10 Best Health Insurance Policies In India: Benefits, Coverage And How To Claim
With the rising costs of medical treatments, bearing hospitalisation and other medical expenses can be challenging during an emergency. It can also affect your savings plan for the future. An ideal solution is to get a suitable health insurance plan. If you are not sure which plan to go for, here’s a list of the 10 best health insurance in India.
Compare the features and benefits before you purchase health insurance for yourself and your family. Read on!
Best Health Insurance Policy In India: Top 10 (2023)
| Plans | Features |
| Navi Health Insurance | Cashless network hospitals: 10,000+ Claim settlement ratio: 97% Processing time: 20 minutes |
| Aditya Birla Activ Assure Diamond Plan | Cashless network hospitals: 9000+ Claim settlement ratio: 94% Processing time: 2 hours |
| Bajaj Allianz Health Guard | Cashless network hospitals: 6500+ Claim settlement ratio: 98% Processing time: 1 hour |
| Care Health Care Plan | Cashless network hospitals: 16,500+ Claim settlement ratio: 95.2% Processing time: 2 hours |
| Bharti AXA Smart Super Health Plan | Cashless network hospitals: 4500+ Claim settlement ratio: 92.37% Processing time: NA |
| Digit Health Plan | Cashless network hospitals: 6400+ Claim settlement ratio: 63.56% Processing time: NA |
| ManipalCigna ProHealth Insurance | Cashless network hospitals: 6500+ Claim settlement ratio: 91% Processing time: 1 hour 30 minutes |
| Kotak Mahindra Health Premier | Cashless network hospitals: 5000+ Claim settlement ratio: 98% Processing time: NA |
| Edelweiss Health Plan | Cashless network hospitals: 3200+ Claim settlement ratio: 85.57% Processing time: NA |
| Niva Bupa Health Companion Individual Plan | Cashless network hospitals: 7600+ Claim settlement ratio: 90% Processing time: 30 minutes |
** Terms & Conditions Apply
Benefits Of Buying A Health Insurance Policy
- Helps Avoid Medical Inflation: Due to medical inflation, treatments are becoming increasingly expensive. Nevertheless, a well-rounded health insurance plan covers such expenses and lets you beat inflation.
- Provides Quality and Affordable Medical Treatment: Health insurance policyholders can get affordable and quality treatments from authorised network hospitals.
- Cashless Hospitalisation: While availing of treatment from network hospitals, individuals can opt for a cashless facility which saves them from having to pay a considerable sum out-of-pocket.
- Save for the Future: Financial liabilities arising from medical expenses can affect your savings plan for the future. Hence, you might want to cover such liabilities by opting for the best health insurance policy.
- Tax Benefits: Members are eligible for tax benefits under Section 80D of the Income Tax Act. The benefits include tax savings on health insurance policy premiums.
Eligibility Criteria for Best Health Insurance Policy in India
The eligibility criteria for health insurance policies depend on their terms and conditions and the particular insurance provider. The following are some standard eligibility criteria for medical insurance policies:
| Age | 18 to 65 years for adults and 90 days to 25 years for dependent children |
| Pre-Medical Screening | Required for individuals above 45, 55 and 60 years |
| Pre-Existing Disease Waiting Period | 2 to 4 years |
Documents Required to Buy Best Health Insurance Policy in India
You will need the following documents mandatorily while applying for insurance plans in India:
- Age proof, such as birth certificate, Voter ID, Aadhaar card, passport, driving licence, 10th or 12th mark sheet
- ID proof such as PAN card, voter ID, Aadhaar card, driving licence
- Proof of address such as electricity bill, rent agreement , driving licence, Aadhaar card
- Medical reports for pre-existing medical conditions if any
- Passport size photographs
Also Read
How to Calculate Premium of Best Health Insurance Policy in India
The calculation of the premiums for your health insurance plan manually can get hectic. There are online calculators which you can take advantage of for calculation. You will need the following inputs for calculation:
- Age
- Members to be insured in case of family health insurance plan
- Sum insured
- Policy tenure
How to File a Claim for the Best Health Insurance Policy in India
You can raise claims for health insurance policies through any of the two modes- reimbursement and cashless. Given below are the procedures for raising claims in case of emergency and planned hospitalisation:
Emergency Hospitalisation
- Inform the insurer within 24 hours of hospitalisation.
- Furnish your health card and obtain a pre-authorisation form.
