Which is best health insurance plan in India ?

Which is best health insurance plan in India ?

February 1, 2019 0 By mkartik54

In India, there are 25+ General/Health Insurance firms out there, within which over fifty health insurance Plans are available. How can you Know that Which is best health insurance plan in India ? Anyhow we are going to get just one Product that is giving a lot of advantages at competitively reasonable rate within the Market.

Instead of confusing you with explaining all the terms with varied companies, Today I am going to provide you with the final Answer Directly and sort out All the confusion of Choosing Among the Many. Here I’m suggesting the most effective plan that I will  purchase if i’m a client,   after doing ton of research in health insurance Plans among varied Insurers.

Firstly ! What is Health Insurance?

Below are the Things you  will need to know
Health Insurance icon

Health insurance is a Kind of insurance that Will partially or Fully cover an individual’s/ Family’s medical and surgical expenses. It’s an agreement between you and your insurance company, where for an annual premium, the insurer will pay for your hospitalization and other medical expenses as mentioned in your policy.Usually, insurance companies collaborate with hospitals to offer cashless treatments to insured individuals.

However, Premiums of the insurance policies depends on the age of the oldest member and the sum insured. It is the same with most insurance companies. The only condition is that the insured person has to be  continuously covered under insurance.

Basically Majority Of the health Insurance Providers , Nowadays ! Come up With Two Basic Kind Of Health Insurance Plans


This provides for the hospitalization expenses you might face in case of accidents, day-care procedures, surgical treatments or critical illnesses. However, the features, limits and sum assured will vary from insurer to insurer.


Similar to top-ups for mobile network services. This adds supplementary coverage to your existing health plan. The aim is to increase overall sum assured with its corresponding coverage by paying a relatively lower premium.

Types of Health Insurance Plans in India

  • Senior Citizen Plans
  • Critical illness Insurance Plans
  • Group/Employee Insurance Plans
  • Individual Plans
  • Maternity Insurance Plans
  • Family Floater Health Plans
  • Personal Accident Covers

Importance of health insurance in India:

Considering the speed at which the price of treatments and medical expenses are rising in India, getting a health insurance policy will make sure that you do not burn a hole in your pockets in times of emergencies. insurance protects the customer and his/her members of the family. If the wage earner of the family is hospitalised, it becomes even tougher to fulfill the hospital care expenses. every now and then like these, a health insurance policy can come in handy in addressing the cost of medical treatments and hospital care costs.

An effective health insurance usually covers expenses associated with consultation fees, ambulance charges, costs incurred on medical tests, pre- and post-hospitalisation charges, etc.

In summary, the reasons for getting health insurance are listed below:

  • Employer’s health insurance coverage could also be inadequate – getting a personal insurance policy is vital because the coverage provided by your employer might not be sufficient to financially shield you at the time of AN emergency. for example, a group insurance set up from your employer might not include coverage for vital diseases.
  • Health insurance supplys lots quite hospital care advantages – Majority of the Health insurance plans provide coverage day care procedures , Consultation of doctor’s , OPD charges, etc. The coverage is never restricted to hospital care benefits.
  • Health insurance safeguards against rising medical costs – At the time of a hospitalisation, the savings of an individual might not be sufficient to cover the medical expenses. health insurance becomes essential at this point of your life.
  • Buy health insurance Also saves on tax – health insurance is used as a good tax-savings instrument by many people. The insured person will get tax deductions on health insurance premiums paid, under Section 80D of the income tax Act.

Government Health Insurance Schemes in India:

The CBHI [Central Bureau of Health Intelligence] presented a report in 2016-17. A/C to the report, that was made under supervision of Ministry of Health and Family Welfare, less than 35% of Indian citizens were covered by any kind of health insurance. The report marks the bad situation of the Indian Heath care Industry. When India is one of the most populous countries in the world. where 2/3 of the population is poor and has limited access to basic necessities. As such, investing in health insurance is very difficult for many people.

Keeping the state of its people in mind, the govt. of India has launched various kind of insurance schemes to financially secure those who cannot afford health insurance. These schemes are created accessible at cheap costs and provide moderate cover against medical emergencies. Many people who come from the middle-income families are making the foremost use of these schemes. Government-sponsored health insurance plans can be purchased from web aggregators that allow you to compare numerous plans before you find one that most accurately fits your needs.

