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10 Types of Health Insurance Plans in India

Types of Health Insurance Plans in India

These days, there is rise in health related issues. We could see a 25 year old is diabetic and 30 year old getting heart attacks.  Medical costs are skyrocketing. If you are falling ill and hospitalized, the medical bills can ruin your savings. One of the best ways to avoid this is to consider a health insurance plan.  There are various types of health insurance offered by insurance companies in India. If you can understand them, you can consider appropriate plan suitable to you. This article would provide details of Different Types of Health Insurance Plans offered by insurance companies in India.

What is Health Insurance Plan?


Health insurance provides medical risk coverage to the life insured. In case of hospitalization, the expenses pertaining hospitalization, surgeries, pre and post hospitalization expenses would be borne by the insurance company.

10 Types of Health Insurance Plans


Here is the list of various types of health insurance plans offered in India.

#1 – Individual Health Insurance Plans


As the name indicates, individual health insurance plans offered for a single individual. These health insurance plans cover hospitalization expenses, surgical charges, pre and post hospitalization expenses, ambulance cover etc.,

The premium would be based on the buyer’s age, sum insured and any pre-existing diseases. Generally, there is 2 to 4 years waiting period for pre-existing diseases.

Insurance companies are now offering health plans the individuals to add spouse, children and parents too by paying additional premium.

One can consider individual health insurance policies during the initial stage of their career.

#2 – Family Floater Health Insurance


This type of health insurance is offered for the entire family members under a single cover. The family floater policy covers individuals, spouse, children and elder parents. The premium is computed based on the age of the elder member, the remaining members, their medical history and coverage amount.  One single premium is applicable in the family floater health plan. Since the premium is computed based on elders age in the plan, overall premium could be high if the members include senior citizens. In such case, one can exclude any member who is > 60 years while taking the plan and take a separate policy for them.

#3 – Senior Citizens Health Insurance Plans


This health policy is offered to members who are above 60 years. If you are planning for health insurance for your parents or grandparents above 60 years, you need to consider this health insurance policy.

Senior Citizen Health Insurance Policy covers hospitalization expenses, pre and post hospitalization expenses, surgery expenses and several other medical expenses.

Since senior citizens can have any health issues, insurance companies would ask them to undergo medical check-up before issuing the policy. In case there are any pre-existing diseases or any diseases identified during medical check-up, insurance company may issue policy with T&C on pre-existing diseases or even sometimes reject the policy.

Premiums under this plan are comparatively higher.

#4 – Top-up and Super Top-up Health Insurance


This is an important aspect of the health insurance plan. Generally, one can consider sum insured of say Rs 5 Lakhs or Rs 10 Lakhs. However, due to skyrocketing of hospitalization costs, the amount may not be sufficient. Here comes top-up or super top-up health insurance plans.

If you already have health insurance amounts of say Rs 5 Lakhs or 10 Lakhs, you can consider taking top up / super top up health insurance plan for Rs 50 Lakhs or 1 Crore.

In a year, if there is a claim for say Rs 5 Lakhs, this would go into basic health insurance plan. Assume there is claim for 20 lakhs, then 10 lakhs would be paid from base policy and balance amount of Rs 10 lakhs is paid through top up or super top-up policy.

Generally, claims are low for top up or super top-up policies, hence these plans comes with very low premiums. E.g. Rs 10 Lakhs to 1 Crore can come within Rs 5,000 per annum for the entire family.

In the initial phase of the career, one can consider a base policy for say 5 Lakhs or 10 lakhs. Then later add a top up or super top up plan without disturbing the base plan.  One need not buy top up or super topup policies from same insurance company. They can buy from different insurance companies too.

#5 – Critical Illness Insurance


This is a type of insurance where the sum insured would be paid in case of diagnosis of life-threatening diseases or critical illnesses.  Such critical illness would be defined in the policy document when it is bought.

Once the policy is taken, if one gets diagnosed with any critical illness specified in the policy, then they can claim the sum insured with the insurance company. One need not get hospitalized to file the claim.

The amount is pre-defined and paid accordingly irrespective of any actual hospitalization charges or pre and post hospitalization charges.

Below are some of the critical illnesses.

Cancer

Kidney Failure

Stroke

Paralysis

First Heart Attack

Bypass Surgery

Organ transplant

One need to go through the policy document and confirm what all critical illness are covered.

#6 – Mediclaim Policy


Often people think that health insurance plan and Mediclaim policies are same.

Health Insurance plan comes with hospitalization expenses as well as several other benefits. On the other hand, Mediclaim policy covers only in-patient expenses i.e. hospitalization expenses, doctor fees, oxygen charges, anesthesia nursing charges etc.,

Mediclaim policies available in India are group Mediclaim policy, individual Mediclaim policy and overseas medical insurance etc.

#7 – Personal Accident Insurance


This insurance amount is paid to the nominee in case of death of the life insured due to accident.  The number of road accidents is increasing year on year, hence there is a need for separate health insurance for accidents to protect the citizens.  Such policy would also come with add-on coverage and pay for temporary total disablement, world wide emergency, accident in-patient hospitalization etc.,

#8 – Hospital Daily Cash Benefit


Other than regular hospitalization expenses, there could be several expenses which might not be covered in regular health insurance plans like food, tea, snacks etc., Under Hospital Daily Cash benefit, the insurance company would pay a fixed daily cash benefit of Rs 500 to Rs 1,000 without any bills if the individual gets hospitalized for more than 1 week.

#9 – Disease specific health insurance plans


There are health insurance plans which are disease specific. E.g cancer care health plan, Corona Kavach health insurance plan etc., If the individual is diagnosed with these specific diseases, sum insured would be paid irrespective of the actual hospitalization expenses and pre and post hospitalization charges.

#10 – Group Health Insurance


This type of health insurance is offered to a group of people. E.g. The employer offers group health insurance to its employees. Premiums under this group health insurance is paid by the employer directly. Generally, premium under this health plan is lower as there is the large size of employees for which this plan is provided.

Understanding various health insurance plans would help you to take right insurance plans based on your life style, family medical history and various benefits provided by such plans.

Suresh KP

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