Health insurance is an insurance product which covers medical and surgical

expenses of an insured individual. It reimburses the expenses incurred due to illness

or injury or pays the care provider of the insured individual directly.

Health insurance covers cost of an insured individual's medical and surgical expenses.
Subject to the terms of insurance coverage, either the insured pays costs out-of-pocket and is
subsequently reimbursed or the insurance company reimburses costs directly.

What is Health Insurance?

Health insurance is an insurance product which covers medical and surgical expenses of an
insured individual. It reimburses the expenses incurred due to illness or injury or pays the
care provider of the insured individual directly.

Types of Health Insurance

Every individual is different and has a unique set of needs. A single health insurance product
is not enough to cover every person's individual requirements. This is precisely where there
are a number of different types of health insurance plans available. Let's take a look at what
they are:

1. Individual Health Insurance

You can purchase an individual health insurance policy to provide cover for yourself,
your spouse, your children and your parents. These policies typically cover all kinds
of medical expenses, including hospitalisation, daycare procedures, hospital room rent
and more. Under an individual health insurance plan, each member has their own sum
insured amount. So, let's say you've taken an individual plan for yourself, your spouse
and both your parents with a sum insured of INR 8 lakhs. Each of you will be able to
claim a maximum amount of 8 lakhs per policy year against your health insurance.

2. Family Floater Health Insurance

A family floater plan allows you to cover your family members under a single policy
and everybody shares the sum insured amount. These plans are typically more
affordable than individual plans since the sum insured is shared. Let's say you
purchase a family floater plan for you and your spouse with a sum insured of INR 8
lakhs. In a single policy year, you can make claims worth only INR 8 lakhs. Your
spouse may make claims worth INR 6 lakhs and you could make claims worth INR 2
 lakhs or vice-versa. Typically, family floater plans are ideal for young nuclear
families.

3. Senior Citizens Health Insurance

These health plans have been designed specifically keeping the medical needs and
requirements of senior citizens in mind. Most senior citizens policies offer additional
cover, such as domiciliary hospitalisation and even some psychiatric benefits. Since
older citizens are more likely to have health issues, these policies may require a full
medical check-up beforehand and could be more expensive than regular insurance
policies.

4. Critical Illness Insurance

There are a number of lifestyle-related diseases that are on the rise. Health issues such
as cancer, stroke, kidney failure and cardiac diseases can be very expensive to deal
with and manage long-term. This is precisely why critical illness insurance policies
have been created. They can either be purchased as a rider or add-on with your regular
health insurance plan or separately as their own plan. These policies offer cover for
very specific issues and often provide claim payouts as a single lump sum payment
after the diagnosis of a critical illness.

5. Group Health Insurance

Unlike individual and family floater policies, group health insurance plans can be
purchased by a group manager for a large number of individuals. For example, an
employer can purchase group insurance for all their employees or a building secretary
may purchase such a plan for all the residents of the building. These plans are fairly
affordable, but they often only provide cover for basic health issues. Employers often
purchase these plans as an additional benefit for employees.

Benefits of Health Insurance

Purchasing health insurance is crucial for a number of reasons. Let's take a look at the most
important benefits of our health insurance policies:

1. Helps Deal with Rising Medical Costs

 People purchase health insurance policies to safeguard their finances against ever-
rising medical costs. An accident or medical emergency could end up costing you
more than a few thousand rupees. With a medical insurance plan, you enjoy cover for
everything from ambulance charges to daycare procedures, making it easier for you to
get the care you need to recover.

2. Critical Illness Cover

Many health insurance policies will also offer cover for critical illnesses at an
additional cost. Given the rising incidence of lifestyle-related diseases today, this is
another crucial cover to have. You will be provided with a lump sum payout in case
you are diagnosed with any of the covered critical illnesses. These issues are often
very expensive to deal with and manage, so critical illness cover is another vital
benefit of having health insurance.

3. Easy Cashless Claims

Every health insurance provider will tie-up with a number of network hospitals where
you can enjoy cashless claims. This makes the entire process of receiving emergency
medical care much easier. At a network hospital, you aren't really required to pay for
any of the covered treatments. For all valid claims, we'll take care of the medical
costs, without you having to pay for anything, except non-covered expenses and the
mandatory deductibles.

4. Added Protection

If you enjoy cover under a group health insurance plan, you may wonder why you
should purchase your own health insurance policy. Well, individual health insurance
plans offer provider more and better cover than group plans. Additionally, if you
happen to leave the group at any time, you risk losing the cover, which could make
you and your finances vulnerable.

5. Tax Savings

Under Section 80D of the Income Tax Act, 1961, premiums paid towards the upkeep
of health insurance policies are eligible for tax deductions. For a policy for yourself,
your spouse, your children and parents below the age of 60, you can claim a
deduction of up to INR 25,000 per year from your taxable income. If you've also
 purchased a policy for a parent who is over the age of 60, you can claim an additional
deduction of INR 50,000.

How Health Insurance Works?

