Health Insurance is a type of insurance that protects you against medical expenses, to the extent of the coverage amount.* It achieves this by directly paying for (in case of cashless) or by reimbursing your medical bills, during the validity and terms of the health policy, to the extent of the coverage amount.The insured or the policyholder pays for this coverage against medical costs through premiums which could be annual or monthly. One can opt for a policy that only covers oneself or add dependents and family members to the policy.

A health insurance policy gives you the financial support you need to deal with a possible medical emergency. It may cover the cost of hospitalization, medical consultations, medical tests, OPD bills, prescription bills, treatment of long-term ailments, therapy, surgeries, etc depending on the kind of policy and the addons / riders chosen at the time of policy purchase or renewal. The coverage is the total Sum Insured that you can choose against monthly or annual premiums.

Several health policies have a cashless feature, which does not require you to clear bills followed by the process of claims settlement. It prevents unnecessary hassle during an already stressful situation and protects against situations where you might not be able to arrange a large sum at short notice. Always check if your prefered hospitals qualify for the cashless facility in the policy you are considering.s

‘Don’t dig a well when the house is on fire.’ This famous Indian proverb captures the need for Insurance like no other.

Medical emergencies, hospitalization, surgeries and long drawn medical treatments are one of the biggest causes of financial distress and ruin in Indian families. Even people with adequate incomes are sometimes forced to borrow, sell assets, etc during health emergencies. The reason is simple - it is a large, unplanned expense which cannot be postponed, and comes during the most stressful time you can think of - a medical emergency involving you or your loved one.

One might procrastinate or avoid getting health insurance by thinking that he or she has enough liquidity / savings set aside for medical expenses. But can you really predict how much medical costs will be when they hit you? As per market reports, medical inflation has remained around 7-10% from 2016 to 2020. And that might increase even further. Also, it’s hard to predict the nature of the medical emergency. Who would have thought that such a large number of people, even young and healthy, will require medical care and hospitalization due to an unexpected pandemic?The Covid crisis left millions wishing they had Health Insurance. Better be safe than sorry! Plan for what may seem like unlikely scenarios, with cost-effective and comprehensive policies.

As discussed above, health insurance plans cover the expenses incurred during medical procedures which may include pre, peri and post hospitalization. They also cover daycare procedures, OPD treatment, besides raising and restoring the sum insured automatically based on situations. Let’s discuss these in more detail:

