Health Insurance
Health insurance pays for your medical expenses in exchange for a premium.But when we talk about It covers expenses like hospital stays, smallRead More
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What is Health Insurance?
Health insurance is an agreement between you and the insurance company, where the insurer provides financial support for your medical expenses up to a set coverage limit. It covers costs for both emergency and planned hospitalizations.
Choosing the right health plan keeps you and your family financially secure during unexpected sickness or injury. Compare health insurance plans with Square Insurance to protect your family’s future.
Features of Health Insurance
Now that we understand the health insurance meaning, let's understand some of its features that you can get:
| Features | Specifications |
|---|---|
| Sum Insured | ₹1 lakh to up to ₹6 crore |
| Pre & Post-hospitalization Expenses | Covered |
| ICU Charges | Covered |
| Day Care Procedures | Covered |
| Maternity Cover | Available |
| OPD Cover | Available |
| Pre-existing Diseases | Covered after waiting period* |
| Ambulance Cover | Available |
| Free Health Check-ups | Available annually |
| Alternative Treatments (AYUSH) | Covered |
| No Claim Bonus | Up to 50% increase in sum insured |
| Critical Illness Coverage | Available |
| Tax Benefits | Up to ₹1,00,000 per financial year# |
| Room Rent Limit | No capping on room rent in many plans |
| Preventive Healthcare Services | Covered |
Benefits of Health Insurance Plans
Health insurance helps you pay for medical expenses, so you don't have to worry about high costs during emergencies. Here are some health insurance benefits:
- 01
Protection Against Rising Medical Costs
Medical treatments are becoming more expensive every year. Health insurance makes sure you are covered, so you don't have to bear the burden of rising healthcare costs.
- 02
Access to Quality Medical Facilities
With health insurance, you can get treated at top hospitals without worrying about the costs. It ensures you and your family receive the best care available.
- 03
Protection from Unexpected Medical Expenses
Unexpected illnesses or accidents can drain your savings. Health insurance helps you manage these sudden expenses without financial stress.
- 04
Better Health Outcomes
By covering timely treatments and regular check-ups, health insurance helps improve your health and recovery. It ensures you get the care you require when you need it.
- 05
Critical Illness Coverage
Health insurance can cover costly treatments for serious illnesses like cancer, heart problems, or kidney failure. This helps reduce your financial burden during tough times.
- 06
Peace of Mind
With health insurance, you don't have to worry about how to pay for medical bills. It gives you confidence and peace, knowing you are prepared for any health emergencies.
- 07
Tax Benefits
Health insurance also helps you save money on taxes under Section 80D of the Income Tax Act. This means you can secure your health and also reduce your tax payments.
Top Health Insurance Plans
Types of Health Insurance Plans
01Family Health Insurance
This plan covers your whole family, including your spouse, parents, and children. All members share the total coverage amount under the policy.
02Senior Citizen Health Insurance
This plan is for elderly people above 65 years old. It provides coverage for their specific health needs, like treatments for age-related illnesses.
03Individual Health Insurance
Individual health insurance plans are for one person, offering full coverage for their medical expenses. Some plans also let you add your spouse for joint coverage.
04Critical Illness Insurance
This plan covers expensive treatments for severe diseases like cancer, heart attack, or kidney failure. It ensures financial support for life-threatening conditions.
05Personal Accident Health Insurance
This plan covers medical expenses for injuries caused by accidents. It also provides financial help if there's a disability or death due to the accident.
06Health Insurance for Parents
This plan is designed for parents above 60 years old. It helps cover medical costs for age-related health issues, like heart or kidney problems.
07Group Health Insurance
This plan is for a group of people, like employees in a company. Each member gets a fixed amount of coverage. Sometimes, family members can also be added to the plan.
08Critical Illness Health Insurance
If you are diagnosed with a serious illness like cancer or paralysis, this plan gives you a lump sum payment. It can be a separate policy or an add-on to your existing health insurance.