Like every kind of insurance policy, health insurance also helps you deal with the financial
repercussions of an accident or emergency. Let's take a look at how health insurance actually
works. The process starts when you apply to purchase a plan. Depending on your age,
medical background, sum insured required and the type of plan youve selected, you will be
provided with premium quotes. In some cases, you might be asked to do a few medical tests
before the insurance provider decides whether they'd like to provide you with the required
cover. Once the terms and conditions are finalised, you will be provided with a policy. Each
policy comes with a few waiting periods. The initial waiting period is only for a few weeks or
a month. During this time, you will not be able to make any non-emergency claims. Let's say
that you require some kind of surgery after the waiting period. If you're able to get the
treatment in a network hospital, you can let us know about the surgery, and we'll get in touch
with the hospital directly to settle all the payments. When you're discharged from the
hospital, you will only have to pay for additional expenses that are not covered and the
voluntary co-pay amount, if any. If you're getting treatment in a non-network hospital, you
can make all the payments and then file for a reimbursement claim. Either way, you can get
the treatment you require without fretting about burning a hole through your pocket.

Need for Health Insurance

Medicare or medical costs are rising year on year. As a matter of fact, inflation in medicare is
higher than inflation in food and other articles. While inflation in food and clothing is in
single digits, medicare costs usually escalate in double digits.

For an individual who hasn't saved that much money, arranging for funds at the eleventh hour
can be a task. This is particularly daunting for seniors, given that most ailments strike at an
advanced age.

One way to provide for health-related / medical emergencies is by taking health insurance.
Health insurance offers considerable flexibility in terms of disease / ailment coverage. For
instance, certain health insurance plans cover as many as 30 critical illnesses and over 80
surgical procedures. The insurance plan disburses the payment towards surgery/illness
regardless of actual medical expenses. The policy continues even after the benefit payment on
selected illnesses.
With health insurance, you are assured of a more secure future both health-wise and money-
wise. This makes health insurance policies critical for individuals, especially if they are
responsible for the financial well-being of the family.

How to Choose Health Insurance Plan?

There are several health insurance policies available in the market. To enjoy cover without
any hassles, you need to find the policy that best looks after your unique needs. Here are
some important factors to consider while choosing a health insurance policy:

1. Check the Sum Insured

Many insurance providers have a limit on the maximum sum insured you can choose.
If you'd like a high sum insured, you need to find a health policy that offers you what
you're looking for. A good rule of thumb is to get cover that is a minimum of six
times your salary. If you earn INR 1 lakh per month, look for a policy that offers at
least INR 6 lakhs as the sum insured. You should also look for other benefits. If
you're planning on starting a family in a few years, make sure maternity costs are
covered. Of course, you will have to check the waiting period as maternity benefits
are subject to slightly longer waiting periods.

2. Scout the Network Hospitals

Different insurance providers may have different hospitals in their network. Ideally,
look for a policy that offers cashless claims at all the top hospitals in your city. You
should also make sure that your preferred hospital is on the list. This will make the
entire process of getting the treatment you want much easier.

3. Check the Fine Print

Every health insurance policy has various limits and sub-limits. You need to check the
policy documents thoroughly to understand exactly how much coverage you will get
per treatment or hospitalisation. For example, some policies may help cover the per
day room cost, but only up to INR 2,000 per day. If you happen to be in a hospital
where the room rent is INR 4,000, you'd have to pay for half the cost of the room.
You should also check the limits of pre- and post-hospitalisation expenses. Some
plans offer cover for only 30 days pre-hospitalisation and 60 days post-hospitalisation.
Others offer 60 and 90 days respectively.
 4. Look for Additional Benefits

Given that the insurance market is fairly competitive, different policies offer various
benefits. No-claim bonuses and the restoration of your sum insured are some of the
most popular ones. You should always check whether your chosen insurance policy
will provide these benefits. Always look for policies that offer you additional benefits.

5. Examine the Exclusions and Other Clauses

Every policy has its own exclusions or medical procedures and situations that it will
not cover. Make sure you check what's covered and what isn't before you purchase a
plan. You should also check if there's a co-pay clause, how much you will have to co-
pay and what the waiting periods are. Shorter waiting periods and voluntary co-pay
are ideal.

Difference BetweenMediclaim Plan or a Critical Illness Insurance Plan?

A mediclaim plan or health insurance policy works a little bit differently as opposed to a
critical illness insurance plan. Let's take a look at the differences between these plans:

 Type of Payout

Mediclaim plans are known as indemnity plans. This means that the claim amount
you receive will help offset costs as per actuals. These payouts are provided against
actual medical costs and bills.

On the other hand, critical illness plans offer a lump sum payout of the sum insured
once you are diagnosed with a covered critical illness. You can use the money to pay
for treatment, repay debts or even replace your lost income.

 What's Covered

Regular mediclaim policies offer cover against a wide range of issues. Everything
from accidents to surgeries, AYUSH and domiciliary treatments are covered under
these policies.

Critical illness plans, on the other hand, provide a lump sum payment only for very
specific critical illnesses.

 What's Better?
 If you weigh out both the options, health insurance plans and critical illness policies
offer very different benefits. If you're planning on purchasing a policy, it's a good idea
to buy a regular mediclaim policy and get additional critical illness cover. You need
both to secure your finances for the future in case anything untoward were to happen
to you.