• In-patient Hospitalization Cover: Once you get hospitalized due to sickness or injury, the health insurance company will cover all your expenses from room rent to medical equipment, up to the limits specified in the policy. For this cover, the hospitalization must be for a minimum of 24 hours.
• Pre and Post-hospitalization Cover: Expenses can happen before and after hospitalization too. To get this covered, a qualified medical practitioner needs to confirm that hospitalization will happen and so will the expenses before and after it. However, the cover will be available for up to 30-60 days before hospitalization and 60-180 days after hospitalization.
• Cover for Daycare Procedures: Some procedures don’t require a 24-hour hospitalization to complete, thanks to medical technology advancements. These are called daycare procedures, which include ear and nose operations, dialysis, chemotherapy, etc.
• Ambulance Fee: Health insurance companies also cover ambulance charges up to a certain percentage of the sum insured amount.
• Organ Transplantation Cover: Many require organ transplantation operation to survive, and for that, they need donors. Health insurance covers the cost of such transplantation, which can be too much for many to bear without it.
• Domiciliary Treatment: Sometimes the condition of patients remains such that they can’t be moved to a hospital. Or sometimes the hospital beds don’t remain vacant. In either of the two, you can go for domiciliary treatment and get covered up to the sum insured or a certain percentage of it. However, the treatment must run for a minimum of 3 days to get this cover.
• Cover for Modern Day Treatment: Health insurance plans cover modern-day treatments such as stem cell therapy, robotic surgeries and oral chemotherapy, etc.
• No Claim Bonus: Staying fit can reward you with a no claim bonus (NCB) on renewal. So, if you don’t claim in a financial year, you could earn a bonus in the form of an increased sum insured. The quantum of bonus, which remains 5-20% after a claim-free year, can go as high as 100%. So, if the sum insured is INR 5 lakh and you get a bonus of 10% on renewal, that INR 5 lakh will rise to INR 5,50,000. In case you don’t claim in the second year too, the overall sum insured will rise to 6,00,000. So when you do fall sick and get hospitalized, you will have plenty to deal with the treatment expenses.
• Automatic Restoration Facility: If the sum insured gets exhausted by claiming your health insurance, you can get it restored automatically and continue to get covered. Some health insurers can provide the restoration facility even on partial exhaustion. However, the restoration facility might apply to illnesses other than the ones you have claimed for. You can check the same in the policy wordings.
• Daily Hospital Cash Allowance: Health insurance plans also offer daily hospital cash allowance on continuous hospitalization of at least 3 days. You can get the allowance for a maximum of 10 days of hospitalization.
• OPD Treatment: Visits to the Outpatient Department can also incur significant costs, which may bother you later if not insured. According to reports, OPD expenses account for nearly 60% of total healthcare costs in India. Keeping in mind the same, health insurance plans offer OPD treatment cover too.
• Free Health Check-ups: Insurers also offer free health check-ups up to a certain limit in a financial year.
• Lifelong Renewability: Health insurance policies can be renewed till your lifetime, ensuring continued benefits for you. Typically, these policies are issued for a year, and one needs to renew them every year by paying the premium. But insurers also offer policies for two and three years. These are called multi-year policies.
• Waiting Period: It means one has to wait for specific periods before getting covered against ailments or conditions. There is an initial waiting period of 30 days from the commencement date of the policy for all illnesses, except for accidental injuries. If you have any diseases or conditions before buying a policy, a waiting period of 2-4 years will apply. In the case of maternity, the waiting period will be for around 2 years. Even if you buy a dedicated maternity plan, a waiting period of 9 months will apply. For COVID plans, the waiting period is 15 days.
• Co-Payment Clause: Often people aged above 45 are offered policies having Co-Payment clauses, which mean the policyholder and the insurer will share the burden of medical expenses. So, if a co-payment clause of 10% is there, it means the policyholder will need to pay 10% of the treatment cost first before the insurer will pay the remaining amount. Remember, the payment can never exceed the sum insured amount. The co-payment clause can lead to a lower premium for policyholders to pay.
• Deductible Clause: It sounds pretty similar to a co-payment clause but remains different from the same. Here also, policyholders and insurers share the claim burden. But the application remains different. Insurers will pay only when medical expenses cross the threshold limit i.e. deductible set by them. So, if a health insurance plan has a sum insured of INR 6 lakh and a deductible of 15%, the insurer will pay only when the expenses cross INR 90,000 (6,00,000 × 15%). The cover will happen up to the sum insured only. The premium for plans with a deductible clause remains lower.
• Pre-policy Medical Check-up: Most health insurers put in a condition of pre-policy medical check-ups for individuals aged more than 45. In that case, the insurer will conduct certain medical tests of such individuals to determine the health condition of the insured.
• Network Hospitals: Health insurers join hands with several hospitals to ensure the cashless treatment of their customers. So if you undergo treatment at any of these hospitals, you won't have to pay for the treatment. Let’s check out the insurers and their total number of network hospitals across India.

Health Insurance Companies	PAN India Network Hospital Count (Approx.)
Niva Bupa Health Insurance	6700+
HDFC ERGO Health Insurance	10,000+
Star Health Insurance	9,900+
ICICI Lombard	6,500+
Care Health Insurance	15,500+
Bajaj Allianz Health Insurance	6,500+
Bharti AXA Health Insurance	4,500+

• Third-party Administrators (TPAs) : These are also a part of the cashless claim process team. TPAs tie up insurers to ensure customers avail cashless treatment at network hospitals without any hassle. So when you visit any of the network hospitals, you will need to contact the TPA desk located there for a cashless claim. You need to fill a pre-authorization form and submit it to the desk, which will then send it to the insurance company for approval.

Till now, you would have understood the importance of having a health insurance plan in light of rising medical expenses, its features & benefits. But how to choose the most suitable health insurance plan from all the options available. It can be a tricky task if you are new to insurance. Let’s check below how you should approach when selecting the best health insurance plan in India.

Assess Your Cover Requirements - The first thing to do before choosing a health insurance plan is to assess your cover requirements accurately. The requirements can vary from individual to individual based on whether the insurance cover required is for an individual or for the family. Someone looking to cover multiple members will need a higher sum insured compared to people looking to cover themselves only.

Choose the Best Premium Amount - Paying too much through premiums is not advisable for anyone seeking a health insurance plan. But how can you say it’s too much? You can decide it based on the premium amount of top health insurance plans for the same sum insured amount. So, a plan striking a balance between a perfect sum insured and an optimized premium amount is worth going for.

