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Religare Health Insurance

In achieving our short term goals, we often tend to ignore aspects of our life which might affect it adversely in the long term. Due attention to health has to be paid, and we are here to help you plan for any future expenses pertaining to healthcare. Having a proper Health Insurance Plan will ensure you do so comfortably without undue stress and minimum financial liability.

Why Do You Need Health Insurance?

Before we look at why we need a Health Insurance, it is prudent to understand what Health Insurance is and what is the importance of health insurance? Health insurance covers any kind of medical and/or surgical expenses of an individual.

Accidents and illnesses cannot be predicted. They can happen to anyone, any time. With modern lifestyle, more and more people are leading a stressful and sedentary lifestyle. The reasons for which include workloads, improper food habits and irregular sleep patterns, resulting in a dramatic increase in lifestyle diseases. These diseases may lead to serious complications if left untreated. Health Insurance is a buffer that can protect you in such cases of medical emergencies. With the rising cost of healthcare in the country, having a good health Insurance in India is a wise decision to ensure you and your loved ones are taken care of, be it a small emergency like fever or a much bigger illness that needs prolonged hospitalisation or even an accident. Having a plan like Religare Health Insurance is a prudent way to ensure you and your family are taken care of, should the need for hospitalisation arise. Hospitalisation, without a good health insurance plan, can put a major dent in your finances with soaring hospital bills, tests and medicines, lost wages and other incidental expenses. Even a nuclear family of four can incur major healthcare costs in the form of health checkups, medicines and injury and illness treatments. An untimely health emergency can put your family finances in a tailspin. Your search for the best health insurance plans ends here.

Why Religare Health Insurance?

Zeroing in on a health insurance plan for your family is a tricky choice, given the number of insurers in the market who offer similar policies. It is not wise to simply choose the policy with the lowest amount of premium. You need to compare different policies, their features and benefits. You also have to carefully examine the fine print to compare coverage and understand exclusions. Religare offers a distinct set of benefits giving a clear choice for providing you with the best possible health insurance.

Benefits:

  • You can apply for Religare insurance online and obtain a policy in no time
  • Religare offers different family floater health insurance plans. Browse through our list of health insurance plans for family and pick a plan that is perfect for you
  • You can choose from a variety of plans to suit your specific needs like Maternity Insurance, Critical Illness insurance and Health Insurance for Senior Citizens
  • We offer the option of availing treatment at more than 5420 leading hospitals that accept our Mediclaim policy
  • If you happen to file a claim, we will attend to the request personally without any 3rd party mediation
  • Religare customer care is always ready to attend any grievances or questions you have.
  • Religare has industry best settlement ratio of 92%

Our products are designed keeping your convenience in mind. From the quick settlement of Mediclaim policies to availing treatment anywhere in the world, you ask for it, we deliver.

Key Features of Religare Health Plans

With over a decade of experience in various fields of health care, Religare provides overall excellence in health plans, making it easy for you to make the right choice.

  • Provision of comprehensive insurance for you. The coverage starts 30 days before pre-hospitalization for all diagnosis work and goes beyond discharge by covering 60 days post hospitalisation. We are always with, and we will make sure our health insurance policy gives coverage throughout, for diagnosis, hospitalisation and post-discharge. It will stand by you from the start to the time you have completely recovered.
  • Ambulance coverage is also provided through reimbursement of domestic road travel, keeping in mind that you get medical attention, especially in case of an emergency.
  • In case of in-patient hospitalisation for a minimum of 24 consecutive hours, these comprehensive health insurance plans for family or individuals pay for room rent, nursing expenses and ICU charges if any, surgeon's fee, doctor's fee, anaesthesia charges, operation theatre charges, etc. If you do not need to stay for 24 hours or more, they still cover 540+ day procedures under the Mediclaim plans for family or individuals
  • With the Lifelong Renewability feature, Religare honours their commitment to giving you the option for lifelong renewability, i.e. once enrolled, you can continue to stay covered for a lifetime, provided your insurance renewal is done from time to time. You can now renew insurance online too for your convenience.
  • Unlike some insurance providers, our plans including 'care', come with no upper age limit for enrollment. So, rest assured, Health insurance for senior citizens is provided too.
  • Avail no claim bonus of 10% annually up to a maximum of 50%
  • Conditional coverage of alternative treatments like Ayurveda, Unani, Sidha and Homeopathy
  • Automatic Recharge of Sum Insured is provided to keep your worries about medical expenses at bay by reimbursing the amount claimed by you in the financial year
  • Other key features provided by our family health insurance being the reassurance of the second opinion, Organ donor cover, Annual health checkup, domiciliary hospitalisation, ICU charges, room charges and many more
  • Our Critical Illness plan covers 32 critical diseases such as cancer, heart, surgeries etc. and also offer cashless treatment across 6000+ hospitals across the country. These plans are offered at a low premium with high coverage. They are available at easy instalment for your convenience