Types of Health Insurance in India

With the rise in health-related issues, there is an extreme increase in the treatment costs too.
Moreover, there is an increase in the demand for Health Insurance Plans. Therefore, several
types of Health Insurance Policies in the market help you save that extra burden on your
pocket. These insurance plans just not let you find the best treatment for your health problems
but also keep you stress-free from the expenditure point of view. Buying the right insurance
plan can be a bit complicated as there are different types of Health Insurance plans in India.
To help you out, we have listed all 11 types of plans and have described all significant
elements of a health insurance policy so that you may buy a plan that is best for you.
Types of Health Insurance Plans Suitable For
Individual Health Insurance Individual
Entire Family- Self, Spouse, Children, and
Family Health Insurance
Parents
Critical Illness Insurance Used for funding expensive treatments
Senior Citizen Health Insurance Citizens of age 65 and above
This insurance plan is beneficial when the
Top Up Health Insurance sum insured of the existing policy gets
exhausted.
Hospital Daily Cash Daily hospital expenses
It can be used in case of any loss or damage
Personal Accident Insurance
to the owner or driver.
Mediclaim In-patient expenses
Group Health Insurance For a group of employees
Suitable for those who are suffering from
Disease-Specific (M-Care, Corona Kavach,
pandemic-manifested conditions or prone to
etc.)
one.
ULIPs The dual benefit of insurance and investment
Different Types of Health Insurance in India
Individual Health Insurance
An Individual Health Insurance plan is meant for a single person. As the name suggests, it
can be bought by a single individual. The individual who gets himself insured with this plan
is compensated for the expenses incurred for illness and medical expenses. Such types of
medical insurance plan cover all the hospitalisation, surgical, pre and post medication
expenditures till the insured limit is reached. The premium of the plan is decided on the basis
of the buyer’s age and medical history. Moreover, the insured individual can cover his
spouse, his children, and parents, too by paying an extra premium under the same plan.
However, if you get insured for any existing illness, there is a waiting period of 2-3 years for
claiming the benefits.
Family Health Insurance
Popularly known as the Family Floater Plan, Family Health Insurance Policy secures your
entire family under a single cover. Health insurance plans for family covers all the
members of your family including your spouse, kids, and elders. Only one member of the
family has to pay the premium, and the entire family gets insured in a single premium. In
case two family members are getting simultaneous treatment, you can claim the insurance for
both of them till the limit is reached. The premium is decided on the basis of the age of the
eldest member to be covered up in the plan. So, try to avoid adding the members who are
above 60 years in your family health insurance plan as they are more prone to illness, and
thus, the premium will get impacted.
Critical Illness Insurance
The Critical Illness Insurance plan insures the person by offering a lump sum amount of
money for life-threatening diseases. At the time of buying the insurance, the chosen health
problems are included, and if you get affected by any of the pre-selected conditions, you can
claim your insurance. Hospitalisation is not required to file a claim under this type of
insurance policy. Only the diagnosis of the disease can make you avail the benefits of the
critical illness insurance. The amount to be paid is pre-decided irrespective of pre and post-
hospitalization expenses. Below is a list of all the critical diseases that are covered up in the
Critical Illness Insurance.
 Major organ transplant
 Cancer
 Aorta graft surgery
 Kidney failure
 Stroke
 Multiple sclerosis
 Paralysis
 First heart attack
 Coronary artery bypass surgery
 Primary pulmonary arterial hypertension
Senior Citizen Health Insurance
As indicated by the name, such types of Health Insurance in India provides coverage to
people who are 65 years and above. So if you are planning to buy an insurance policy for
your parents or grandparents, then this is the best insurance policy for you. The Senior
Citizen Health Insurance will offer you coverage for the cost of hospitalisation and
medicines, whether it arises from a health issue or any accident. It covers hospitalisation
expenses and post-treatment costs too. On top of this, some other benefits like Domiciliary
Hospitalization and Psychiatric benefits are also being covered. The upper age limit has been
marked at 70 years of age. Also, the insurer can ask for a complete body checkup before he
sells the Senior Citizen Health Insurance. Moreover, the premium for this plan is
comparatively higher as the senior citizens are more prone to illness.
Top Up Health Insurance
An individual can buy the Top Up Health Insurance plan if he seeks coverage for higher
amounts. But there is a “Deductible Clause” added to this policy. Therefore, when the claim
is made, the payment done is over and above the pre-defined limit that is mentioned in the
policy. Moreover, there is also a Super Top-Up plan available for the individual. It provides
additional coverage over the regular policy to increase the amount of sum insured. The Super
