement.


The benefits of a group health insurance policy are as follows:


  • The plan improves employee retention by providing health coverage for employees and their dependents. It fosters a sense of security, enhancing long-term employee commitment.
  • Offering features like teleconsultations with mental health professionals helps employees manage stress effectively.
  • It includes fitness tracking and quick access to doctors, enabling preventive healthcare measures to maintain a healthy lifestyle.
  • All members within your group receive the same level of coverage, regardless of age, medical history, or pre-existing conditions.
  • A group health insurance plan for families often covers a broader range of medical expenses, including hospitalisation, pre- and post-hospitalisation care, daycare procedures, maternity care, and specific illnesses.
  • The group administrator handles general tasks like enrollment and claim processing, making it easier for you.

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Critical Illness Insurance
Critical Illness Insurance

Critical illness insurance plans in India provide financial protection in cases where you are diagnosed with a severe medical condition. These plans go beyond traditional health insurance and offer a lump-sum payout upon diagnosis of a covered critical illness, regardless of the treatment cost. This lump sum can be used for various purposes, such as:


  • Covering treatment expenses: Critical illnesses often require specialised care and expensive procedures that can significantly strain your finances. The payout from the plan can help bear the expenses of the treatment.
  • Maintaining your lifestyle: During an illness, you might need to take time off work or adjust your lifestyle. The payout from medical health insurance can help you retain financial stability and continue providing for your family.
  • Managing debt: Critical illnesses can lead to mounting medical bills, potentially leading to debt. The payout can help you manage existing debt or avoid taking on new debt during a challenging time.

Given below are the key features of critical illness plans:


  • Coverage for specific illnesses: These plans cover a defined list of critical illnesses, including cancer, heart attack, stroke, kidney failure, and others. The number of illnesses covered varies depending on the plan.
  • Lump sum benefit: Upon diagnosis of a covered illness, the plan pays out a lump sum amount, regardless of the actual treatment cost. This amount can be used for any purpose as per your needs.
  • Optional riders: Many plans offer riders, such as early-stage critical illness benefits, waivers of premiums, and accelerated benefits for specific illnesses, that you can opt for.

Consider your age, health, family history, and financial situation to determine the level of coverage you need.

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Maternity Health Insurance
Maternity Health Insurance

This policy is tailored specifically for women and their unique healthcare needs during pregnancy and childbirth. It offers coverage for various expenses related to maternity care, including prenatal and postnatal care for the expecting mother, normal and cesarean deliveries, and additional costs that may arise due to post-delivery complications. Some plans cover expenses for the newborn, including vaccinations, nursery stays, and treatment for congenital conditions up to a specific period.


However, watch out for certain exclusions, such as expenses for supplements, diagnostic tests during pregnancy, infertility treatments, costs associated with harvesting and storing stem cells, and costs incurred during the waiting period before the policy becomes active.


A maternity health insurance policy is recommended for women planning to start a family or who are already pregnant. However, consider purchasing one as soon as you are married, as most plans have a waiting period before the coverage becomes effective. Additionally, you must usually be between 18 and 45 years old to qualify.


Here are some factors you should take into account:


  • Compare policies from different insurance companies to find the most suitable coverage according to your needs.
  • Understand the waiting period and exclusions of the policy to avoid surprises during the claim process.
  • Assess your healthcare needs and select coverage for comprehensive protection throughout your maternity journey.
  • Make a well-informed decision regarding maternity health insurance for financial security and peace of mind during this significant phase of life.

Maternity health insurance plans can also be added to a basic policy.

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Top-up Health Insurance
Top-up Health Insurance

With steadily rising healthcare costs, sometimes even comprehensive plans have limitations, with the sum insured getting exhausted due to expensive treatments. This is where top-up health insurance comes to the rescue. It bridges the gap between your existing plan's coverage and your actual medical expenses.


Unlike regular health insurance plans, top-up insurance is a layered product. It's an addition to your existing primary policy, be it an individual or family floater plan. It gets activated after your primary plan's sum insured is exhausted.


The plan comes with a deductible, a fixed amount you need to pay out of pocket at the time of purchase before the top-up coverage kicks in.


The key features of top-up health insurance are:


  • Increased Coverage: Top-up plans offer a significantly higher sum insured than their premiums, making them cost-effective ways to boost your overall coverage. You can choose the sum insured, ranging from Rs. 5 to 50 lakhs or even higher, as per your needs and budget.
  • Flexibility: You can add top-ups to either individual plans or floater plans covering your entire family. They are also renewable, allowing you to continue the coverage.
  • Affordability: Compared to upgrading your primary plan to a higher sum insured, these plans offer significantly lower premiums. This makes top-ups an effective option to increase your coverage without breaking the bank.