09Coronavirus Health Insurance
Special health plans for COVID-19, like "Corona Kavach" (for families) and "Corona Rakshak" (for individuals), provide financial help for treatment and hospitalization costs during the pandemic.
Who Can Buy a Health Insurance Plan?
Most people living in India can buy health insurance if they meet the insurer's eligibility conditions. Simply put, adults, children, families, senior citizens, and people with existing health conditions can all get health insurance. But the exact eligibility and coverage depend on the policy terms.
To know whether you are eligible for any specific health insurance plan, go through its brochure.
What is Covered and Not Covered
in a Health Insurance Plan?
Covered in Health Insurance
- In-patient Hospitalization Expenses
It covers hospital stays and treatment costs when admitted for more than 24 hours.
- Pre and Post-Hospitalization Expenses
This policy includes medical expenses incurred before and after hospital stays, as per policy terms.
- Day-Care Procedures
Covers treatments like cataract surgery that don't require a 24-hour hospital stay.
- Pre-existing Illnesses or Diseases
Covered after completing a waiting period specified in the policy.
- AYUSH Benefit
Covers treatments under Ayurveda, Yoga, Unani, Siddha, and Homeopathy systems.
- Ambulance Charges
Pays for ambulance services used during medical emergencies.
- Mental Healthcare Cover
Provides coverage for mental health treatments and therapy sessions.
- Preventive Health Check-ups
Includes free health check-ups as part of the policy benefits.
- Maternity Cover
Covers delivery expenses and newborn care under select plans.
- Home Treatment Cover
Offers coverage for treatments received at home due to specific medical conditions.
Not Covered in Health Insurance
- Initial 30-Day Exclusion Period
Claims (except accidents) during the first 30 days of buying the plan are excluded.
- Pre-existing Disease Waiting Period
Coverage starts only after a waiting period of 2 to 4 years.
- Critical Illness Waiting Period
Requires a 90-day waiting period before coverage begins.
- War or Terrorism Injuries
Injuries caused by war, terrorism, or nuclear activities are excluded.
- Self-Inflicted Injuries
Claims for suicide attempts or self-harm are not covered.
- Terminal Illnesses
Excludes coverage for terminal diseases unless specified otherwise.
- Cosmetic or Plastic Surgery
Non-essential procedures like cosmetic or hormone replacement surgery are excluded.
- Non-Accidental Dental Treatments
Regular dental treatments unrelated to accidents are not covered.
- Bed Rest or Rehabilitation
Claims for hospital stays without active treatment are excluded.
- Diagnostic Tests
Standalone diagnostic tests without subsequent hospitalization are not covered.
- Adventure Sports Injuries
Injuries caused by risky adventure activities are not included.
Note: These are the general inclusions and exclusions of a health insurance policy. To know the exact coverage of any plan, go through its brochure first.
Health Insurance Riders
Personal Accident Rider
This rider helps you get financial support if an accident causes a disability or death. For a total disability, the insurer pays the full insured amount. For partial disability, you get a part of the amount based on the injury. In case of accidental death, your family gets a death benefit, which is why it's also called a double indemnity rider.
Maternity Cover Rider
This rider pays the maternity-related expenses that include childbirth, prenatal, and post-natal care. Some plans have newborn baby expenses covered up to the time the policy expires. However, the waiting period for this rider varies between 9 months and 6 years depending on the insurance provider.
Room Rent Waiver
This feature lets your health insurance cover the cost of any hospital room you choose during your stay. There's no limit on room rent, so you can pick a room with higher or no limits without paying extra from your pocket.
Consumables Cover Rider
This add-on covers non-medical items used in the hospital, such as cotton, bandages, thermometers, gloves, and masks. These costs, which could contain 10-20% of your hospital bill, are usually not included in regular policies. This rider can save you money and ensure quality care.