Top-up plan can only be used once the insured sum of the regular policy gets exhausted.
Hospital Daily Cash
Another segment is the different types of health insurance policy providing an innovative
solution is the Hospital Daily Cash. If you feel insecure about buying an insurance policy,
then you should go further with this plan and learn about how these health insurance policies
work. This plan can help you to protect yourself from unexpected expenses during your
hospitalisation. Once a person gets hospitalised, the routine hospital expenses are not fixed,
and they tend to change as per the condition. In such a situation, the Hospital Daily Cash
works the best for an individual. In this plan, the individual gets a daily cash benefit of Rs.
500 to 10,000, as per the coverage amount selected at the time of insurance. Convalescence
benefits are also offered in some of the plans if the individual gets hospitalised for more than
seven days. Other add-ons include Parental accommodation and wellness coach.
Personal Accident Insurance
The number of road accident cases have increased over the years, and that is why today, there
are dedicated types of health insurance in India to protect the citizens. Thus, people end up
losing their life or getting disabled, and bearing the treatment expenses can be a bit
traumatising. So, availing of the personal accident insurance policy is a wise idea. This policy
provides a lump sum amount to the victim or his/her family as support. Some of the plans
also offer education benefits and orphan benefits meant to cover the expenses of the children.
Moreover, Bajaj Allianz also provides add-on coverage like temporary total disablement,
assistance service, worldwide emergency, and accident in-patient hospitalisation with
personal accident plans. Other than this, if the insured suffers from an accident and has any
loan obligations, it will also be taken care of by the insurance provider.
Mediclaim
Illnesses and accidents do not come with a pre-notification. The same goes for the expenses
that one has to bear once the person gets hospitalised for any of these. Therefore, one should
go for buying a Mediclaim Policy. The Mediclaim Policy ensures compensation for your
hospitalisation expenses in case of any illness and accident. It provides coverage for the in-
patient expenses that include surgery expenses, doctor’s fees, nursing charges, oxygen, and
anaesthesia. The Mediclaim Policy is available in the market as group mediclaim, individual
medical insurance, overseas medical insurance, etc.
Group Health Insurance
Group Health is one of the up and coming types of health insurance plans trending these
days. Many medium and large-scale enterprises are offering this insurance policy to the
employees. This type of health insurance is bought by the employer of the company for its
employees. The premium of this policy is comparatively lower than the Individual Health
Insurance Policy. It is offered to the group of employees to meet the financial crisis and
prudence in the company.
Disease-Specific (M-Care, Corona Kavach, etc.)
Nowadays, people are prone to get infected by an array of illnesses, and one of them is
Covid-19. Thus, treatment for such infections can be a bit heavy on your pocket. Therefore,
to make it easy for the people to avail treatment Bajaj Allianz has introduced some disease-
specific insurance policies. Therefore, you must think of buying a health insurance policy that
helps you in such severe health problems. Disease-Specific comes under the situation-
oriented types of medical insurance policy that provides you coverage for specific diseases.
One of the insurance policies is Corona Kavach that provides a fund of Rs. 50,000 to Rs.
5,00,000 to the person insured. The age limit is set between 18 to 65 years. It is a type of
Family Floater Policy. If we talk about M-Care Health Insurance Policy, it provides insurance
to the insured person against the diseases caused by mosquitoes. There are different types of
mosquito-borne diseases that include Dengue Fever, Malaria, Chikungunya, Zika virus, etc.
Thus, M-Care offers you coverage for these diseases.
ULIPs
ULIPs expands to Unit Linked Insurance Plans. In these plans, a part of your premium is
invested, and the other remaining part is used for buying health covers. Therefore, this plan
helps you earn a return besides providing you a safety net. Your savings can run short with
the ever-rising cost of health facilities. So, it is always better to have more money at your
disposal. ULIPs don’t assure you a fixed amount as it is subjected to market risks. And the
returns that are earned from ULIPs are paid to the buyer at the end of the policy term.
Indemnity & Fixed Benefit Plans
Indemnity
Indemnity plans are those types of health insurance plans where the policyholder can claim
the hospital expenses up to a fixed limit. The policyholder can make multiple claims only till
the maximum limit is reached. There are two different ways by which your insurance
provider will provide you with your medical expenses:
 Reimbursement Facility- The bills are first paid by you, and then the insurance
provider reimburses those bills.
 Cashless Facility- Where you do not have to pay any bills as the insurance
provider pays them directly to the hospitals.
The types of medical insurance policy that fall in the category of Indemnity plans are as
under:
 Individual Health Insurance
 Family Floater Plan
 Group Health Insurance