When selecting an insurance plan, consider the deductible carefully. Opting for a higher deductible reduces premiums but ensures they remain manageable in emergencies. In addition, be mindful of coverage exclusions, such as pre-existing conditions or specific treatments outlined in the policy.

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Super Top-up Health Insurance
Super Top-up Health Insurance

This plan provides additional coverage for medical expenses that exceed the sum insured amount of your base medical plan. Super top-up health insurance differs from a regular top-up plan. It considers the total medical expenses incurred during the policy period rather than just the amount of each claim. This means that you could have multiple claims throughout the year that are each less than the deductible limit, but if the total cost of all of those claims exceeds the deductible, the super top-up plan would kick in and cover the difference.


Here are some key points to consider when choosing between a top-up and a super top-up health insurance plan:


  • Deductible: Top-up plans typically have a per-claim deductible, while super top-up plans have a per-policy deductible.
  • Premium: The premium for a top-up plan is usually lower than that of a super top-up plan, as it provides less coverage.
  • Coverage: Super top-up plans provide more comprehensive coverage than top-up plans. They may have higher limits on the amount of coverage they provide.

Ultimately, the best health insurance plan for you will depend on your needs and budget. If you are concerned about incurring high medical expenses, a super top-up plan may be a good option for you. However, if you are on a tight budget, a top-up plan may be a more affordable option.

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Reasons to get a Health Insurance

Combating Medical Inflation
Combating Medical Inflation

The medical inflation in India for 2023 stood at 14%, almost twice the general inflation during that year.In this scenario, getting the best treatment at top hospitals has become costlier. The expenses are not only limited to hospital bills but also include doctor's consultations, diagnostic tests, ambulances, room rent, and medicines.

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Access to Premium Medical Care
Access to Premium Medical Care

If you or your family falls sick, you want the best treatment from the most qualified doctors available.However, if the high costs hold you back, you may compromise on the quality of treatment. But with a health insurance policy, you and your loved ones can access quality healthcare solutions from the hospital of your choice or choose the best among the network hospitals.

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Cashless Hospitalisation Advantage
Cashless Hospitalisation Advantage

Managing finances while your loved one gets hospitalised can be stressful. Insurance companies understand this, hence they have built a network of partner hospitals. As a part of their health insurance plans, you can access these hospitals and treatments without worrying about finances. The insurer will settle the dues directly with the hospital.

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Chronic Condition Management
Chronic Condition Management

Critical and chronic conditions like cancer, diabetes, and heart disease are hard to deal with. Not only are they life-threatening but they also require regular and expensive treatment. The best health insurance plans will include higher coverage (often at an added cost) for these illnesses. You will receive a lump-sum amount when you are diagnosed with any of the covered ailments.

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Preventive Care
Preventive Care

Prevention is always better than cure. Health insurance policies may provide for annual check-ups, including preventive screenings,health assessments, and diagnostic tests. It can lead to early detection of diseases, thus helping you prevent the associated complications.

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Emergency Coverage
Emergency Coverage

Accidents and sudden illnesses can strike anytime, anywhere. In the event of an emergency, where time is of the essence, you may not have immediate access to the resources to cover the expenses. Health insurance with cashless benefits ensures you receive prompt and necessary treatment without worrying about ambulance services, hospitalisation, and surgical procedures.

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Maternity and Family Planning
Maternity and Family Planning

The best health insurance plans extend comprehensive maternity coverage, including prenatal care, delivery charges, postnatal care, and newborn care up to a specific number of days. This financial support ensures that both mother and child receive proper medical attention.

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Network Discounts
Network Discounts

Most health insurance plans offer discounts on various medical services at their network hospitals,pharmacies, and diagnostic centres. These discounts will reduce your out-of-pocket expenses.

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Tax Savings
Tax Savings

The health insurance premium you pay is available for deduction under Section 80D of the ,Income Tax Act, 1961, provided you choose the old regime You can claim a deduction of Rs. 25,000 for the health insurance premium you paid, covering you, your spouse, and your children. In addition, a deduction of up to Rs. 25,000 is available for the premium paid for your parents under 60 years of age, which will be Rs. 50,000 if they are above 60.

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Peace of Mind
Peace of Mind

Knowing you and your loved ones are financially protected against unexpected medical expenses definitely brings peace of mind.Thanks to a great health insurance policy, you can get the best possible treatment without worrying about finances and focus on a quicker and more stress-free recovery.

