Health Insurance

Importance of Buying Health Insurance

In a country like India, where healthcare costs are growing and disease risks are evolving more rapidly than ever, securing the best health insurance plan is no longer a choice; it's crucial. The health landscape demands a shield from heart disease to silent outbreaks of viral infections.

• High burden of non-communicable diseases (NCDs): According to a WHO report, approximately 66% of deaths in India in 2019 were due to NCDs, including cardiovascular diseases, cancer, diabetes and chronic respiratory disease. This highlights the importance of having a firm health insurance policy that covers lifestyle-related diseases.
• Rise in diabetes, hypertension, and obesity: According to a 2021 study by the Indian Council of Medical Research (ICMR), the increases were 11.4% for diabetes, 15.3% for pre-diabetes, 35.5% for hypertension, 28.6% for generalised obesity, and 39.5% for abdominal obesity. With these increasing numbers, the financial risk of treatment necessitates considering medical insurance offering coverage for chronic care.
• Growing risk of cardiovascular disease: Cardiovascular disease (CVD) is among the leading causes of death and disability in India, accounting for a significant share of NCD fatalities. Therefore, selecting the top health insurance plans in India that cover heart-related treatments is crucial.
• Growing threat from viral hepatitis: India is a primary hotspot for viral hepatitis; it accounted for over 11% of the global hepatitis burden in 2022, with around 2.9 crore cases of HBV and 55 lakh cases of HCV reported. Because such diseases often progress undetected, a comprehensive medical insurance policy with extensive coverage is becoming increasingly essential.
• Persisting danger of communicable diseases: While NCDs prevail, India still faces a prevalence of infectious and vector-borne diseases. The dual burden increases unpredictability in healthcare requirements.
• Peace of mind amid health uncertainties: Whether it's cancer, cardiac arrest, viral hepatitis or sudden communicable diseases, having the best medical insurance plan in India ensures you're prepared for the unpredictable. The emotional and economic peace it brings is priceless.

What Makes a Health Insurance Plan Ideal for You and Your Family?

Finding the ideal health insurance policy requires consideration of both personal and financial factors to guarantee maximum security and value. Here are the factors you need to be mindful of when selecting the best health insurance policy in India:

• Insured's Age: Premiums and coverage choices differ with age. Younger individuals can choose lower premiums and comprehensive coverage in health insurance plans.
• Location: The availability of network hospitals and clinical costs in your city affects the selection of health insurance in India.
• Health Conditions: Pre-existing diseases, lifestyle, and medical history define eligibility and coverage in the best mediclaim policy.
• Budget: Pick a health insurance policy that assists you in balancing coverage and reasonability without compromising on crucial benefits.
• Family Size: Determine whether a family health insurance plan or individual policies best suit your household requirements.
• Coverage Needs: Select the best health insurance policy that covers hospitalisation, critical illnesses, daycare procedures, preventive care, and other essential benefits.

Why Choose a Health Insurance Plan?

As one of the leading health insurance providers in India, we offer tailor-made services, swift claim settlements, and a comprehensive range of health insurance plans. Here are some of the key reasons why choosing a policy from us can be the right decision for you:

Benefits of Health Insurance

Having the best health insurance policy isn’t just about covering hospital bills; it’s about securing your mental peace. A well-chosen health insurance plan secures you and your loved ones, preparing them for life’s medical uncertainties. Here are some of the key benefits of choosing the mediclaim policy:

• Financial Protection: A Medical crisis can be costly and unexpected. With a comprehensive health insurance policy, you can protect your savings while securing access to quality treatment. By paying regular premiums, you share the financial risk with your health insurer.
• Coverage for Critical Illnesses: A Health insurance plan in India usually covers serious diseases, such as cancer, heart disease, or kidney failure. The best health insurance plan ensures you can access advanced treatments without stressing about the increased costs associated with them.
• Protection Beyond Corporate Health Insurance: Your employer’s health plan may not be sufficient. Having your own best mediclaim policy guarantees uninterrupted coverage, even after you leave a job or retire. An exhaustive health insurance policy effectively fills this protection gap.
• Wellness & Preventive Care: Current health insurance plans go beyond treatment; they facilitate wellness. Benefits like free annual health check-ups, fitness rewards, and preventive screenings help detect problems early, keeping you healthier and more protected.