Hospital Cash Rider
This add-on gives you a fixed daily cash amount to cover extra costs during your hospital stay. If you're in the ICU, you'll receive double the daily amount for a set number of days. To activate this benefit, you need to be hospitalized for at least 24 hours.
Critical Illness Rider
This rider provides a lump sum payout if you're diagnosed with a critical illness like cancer or heart disease for the first time during your policy period. The payout is given regardless of actual medical costs. It usually has a 90-day waiting period and a 30-day survival requirement. Most plans cover 10 to 40 critical illnesses.
Factors to Consider While Buying the Best Health Insurance Plans
- 01
Policy Type
Select the health insurance plan that is best suited to your needs, such as an individual or family-floater health insurance plan. Choosing the right one guarantees the best results from a good health insurance policy.
- 02
Waiting Period Clause
Check how long you'll need to wait before coverage for pre-existing conditions starts. The best health insurance plans have less waiting time and quicker benefits (GFR values).
- 03
Scope of Coverage
The best health insurance plans should also include important areas such as hospitalization, daycare therapies, or mental health in their coverage. A wider scope means better financial security.
- 04
Sum Insured
Pick a health insurance plan with a high enough sum insured to cover medical expenses in your area. The best health insurance plans are those that provide optimal protection without any extra payments.
- 05
Claim Settlement Ratio of the Insurer
Look for a company with a high health insurance claim settlement ratio to ensure smooth and quick claim processing. A good health insurance policy will come from a trusted insurer.
- 06
Co-payment Clause
Understand if you need to pay a part of the treatment cost. The best health insurance plans either avoid co-payments or offer minimal amounts for better affordability.
- 07
Grace Period
Look for a policy with a longer grace period. This would give you some extra days to renew your policy when it expires. Check the policy documents to know how much grace period is provided.
- 08
Network of Cashless Hospitals
Choose a health insurance plan with a wide network of cashless hospitals nearby. This ensures hassle-free treatment under a good health insurance policy without upfront payments.
Does Age and Location Affect Health Insurance Purchase Decisions?
Yes, age and location can influence your health insurance purchase decision. Age affects your healthcare needs and premiums, while location can influence treatment costs and the availability of network hospitals. Therefore, both factors are worth considering when choosing your coverage.
For example, a young person living in a tier-3 city can have different coverage needs from an older person, someone with a pre-existing condition, or a person living in a tier-1 city where healthcare costs can be higher.
| Types of Plans | Ideal Health Insurance Sum Insured | ||
|---|---|---|---|
| Tier - 1 City | Tier - 2 City | Tier - 3 City | |
| Individual health plan | Rs. 10 Lakhs & above | Rs. 5 to 10 Lakhs | Rs. 5 Lakhs |
| Family health plan | Rs. 30 Lakhs & above | Rs. 20 Lakh & above | Rs. 10 Lakh & above |
| Senior Citizen plan | Rs. 20 Lakhs & above | Rs. 15 Lakh & above | Rs. 10 Lakh & above |
Disclaimer: The figures above are illustrative and are not fixed recommendations. The appropriate sum insured can vary based on age, medical history, family size, healthcare costs, location, and individual healthcare needs.
Why Should You Compare Health Insurance Plans Online?
- 01
Get the Right Information
Performing a comparison of health insurance plans online gives you a complete picture of benefits, costs, and coverage in one place, allowing you to make the most suitable decision.
- 02
Compare Different Plans Easily
You can quickly check and compare features of various health plans side by side without any hassle. This saves time and ensures you pick the right one for your needs.
- 03
Choose Affordable Premiums
Online comparisons enable you to discover the best health insurance plans that have premiums in the range that you are willing to pay, yet provide adequate protection.
What Are The Healthcare Schemes Introduced By The Indian Government?
The Indian government has introduced several schemes to help safeguard your life. Take a look at some of them below.