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Protects Your Savings
Protects Your Savings

Unexpected medical expenses can quickly deplete your hard-earned savings, which you may have kept aside for education, marriage,retirement, or other goals. With a medical insurance policy, you can rest assured that your savings remain untouched even in the face of medical emergencies.

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Rise in Sedentary Lifestyle
Rise in Sedentary Lifestyle

Due to our increasingly sedentary lifestyle, diseases like diabetes, heart disease, obesity, and hypertension are on the rise.Health insurance plans often include coverage for these ailments in the form of financial support for medical treatments, medications, and preventive care.

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Factors for deciding Premium

Age And Health
Age And Health

Your chance of developing health problems rises with age. As a result, the health insurance premium also increases For instance, for the same plan, a 25-year-old person will pay Rs. 5,000 annually, while a 50-year-old person may have to pay Rs. 10,000.

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Sum Insured
Sum Insured

This represents the maximum amount the insurer will provide for your medical expenses. Your premium is directly proportional to the sum insured - the higher the sum insured, the higher the premium. For instance, a health insurance policy with a Rs. 5 lakh sum insured will cost Rs. 8,000, but when you choose a Rs. 10 lakh policy, it may cost Rs. 12,000.

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Policy Type and Coverage
Policy Type and Coverage

Different policies offer different coverages. Comprehensive plans that cover hospitalisation,daycare procedures, and critical illness will have higher premiums than basic plans with limited coverage.

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Location
Location

Premiums can vary based on your city or state due to differences in healthcare costs and claim frequencies. They are on the higher side in metro cities compared to smaller towns. For instance, health insurance costing Rs. 10,000 in Mumbai may cost Rs. 7,000 in Nashik.

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Medical History
Medical History

Pre-existing conditions can significantly impact your premium. For example, someone with a pre-existing heart condition will have to pay 20-30% more than someone without such medical ailments.

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Lifestyle Habits
Lifestyle Habits

Smoking, tobacco use, and excessive alcohol consumption are considered high-risk factors and can inflate your premium. This is because these habits are statistically linked to a higher likelihood of developing serious health conditions, which can lead to increased costs for the insurer. The risks include various cancers, heart disease, respiratory illnesses, and liver damage, among others..

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Deductibles
Deductibles

This is the amount you pay upfront before the insurance coverage kicks in. You can either pay the deductible amount from your own pocket or use any other retail insurance plan. Choosing a higher deductible lowers your premium and increases your out-of-pocket expenses. For example, a health insurance policy with a Rs. 10,000 deductible will be cheaper than one with a Rs. 5,000 deductible.

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Riders
Riders

These are optional add-ons, like maternity, critical illness, or room-rent waiver benefits, for additional coverage beyond the primary policy.Each rider adds to the cost of your premium. For instance, the premium for the base policy of Rs. 10 lakhs are Rs. 5,000 and you consider riders like critical illness (which supposedly covers 5 critical illnesses for Rs. 1,500 extra) and a maternity cover (for Rs. 2,000).

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Secure Your Family's Future. Let's Start Safeguarding Lives Together!

FAQs for Health Insurance

What is the right age to buy health insurance?

There's no 'right' age to buy a health insurance plan. However, it is recommended to start early. Early purchase locks in lower premiums and avoids exclusions due to future health conditions. Consider buying a plan in your 20s or 30s when premiums are lower and you are healthier.

Is undergoing a medical examination a must before buying a health insurance policy?

It depends on your age, the sum insured, and the insurance company's policy. The company might waive off the medical tests if you are younger and with lower sum insured amounts. However, medical tests are often mandatory if you are older or opt for higher coverage.

Can I buy health insurance if I have diabetes?

Yes, you can buy health insurance even if you have a pre-existing disease like diabetes. However, you may have to pay higher premiums or deal with exclusions for pre-existing conditions. Some insurers even offer specialised plans for diabetes. It is vital to disclose your diabetes diagnosis clearly during the application process.

What does cashless hospitalisation signify?

Cashless hospitalisation allows you to get medical treatment without making direct payments. The insurer settles the expenses directly with the hospital, provided you take the treatment within the network hospitals specified by the insurance provider.

When am I eligible to enrol my children in my health insurance coverage?

Most plans allow enrolling children from birth or 30 days later. Age limits and eligibility criteria vary depending on the insurer and plan.

What is a free-look period in health insurance?

The free-look period is a 15-day window after the policy purchase where you can review the policy terms and conditions. If unsatisfied, you can cancel and get a full refund (excluding taxes and any expenses incurred by the insurer).