Features of Health Insurance Plans

The best health insurance in India offers a wide range of features designed to meet diverse healthcare needs. These features ensure timely treatment, financial protection, and long-term health security for individuals as well as families. Below are the most important features included in modern health insurance plans:

• Comprehensive Coverage: Modern health insurance plans provide broad protection, including inpatient hospitalisation, day-care procedures, domiciliary treatment, ambulance services, and more. This ensures you receive the required care without financial stress.
• Cashless Hospitalisation: Leading health insurance companies in India partner with an extensive network of hospitals. Policyholders can avail of treatment without paying upfront, as the insurer settles bills directly with the hospital, ensuring smooth and fast medical support.
• No-Claim Bonus (NCB): If you do not make a claim during the policy year, your insurer rewards you with a No-Claim Bonus. This increases your sum insured without any extra premium. Many top health insurance plans offer cumulative bonuses of up to 50% or more.
• Lifetime Renewability: As per IRDAI regulations, most insurers offer lifetime renewability. This ensures uninterrupted coverage throughout your life, irrespective of health changes or age-related medical conditions.
• Preventive Health Check-Ups: Several health insurance policies include complimentary annual health check-ups. Early screenings help detect health issues at an initial stage, reducing long-term medical expenses and improving overall well-being.
• Digital & Fast Claim Support:Insurers provide digital claim support with online documentation, app-based claim submission and real-time tracking, enabling faster approvals and a smoother claims experience for customers.

Advantages of Buying Health Insurance Online

Embrace the ease of securing your health online, with our digitally-enhanced portal.All you need to do is simply select your preferred health cover plans, fill up the details, and pay through secure transaction modes. Here’s why and how we ensure a customer-friendly purchase a medical insurance plan online:

Chat Option for Queries

Our team is always available for all your queries concerning the terms and conditions of our healthcare policies. By accessing the live chat option, you can quickly discuss any policy-related matter at your convenience. No appointment is required.

5% Digital Discount

When you buy your health insurance policy online through our official website, you become qualified for an exclusive 5% direct‐purchase discount on the premium. This discount rewards the convenience of purchasing a policy directly, enabling you to reduce the cost while obtaining one of the best health insurance policies in India.

Get Health Insurance Quotes

We facilitate digital premium calculators to help you evaluate and opt for customised healthcare insurance for your family members.The ability to choose your desired health coverage and optional benefits helps us serve you the best mediclaim policies.You can get numerous health insurance quotes online. All you need to do is select a health insurance plan and enter details such as age, health condition, etc. Compare premiums, coverage, and exclusions to buy health insurance online.

Secure Payment Modes

Our fortress-like secure payment gateways offer various digitally secure modes, including credit/debit cards or net banking. Once purchased, you will receive authentic policy documents immediately.This way, we help you get an instant mediclaim policy in less than an hour.

Transparent Policy Evaluation

What we promise in writing is exactly what you’ll receive during emergencies. Each of our health insurance plans includes clear terms and conditions for your convenience. You can compare quotes online, making the process transparent and easy to follow. Top providers usually let you adjust benefits, coverage amounts, and the number of members. Based on your choices, the premium updates automatically—so you can see the impact instantly.

Readily Available Value Added Services

While browsing online through our mediclaim policies, you can easily check out other add-on benefits. These include OPD care, co-payment waiver, and reduced wait time for pre-existing diseases, among others, to cover your specific needs.

Helps Save Money

The offline method of buying mediclaim policies usually result in increased costs due to numerous factors like agent fees. Insurance agents get a commission for selling mediclaim policies , which increase the cost of the policy. Purchasing a health insurance plan online can help eliminate overhead expenses. Further, some insurance companies also offer an additional discount when you purchase plans using their online platform.Further, it can also help you save a lot of time and effort as you can buy good health insurance in India in just a few clicks.