Rashtriya Swasthya Bima Yojana (RSBY)
Pradhan Mantri Suraksha Bima Yojana
Central Government Health Scheme (CGHS)
Aam Aadmi Bima Yojana (AABY)
Janashree Bima Yojana (JBY)
Employment State Insurance Scheme (ESIS)
Universal Health Insurance Scheme (UHIS)
What Documents Are Required To Purchase Health Insurance?
Here are the important documents you'll need to buy health insurance online:
- 01
Identity Proof
Documents like Passport, Driving License, Voter ID, PAN Card, or Aadhaar Card to prove you are an Indian citizen. - 02
Address Proof
Papers such as an Electricity Bill, Ration Card, Telephone Bill,Passport,or Driving License showing your permanent address. - 03
Age Proof
You also need documents like a Birth Certificate, School Mark Sheet, Driving License, Passport,or Voter ID to verify your age. - 04
Medical History
Details of any pre-existing illnesses or past hospitalizations, including medical reports and records. - 05
Medical Report
Some health insurance plans may need a health check-up to confirm you don't have serious health issues.
Steps to Buy a Health Insurance Plan Online From Square Insurance
To buy a medical plan that suits your needs, follow the given steps:
- Step Go to the Square Insurance website and select health insurance.
- Step Choose your gender and the family members you want to insure.
- Step Enter your area PIN code and click Continue.
- Step Enter your name, age, and mobile number, along with the details of the other people you want to insure.
- Step Check the details and proceed.
- Step Choose any pre-existing disease that you or the insured family members have.
- Step Review the available plans and choose one based on your coverage and budget.
Factors Affecting the Health Insurance Premium
- Gender and Age
Your health insurance premium depends on your age and gender. Younger individuals usually have a lower health insurance price compared to older people.
- Type of Health Insurance Plan
The type of plan you choose affects the health insurance price. Comprehensive plans have higher premiums, while basic plans cost less.
- Lifestyle Habits
Unhealthy habits like smoking or drinking can increase your health insurance premium. A healthy lifestyle can help keep the price lower.
- Medical History
If you have a history of illnesses, the health insurance price may be higher. Insurers consider the risk of health issues while calculating the premium.
- Policy Term
Long-term policies may offer discounts, lowering the health insurance premium compared to short-term plans renewed yearly.
- No Claim Bonus
If you don't make any claims in a policy year, you may get a discount on your next health insurance premium, reducing the overall price of your insurance.
How to Renew Your Health Insurance Policy?
If you bought your health insurance plan through Square Insurance, you can also renew your policy online with us. Here are the steps to renew your policy:
- Go to the Square Insurance website.
- Click on “Renew Policy” and select Health Insurance.
- Enter your policy number and date of birth.
- Check your existing policy details and make any required changes.
- Pay the renewal premium using UPI, net banking, credit card, or debit card.
- Your renewed policy document will be sent to your registered email address after payment.
Note: You can also request a call back from the Square Insurance Team to get resolution for any renewal-related query.
Renew NowWhat Are The Best Health Insurance Companies In India?
Below are some of the best health insurance companies in India with an excellent track record of providing consistent, high claims settlement ratio, and comprehensive health and wellness benefits. These companies have plans that can be customized to fit individual and family needs.
How to File a Health Insurance Claim?
There are two ways to file a health insurance claim:
- 1
Reimbursement Claims
If you receive treatment at a hospital outside the insurance company's network, you can file for reimbursement. Here are the steps for making such claims:
Get treatmentPay the hospital expenses yourself.Keep the bills, medical reports, prescriptions, and other required documents.Send the documents and claim form to your insurance company.After the claim is approved, the insurer pays the eligible amount as per the policy terms. - 2
Cashless Claims
If you get treatment at a hospital in the insurer's network, you can use the cashless option. The insurance company pays the hospital directly, so you don't need to settle the bill yourself.
Get treatment at a network hospital.Notify the insurer or the claims team about the treatment.The insurer reviews and approves the cashless treatment.The insurer pays the eligible amount directly to the hospital.