Types of Health insurance plans

We offer a host of Health insurance plans and services for your specific needs. To pick a plan that is most convenient for you, compare different plans, their features, benefits and premium and make your choice. The different health insurance plans offered by Religare are

  • Individual health insurance plans
  • Health insurance for senior citizens
  • Comprehensive Health insurance plan
  • Maternity Health Insurance
  • Group Health Insurance

Comprehensive Family Health Insurance – Religare Care

A family floater health insurance is the best-suited health insurance plan for the family. As the name indicates, one single policy covers the entire family (Usually, You, spouse and children and in some cases parents and parents-in-law too). A floater medical policy for the family has many advantages over having individual policies for each member of your family. In addition to the convenience of not keeping a tab on all the individual policies, as it is one single policy with umbrella cover for the entire family, you get higher sum insured at an affordable premium. In a policy year, the entire sum insured amount can be utilised by one or more members of the family.

Religare Care is one of the best family health insurance plans in India. It is a comprehensive health insurance plan that offers coverage for you and your family. The plan comes with auto-renewal feature and free check-up facility making it one of the most sought after health insurance plans in India for the family.

Key features of Religare ‘Care’ Plan that caters to family medical insurance:

  • Cashless facility across 6000+ hospital under Religare network
  • Auto Renewal Health Insurance policy. If at all you run out of your health cover due to claims made, we will auto-renew the entire Sum Insured amount of your policy
  • You can your family can avail free annual checkups
  • Religare policies support global health care treatment
  • You can obtain your policy online without the hassle of tons of paperwork

Eligibility:

  • The minimum age to enter this plan is 91 days, and there is no cap on maximum age.
  • The policy provides the option of lifelong renewal upon expiry. It can be renewed under the then available Health Insurance Product, or it's the nearest substitute that is approved by IRDA
  • The plan has a minimum waiting period of 30 days for illnesses except in case of emergencies like injuries. In the case of a pre-existing illness, the waiting period is 4 years of continuous coverage from the time of taking the plan
  • You can enhance the sum insured only at the time of renewal
  • No co-payment has to be paid if the age of the eldest member of the family at the time of taking the first policy with us is less than 61. Else, a co-pay of 20% is applicable
  • A grace period of 30 days is provided for renewal upon expiry of the family health plan
  • Coverage range from Rs.3 Lakhs to Rs.6 Crores depending on the plan

Other Benefits:

  • Pre-hospitalisation expenses of 30 days and post hospitalisation expenses of 60 days are provided
  • This plan offers tax benefit under Section 80D of the Income Tax Act
  • Up to 150%, no claim bonus can be availed for special plans
  • You can avail a discount 10% on a 3-year policy and avail a discount of 7.5% on a policy of 2 years

It provides coverage that ranges from between Rs.3 Lakhs to Rs.6 Crores

Religare health insurance has 5 different budget options for family health insurance Policy popularly called Religare Care plans. Depending upon the coverage, their family health plan is divided into 5 categories.

  1. Super saver plan(care 3) – Sum assured is up to a maximum of 4 lakh rupees
  2. Elite plan(care 4) – Sum assured is in 4 lakhs, 7 lakhs and 10 lakhs
  3. Elite Plus Plan(care 5) – Sum assured is in 15, 20, 25,30 and 40 lakhs
  4. Global plan(care 6) - Sum assured is in 50, 60, 75 lakhs
  5. Global Plus plan (care 7) – Sum assured is in 1, 2, 3 and 6 crores.

Apart from the sum assured, these plans vary with respect to Max cap allowed in categories like alternate treatments, Domiciliary hospitalisation, ICU charges and Room rent.

Maternity Health Insurance – Religare Joy

The joy of a new addition to the family is wonderful. It is a dream come true that brings an immense amount of happiness to us. But in today’s world, the cost involved during the entire journey of around 9 months of pregnancy to delivery is very high. It will be wise to obtain health insurance that covers pregnancy. While obtaining health insurance, if you are going to expect a baby in the house, shop for an insurance plan that offers pregnancy insurance too. Religare Health Insurance presents Religare Joy, a comprehensive insurance plan that covers maternity health insurance.