Is it possible for a person to buy multiple health insurance policies simultaneously?

Yes, you can purchase multiple health insurance policies to enhance coverage. Each policy will contribute independently towards covering medical expenses. Consider coordinating benefits to avoid over-insurance.

Is it necessary for me to buy a separate health insurance plan even if I am covered by my employer's group policy?

It depends on your needs and the employer's plan coverage. Group plans might have limitations, like limited network hospitals or low sum insured. You can consider a top-up plan or individual health insurance for additional protection.

Will my health insurance expire if I switch jobs?

Individual health insurance policies are portable and continue even if you change jobs. However, if you are covered under a group health insurance plan, it might expire. Therefore, checking with your employer if the policy is portable is recommended.

Under which section can I claim tax benefits for health insurance?

Under Section 80D of the Income Tax Act, you can claim tax deductions for health insurance premiums paid for yourself, your spouse, dependent children, and your parents. This deduction is applicable only under the old tax regime.

Deduction Limits:

  • Individuals below 60 years old: Up to Rs. 25,000 for self, spouse, and dependent children.
  • Individuals aged 60 years and above: Up to Rs. 50,000 for self, spouse, and dependent children
  • Additional deduction for parents who are senior citizens (aged 60 years and above): Up to Rs. 50,000 for parents' health insurance premiums.
  • Additional deduction for preventive health checkups: Up to Rs. 5,000

What is the procedure for adding family members and elderlies to my existing medical insurance policy?

Contact your insurance provider and inquire about adding dependents. You might need to submit documents like birth certificates or marriage certificates. Please note that you will have to pay additional premiums for adding dependents to your health insurance plan.

How can I increase the sum insured if I already have a health insurance policy?

Most insurers allow increasing the sum insured when you request an enhancement during policy renewal. You might need to undergo a medical checkup, and premiums will increase accordingly.

Can I claim two health insurance policies together?

Yes, you can claim benefits from multiple health insurance policies simultaneously. However, the total claim amount received cannot exceed the actual expense incurred. This action is permissible only when the coverage from one policy is insufficient, so you submit a claim under another policy to cover the remaining costs.

Can I buy a health insurance policy in India if I am a non-resident Indian?

Non-resident Indians (NRIs) can purchase medical health insurance plans in India. Specific plans for their needs are offered by many insurance companies. However, the premium calculations might differ.

What is deductible in health insurance?

The deductible is a fixed amount you pay upfront before the insurance company starts covering your medical expenses. Choosing a higher deductible lowers your premium but increases your out-of-pocket costs.

What are underwriting charges in health insurance?

Underwriting charges are fees associated with the assessment of your risk profile. The insurer will charge this amount during the underwriting process, where they evaluate your health and determine the premium rates accordingly. This is usually a percentage of the sum insured.

How to get higher health insurance coverage at a lower premium?

To obtain higher health insurance coverage at a lower premium, you can consider policies with higher deductibles, maintain a healthy lifestyle, and compare quotes from different insurers to find the most cost-effective option. Additionally, opting for long-term policies may offer better rates.

How long does it typically take for my claim to be processed?

Claim processing time can range from a few days to several weeks, as it depends on the insurer, the claim's complexity, and the availability of all the documentation. Most insurers have online claim tracking tools where you can track updates.

What happens if my claim is denied? What is the appeals process?

If your claim is denied, you will receive a communication explaining why. Review the denial carefully and gather any additional supporting documents. Most insurers have an internal appeals process outlined in their policy documents. Follow the process and submit your appeal within the stipulated timeframe. If you are unsatisfied with the internal outcome, you may escalate to external grievance redressal mechanisms.

What happens to my coverage if I travel abroad?

Coverage for international travel depends on your specific plan. Some health insurance plans offer limited emergency coverage abroad, while others might require separate travel insurance. Check your policy wording or contact your insurer for clarification.

Will my premium increase at renewal? If so, by how much?

Health insurance premiums can increase at renewal based on various factors, like age, claim history, inflation, and policy changes. The increase can vary depending on these factors and the insurer's terms and conditions. Check with your insurance provider to get specific information.

What happens if I miss a premium payment?

Missing a premium payment can lead to a grace period (typically 15-30 days) to make the payment without penalty. After that, your health insurance coverage might be suspended or terminated, requiring reinstatement procedures and late fees.

Am I covered for dental or vision care?

Most basic health insurance plans don't cover dental or vision care. However, some insurers offer add-on riders or separate dental and vision insurance plans you can purchase. Check your policy details or contact your insurer for specific coverage information.