 ULIPs
Fixed Benefits
Fixed Benefits offers you a definite amount of money for specific health issues caused due to
accidents or illness. It covers those health conditions that are listed at the time of buying the
policy. The popular Health Insurance Policies that are covered in the fixed benefits are listed
below;
 Personal Accident Plan
 Critical Illness Plan
 Hospital Cash Plan
Why is Health Insurance Important?
 Financial Assistance - The Health Insurance Policies offer the insured individuals
financial assistance during any sort of medical emergencies.
 Tax Benefits - Buying a Health Insurance Policy will help you in tax deductions as
it is listed under Section 80D of the Income-tax.
 Investment plus savings - Once you buy the Health Insurance Policy worrying
about the treatment expenses is not a concern anymore. That’s because the
expenses will be covered by the insurance company.
 Annual health checkups - Bajaj Allianz provides you with the coverage benefits
of annual health check-ups. Hence, the company looks after the expenses that incur
in the insured person’s annual health check-ups.
 Deal with Medical Inflation - Investing in Health Insurance Policies will help you
to deal with medical inflation in a much easier and a better way without putting
any burden on your pockets.
  Covers complex procedures - Health Insurance Policy provides coverage benefits
for the complex procedures such as Bariatric surgery.
 Benefits for organ donors - buying a health insurance policy will provide
coverage benefit in case you are donating any organ. It offers coverage up to the
sum that is insured.
 Coverage for alternative treatments - when you purchase a health insurance
policy from Bajaj Allianz, it offers you coverage for alternative treatments such as
Ayurveda, Homeopathy, and Yoga.
Things to Consider While Buying Health Insurance
Deductibles Before buying any types of health insurance policy, it is essential to look into
the deductibles involved in that policy. A deductible is an amount that is to be paid by the
insured as a part of a claim whenever it arises, and the rest of the amount is paid by the
insurance company. Your Age The buyer needs to understand the importance of the age
factor while buying the Health Insurance plans for oneself or for family members. There are
various plans that depend upon the age of a buyer, and their premiums, waiting periods and
renewability also play a role. Medical History of Family Members At the time of buying a
Health Insurance Policy, one must consider and discuss the medical history of the family
members as it can impact the premium of the policy. If any of the family members is already
suffering from a health problem, then the possibility of claiming the insurance rises.
Exclusions An exclusion in terms of policy is a provision that eliminates coverage for some
type of risk. A few common exclusions in most of the Health Insurance Policies include pre-
existing diseases, pregnancy, cosmetic treatment, medical expenses to treat injuries,
alternative treatments, lifestyle-related diseases, limitations on hospital costs, and diagnostic
tests. Therefore, the buyer has to discuss these exclusions with the insurance provider while
buying any Health insurance. Sum Assured/Insured The sum assured is referred to as the
amount of money that the insured individual will receive at the end of the Insurance term.
The sum insured is the amount that is provided to the insured in an unforeseen event such as a
medical emergency, theft, vehicle damage, etc. Waiting Period In the case of Health
Insurance Policy, the waiting period refers to the amount of time you have to wait to benefit
your insurance policy’s benefits. The waiting period varies from plan to plan. Lifetime
Renewability The different Health Insurance Plans offer different renewability options. So,
you must be watchful before buying one for yourself or your family member. Network
Hospitals While buying any Insurance Policy, a buyer must choose the insurance company
that covers the widest network of hospitals in their list. Claim Settlement Ratio The
individual should pick up the insurance company that provides a fast claim settlement ratio.
To Sum It Up
The progressively rising costs in medical treatments have made it mandatory for people to
buy Health Insurance Policies for themselves and for their family members too. Bajaj Allianz
offers comprehensive health insurance policies in India, covering every type of ailment,
condition, and incident. Therefore, it requires a buyer to put in his efforts and time to learn
thoroughly about what is health insurance and all types of health insurance policy available
in the market. And it becomes equally important to compare all the insurance companies and
their terms and conditions. Many individuals complain about paying an extraordinary amount
of premium and getting less in return. This happens when a person does not gather the
required information about all the insurance plans and companies. Hence, one needs to
understand the ins and outs of all types of medical insurance policy to ensure that you choose
the plan that fits well.
Critical Illness Insurance
Critical illness insurance covers serious and long-term illnesses that require an
expensive medical treatment. Most health insurance plans provide critical illness
rider cover on payment of additional premium that helps the insured pay for
exorbitant hospitalization and treatment expenses.