Easy Comparison

People have diverse needs. When you buy health insurance online, you can compare and pick a plan that suits your specific needs. You can also get health insurance quotes from different providers to choose one that suits your budget. You can get an understanding of the premium factors based on the plans you choose and the number of people you add.

Comparing Our Health Insurance Plans with Other Insurers

Every health insurance plan offers a different mix of benefits, features, and coverage options. To make an informed decision, it is essential to compare how we stand against other health insurers in the market. Here's a clear comparison to help you understand the difference:

Find the Right Health Insurance Plan for You

Our best health insurance plans in India are thoughtfully designed to offer comprehensive healthcare coverage at reasonable premiums, offering complete protection for you and your loved ones. Explore our top health insurance policies crafted to match your life stage and lifestyle needs:

• Ultimate Care
• Care Supreme
• Care Advantage
• Care Supreme- Senior

• Get rewarded every 5 claim-free years with the exclusive MoneyBack feature.
• Enjoy a 100% increase in coverage with continuous policy renewals.
• Coverage doubles after seven consecutive claim-free years.
• Tenure multiplier for one big claim up to the limit of the remaining SI.

• Cover Amount₹5 lakh
• Starting At₹372/month
• Buy Now

• Cumulative Bonus Super to boost coverage up to 500% in 5 years.
• Advanced Technology Methods and AYUSH Treatments Covered.
• Unlimited Automatic Recharge during the policy year.
• No Sub-limits on Room Rent or ICU charges.

• Cover Amount₹5 lakh
• Starting At₹651/month
• Buy Now

• Worldwide coverage up to ₹6 Crore for you and your family.
• Advanced Technology Treatment covered up to SI.
• Get a 10% bonus for every claim-free year, up to 50% of your SI.
• Connect with general physicians through E-consultations.

• Cover Amount₹1 Crore
• Starting At₹1305/month
• Buy Now

• No mandatory pre-policy medical check-up.
• Boost coverage up to 500% in 5 claim-free years.
• Unlimited Automatic Recharge during the policy year.
• Access general physicians anytime through E-consultations.

• Cover Amount₹5 lakh
• Starting At₹1535/month
• Buy Now

How Do Health Insurance Plans Work?

A health insurance plan works simply—your insurer offers financial protection during medical emergencies in return for a regular premium payment. It ensures that during a health crisis, you are not burdened with heavy medical bills. Here is a clear step-by-step explanation of how a health insurance policy works:

Shortlist a Health Insurance Plan: Choose a plan that matches your healthcare needs and purchase it online by submitting basic details and paying the premium.

Complete Verification: Some plans may require medical check-ups or document verification before activation.

Receive Policy Documents: After approval, your policy becomes active and the insurer sends your e-policy, health card, and policy details.

Make Regular Payments: Continue paying your premiums on time to keep your policy active and avoid any issues during claim settlement.

Know How to Use Your Policy: Understand network hospitals, cashless claim procedures, reimbursement steps, and customer support information.

Use Cashless Facility During Hospitalisation: During a planned or emergency hospitalisation, visit a network hospital and show your health insurance e-card/ID for cashless treatment.

Claim Settlement (Cashless or Reimbursement): There are two ways to settle claims:
Cashless: The hospital and insurer handle the payment directly.
Reimbursement: If treated in a non-network hospital, submit bills and medical documents to receive a refund.

To understand the process better, here’s an example:

Suvidha purchased a health insurance policy with a coverage of ₹10 Lakh for her family. A few months later, her mother fell ill and needed medical attention. As her condition worsened, she was admitted to a nearby network hospital.

Suvidha informed her insurer about the emergency hospitalisation and completed the required formalities. Since the hospital was within the insurer’s network, the treatment was covered under the cashless facility.

After discharge, the hospital directly settled the eligible bills with the insurer, and Suvidha paid only for the non-payable items.

Later, she filed a reimbursement claim for the pre- and post-hospitalisation expenses. She submitted all necessary bills, reports, and the reimbursement form. The insurer verified the documents and credited the claim amount to her bank account.