Compare Add-Ons Offered - NCB (No Claim Bonus) and sum insured restoration facilities have already been discussed above. But check whether they are part of a base plan or come as an add-on. In the case of add-on, the premium will rise. Ideally, a base plan should have these offers so that you could get covered by paying an optimized premium amount.
Check which plan offers you more bonus on no claim in a financial year. Also, see the number of times you are allowed to use the restoration facility. Do such due diligence on NCB and sum insured restoration before choosing a plan.

Check for Plans Offering No Sub-limits on Room Rent Till now, it’s clear that the cover is available up to the sum insured chosen at the time of policy inception. But some plans come with certain sub-limits on room rent. The sub-limit remains a certain percentage of the sum insured per day. In case the actual room rent exceeds the sub-limits, you will need to pay the extra amount. For example - if the sum insured is INR 5 lakh and the sub-limit remains 1%, anything beyond INR 5,000 (5,00,000 x1%) per day is your liability. But to your delight, many health insurance plans come with zero sub-limits. You can choose from them.

Compare Top Health Insurance Plans in India

The time has come for us to compare the best health insurance plans based on coverage, premium amount, etc. Let’s check the plans that score the maximum on these.

Why Should You Compare Health Insurance Plans Online?

For something as important as Health Insurance, one needs to do their homework well. The devil is in the details. Is your Insurance Company good? What is the Claims Settlement Ratio? Which policy has the lowest premiums? Is your prefered hospital covered? Do you really need a particular add-on? The questions are endless. And so is the information available. Here’s why you should always compare policies from different companies on a neutral and unbiased service like WishPolicy:

Accurate Information - To choose the Policy you can depend on, you need information you can trust. WishPolicy goes through great lengths to ensure accuracy of information for its users.

Accurate Information - To choose the Policy you can depend on, you need information you can trust. WishPolicy goes through great lengths to ensure accuracy of information for its users.

Saves Time - Researching Insurance before a purchase can be daunting and time-consuming. WishPolicy brings multiple plans with their offers online, in one place, enabling you to compare them easily and quickly. It helps you not only go through each plan individually but also compare multiple plans parallely.

Neutral, Unbiased & Transparent - WishPolicy does not push a particular company, policy or plan. It gives unbiased information, allows a fair comparison and empowers you to take a call that’s right for you.

There is a lot of variety in Health Insurance Plans, because people may have very different needs. Let’s examine them below:

Individual Health Insurance Plans - Under this type, only a single individual is covered for a range of diseases and conditions. The premium for these plans depends on the age, income and existing health conditions of an individual.

Family Floater Health Insurance Plans - These plans cover not only an individual but also his/her family. The eldest member of the family will dictate the premium amount applicable to these plans.

Senior Citizen Health Insurance Plans - These plans are designed for senior citizens aged more than 60 years. As senior citizens are most likely to fall ill, the premium for these plans is likely to be high.

Critical Illness Health Insurance Plans - Health insurance companies offer critical illness plans by which you can get cover for diseases such as heart attack, kidney failure, cancer, etc. Most critical illness plans offer a fixed benefit upon the diagnosis of these diseases.

Group Health Insurance Plans - Health insurance companies offer critical illness plans by which you can get cover for diseases such as heart attack, kidney failure, cancer, etc. Most critical illness plans offer a fixed benefit upon the diagnosis of these diseases.

Maternity Insurance Plans - Insurers offer dedicated plans for pregnancy and its complications. The sum insured for these plans will depend on the cost of pregnancy (Normal/Caesarian Cost & Other Expenses)

Coronavirus Health Insurance Plans - As COVID has caused immense physical and financial distress among people, health insurers offer dedicated plans to people wanting a cover against this disease. There are two COVID plans - Corona Kavach and Corona Rakshak - you can apply for. While Corona Kavach is an indemnity plan that indemnifies you financially against the expenses incurred on the treatment of COVID-related complications, a fixed benefit is payable upon the diagnosis of Coronavirus when choosing a Corona Rakshak plan. Let’s check both these plans at a glance.

Arogya Sanjeevani Plan - The Insurance Regulatory Authority of India (IRDAI) launched Arogya Sanjeevani Plan on April 1, 2020, offering coverage for several illnesses including COVID-19 and its complications. You can choose the sum insured ranging from INR 1-5 lakh. Let’s check below the coverage of this plan.