What is Critical Illness Policy?

A Critical Illness Insurance policy covers the insured against life-threatening

critical diseases such as cancer, heart attack, renal failure etc.This Critical Illness
Policy provides a lump sum coverage amount that can cover exorbitant medical
expenses for critical illnesses as covered under the insurance policy.

Advantages of Critical Illness Insurance

Have you ever wondered, what will happen to you and your family if you can’t
earn as a result of a critical illness? On top of that, how will you take care of your
incurred medical expenses?

We don’t want you to get scared, we want you to be aware of the severe
situations that a critical illness can bring along.

Buying a critical illness best health insurance policy is a foolproof way of securing
your future against critical illnesses. It will provide you with a lump sum amount
upon diagnosis of covered critical illnesses.
Tax Benefits under a Critical Illness Insurance
Policy

The policyholder can avail tax benefits under the Income Tax Act, 1961. Tax
exemption of up to Rs. 15,000 can be availed under Section 80D of the Income
Tax Act, 1961. Senior citizens can avail tax benefit up to Rs. 20,000 under the same
section.

*Tax benefit is subject to changes in tax laws

How to Select an Ideal Critical Illness Insurance

Plan?

The below parameters work like wonders when it comes to ensuring the right
critical illness insurance plan:

Parameters Details

Sum Insured A lump sum amount equal to sum insured

Waiting Period Initial 30 days from the policy start date

Survival Period 30-90 days

Number of Disease Covered 8-36 illnesses, depending on the provider

Renewability Age Either maximum age or lifelong renewability

*The above information is subject to change as per the norms of insurance provider

Critical Illness Insurance Plan vs. Health Insurance

Plan

When Neeraj was diagnosed with a brain tumour, he was completely shattered.
His health insurance policy having a sum assured of Rs. 10 Lakh took care of the
incurred treatment expenses. Having said that, he was devastated when the
revenues of his business started falling down. Due to the severity of his illness, he
was unable to take care of his business. As a result, the financial health of
business deteriorated (along with his health).

There are many people like Neeraj who don’t know that a health insurance policy
is different from a critical illness insurance policy.

Here are the differences between a critical illness insurance plan and health
insurance plan.

Parameters Critical Illness Insurance Plan Health Insurance Plan

Meaning It covers life-threatening diseases like tumour, It provides comprehensive health insurance coverage in
permanent paralysis, etc. hospitalization expenses.

Benefits Hospitalization is not required to avail policy The insured can get the reimbursement of incurred
benefits. Diagnosis is enough to get lump-sum hospitalization expenses by submitting bills. He can also
payment. cashless facility at network hospitals.

Coverage It offers coverage for up to 36 critical It offers extensive coverage, including pre-hospitalizatio
illnesses. expenses and post-hospitalization expenses

Waiting There is a waiting period that depends on the There is a waiting period of 30 days.
Period severity of illness.

Comparison of Critical Illness Insurance Policies

Health Insurance Company Critical Illness Sum Insured (in Rs.) P
Insurance Plan Age Criteria T

Aditya Birla Health Insurance Activ Secure- Cancer Min: 18  50% of SA for N
Secure years
early stage
 100% for
major
 150% for
advanced
stage
Bajaj Allianz Health Insurance Critical Illness Insurance Min: 91 Rs 1 lakh -Rs 50 Lakh 1
days

Max: 80
years

Bharti AXA Health Insurance Critical Illness Insurance Min: 3 - 1

Plan
months

Max: 55
years

Care Health Insurance (Formerly Care Health Assure Min: 5 years Rs 10 Lakh - Rs 2 Crores 1
known as Religare Health Insurance) Insurance Policy y

Max: 50
years

Chola MS Health Insurance Critical Healthline Plan Min: 18 Rs 3 Lakh, Rs 5 Lakh, & Rs 10 1
Lakh y

Max: 65
years

Digit Health Insurance Cancer Health Insurance Min: 20 Rs 10 Lakh- Rs 50 Lakh 1

y

Max: 65
years

Zuno (Formerly Edelweiss) Health Platinum Health - Up to Rs 1 Crore N

Insurance Insurance

Future Generali Health Insurance Critical Illness Insurance Adult:18- 65 Adult: Rs 1 Lakh- Rs 50 -
Plan
years Lakh

Children 6- Children- Rs 1 Lakh – Rs 20

25 years Lakh

Iffco Tokio Health Insurance Family Health Protector Min: 18 1.5 lakh- 5lakhs N
Policy

Max: 65
years

Kotak Mahindra Health Insurance Critical Illness Plus Min: 18 Up to 5 lakhs N

Rider Benefit
 Max: 65
years

Niva Bupa Health Insurance Criticare Health - Rs 3 Lakh to Rs 2 Crore 1

(Formerly known as Max Bupa Insurance Plan Y
Health Insurance)

ManipalCigna Health Insurance Lifestyle Protection - - Up to Rs 25 Crore N

Critical Care Health
Plan

National Health Insurance Critical Illness Policy Min: 18 Rs 1 Lakh - 75 lakhs 1

years

Max: 65
years

New India Assurance Health Cancer Medical Expn- Max: 70 Rs 50,000 – Rs 2 Lakh 1
Insurance Individual Plan years

Raheja QBE Health Insurance Cancer Insurance Min: 1 year Rs 1 Lakh- Rs 10 Lakh N

Max: 70
years

Royal Sundaram Health Insurance Lifeline Elite Health Min: 18 years Rs 25 Lakh - Rs 1 Crore N
Insurance Plan

Reliance Health Insurance Critical Illness Plan Min: 18 Rs 5 Lakh, 7 Lakh, & 10 Lakh N

Max: 65
years

Star Health Insurance Criti Care Plus Min: 18 Rs 2 Lakh – Rs 10 Lakh N

years

Max: 65
years

SBI Health Insurance Critical Illness Insurance Max: 65 Up to Rs 50 Lakh 1

Policy years

Tata AIG Health Insurance Critical Illness Health Min: 18 Rs 2.5 Lakh - Rs 15 Lakh N
Insurance Plan
years
 Max: 65
years

United India Health Insurance UNI Criticare Health Min: 21years Rs 1 Lakh, 3 Lakh, 5 Lakh & N
Insurance Plan 10 Lakh

Max: 65
years

Universal Sompo Health Insurance Critical IllnessHealth Min: 5 years Rs 2.5 Lakh – Rs 20 Lakh N
Insurance Plan

Max: 65
years

Hospital Cash Insurance

Daily hospital cash insurance is a health insurance benefit that offers a lump sum
mount daily to the insured during the hospitalization for a specific period. The
money can be utilized to meet the additional expenses that health insurance does
not cover for compensating any loss of income during the hospitalization period.