Religare Joy is a maternity insurance policy that provides coverage for maternity and newborn babies.

The following is the eligibility criteria for Religare Joy:

  • You need to be of at least 18 years of age to enter the policy, and the baby needs to be at least one day old to enter the policy
  • Maximum entry age to enter into this maternity health insurance is 65 years for adults, 90 days for newborn babies, and 24 years for children.
  • The exit age for the policy is lifelong
  • The policy is available under individual and family floater too
  • This maternity cover insurance comes with lifelong renewal. It can be renewed under the then existing health insurance with maternity benefits policy, or it's the nearest substitute that is approved by IRDA
  • The waiting period for Religare joy policy is 30 days for any illness except accident, 24 months for maternity joy tomorrow, 9 months for maternity joy today, 2 years for specific treatment or illness, 4 years for pre-existing conditions
  • You will have 30 days grace period to renew the policy upon expiry
  • The Policy tenure is for 3 years
  • Maternity cover is available only up to 45 years of age

Other Benefits Of This Policy

  • Tax benefits are given for all the paid premiums under section 80D
  • You can avail 15 days of free look period under this plan
  • We will also cover the medical expenses of your newborn up to a period of 90 days under your plan. After 90 days, the baby will be treated as an individual and will be covered under family floater or regular policy upon payment of extra premium
  • Pre-hospitalisation of 30 days and post-hospitalisation of 60 days is also provided under the Religare joy policy

Health Insurance for Senior Citizens – Religare Care Freedom

Your family may consist of your kids and your parents. While it is easy to procure insurance for your spouse and kids, it is relatively challenging to procure health insurance for parents. Health insurance for Senior citizens has different terms and premium once they cross the regular insurance age limit. Religare Health insurance offers Religare Care freedom plan, a premium medical insurance for senior citizens.

It provides coverage between Rs.3 Lakhs to Rs.10 Lakhs for the policy term of one, two, and three years.

Eligibility:

  • The minimum entry age to enter into Mediclaim for senior citizens is 46 years
  • There is no upper limit for maximum entry. You have lifelong eligibility to Freedom plan with variable premium, depending upon your age of entry
  • Age of proposer needs to be 18 years or above
  • Health insurance for senior citizens can be covered as individual or floater insurance
  • Freedom Care comes with lifelong renewal. It can be renewed under the then existing health insurance with Mediclaim benefits for senior citizens, or it's the nearest substitute that is approved by IRDA
  • You have a grace period of 30 days to renew your Senior citizen health insurance policy upon expiry
  • There is an initial waiting period of 30 days from any illness
  • You need to have continuous coverage of two years as a waiting period for name ailments
  • There is a waiting period of 2 years for pre-existing health conditions. You need to have continuous coverage in this period

You can get Mediclaim policy for parents with varied coverage. The Religare Care Freedom is available for coverage of 3 lakhs, 5 lakhs, 7/10 lakhs. The various sub-limits of coverage are mentioned in the below table:

Sum Insured 3 Lac 5 Lac 7 Lac / 10 Lac
Room Charges/Room Category Twin Sharing Room can be availed subject to a maximum of 1% of Sum Insured per day Twin Sharing Room can be availed Eligible Single Private Room
ICU Charges Up to 2% of Sum Insured per day No upper limit No upper limit
Co-pay 20% or 30% per claim 20% or 30% per claim 20%
If the insured individual is beyond 70 years of age the co-pay is increased by 10% per claim(optional, but mandatory for new entrants at the age)
Cataract Treatment Up to 20,000 per eye can be availed Up to 30,000 per eye can be availed. Up to 30,000 per eye can be availed.
Treatment of Total Knee Replacement Up to 80,000 per knee can be availed Up to 1,00,000 per knee can be availed Up to 1,20,000 per knee can be availed
Surgery for treatment of all types of Hernia

Hysterectomy procedure

Surgeries/treatment for Benign Prostate Hypertrophy (BPH)

Surgical treatment of renal stones.
Up to 50,000 Up to 65,000 Up to 80,000
Treatment of Cerebral-vascular and Cardiovascular conditions

Treatment/Surgeries for Cancer

Treatment of other renal complications and disorders

Treatment for breakage of bones
Up to 2,00,000 Up to 2,50,000 Up to 3,00.000

Religare provides one of the best health insurance for senior citizens.