• In-patient Hospitalization expenses including -
• Room rent, boarding and nursing expenses up to 2% of the sum insured, subject to a maximum of INR 5,000 per day
• Intensive Care Unit/Intensive Cardiac Care Unit charges up to 5% of the sum insured, subject to a maximum of INR 10,000 per day
• Fees of doctors, surgeons, along with charges of anaesthesia, oxygen, blood and operation theatre
• Covers alternative treatments such as Ayurveda, Unani, Siddha and Homeopathy (AYUSH) performed in a government hospital or a hospital accredited by the Quality Council of India or National Accreditation Board
• Cataract Treatment up to 25% of the sum insured or INR 40,000, whichever is lower
• Covers pre-existing diseases after a waiting period of 4 years
• Both individual and family floater health plans are available

Besides, the plan offers a cumulative bonus of a 5% increase in the sum insured for not claiming in a year. The maximum rise is capped to 50% of the base sum insured. Tax benefits, lifelong renewability only add to its attraction among the customers.

Does a Regular Health Insurance Plan Cover Coronavirus?

In 2020, the IRDAI asked insurers to cover COVID under their regular health insurance plans. So if you get diagnosed with COVID, your regular health plan will cover the same. However, the diagnosis report must be from an authorized centre. In the absence of the same, the insurance company may not honour the claim. These rules also apply to dedicated COVID plans discussed above.

Health insurance premiums depend on several factors such as the age of policyholders, their medical history, the type of plan chosen, etc. Let's see how these impact the premium amount:

Age - The age of the policyholder determines greatly the premium he/she would pay. In case you buy a policy at a young age, the premium will be lower compared to when you do so later. Also, the premium of health insurance changes depending on the year slab you move on to. Typically, there is a slab of 5 years based on which the premium varies. For example, you are aged 32 years and are in the slab of 30-35 years. The premium now is INR 8000 ( assumed) a year. Once you attain 36 years and enter into the next slab of 5 years, the premium could notch up to more than INR 10,000 a year.

Type of Plan Chosen - The premium also depends on the type of plan you choose. Policyholders' age matters when it comes to deciding the premium amount. So if it is a family floater plan covering multiple members, the health insurance company will determine the premium based on the age of the eldest member.

Sum Insured - The Sum Insured amount also dictates the calculation of the premium amount. The greater the sum insured, the higher the premium outgo and vice versa.

Medical History - It plays a vital role not only in deciding the premium amount but also in the approval of health insurance applications. If the policyholder does not have any health complications, not only will the premium amount be lower but also the application will get approved quickly. Whereas, if you have health issues, the underwriters of the health insurance company will examine them carefully before approving your case. In case they approve your case, they will compute your premium based on your health conditions. An increased premium from the standard rate is a formality. But the rise in the premium amount depends on the severity of conditions, the sum insured, the number of members covered in a policy, etc.

Can You Get Discounts on Health Insurance Premiums?

Yes, discounts are available on health insurance premiums if you pay the premium for 2 years or more in advance. Discounts can also be available on choosing a family floater plan or a multi-year plan. The discount rate will, however, vary from one plan to another.

Health Insurance Premium Calculator and Its Benefits

The premium calculator, which is available online for use, shows the estimated premium for the health insurance plan you wish to buy. As expressed above, the premium is dependent on factors such as the age of the policyholder, the type of plan he/she chooses, his/her existing health conditions, etc. As soon as you enter the same in the calculator, the premium payable will flash on your screen. The calculator provides reliable results quickly based on the details mentioned above.

Tax Benefits on Health Insurance

Besides the financial cover against health emergencies, health insurance also offers tax benefits up to INR 1,00,000 on premiums paid in a financial year, under Section 80D of the Income Tax Act. Tax deductions of up to INR 5,000 apply to preventive health check-ups.

Inclusions at a Glance

Health insurance plans cover numerous diseases and conditions up to the sum insured you choose at the time of policy inception. Let's check the coverage of these plans below.

• In-Patient Hospitalization
• Pre and Post-hospitalization
• Day Care Procedures
• Organ Donor Expenses
• Ambulance Fee
• Daily Hospital Cash
• Fees of Doctors, Surgeons
• Ayush Treatment
• Domiciliary Hospitalization
• OPD Treatment
• Cataract Surgery

Exclusions to Keep in Mind

Knowing exclusions are as important as being aware of inclusions as it could help avoid a potential claim rejection from the insurer. Let's check the exclusion list below.

• Sex Change
• Hormone Replacement
• Dental Surgery
• Non-allopathic Treatment
• Injuries Caused by war, attempt to suicide, terrorism, nuclear activity
• Cosmetic Surgery unless it is necessary for the survival of the insured
• Terminal Illness
• Treatment carried out abroad
• Treatment based on the advice of an under-qualified medical practitioner
• HIV AIDs and other sexually transmitted diseases

The Claims situation is the key concern when it comes to Health Insurance. Because, whether you have a good Health Policy or not comes down to your claims experience. There are two ways by which you can claim - Reimbursement and Cashless. As the name suggests, the Reimbursement method requires you to foot the medical bills and later get them reimbursed by the insurance company. A cashless claim means no upfront payment from your end towards hospitalization. However, this is possible only at network hospitals included by the insurer. Let's explore how to navigate both claim types.