- Submit this form to get Third-Party Administrator (TPA) approval for cashless claims.
- On approval, the insurer will directly settle the amount with the hospital.
- In case of disapproval, you can file for reimbursement later.
- For reimbursement, you need to submit documents such as hospital bills, discharge bills, etc.
Planned Hospitalisation
- Inform the insurer at least 48 hours before your treatment.
- On getting TPA approval, you can file for reimbursement or a cashless process by submitting the claim form.
- Attach other essential documents such as bills, reports, etc.
- After successful approval, you can get the reimbursed money from the insurer. However, in the case of cashless mode, the insurer will directly settle the payment with the hospital.
Navi Health Insurance policy comes with a range of benefits like a simple claims process and an affordable premium. Download the Navi App on Android or iOS and get comprehensive coverage for you and your family.
Claim Settlement Process in Health Insurance Plans
There are two types of claim settlement processes in Health Insurance:
- Cashless:
The insurer will settle the claim with the hospital. However, this facility can only be availed if hospitalisation is done at a Network Hospital. - Reimbursement:
The insurer settles the claim later by reimbursing the amount paid by the policyholder. You can claim reimbursement at a network or a non-network hospital.
How to File for a Cashless Claim?
Cashless claims can be made in either of the two situations- planned and emergency or unplanned.
1. For planned treatment:
- Step 1: Submit the cashless claim to your insurer five days before the treatment
- Step 2: The insurer will contact the hospital for a cashless claim form
- Step 3: You will get a confirmation message or email which will be valid for 7 days from the date it was issued
- Step 4: Submit the health card and confirmation letter during admission and your expenses will be paid by the insurer
2. For an emergency or unplanned treatment:
- Step 1: Notify the insurer within 24 hours of hospitalisation and you will get a reference/intimation number
- Step 2: The hospital will submit a cashless form to your insurer and they will send an authorisation letter to confirm the same
- Step 3: Your medical expenses will be paid by the insurer afterwards
How to File a Reimbursement Claim under Health Insurance?
Reimbursement claims are made when the policyholder doesn’t go to one of the enrolled hospitals and has to pay the medical expenses on their own.
The following process in followed to claim a reimbursement:
- Step 1: Submit the documents regarding the treatment expenses to your insurer
- Step 2: The insurer will verify the details on your medical bill
- Step 3: After successful verification, your insurer will process the reimbursement which can take up to 21 days
How To Buy The Best Health Insurance Policy In India
Things to Consider Before Buying a Health Insurance Plan
- Coverage Scope: You might want to consider checking the coverage benefits under a health insurance plan before choosing one. Consequently, you can raise a claim accordingly.
- Sum Insured: If you are looking for better coverage under medical insurance, you might want to settle for a plan that comes with a high sum insured.
- Policy Type: There are several options available under a typical health insurance plan. One can choose from individual, family floater, senior citizen, critical illnesses policy types, etc.
- Waiting Period: Health insurance policies come with a certain waiting period after which the coverage plan kicks in. Ideally, you might want to consider a plan that has a minimum waiting period.
- Cashless Hospitals: One might want to choose the best health insurance plan from the top insurers who entail a wide network of cashless hospitals.
Exclusions Under Health Insurance Policy in India
- Injuries arising from war, acts of terrorism, etc.
- Suicide attempts or self-inflicted injuries.
- AIDS, terminal diseases and other diseases of the same category.
- Costs of cosmetic or plastic surgery and hormone replacement surgery.
- Expenses arising from dental or eye surgeries.
- Rehabilitation or bed rest costs, common illnesses, etc.
- Costs of post-care procedures and diagnostic tests.
- Expenses for the treatment of adventure sports injuries.
Factors That Affect the Premium of Best Health Insurance Policy in India
While applying for a health insurance plan, one should keep in mind the following factors which will affect the premiums of the plan:
- Past medical records: If the policyholder or his/her family has a record of some chronic illnesses, there are chances of the premiums rates being higher than someone with no pre-existing medical conditions or history.
- Age: The older a person, the higher the risk of getting sick more often. So, younger people usually get the benefit of lower premiums as they are at low risk than the older ones. Hence, it is advisable to get health insurance when you are young to make the most of the benefits at lower costs.
- Location: Insurance companies base their insurance premiums on the location of the insured. It is believed based on data provided that people living in certain locations live healthier lives due to the culture and climate compared to some others. The premiums in those areas with unhealthy habits are generally higher than the healthier ones.