Group Health insurance – Group Care

Religare Health Insurance also offers customised Group health insurance coverage that is tailor-made to suit the individual requirements of your organisation or group. The group insurance policy from Religare - Group Care, facilitates to safeguard the most important asset for your company and you – the employees/Customers. The key factors of the group insurance scheme are as follows:

  • Coverage at all stages of ill-health, 30 days pre-hospitalisation cover that includes diagnostic tests and 60 days post hospitalisations cover that include all expenses including of medicines.
  • Inpatient Hospitalisation that covers Room charges, Surgeon’s fee, doctors fee, nursing charges, ICU charges, Operation theatre charges, Oxygen charges, anaesthesia charges and many more.
  • More than 540-day care treatments are covered under Group Mediclaim policy that requires hospitalisation for less than 24 hours.
  • Domestic road ambulance cover in case of an emergency. Helicopter coverage if deemed fit and recommended because of the condition of the patient
  • You will have the flexibility to select sum insured amount and product mix basis – your budget
  • Expenses incurred towards critical ailments like Chemotherapy and Radiotherapy are also covered under group insurance for employees
  • Organ donor expenses are covered to a certain limit
  • Corporate Floater policies are available is optional
  • Floaters and sub-floater policies are optional
  • Cover extension outside of India is optional
  • Modification of wait period can be tailor-made
  • Variable co-pay
  • The second opinion is also covered at no extra cost to you, from a doctor arranged by us
  • Alternative treatments such as Ayurveda, Unani, and Homeopathy are also covered to a limit
  • Complementary health checkups for all Insured members can be availed
  • Coverage for outpatient treatment as well
  • The group mediclaim policy for employees has in-built maternity coverage too

In addition to all of the above, you can get a bouquet of health and wellness top- when you take up a group health insurance policy. The top-ups will include health assessment clinics, health maintenance programs, and priority access to wellness providers for insured employees as well as their families. You can opt for a flexible policy or go for a comprehensive policy. Religare offers in-house claim management services too. You being our prime priority, we partner with preferred TPA’s all well.

Coverage under Religare Health Insurance

Any insurance policy will have specific procedures when it comes to insurances claims.

Procedure for hospitalisation:

The Religare health insurance company claim policy requires you to report within 24 hours in case of immediate hospitalisation and 48 hours before in case of planned hospitalisation.

In case you want to avail cashless hospitalisation, you can collect the Religare Health Insurance claim form from the insurance desk available at the hospital and submit the filled form to us through fax or email. The outcome can be one of the following – You will get an approval letter by the claim management team, or you can get a query raised by the claim management team, or if at all your cashless hospitalisation request gets rejected you can continue your treatment and later file for expense reimbursement.

If your mode of claim is reimbursement for hospitalisations, submit policy forms along with required documents as per the policy terms and conditions. The outcome can be one of the following – Approval letter sent by the claim management team or a query with regards to the claim, or rejection of claim with reason clearly communicated. You can also avail your insurance claims for everyday Care card and for OPD care.

Religare health insurance renewal: The process for Religare health insurance renewal is very simple and quick. It can be done from the comfort of your home computer. All you have to do is enter the existing policy details, make renewal payment online and you are done. You have a grace period of 30 days to renew your health insurance.

There are some usual terms and clauses that are common along most of the policies by Religare health insurance like in-patient care, Post and pre-hospitalisation coverage, individual and family floater insurance plans, domiciliary coverage, Daily allowance, Ambulance cover, Organ donor cover, lifelong renewability, annual health checkup, no claim bonus, second opinion and health insurance tax benefit.

What is not covered under Religare Health Insurance?

Religare health insurance offers the best competitive plans in the industry. However, misuse of the plan is prohibited, and there are certain exclusions from the plan coverage, which is standard across most of the insurance providers.

The standard policy exclusions specific to Religare are:

  • As mentioned above, Religare Care plans have a wait period of a minimum of 30 days for non-critical health conditions. So any diagnosis of diseases in this 30-day period or any surgery requirement during the first 30 days of policy or occurrence of any other event, whose signs or symptoms are occurring within 30 days of policy period start date, will not be covered.
  • Religare coves more than 540 same day treatments for your convenience. However self-inflicted injuries or harm cannot be covered such as suicide attempts or suicide.
  • Your Religare medical insurance premium does not cover expenses attributable to the misuse or use or abuse of alcohol.
  • Medical expenses that are incurred for treatment of HIV / AIDS
  • Treatments that arise from or can be traceable to Pregnancy, childbirth, miscarriage, abortion and its consequences. You need to avail separate maternity insurance for this
  • Congenital diseases are not covered under Religare Health Insurance Plans
  • Tests and treatment expenses incurred for infertility and also in-vitro fertilisation
  • Hospitalisation due to war, riot, strike or nuclear weapons