Steps to Follow in a Cashless Claims Process

• Choose from the list of network hospitals included by your Health Policy
• Visit the chosen hospital and show your cashless card and Photo ID proof (PAN Card/Voter ID/Aadhaar Card) to the TPA/Insurance Desk
• The concerned officials will verify your identity before sending a pre-authorization form to the insurer, which will examine the details thoroughly before approving a claim.
• Once the claim is approved, you and the network hospital will get a notification regarding the same.
• The insurance company will settle the bill directly with the network hospital based on terms and conditions laid down in your plan.

Important Notes for a Successful Cashless Claim

• Intimate the insurer about your hospitalization at least 48 hours before a planned admission.
• Intimate within 24 hours of an emergency admission

Reimbursement Claim Steps

• Pay for your treatment expenses at a non-network hospital.
• Submit all the treatment-related documents along with a duly filled claim to the health insurance company at its registered address via post.
• You can download the claim form on the official website of the insurer.
• The company will review these documents carefully before approving your claim.
• You will get the notification of approval the moment it happens.
• A few days from the approval, you can get the amount reimbursed to your bank account.

List of Documents Required for a Reimbursement Claim

• Discharge Card signed by the hospital authorities.
• Duly signed in-patient hospitalization bills.
• Prescriptions of doctors, including the one for consumables and disposables.
• Medical store bills.
• Doctor’s consultation bills.
• A valid investigation report.
• Copy of previous year and current year policy.
• Copy of TPA ID Card.
• Any other relevant documents

Who is Eligible to Buy a Health Insurance Plan?

Individuals aged 18 to 65 years can buy a health insurance plan. In some cases, health insurers also offer plans to individuals aged up to 70 years.

Can You Port Your Health Insurance Plan?

If you don’t want to continue with your existing health insurance plan and switch to a new plan by another insurer, you can do so using the ‘Porting’ facility. As per the IRDAI norms, people can switch from one insurer to another provided they submit such a request 45 days before the due date of renewal. While submitting the request, you are required to mention the name of the new insurer where you want to port your policy. After that, both the new and old insurer will coordinate and ensure a seamless switch on the renewal date. The new insurer will consider points such as no claim bonus earned and completion of waiting period for pre-existing diseases with the previous insurer.

Partnership with 20+ Top Insurance Players - By bringing you the widest range of policies from top insurance companies, WishPolicy ensures that you do not miss out on the policy that might be right for you! We are tied up with 20+ top insurance companies that boast of a high claim settlement ratio and a wide selection of customized term insurance plans, etc.

Tech that Enables Peace Of Mind - WishPolicy’s advanced algorithms are designed to factor in the needs and concerns of our customers. The quotes that you receive are not only relevant, but empower you to make a fair comparison with full transparency. We bring you the cutting-edge of insurtech, not to choose for you, but enable you to choose what’s best for you.

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24X7 Support - As soon as you apply, we start planning the perfect term plan for you based on your needs. We use our market expertise to find the custom-fit plan that offers you the desired sum assured at least premium and for an optimized time. From application to the issuance of the policy, we offer our uninterrupted support to secure the future of your loved ones. Think of us as your go-to insurance companions.

Claim Assistance Services - We don’t stop at the issuance of the right term plan! In case your loved ones claim upon your unfortunate demise, we stand with them in this challenging time by assisting with the claims process and following up with the insurance partner.

Paperless Process - Our paperless process ensures hassle-free issuance of the term plan and quick disbursal of the claim amount.

Trusted by Millions - WishPolicy is the insurance division of Wishfin (MyWish Marketplaces), one of India’s largest and most trusted financial marketplaces. With almost 40 Million Satisfied Customers across India, you can ‘Rest Insured’ with WishPolicy.

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Applying for health insurance on WishPolicy is simple - just a few steps and you are done!

1. Go to www.wishpolicy.com
2. Click on ‘Health Insurance’
3. Mention your gender
4. Choose who you want the policy to cover - Self, Self & Spouse, Self, Spouse & children, or self & children
5. Mention your age as well as that of your spouse and children (in case you are covering more than two members in a policy)
6. Mention the place of your residence
7. A list of quotes (showing the sum insured and premium amount) will appear on your screen
8. Choose the quote you want

Once approved by the insurer, you would receive a notification, followed by policy documents on email and by post.