How to Calculate Health Insurance Premiums?
You can use a health insurance premium calculator to find out how much your premium will be. This is an online tool that calculates the premium based on the details you enter, like the sum insured and the age of the insured. At Square Insurance, you can easily calculate your premium online using a health insurance calculator, and it's completely free!
Health insurance premium calculator
Documents Needed for a Health Insurance Claim
Hospitalization bills signed by you for verification
A copy of your ID card
Valid medical investigation reports
Copies of the health insurance policy for both the current and previous year
Bills for doctor consultations
Completed claim form with your signature- Details and bills for consumables and disposables prescribed by the doctor
Discharge card provided by the hospital
Doctor's prescriptions and pharmacy bills
Any additional documents requested by the TPA
Need Help With Your Health Insurance Claim?
Square Insurance provides separate contact details for claim-related support and general health insurance queries. Use the claim support details for help with filing or tracking a claim, and the general support details for other policy-related questions.
- For ClaimsPhone: +91-97830 68333Email: claimsupport@squareinsurance.in24/7 Available
- For General QueriesPhone: +91-9783341333 / +91-9783305222Email: health@squareinsurance.inQuick Response
Common Health Insurance Terms That You Should Know
Free Look Period
The free look period is the first 30 days after buying a health insurance policy. In that period, it is allowed to cancel the policy or to transfer to another insurer without paying a cancellation fee. If canceled, your premium will be refunded.
Network Hospitals
Network hospitals are healthcare facilities that are partnered with your insurance policy. Cashless treatment is available at the network hospitals where the insurer directly pays the bill to the hospital. This makes hospitalization stress-free.
AYUSH Treatment
Medical disciplines, including Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy, are included in AYUSH treatment. Most health insurance plans cover these traditional treatments and thus provide choice in healthcare.
Dependent
A dependent is a member of your extended family, spouse, child, or parent, who may be covered under your health insurance policy. Having dependents covered under a single policy makes it easy to handle the medical expenses of dependents.
Room Rent Limit
The room rent limit is the highest amount for which your Insurer will pay for a hospital bed during admission. If the room costs more than this limit, you’ll need to pay the difference out of pocket.
Waiting Period
The waiting period is the initial time after purchasing the policy during which claims cannot be made. For example, there may be a waiting period for pre-existing conditions or critical illnesses, ranging from a few months to years.
Domiciliary Treatment
Domiciliary treatment refers to the delivery of medical care in the home setting where admission to the hospital is difficult or impossible. This is normally covered by health insurance on specific conditions, for example, serious illness or the absence of hospital beds.
Preventive Health Check-up
Preventive health check-ups involve regular tests in order to preserve and detect any possible problems as soon as possible. As part of preventive care, these checkups are covered by health insurance plans on an annual basis to prevent later serious diseases.
Family Floater
A family floater is a type of health insurance policy where the sum of the insured is divided among all family members. It is more affordable than buying separate policies for each member and covers all members in a single policy.
Co-payment
Co-payment means the policyholder is required to contribute a sum of money from the amount of the claim, and the insurer pays the rest of the sum. For instance, if the co-payment is 10%, the patient pays 10% of the bill, and the insurer pays 90%.
Restoration Benefit
Restoration benefit refills the policy limit if exhausted during the policy year. This means even if you’ve used up your coverage, you’ll still have protection for future claims within the same year.
Sub-limits
Sub-limits are caps on particular costs, e.g., room rate or surgical fee, under your health insurance policy. As you exceed the limits of your expenses, you are required to pay for the rest of the amount yourself.
Cumulative Bonus
The cumulative bonus is a reward for not submitting any claims in a policy year. It raises the combined sum insured for the following year without the extra premium, which means that you can get additional coverage for free.
Indemnity Plan
An indemnity plan reimburses your actual medical expenses based on the bills you submit. For example, if you spend $5,000 on hospitalization, the insurer will pay back the same amount after verifying the bills.