Eligibility Criteria for Health Insurance

A set of rules and criteria with regards to your age and medical history must be met to be eligible for obtaining health insurance. Medical history plays the main role in determining the amount of your health insurance premium. If you are over a certain age or if you are opting for coverage greater than a certain amount, you may be required to undergo medical tests before issuing the policy. People with a history of medical conditions, diabetes, hypertension and smokers are usually charged higher health insurance premiums. Entry age also determines the amount of your health insurance premium. Older people are at a greater risk of falling sick or developing critical illnesses. Therefore health insurance premiums will be high for older people.

One can buy an Individual health insurance plan for self or Family floater health insurance policy for the self, spouse and children. In some cases, dependent parents and parents-in-law can also be included in your Family floater health insurance policy.

  • Entry age for Adults: You must be at least 18 years old and be younger than 65 years
  • Entry age for Children: 91 days to 18 years
  • Lifelong renewability is usually offered subject to clearing the medical tests

Minimum entry age is 91 days, and there is no bar on maximum entry age for health insurance plans offered by Religare. There is no upper age entry limit for all policies offered by Religare. Once you start your journey with Religare, you can be assured of continuous coverage throughout your life as long as your policy is renewed on time every year. Lifelong renewability is applicable to these policies, and the policy can be renewed under the then prevailing Health Insurance product or its closest substitute product.

Best Time To Buy Health Insurance

It is a common misconception that health insurance is for the elderly and can be obtained when you are above 50 years and above. Nothing can be farther from the truth. It is true that older people are more susceptible to cardiovascular disease and other critical illnesses. But health insurance policy offers much more. Health insurance plans cover all hospitalisations that result from any illness or accident, maternity benefits, newborn coverage and many other treatments that younger people also need.

Entry age is the major determinant in calculating your health policy premium. The premium varies based on the age of the person insured in case of individual health plans. Age of the oldest member is taken into consideration while calculating the premium for Family floater health insurance plans.

Best time for taking health insurance policy is when you are young and healthy and when the premiums are low. As a student or a young professional when you are starting your career, it is important for young people to be covered under health policy. Once a child attains an age which disqualifies him/her for Family floater policy, an individual health insurance policy must be taken for him/her. It is particularly more important for students who go abroad for studies. There are student insurance plans that offer health coverage for students studying abroad. For those young couples that are planning to start a family, health care expenses pertaining to pregnancy, childbirth and newborn care can be daunting, and they must ensure that their health insurance policy covers maternity and childbirth.

Health care costs are steadily rising, and lifestyle diseases are more prevalent now, it is critical to have health insurance from a young age. Given the long waiting time before pre-existing diseases are covered, it is certainly prudent to start out early when you are young and healthy.

Importance Of Having Health Insurance Coverage

With the rising cost of healthcare, Health insurance is a prudent way to ensure you and your loved ones are taken care of should the hospitalisation need arises. Hospitalisation either due to illness or due to an accident can put a major dent in your finances with hospital bills, cost of diagnostic tests and medicines, lost wages and other incidental expenses.

Accidents and illness can happen anytime. With the modern lifestyle, more and more people are leading a lifestyle of stressful workloads, improper food habits and irregular sleep patterns, which has resulted in a dramatic increase in so-called lifestyle diseases. These diseases require regular monitoring with the help of health checkups and can lead to life-threatening situations if left untreated. Even a nuclear family of four can incur major healthcare costs in the form of health checkups, medicines and injury and illness treatments. An untimely health emergency can put your family finances in a tailspin, and taking a health insurance policy is a must to address these concerns. Now, let us consider a few scenarios to illustrate the benefits and importance of having adequate health insurance policy.