What is Covered in a Health Insurance Policy?

Health insurance policies cover a wide range of medical expenses to provide strong financial protection during unexpected health emergencies. These plans go beyond basic hospital bills and include several healthcare benefits as per the policy terms and conditions. The expenses covered under our health insurance policies include:

The best health insurance policies also provide optional maternity benefits for delivery-related expenses. Additional add-ons such as OPD Care are available at an extra premium, helping cover OPD consultations, diagnostic tests, and medicines.

Disclaimer: For detailed information on product coverage, please refer to our product pages and policy documents.

What is Not Covered under Health Insurance Policies?

Here are the standard exclusions that one should be mindful of when investing in a health insurance plan:

• Self-Inflicted Injuries: Any injuries caused intentionally by the insured, including suicide attempts or acts of self-harm, are not covered under the health insurance policies.
• Initial 30-Day Waiting Period: Diseases, surgeries, or medical treatments arising within the first 30 days from the start date of the policy are generally excluded, except for accidental injuries, which are covered from day one.
• Pregnancy and Childbirth: Medical treatments related to pregnancy, childbirth, miscarriage, abortion, or any complications arising from these conditions are excluded.
• Cosmetic Treatments: Any procedure done solely for cosmetic purposes, such as plastic surgery or aesthetic enhancements, is excluded, unless it's medically necessary due to an accident or reconstructive need.
• Substance Abuse: Expenses resulting from the use, misuse, or abuse of alcohol, drugs, or other intoxicants are not covered under health insurance plan.
• War and Related Events: Hospitalisation resulting from war, riots, civil unrest, strikes, acts of terrorism, or exposure to nuclear weapons or materials is not covered by the insurance policy.
• Obesity/Weight Control: Expenses related to the surgical treatment of obesity that do not fulfil conditions, like the patient being 18 years of age or more, surgery supported by clinical protocols, and a BMI greater than or equal to 40, are not covered under the mediclaim policy.
• Change of Gender Treatments: Medical expenses for treatments to alter one's physical characteristics to those of the opposite sex, through surgery or other means, are not covered under the health insurance policy.

Which Add-ons are included in Health Insurance Policy?

Health Insurance plans involve different add-on benefits that help you customise premiums and/or expand your coverage. The following are some of the add-ons in a mediclaim policy:

• Air-ambulance cover: Financial cover for transportation by air ambulance if deemed medically necessary.
• Claim Shield: This add-on benefit provides coverage for 68+ non-payable items like gloves, mask, etc. under Annexure I (List I).
• Claim Shield Plus: This add-on benefit provides coverage for non-payable items under Annexure I (List I, II, III, and IV).
• Co-payment waiver for senior citizens: Removes the co-payment requirement for an extra premium.
• Annual health check-up: Provides free yearly check-ups for every insured member at network labs.
• Smart Select: Get a 15% premium discount by using network healthcare providers, but a 20% co-pay applies for non-network.
• Reduction in the PED Waiting Period: Waive the waiting period for pre-existing conditions.
• No Claim Bonus Super: Get a 50% increase in SI over 5 years if no claims are made in this time period.
• Care OPD: Get reimbursement for a limited number of general physician and specialist consultations annually.

How to Buy a Health Insurance Policy?

Buying a health insurance policy is effortless when you ensure you follow the proper steps. Here’s a straightforward, step-by-step guide to assist you in purchasing the right plan smoothly:

• Assess your needs: Identify whether you require an individual plan, family floater plan, senior citizen plan, critical illness coverage, or a top-up plan based on your requirements.
• Compare health insurance plans: Review benefits, premiums, exclusions, waiting periods, and the list of network hospitals offered by different insurers to make an informed decision.
• Select the sum insured: Choose an appropriate coverage amount depending on your city of residence, lifestyle, family size, and expected medical expenses.
• Fill the proposal form: Accurately provide your personal and medical information while completing the proposal form to avoid claim-related issues later.
• Submit required documents: Depending on your age or health history, some insurers may request medical test reports or additional documents for verification.
• Make the payment online: Pay the premium securely through the insurer’s online payment options. We offer instant discounts (such as 5%) for online purchases.
• Receive your policy documents: Once approved, your policy will be issued, and you will receive your e-policy, health card, and complete coverage details via email.