- Body Mass Index (BMI): People with higher BMI have to pay higher premiums than the ones with normal BMI. Higher BMI means more risk of medical conditions such as heart-related diseases and diabetes and needs to be kept under regular medical supervision.
- Insurance features: Insurance features differ from company to company. However, if you choose an individual or group insurance plan then your premiums will be lower than a family insurance plan. If you have add-ons then the premiums will also be higher. While applying for insurance, you should check if the company has the option for co-insurance. This will reduce the premiums significantly.
- Other habits: The habits of the insured will have an impact on the premiums of the insurance. People with habits of injurious substances have to pay higher premiums as they are prone to getting life-threatening diseases like cancer.
Optional Add-On Covers under Best Health Insurance Policies in India
Add-ons are facilities provided by the health insurance companies but are not generally included in the standard plan. The policyholder can add them to their plan by adding a little extra on premiums which covers certain expenses and also increases the sum insured. Following are few of the best optional add-ons one should include in their plan for better medical coverage and emergencies:
- Room charge waiver: With this add-on, one can enhance the limit of the room charge or can opt for no sub-limit on room charges
- Maternity and newborn cover: Pregnancy is not predictable and so is not the medical expenses related to the surgery and childbirth. These large expenses can be managed by including this add-on to your health insurance. The following months will require regular medical supervision and doctor visits as well. So, adding this to your health insurance will be helpful for such foreseen circumstances.
- Hospitalisation cash cover: This add-on will take care of the diagnostic and medical expenses during the hospitalisation of a person. With this coverage, one can get up to Rs.10,000 daily coverage for 30 days.
- Emergency ambulance services: With this add-on, one can avail of benefits of up to Rs. 30,000 on emergency ambulance services.
- Critical illness cover: This add-on is the most beneficial and important when it comes to health insurance. With this add-on, one can get up to Rs. 10 lakh of coverage on treatments of critical illnesses such as cancer.
Significance of Health Insurance in Covid-19 Pandemic
The unpredictable attack of Covid-19 worldwide has taught everyone how important it is to have medical insurance and everyone is at risk. If you still don’t have health insurance, you should consider the following factors to know why.
- High requirement for ICU
- Costly protection gears
- Emergency coverage
- AYUSH treatments
- Zero paperwork
- Insure you and your family within 5 minutes
- One-time subscription-based model
- 10,000+ network hospitals across 400+ locations in India
- Cashless claims under 20 minutes
- Claim settlement ratio of 97%
Navi Health Insurance policy comes with a range of benefits like a simple claims process and an affordable premium. Download the Navi App and get comprehensive coverage for you and your family.
Final Word
With the ongoing medical inflation, you might want to consider an insurance cover that curtails your financial burden during times of emergencies. In this regard, you may want to look for the best health insurance policies due to their attractive features and benefits.
Also Read
FAQs
Ans: The factors that affect health insurance premiums are:
• Medical history
• Age and gender
• Policy term
• Pre-existing medical conditions
• Marital status
• Whether previously insured or not
Ans: Yes, you can buy multiple health insurance policies in India. For instance, if you have a corporate health insurance plan, you can get an individual or family floater health insurance plan.
Ans: You will need to furnish basic KYC documents for proof of your identity, residential address and age etc. Apart from these, you do not need to furnish other documents while purchasing health insurance.
Ans: Yes, you can add family members like your spouse, dependent children, parents and in-laws. You can add them at the time of purchase or when purchasing an insurance policy.
Ans: Yes, your existing health insurance policy can provide COVID-19 coverage benefits. Besides these, two special standard policies have been introduced by IRDAI to provide exclusive coverage for COVID-19 treatment. These are- Corona Kavach policy and Corona Rakshak policy.
Ans: There are many options available in the market when it comes to health insurance policy. One should primarily consider the following things while opting for a policy:
• Coverage amount
• Available add-ons
• Network of hospitals
• Co-insurance feature
• Pre and post hospitalisation coverage
Ans: Restoration is provided by an insurance company when the sum gets wholly exhausted due to treatment of some certain illness. The insurance company restores the whole insured amount in such circumstances.
Before you go…
How about an affordable health insurance policy 👨⚕️ starting at a monthly premium of just ₹235? Install the Navi app now and get your policy in under 2 minutes.
Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
Health Insurance Knowledge Base