  • Ajay, aged 45 is a businessman who travels a lot to meet his customers and distributors. One night, he complains of chest pain, is taken to nearby hospital and doctors detect clogged arteries and successfully operate on him the next day. He gets discharged within a week and is advised rest for 30 days. His hospital bill came up to INR 4 lacs which he paid out of his savings meant for his son's college education.
  • Vijay, on the other hand, is a stockbroker around the same age and has suffered a heart stroke. Admitted into the city's best hospital, he received the best possible care and did not have to pay anything out of his pocket. This was because his health insurance policy has the cashless feature and has settled directly with the hospital.
  • Ravi is an employee in Private Sector Company, and when his wife Valli gave birth to their first child, they were shocked to learn that their employer-provided group health insurance policy does not cover maternity and childbirth-related hospital expenses. Added to this, with all the expenses related to newborn care and doctor visits, Ravi is forced to take a personal loan from his employer.
  • Srikanth and Divya are recently married and want to start a family. Srikanth made sure that his health plan is upgraded to include maternity benefit. Eventually, when they had their first child, all the hospital expenses including newborn care are covered.
  • Mukesh is recently diagnosed with cancer and as his treatment costs have exceeded the sum insured value of his health insurance policy. As his policy does not have critical illness cover, after the sum insured is exhausted, his insurer stopped paying further and terminated the policy. He and his family had to sell their house to meet the cost of treatment.
  • Sukesh whose family has a history of heart disease has wisely taken critical illness policy along with his health insurance. When he was eventually hospitalised for major heart surgery, he has received a lump sum amount from his critical illness policy over and above the cost of treatment being paid by his health insurance policy.

From these scenarios, it is clear that you should consider these aspects including medical inflation and choose a health policy that has an adequate sum insured and coverage of treatments.

Choosing The Most Suitable Health Insurance For Your Needs

There are basically two types of insurance plans.

  1. Indemnity based health insurance plans - These are the most popular health insurance plans and can be offered in two variants. These plans also known as mediclaim policies cover your hospitalisation expenses. You can opt for cashless settlement with network hospitals or get reimbursed later on submission of evidence.
    • Individual Health Insurance plan - If you are a single adult, you can choose to buy an individual health plan for yourself with a specific amount of sum insured.
    • Family Floater Health Insurance plan - On the other hand, family floater health insurance policy covers the entire family in one single policy. If you are a family of four, you can opt for a single family floater policy covering all 4 members of the policy with a floating sum insured. Floating sum insured means any un-well member of the family can utilise the part or whole of sum insured in a policy year. You will end up paying a significantly lower premium under family floater policy compared to multiple individual policies and at the same affording greater sum insured. A normal family floater insurance policy covers the individual, spouse and two children.

      In some cases, you can opt for coverage of siblings, dependent parents and parents-in-law with an additional premium. Family floater health insurance policies allow the flexibility of adding or removing a family member from the policy and the premium will be accordingly adjusted. The premium for the family floater policy is determined by the oldest member of the family and the number of people in the family.

  2. Fixed benefit plans - Fixed benefit plans give fixed benefits/payouts when a certain medical event usually occurs a critical illness or an accident regardless of actual cost of treatment. Usually, these policies are taken as a supplementary cover for critical illnesses. The payout from these policies can be made even if your regular policy has covered the hospitalisation expenses. Critical illness plan is a fixed benefit plan in which a certain amount is paid out if you are diagnosed with one of the pre-listed critical illnesses. Critical illness plans aim to cover not just your treatment costs but also lost income due to the illness. Surgical benefit plans, accident insurance plans are other examples of fixed benefit plans.

Everyone must have a reimbursement based health plan in the form of either individual or family floater as basic protection and eventually depending on life stage and prior family medical history, critical care cover can be added.

Factors to Consider When Buying Health Insurance Online

There are a number of insurance companies offering health insurance policies in India and choosing the health insurance plan that is right for you and your family is tricky. Most of these health insurance plans from different companies look very similar at a high level, but you must compare the features and benefits, take time to read the fine print to understand what is covered and what is excluded etc. Let us now understand various factors that you should consider when buying a health insurance policy online.