Eligibility Criteria to Buy a Health Insurance Policy

For health insurance in India, check policy-specific eligibility for conditions like co-payments and waiting periods. Below are Care Health Insurance's eligibility criteria:

Document Required While Buying Health Insurance Plans Online

Here’s a list of documents you'll need when buying health insurance online:

• Proof of Identity- Aadhaar Card, Passport, Driver’s Licence, etc.
• Proof of Address- Aadhaar Card, Passport, Voter ID, etc.
• Medical Documents- In some cases, previous Medical Records, Prescriptions, etc, might be needed.

How to Calculate the Premium of Health Insurance Plans?

You can now calculate the premium using a simple digital calculator designed especially for medical insurance policies. This tool helps you get the right estimate of the amount of premium you will have to pay for your policy. It considers various factors to calculate the premium, including the information you have entered.To help you understand the benefits, a good health insurance plan in India is crucial for financial protection against rising medical costs. Here are the steps to calculate your premium:

• Step 1: Visit the Health Insurance Premium Calculator page.
• Step 2: Choose the desired policy and enter your mobile number in the 'Get Quote' section.
• Step 3: Enter the PIN code and email, followed by the details of all the members to be insured.
• Step 4: Customize the policy by changing the sum insured and add-ons as per your needs.
• Step 5: That's it! Your instant health insurance quote is calculated.

What are the Factors Affecting the Premium of Medical Insurance Policies

Given below are some of the factors that affect the premium of your health insurance policy:

• Age: The higher the age, the higher the premium, and vice versa.
• Pre-existing Conditions: Pre-existing lead to higher premium costs.
• Body Mass Index(BMI): High BMI leads to a higher premium amount.
• Lifestyle Habits: Unhealthy and risky habits like drinking can increase premiums.
• Type of Plan: Family plans typically have lower premiums than individual plans.
• Sum Insured: A higher sum insured has a higher premium.
• Deductibles and Co-Payment: Higher deductible/co-pay leads to lower premiums.
• Add-On Covers: Additional coverage increases the premium.
• Location: Areas with high medical costs have higher premiums.
• Medical History: History of an illness can lead to higher premiums.

How to File a Claim under Health Insurance Plans

Documents required for Health Insurance Claim

Given below are the set of documents that you will have to submit while making a claim:

What are the Common Reasons for Claim Rejection?

Dealing with a health insurance claim rejection can be really disappointing, especially when you're in the middle of a medical emergency. However, you should be aware that most rejections occur due to simple mistakes that can often be avoided. Let’s look at some common reasons why claims get rejected and how you can help prevent them.

• Incomplete or incorrect information - A primary reason for claim rejection is providing incomplete or inaccurate information to the policyholder. Be honest and transparent when buying health insurance by sharing accurate personal and medical details to prevent issues or rejection later.
• Claiming during the waiting period - Some medical conditions have a waiting period, and claims during this time may be rejected. To avoid rejection, understand the waiting period when purchasing the plan.
• Treatment not covered under the policy - Certain treatments like cosmetic or non-medically necessary dental procedures aren't covered by insurance. Claims for these will be rejected. Review policy exclusions before purchasing extensive health coverage to prevent rejection. Claiming cashless treatment at a non-network hospital - You need to get admitted to an in-network hospital for cashless claims. Find the hospital list on our website to avoid rejection.
• Delay in Claim Intimation or Submission - Delay in claim intimation can result in claim rejection. Inform your insurance provider about hospitalisation promptly and submit the necessary documents on time to avoid rejection.
• Documentation errors or missing paperwork - Incomplete documentation can lead to claim rejections. Keep original documents safe and verify paperwork before submission to prevent rejection.
• Policy not active or lapsed - Claiming under an expired or not renewed policy leads to rejection. To avoid this, set reminders and renew on time.
• Breach of policy terms - Violating terms, like hospitalisation for non-medical reasons or ignoring a doctor’s advice, can lead to rejection. To avoid this, read your policy's terms and follow your doctor's medical protocol.