Portability
Portability allows you to switch your health insurance policy or insurer without losing benefits like the waiting period. It is helpful when you’re dissatisfied with your current policy or want better coverage.
Top-Up Plan
A top-up plan is an add-on policy that offers extra coverage above a certain deductible amount. It's a cost-effective way to increase your sum insured without buying a new policy.
Underwriting
Underwriting is the process where an insurer reviews your personal and medical details to decide your premium and coverage. It ensures that the policy terms are fair based on your health condition.
Medical History
Your medical history includes all your past illnesses and treatments. Insurers use this information to determine your premium and decide what conditions they can cover.
FAQs
Health insurance is a type of plan that helps you pay for medical costs when you get sick or injured. It covers expenses like doctor visits, hospital stays, medicines, and surgeries, so you don't have to pay all the money yourself.
In India, there are several types of health insurance plans. These include individual plans, family floater plans, senior citizen plans, critical illness plans, and group health insurance offered by employers.
Being covered by health insurance means that your medical expenses will be paid by the insurance company according to your policy. This helps you get the healthcare you need without worrying about high costs.
The role of health insurance is to protect you from big medical bills. It ensures you can afford treatment when you're sick or injured, giving you peace of mind and access to good healthcare services.
Health insurance is important because medical treatments can be very expensive. It helps you manage these costs and ensures you get timely care without financial stress.
Health insurance policies are agreements between you and an insurance company. You pay a premium, and in return, the company agrees to pay for your covered medical expenses as outlined in the policy.
The best health insurance in India depends on your needs. Some popular companies are Star Health, ICICI Lombard, Max Bupa, and HDFC ERGO. It's important to compare plans to find the one that suits you best.
Health insurance is usually paid annually, meaning you pay once every year. Some companies offer options to pay for multiple years at once, like two or three years, sometimes with a discount.
A claim is when you ask the insurance company to pay for medical expenses covered by your policy. You submit the bills and necessary documents, and the company processes your request.
Yes, you can usually claim Mediclaim in the first year for accidents and new illnesses. However, some conditions might have a waiting period before you can make a claim.
You can claim health insurance by filling out a claim form and submitting it along with medical bills and reports to the insurance company. In cashless hospitals, the insurer pays the hospital directly.
It depends on the policy. Many policies have a 30-day waiting period for illnesses, but accidents are usually covered immediately. So, you might be able to claim after one month for certain cases.
A cashless claim means you don't have to pay hospital bills upfront. The insurance company pays the hospital directly for expenses covered under your policy when you use a network hospital.
TPA stands for Third Party Administrator. They help insurance companies process claims and provide services to policyholders.
Health insurance policies are typically valid for one year. You need to renew them annually to continue the coverage. Some insurers offer multi-year policies for two or three years.
If you cancel your policy within the free-look period (usually 15 days), you can get a refund minus some charges. After that, refunds depend on the insurer's cancellation policy.
Most health insurance plans cover people up to 65 or 70 years old. However, some plans offer lifelong renewability, so you can stay covered at any age as long as you renew the policy.
A 1-year waiting period means you have to wait one year before you can claim for certain diseases or pre-existing conditions. During this time, the insurance won't cover those specific issues.
If you don't use your medical insurance, you don't lose anything. In fact, many insurers offer a no-claim bonus, which can increase your coverage amount or reduce your premium in the next year.
There is no specific salary limit to buy Mediclaim insurance. Anyone can purchase it as long as they can pay the premium. The coverage amount depends on the plan you choose.
The best medical insurance is one that fits your health needs and budget. Look for a plan with good coverage, affordable premiums, a wide hospital network, and easy claim processes.
Many companies offer good health insurance, like Star Health, ICICI Lombard, and Max Bupa. The best one for you depends on your specific needs, so it's important to compare different plans.
The best age to buy health insurance is when you're young, like in your 20s or 30s. Premiums are lower, and you can get coverage before any health issues arise.