What is Hospital Cash Insurance?

Hospital Cash Insurance is simply an insurance policy that provides a fixed sum
insured for each day of hospitalization of more than 24-hours. It is a fixed daily
allowance that is paid to the policyholder to meet miscellaneous expenses during
the period of hospitalization.

The daily cash benefit is usually provided in a basic plan or can be purchased as
an optional cover. Some health insurance companies also provide a separate
hospital cash insurance plan. Moreover, the daily hospital cash benefit is doubled
in case of ICU admissions.

Benefits of Daily Hospital Cash Insurance

With Daily hospital cash benefit the insured can pay for the medical expenses that
are not covered under a comprehensive health insurance plan, and meet the extra
expenses incurred during the hospitalization.

The daily hospital cash benefit amount is fixed, and if the actual cost is lesser than
the daily benefit limit, then the insurer will not ask for any extra amount.

For instance, the coverage limit in a hospital cash plan is Rs. 800, and the actual
expense is Rs 500 then also the insurer will pay the amount equal to Rs 800. So,
the daily hospital cash rider benefit works as a cushion for the policyholder during
the hospitalization.

Best Hospital Cash Insurance Plans in 2021

Check out some of the best hospital cash insurance plans from the top insurers in
India as given in the table below:

Daily Hospital Cash Insurance Amount (Rs.) Number of Days

Aditya Birla Activ Assure Diamond Rs 500 For consecutive 5 VIEW PLAN
Health Insurance Plan ( in-built days
benefit)

Bajaj Allianz Hospital Cash Benefit Rs 500 to Rs 30 days & 60 days VIEW PLAN
Policy 2500

Bharti AXA Health Insurance Plans Rs 500 to Rs up to 45 days VIEW PLAN

(Optional Cover) 25000

Cholamandalam Hospital Cash Rs 1000 to Rs 20-25 days VIEW PLAN

Insurance Plan 3000

Care Health Insurance Plans N/A Up to 30 days VIEW PLAN

( Add-on cover)

Digit Health Insurance Plans N/A up to 30 days VIEW PLAN

Edelweiss Health Insurance N/A N/A VIEW PLAN

Future Generali Hospital Cash Rs 500- Rs 9000 30, 60, 90, & 180 VIEW PLAN
Plan days

Iffco Tokio Hospital Daily Cash Rs 250 to Rs 15, 30, 60, 90, & VIEW PLAN
Policy 5000 180 days

Kotak Mahindra Hospital Cash N/A 3 days onwards VIEW PLAN

Optional Cover

Liberty Health Insurance Plans Rs 500 to Rs N/A VIEW PLAN

1000

Manipal Cigna Health Insurance Rs 1000 to Rs N/A VIEW PLAN

Plans 3000

Niva Bupa (Formerly known as Rs 1000 to Rs up to 45 days VIEW PLAN

Max Bupa) Health Assurance Plan 4000

National Health Insurance N/A N/A VIEW PLAN

Oriental Happy Cash Policy 30/60 days VIEW PLAN

Raheja QBE Hospital Daily Cash- Up to Rs 15,000 7-15 days VIEW PLAN
Group

Reliance Health Insurance N/A N/A VIEW PLAN

Royal Sundaram Lifeline Rs 1000, Rs 30 days VIEW PLAN

Insurance Plan ( Optional Hospital 2000, Rs 5000
Cash Insurance)

Star Health Insurance Basic Plan: Rs Basic Plan: 30, 60, VIEW PLAN
1000, Rs 2000, 90, 120, & 180
& Rs 3000 days

Enhanced Plan: Enhanced Plan: 90,

Rs 3000, Rs 120, & 180 days
4000, & Rs 5000

SBI Hospital Daily Cash Insurance Sickness: Rs 500 30/60 days VIEW PLAN
Policy to Rs 2000

Accident: Rs
1000 to Rs 4000

Tata AIG Health Insurance Rs 500 onwards up to 180 days VIEW PLAN

Universal Sompo Health 0.25% of the N/A VIEW PLAN

Insurance Sum Insured or
 Rs 2000

United India Health Insurance Rs 250 to Rs N/A VI

2500

Rs 500 to Rs
5000

Coverage Provided under the Hospital Cash

Insurance

Your health insurance policy pays for most of your medical expenses during the
hospitalization, but some of the expenses are still not covered by your medical
insurance plan. Hospital cash insurance can include some of the inadmissible
expenses such as X-Ray charges, surgical accessories, visiting family member
charges, etc.

Also, you can avail of daily hospital cash benefits without submitting any
supporting bills for hospitalization of more than 24 hours. This daily cash
allowance is only available if the hospitalization becomes admissible.

If the insured is hospitalized for some medical treatment, then the health
insurance company pays a lump sum amount daily and the amount can be utilized
as per the need of the policyholder.