Hassle-free Claim Settlement Through the Customer App

Care Health Insurance strives to make quality health care accessible to everyone while maintaining a quick and hassle-free claim experience. Our Customer platform is an integrated app for all your health insurance needs. You can use this app for claim intimation, fill out a claim form online, upload the necessary claim documents, and track your claim status. Below is the step-by-step process to file claim intimation using ‘Claim Genie’

• Step 1: Open Our Customer App on your phone.
• Step 2: Click on ‘Claim Genie’ on the home screen. Click ‘Claim Intimation’
• Step 3: Select claim type.
• Step 4: Select the member and enter all the claim related information.
• Step 5: Upload any claim related medical documents.

How much Tax Benefit Can I get from Health Insurance?

If you fall into the taxable slab, then your health insurance plan can fetch you tax benefits. Here’s how:

• If you are paying the health insurance premium for yourself, your spouse, your children, or your parents, you can avail of tax benefits under Section 80D and save more.
• As a policyholder, you can also claim up to ₹5,000 towards preventive health check-ups.
• Take a look at the table to understand the deductions in detail:

Disclaimer: The deduction for preventive check-up of up to Rs 5,000 will be within the overall limit of Rs 25,000 / 50,000.

How to Port Your Policy to Care Health Insurance?

Porting a medical plan is easy and can be done before the policy renewal stage. Just notify your existing insurer at least 45 days before the policy renewal date of your existing medical cover. Follow this simple step-by-step guide to port your existing health insurance policy and enjoy uninterrupted coverage with your new plan:

Things to Keep in Mind When Porting Your Health Insurance Policy

Before porting health insurance, it's helpful to be aware of some key factors that can ensure a smooth and successful process. Some of them are:

Inform Your Previous Insurer

Before porting your policy to a new health insurer, it is essential to notify your existing insurance provider. You should write an application for this purpose. You can make this request to your insurer at least 45 days before your policy’s expiry date. Once you apply, your application will be reviewed, and you will receive an acknowledgement within 3 business days.

Understand the Premium Changes

When you decide to port your health insurance policy to a new insurer, you should enquire about the premium. You should check whether the premium will increase or decline on porting. The change in premium indicates the changes in your coverage or benefits. So, gather this information before you finalise the porting.

Explore Available Add-ons

If you are thinking of switching to a new insurer to enhance coverage or benefits, you should check for the available add-ons. You can buy the add-ons of your new insurer to avail of the extended benefits.

Understand the Waiting Period

You should understand the waiting period cycle before you port to a new insurer. Simply put, the waiting period is divided into three parts.

• The first waiting period starts with buying the policy. This is for only 30 days.
• The second waiting period is for slow-growing diseases and is served for 2 years.
• The third waiting period is for 3 years, and it applies to pre-existing diseases. The good news is that when you port your existing policy to a new insurer, your waiting period does not start from the beginning. It starts where you left off with the previous insurer.
  Suppose you have served a two-year waiting period for a pre-existing disease that has a total waiting period of three years. Then, after porting your policy, you need to wait for only one year before filing a claim.

Provide Accurate Details About Your Medical History

Hiding your medical history when you make a porting request to the new insurer can be a mistake. Your new insurer may or may not make you undergo a medical test. In case you have been suffering from any chronic illness , your porting request may be rejected considering the probability of frequent medical visits or hospitalisation.

Choose a Higher Sum Insured

Obviously, you have decided to port to a new insurer because you are optimistic about new benefits there. Hence, you should try to choose a higher sum insured when you port.

Verify Insurer Details

Before you decide to port your mediclaim policies to a new insurer, it might be a good idea to be aware of a few metrics. You should always check for details like discounts being offered, any consumer complaints, empanelled network healthcare providers and the claim settlement ratio. It might also help to check the ratings on their social media handles to understand the overall customer experience.