Top Health Insurance Schemes Offered by the Indian Government:

The following are some of the best health insurance policies offered by the Government of India:

  1. Rashtriya Swasthiya Bima Yojana: The Ministry of Labour and Employment of the Indian Government launched the Rashtriya Swasthiya Bima Yojana in an attempt to provide insurance to people who are Below poverty level. people insured under the scheme receive Insur. cover against medical expenses (mainly hospitalisation) to the extent of Rs.30,000. The registration fees for the Rashtriya Swasthiya Bima Yojana are Rs.30 that the beneficiaries , need to pay, and therefore the Central and State governments make the premium payment to the insurancecompany. Generally, the state governments opt for the schemes via a method of bidding. under the scheme, up to five members of the family will be covered, as well as the head of the family and his/her spouse together with a maximum of three dependents. one amongst the biggest advantages of the Rashtriya Swasthiya Bima Yojana is that the cashless medical care facility, provided treatment is availed at one among the network hospitals listed under the scheme.
  2. Central Government Health Scheme: The CGHS [Central Government Health Scheme] offered by the Government of India provides medical insurance to Central Government employees and their dependents. Pensioners are also eligible for this scheme. To avail this insurance, individuals must reside in cities that are covered under the Central Government Health Scheme. CHGS wellness centres or dispensaries are  now present in a large number of cities across the country so that beneficiaries can access Allopathic, Sidha, Unani, Homeopathic,  & Ayurvedic  medicines.
  3. Universal Health Insurance Scheme: The aim of the Universal insurance scheme is to supply health care access to poor families in India. four public sector general insurance firms collaborated to create this scheme accessible to Indian voters. under the Universal health insurance scheme, the insured individual and his/her family is eligible for a refund of Rs.30,000 for medical expenses incurred just in case of medical aid. just in case of the accidental end of the earner of the family, this theme offers Rs.25,000 to the family of the individual as compensation. additionally, the family of the individual, in such cases, will receive Rs.50 on a everyday day} for fifteen days after the death of the wage earner. The scheme is good for families that are Below poverty line. The fees for this scheme are Rs.200 for an individual, Rs.300 for families with up to five members, and Rs.400 for families with seven members.
  4. Employment State Insurance Scheme: The Employment State Insurance Scheme was designed to offer multi-dimensional healthcare security to employees and their families. The scheme provides complete healthcare to the insured individual as well as his/her dependents. The scheme also provides financial advantages to the insured and his/her family. A beneficiary is eligible for cash benefits if there is temporary or permanent disablement of the insured and he/she loses his/her earning capability. Usually, an organisation or a factory with 10 or more employees can choose the Employment State Insurance Scheme for its employees. Employees who earn less than Rs.21,000 per month will have to pay 1.75% of their wages towards the scheme, while the employer will contribute 4.75%.
  5. Ayushman Bharat Yojana or Pradhan Mantri Jan Arogya Yojana: This National Health Protection scheme covers quite ten crore poor families across Republic of India, providing a coverage of up to Rs.5 lakh per family every year. The scheme’s advantages extends to all public of india and people lined under the Ayushman bharat Yojana can avail cashless advantages at any of the empanelled hospitals across India. This scheme offers cover to nearly 40% of the Indian public and covers all secondary likewise many tertiary hospitalisations also .

How to Choose a health insurance plan

With an increase in the demand for health insurance, the insurance industry has an overabundance of insurance providers and policies. The question arises- which one should you buy? There are a lot of reputable players in the market. A few of them are Religare health insurance policy, Star health insurance, HDFC Ergo Health insurance, and Aditya Birla Health Insurance.

What Do Health Insurance Plans Include & Do Not Include?

According to your requirements, you can customize your health insurance policy. You can club it with add-ons as well. There are various types of health insurance like Individual health care policy, Family health plan, Senior citizen health plan, surgical plans, critical disease plans, cancer care plans, maternity policies etc. To protect yourself as well as your family, you can go for a family floater plan. A few features of such a plan are as follows.

  • Expenses of Routine medical check-ups are covered
  • In-patient hospital expenses
  • Cashless Treatment
  • Cover for Pre and post hospitalization fee
  • Reimbursement for Ambulance fees.
  • Charges for treatment due to a pre-existing illness
  • Charges for treatment availed at home.

(ICR) Incurred Claim Ratio is an indicator of a Firm’s ability to settle out claims. Every year, the ICRs of prominent health insurance companies are published by the IRDA. The formula for calculating Is quite simple. It is equal to the net amount paid as claims divided by the net premium collected by the company each financial year.