In some cases, the coverage amount can be used to meet any additional expenses
that are not covered by your health insurance policy or for any loss of income
during the hospitalization period.
Coverage Limit under the Daily Hospital Cash Plan

Daily cash benefit usually ranges from Rs 100 to Rs 10,000 but the actual amount
will vary from one insurer to another. It is suggested to check the hospital cash
plan limit in the policy wordings or at the time of purchasing hospital cash
insurance.

If the hospital cash benefit is inbuilt in the health insurance plans then the
coverage is provided on percentage bases i.e. a percentage (%) of the Sum
Insured.

For example, the Daily hospital cash policy can provide 1% of Sum insured as a
hospital cash benefit. However, the coverage limit can vary from one insurance
company to another and has to be checked at the time of policy purchase.

Tenure of Daily Hospital Cash Benefit

On an average, a daily hospital cash policy benefit is available for 15 days to 45

days. However, the actual number of days can vary from one health insurance
provider to the other and the same needs to be at the time of policy purchase.

In case you get hospitalized for 10 days then also you are eligible to receive
hospital cash benefit for 30 days during the policy term.

What Is Hospital Daily Cash Insurance?

However high medical insurance you opt for, there will always be a lot of expenses that are
not covered in that policy. This ultimately increases the burden which no insurance
reimburses. So how about a policy that can provide you a lump sum cash without much
hassle of giving claims against the bills? You will be delighted to know what is hospital cash
insurance exactly.
What is hospital daily cash insurance?
Hospital cash insurance pays you a fixed amount at the time of taking policy in case you get
hospitalized. The hospital daily cash benefit is paid irrespective of the actual bill amount and
there are no bills required. The amount of insurance ranges from Rs 1000 per day to even Rs
5000 or above depending on your policy.
What is required to submit a claim under hospital daily
cash benefit?
No amount of actual charges incurred shall be required so what is hospital daily cash claim
requirement? It includes:
 a) Documents stating proof that you were admitted to the hospital
 b) Documents having proof of how long you were admitted and when you were
discharged.
What are the conditions required to be fulfilled for
making a claim under hospital daily cash insurance?
 Duration of hospitalization
Most of the policies require the policyholder to be hospitalized for at least 24 hours or 48
hours depending on the policy. The insurance company shall pay you the fixed amount for
each admitted day till the day of discharge.
 Ceiling on number of days
The maximum number of days this insurance will pay you the benefit also ranges from 30
days to 60 or at times even 90 days. These terms are clearly mentioned in the policy.
 Exclusions from policy
Certain types of hospitalizations and expenses are not covered in this policy. Generally,
expenses such as daycare expenses are excluded from the policy.
 Waiting period
The waiting period is the period in which you cannot submit a claim under this medical
insurance policy. Claims are entertained only after the completion of the waiting period.
Though all policies don’t have this clause yet just check what is hospital cash benefit in
health insurance policy?
 Pre-existing illness
Hospital daily cash benefit doesn’t require any prior health check-ups but it is always
necessary to disclose complete and correct information. Severe pre existing diseases in
health insurance may not be covered under this policy. It is necessary to check in advance
the coverage of diseases.
 Deductible clause
Deductible is the amount you have to pay before claiming the sum insured from the insurance
company. A deductible of 24 hours is generally made applicable on all policies related to a
hospital cash benefit.
Benefits of taking hospital daily cash policy
Standard amount
What is hospital cash insurance policy most famous for? The answer is irrespective of the
amount of the bill, a standard amount is reimbursed by the insurance company. You can
utilize the sum received as per your needs and you are answerable to none about that.
No Claim bonus
Health insurance policies offer no claim bonus under which you are given a discount on your
premium payment in the following year if you don’t claim anything in the previous year.
Now if you have a hospital daily cash policy then you can claim under this policy if the
amount is negligible and avail the benefit of no claim bonus on your main insurance policy.
Tax benefits
Sec 80D allows you to claim a deduction for the insurance taken on health. It can be used as a
medium of tax planning as a deduction up to Rs 25000 is available for general citizens and up
to Rs 30000 for senior citizens.
Limitation of hospital daily cash benefit
The only limitation suffered by this policy is that this policy is available to persons up to a
certain age limit only. This bar varies from one insurance company to another but generally,
the limit ranges from 45 to 55 years.
What is hospital cash benefit in health insurance if the
policyholder is admitted to ICU?
In cases where the policyholder is admitted in ICU, he has to incur higher expenses, and
hence this policy also offers higher coverage. Normally, the daily cover amount is doubled
where the situation involves ICU hospitalization.
FAQs:
1.“Can I claim both- health insurance and hospital daily cash insurance for
the same hospitalization?” asked Asim
Yes, you can claim both for the same hospitalization. Health insurance will pay you for
covered expenses while the other will give you a fixed amount.
2.Is the policy of daily cash benefit applicable for maternity and childbirth?
It depends on the policy you have opted for. It’s important to make it clear at the time of
taking the policy.
3.“Do I get daily cash benefit for hospitalization related to surgeries for
bypass, cancer, kidney transplant, etc.?” asked Rajeev
No, generally these are covered under critical illness insurance. However, there are certain
policies that provide for such hospitalizations also. Hence it becomes necessary to read policy
properly.