  • Pre and Post Hospitalisation expenses (No. of days before and after hospitalisation)
  • The waiting period for pre-existing diseases (Most policies usually require a waiting period of 24 to 48 months to cover pre-existing diseases. Shorter the waiting period is better)
  • Coverage – Most policies cover surgeries, day-care procedures, ambulance charges etc. But if you are planning to start a family, you might want to consider a policy that covers maternity and childbirth. There may be waiting times for certain procedures such as cataract surgery, knee replacements etc. You should compare these waiting times to choose the right plan for your family. Some plans offer coverage for alternative treatments such as Ayurveda, Homeopathy and Unani as well.
  • Lifelong renewal: Most insurers renew their policies only up to a certain age. You should ask and compare the maximum renewal age of each policy and choose the one that offers continued coverage by guaranteed renewals in your old age when you will need it most.
  • Sum Insured – You should also compare the maximum sum insured that different policies offer and the flexibility to increase the sum insured as the costs of healthcare are continuously raising.
  • Easy Claim Settlement – You should check for the list of network hospitals in your location where the insurer offers cashless settlement for a hassle-free experience. You should also look at claim settlement ratio of different health insurance companies in India, and higher this number is better.
  • Restore and No claim Benefit - Some plans offer restoration benefit if you exhaust the sum insured in a policy year. Sum insured is automatically restored for that policy year and can be used by other family members. If there are no claims made during a policy year, some insurers offer no claim bonus in terms of increased sum insured.
  • Other benefits – Some policies offer additional benefits such as free health checkups once a year, free cash during a hospital stay, insurance for parents at additional cost etc

When choosing your family health insurance, you must keep the above factors in mind.

How to File Your Health Insurance Claim

Filing your health insurance claim is often a very simple step as most insurance companies have tie-ups with all the important hospitals across India. Insurance claims can either be cashless settlement claims or reimbursement claims.

Cashless claims: Insurance claim process is a breeze if you opt for planned hospitalisation in a network hospital. All insurance companies maintain a list of network hospitals with whom they have tie-ups to process direct settlement of claims. If you get your treatment in one of the network hospitals, you can avail of cashless settlement. If your hospitalisation is planned, then you can inform your insurer in advance to seek authorisation for your treatment, and cashless, direct settlement can be done directly with the hospital. If your hospitalisation is unplanned either due to an emergency or accident, you can inform within 24 hours of hospitalisation usually.

Reimbursement claims: Insurance claim process is a bit more cumbersome if you are seeking reimbursement. If you get treatment in a non-network hospital or if you fail to inform your insurance company in time to get a cashless claim, you will be required to first pay the hospital bill from your pocket and then submit a claim with the insurance company for reimbursement. You must fill out a health insurance claim form and attach all the documentation pertaining to your treatment such as bills, prescriptions, test reports, discharge summary etc. Claim settlement team from your insurer will work with you to process your insurance claim, and insurance claims are usually settled within 30 days.

It is important to ensure that all major hospitals in your area are included in the list of network hospitals of your prospective insurance company. You should understand claim settlement record and health insurance claim settlement ratio of different insurance companies in India and choose the one with the best record.

What Is Health Insurance Premium?

Your health insurance plan premium is a monthly or annual fee you pay to your insurance company to provide coverage for your health care and hospitalisation expenses. Health insurance premium varies from person to person and is dependent on several factors such as sum insured, age, gender, health condition, history of diseases, family size, profession and your city as well.

Similarly, insurance companies offer different health insurance plans tailored to people with different needs. Factor such as which treatments are covered, waiting times for pre-existing diseases, exclusions etc. can vary from plan to plan, and health insurance premiums are accordingly adjusted.

Religare offers several different health insurance plans aimed at people with different stages of life and different needs of health insurance. You can go to Religare health insurance website and use Religare health insurance premium calculator to obtain a free quote on your health insurance premium for different plan options. You will need to enter your age, your family composition and indicate the quantum of sum insured and tenure to get premium for different plan options.

Factors Which Affect Health Insurance Premium

There are several factors which have a bearing on how much health insurance premium you will pay. Now, let us a take a brief look at the main factors which affect the health insurance premium.

Age: Age is the main determinant of the health insurance premium that you will pay. There is a significant amount of difference between premium for a 25-year-old and a 45-year-old. Health insurance premiums are significantly lower for younger people, and they go up as you get old.

Medical History: Your medical history such as your pre-existing diseases, any hospitalisations and surgeries you may have done will play a role in determining your health insurance premium. You must declare any pre-existing diseases that you may have, and your premium may go up as a result. But after a waiting period of 24 to 48 months, your insurance will start covering those pre-existing diseases.

Occupation: Your occupation can also play a role in deciding how much premium you will pay on your health insurance policy. If you are in a high-risk profession, you may end up paying a higher premium.

Smoking and alcohol consumption habits will also have an impact on your health insurance premium. Smokers tend to pay significantly higher premiums compared to non-smokers. Finally, taxes on insurance premium will determine the final outgo from your pocket. Currently, GST on insurance premium stands at 18%.

How Much Insurance Premium Are You Paying?

