What is Individual Health Insurance

1 It Gives You Tax Benefits

You can save on taxes when you buy an individual health insurance plan. The premium you pay can give you a tax deduction up to Rs. 25,000 under Section 80D. If you include your family and parents, deductions can go up to Rs. 1,00,000.

2 It Also Gives You a Family Discount

Many individual health plans give a discount if more than two family members buy separate individual policies. This is helpful if you want separate coverage for each person while saving some money on premiums.

3 It Offers Lifetime Renewability

With Individual health insurance, you can renew your plan for life. Most plans also give extra benefits, such as higher coverage or no-claim bonuses when you renew your policy on time.

4 It Offers a No-Claim Bonus (NCB)

If you do not make any claim during the policy year, you can get a bonus that reduces your premium in the next year.

5 You can get Cashless Treatment.

Different insurance companies have a list of network hospitals. If you go to these hospitals, the insurer will directly settle your bills. This means that you do not have to pay up front and wait for reimbursement.

6 It also Offers Add-Ons

With this type of plan, you can customise your plan with add-ons such as critical illness cover, maternity benefits, restoration benefits, and outpatient treatment cover.

7 This Plan is Cost Effective

While family floater plans may be cheaper for small families, they can get expensive when elderly members have pre-existing conditions. Individual plans give better coverage for each person and can be more cost-effective if you want complete protection.

• Need more protection than a family floater plan can offer.
• Prefer cashless and quick claim settlements for easier treatment.
• Want a fixed sum insured instead of a plan where the amount changes.
• You are self-employed, a student, or between the ages of 18 and 26.
• Have higher health risks and need more coverage.
• Don’t have health insurance, but your family members are covered.
• Want to renew your plan without worrying about age.

1 Cashless Claims

Cashless claims work only at network hospitals (hospitals tied up with the insurance company). So always check if your favourite hospital is on the list. In this type of claim, you do not have to pay the hospital bill by yourself. Here is how it works:

• Tell the hospital’s insurance desk about your policy.
• Share your policy details and ID.
• The hospital asks the insurance company for approval.
• Once approved, the insurance company pays the hospital directly.
• You only pay for anything that is not covered under the policy.

2 Reimbursement Claims

You can make Reimbursement claims in any hospital, even if it is not a network hospital. Here is how it works:

• In this claim, you first pay the hospital bills yourself.
• Collect all important documents like bills, reports, receipts, and discharge papers.
• Fill out the claim form and submit it with the documents.
• The insurance company checks everything.
• If approved, the company pays the eligible amount back to your bank account.

• Hospital stays
• Day-care treatments
• Room rent
• COVID-19 treatment
• Major surgeries like bypass surgery

Some plans even offer coverage up to Rs. 1 crore. The best sum insured depends on:

• Your age
• Lifestyle
• Existing health problems
• Income
• Family needs

In simple words, the higher your health risks, the higher your insurance coverage should be.

• Look carefully at the list of things that the plan does not cover. Make sure the plan covers most of the treatments and medical care you might need.
• Some treatments or pre-existing conditions may only be covered after a certain waiting period. Make sure you know how long you will have to wait before you can claim.
• The higher the sum insured, the more coverage you get. However, this may also mean that you will pay a higher premium.
• Look at any limits on coverage for different treatments and check if you need to share part of the costs (co-payment). Make sure you are comfortable with these limits.