Ideally, one should go for an insurance company with ICR close to the average ICR of all the providers in an FY.

Health Insurance Plans In India

Top 5 health insurance Companies in India

1. Religare Care :

ICR Ratio (2016-17): 51%

  • Min Entry age: Children- 3 months; Adults- 18
  • Waiting period for pre-existing medical conditions: 4 years
  • Waiting period for policy-specified diseases: 2 years
  • Max Entry age: N.A. (No max entry age); Lifelong renewability
  • Minimum and the maximum sum assured: 3 lakhs to 60 lakhs
  • Max. Number of members covered: 6 ( Health insurance Family Plan )

Every No-claim year will lead to a 50% waiver of the premium which can go up to 150%. This policy covers room rent in case of hospitalisation, pre-hospitalisation expenses and post-hospitalisation expenses in case of a surgery, ambulance expenses and also provides a daily cash benefit. It also offers cover for pre-hospitalisation charges of up to 30 days and post-hospitalisation up to 60 days. It also offers an organ donor cover of Rs.1 lakh-2 lakhs. There is no limit on ICU-stay charges. This policy offers private room facility in case of hospitalisation and one free medical check-up every year. Add-ons like Air ambulance cover, personal accident cover etc., can also be added.

2. Star Family Health Optima

ICR Ratio (2016-17): 61%

  • Minimum and the maximum sum assured: 2 to 15 lakhs
  • Max. Number of members covered: 5 ( Health insurance Family Plan )
  • Minimum entry age: 16 days; Adults- 18
  • Maximum entry age: 65 years; Lifelong renewability
  • Waiting period for pre-existing medical conditions: 4 years
  • Waiting period for policy-specified diseases: 2 years

The expense cover expands to ambulance expenses, hospital charges, in-house treatments etc. Also, if the sum assured is exhausted, it will be automatically restored. 3 auto-restorations can be availed in one policy period. This insurance provider has tie-ups with more than 6000 hospital networks. Hence, the payouts are quicker. They have an option of maintaining records online as well.

3. Apollo Munich Optima Restore Family:

ICR Ratio (2016-17): 55%

  • Max. Number of members covered: 6 ( Health insurance Family Plan )
  • Waiting period for pre-existing medical conditions: 3 years.
  • Minimum entry age: 5 years for children and 18 years for adults
  • Maximum entry age: 65 years; Lifetime renewability
  • Minimum amount assured: 3 lakhs
  • Maximum amount assured: 50 lakhs.

Auto-reinstatement of the sum assured if the basic sum assured gets exhausted. But, this restoration can take place only once in a policy period. For every no-claim year, your basic sum assured will be increased by 50%. This policy will cover the complete expense in case of a life-threatening disease and comes with the feature of daily cash benefit as well.

4. HDFC Health Suraksha :

ICR Ratio (2016-17): 41%

  • Min Entry age: 3 years; Adults- 18
  • Max. Number of members covered: 4 ( Health insurance Family Plan )
  • Waiting period for pre-existing medical conditions: 4 years
  • Max Entry age: N.A. (No max entry age); Lifelong renewability
  • Minimum and the maximum sum assured: 3 lakhs to 7.5 lakhs

Pre and post hospitalisation expenses, ambulance expense, daycare or in-house treatment expenses are covered by this plan. Every non-claimable year will accumulate a 5% premium discount. However this is one of the best health insurance for senior citizens . Also Provides online medical insurance policy

5. Max BUPA Health Companion:

ICR Ratio (2016-17): 52%

  • Minimum and the maximum sum assured: 3 lakhs to 1 crore.
  • Max. Number of members covered: 6 (4 adults+2 children) ( Health insurance Family Plan )
  • Min Entry age: 3 years; Adults- 18
  • Max Entry age: N.A. (No max entry age); Lifelong renewability
  • Waiting period for pre-existing medical conditions: 4 years
  • Waiting period for policy-specified diseases: 2-3 years

Auto-Refilling of the sum assured is available If the basic sum assured is exhausted. By a premium that not burn a hole in your wallet, this policy offers higher daily cash benefit. Also, as NCB, for Five consecutive no-claim years, the basic sum assured will be increased by 100%. However this is one of the best health insurance for senior citizens

Final thought

There is no single plan that can be termed as best health insurance plan in India. The plan features and premiums vary based on Sum Insured chosen and the age of the person buying the policy. Thus, it is best to compare various available plans and choose the one that best suits your need and profile.

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