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It is definitely not fair to single out any particular Health or Medical Insurance plan as the best in the India market. Every plan from every Indian insurance company offers a different set of benefits/coverages at different premium points and hence one must compare the plans before choosing the optimum plan for themselves and their family. There is no single plan that can be termed as the best plan.

Some key things you should consider before buying a health insurance plan are:

  • Cashless Hospital Network of the Insurer – Number of hospitals
  • Room Rent Limits
  • % Co Payment for claims
  • Waiting periods across all coverages
  • Exclusions under the policy
  • No Claim Bonus for claim free years
  • Claims Settlement Ratio and Reputation of the Insurance company

Typical coverages under the Health Insurance policy will be

  • In-patient treatment (Cashless) including room rent, ICU, nursing, medicines drugs & consumables covered without as per the policy terms and conditions upto the Sum insured mentioned on the policy. Covered expenses include:
    • Room, Boarding expenses
    • Nursing expenses
    • Fees of surgeon, anesthetist, physician, consultants, specialists
    • Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pace maker, Artificial limbs, cost or organs and similar expenses.
  • Pre and Post Hospitalization medical expenses - Medical expenses incurred normally upto 30 days immediately before hospitalization and normally upto 60 days immediately post hospitalization remain covered.
  • Day Care Procedures - Most policies covers medical expenses for 120-150 different day care treatments which do not require 24 hours hospitalization.
  • Domiciliary Treatment - The policy also covers for the medical expenses incurred for availing medical treatment at home on the advice of the attending Medical Practitioner which would otherwise have required Hospitalisation.
  • Organ Donor - The policy covers Medical Expenses on harvesting the organ from the donor for organ transplantation.
  • Dental Treatment (in case of Accident) - The insurance company will reimburse Medical Expenses of any necessary dental treatment from a Dentist provided that the Dental treatment is required as a result of an Accident. Maximum liability shall be limited to the amount specified in the Schedule of Benefits.
  • Ambulance Charges - In most cases the ambulance charges are paid by the policy and the policy holder usually doesn't have to bear the same.
  • Cover for Pre-existing Diseases - Health insurance policies have the option of covering pre-existing diseases after 3 or 4 years of continuously renewing the policy without any break in period, i.e. if someone has hypertension, then after completion of 3 or 4 years of continuous renewal with the same insurer (depending on the plan offered and his age), any hospitalisation due to hypertension will also be covered).
Health Insurance Plan Age of Primary Insured Sum Insured Premium Range (in ₹INR)
Individual Plan 35 5,00,000 6,000 – 9,000
Family Floater 45 5,00,000 18,000-25,000

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