As already discussed above, health insurance premium varies from person to person and can depend on various factors. Knowing how much insurance premium you will need to pay is useful when deciding upon the plan and sum insured. Religare Health insurance premium calculator is a very useful tool and lets you do exactly that. You can provide very little information about yourself and your family and can get free quotes on medical insurance premiums for different insurance policies. Here's how you can get free quotes for health insurance premiums using Religare Health insurance premium calculator.

  • You can visit Religare Health Insurance website to access the Religare Health insurance premium calculator
  • You should enter family composition, number of adults and number of children
  • You should enter the age of the oldest member of the family
  • You should choose the tenure which is usually 1 year. But if you opt for 2 years or 3-year tenure, you can get a discount up to 10% on your mediclaim insurance premium
  • Finally, you enter your mobile number so that in case you need any assistance or clarification, an associate can reach you
  • Your health insurance premium inclusive of GST for different plan options is displayed

Save Tax On Health Insurance Premium

There are income tax benefits when you buy a health insurance policy. You can save tax by claiming deduction under section 80 D of the Income Tax Act on the amount of health insurance premium paid towards your health insurance policy subject to certain limitations. Now, let us take a look at how you can qualify to save tax and the limits under section 80 D of the Income Tax Act.

  • You can save income tax by claiming a tax deduction up to INR 25,000 if you are below 60 years of age and up to INR 30,000 if you are above 60 years of age.
  • You can claim deduction up to INR 5000 per year spent towards annual preventive health checkups.
  • Additionally, you can also avail an additional deduction up to INR 30,000 if you have paid a premium for a health insurance policy for your either of your parents.
  • Health insurance premium paid only by way of banking channels are allowed for deduction, and a cash payment of premium is not allowed.
  • Premium payments are considered for a financial year, and if you have a family floater health insurance policy, the premium paid towards health insurance for you, your spouse, dependent children are allowed.

You should consult your tax consultant or auditor for determining the actual eligibility and deduction amount under section 80D of the Income Tax Act.

Health Insurance Portability

As pre-existing conditions are covered after a certain waiting period, health insurance portability is very critical. Health insurance portability means that your seniority, waiting period you have served will remain intact even if you switch the health insurance plan or even insurance provider itself. IRDA has provided certain guidelines regarding the portability of health insurance policies across different providers to safeguard the interests of the policyholders.

  • If you are not satisfied with your health insurance provider, you can choose a different insurance company and opt for a different plan
  • You will not lose the waiting period you have served for coverage of pre-existing conditions, and your new insurance provider must give credit for the same. To illustrate, if you have already served two years waiting period on your old health insurance policy and if the new provider has a waiting period of three years, then you will only need to serve 1 year waiting period before your pre-existing conditions are covered.
  • The insurers must acknowledge all porting requests within three working days

Waiting Period For Getting Health Insurance Coverage

When you buy a health insurance policy for the first time, there is a certain waiting period before insurance coverage kicks in for different treatments. It is important to understand these waiting periods and how they affect the coverage and plan accordingly.

  • There is usually a 30 day waiting period on any type of treatment. Treatment or hospitalisation due to an emergency such as accidents is an exception to this waiting period
  • The waiting period for pre-existing diseases - Most insurers require you to wait a period of 24 to 48 months depending on the plan you choose before insurance coverage for your pre-existing conditions is initiated. It is important to give true declaration of your pre-existing conditions and serve the waiting period. Otherwise, if any pre-existing condition is later discovered, your health insurance policy may be cancelled
  • Certain procedures like cataract surgeries, joint replacements, hernia operations, hysterectomy are not covered in the first two policy years

Important Documents Required To File For Health Insurance Reimbursement

In case if you get your treatment in a hospital that is not listed under the list of network hospitals maintained by the insurance company, then you will be required to pay the hospital bill yourself and file a claim for the reimbursement later. A member of either in-house claim settlement team or third party administrator(TPA) will work with you to process your insurance claim. We take a look at the list of important documents that must be submitted for speedy processing of your insurance claim.

  • You must submit a duly filled and signed the claim form
  • Doctor's prescription advising hospital admission
  • Hospital discharge report duly signed by the doctor
  • Final hospital bill and payment receipt
  • Medical lab reports and diagnostic test reports if any
  • Pharmacy bills with doctor's prescription
  • Any other bills for expenses related to the treatment

How To Avail Cashless Health Insurance

All health insurance companies offer cashless health insurance claim facility to their customers subject to some conditions. Insurance companies maintain a list of hospitals across the country with whom they have a tie-up for cashless claim settlement. You are eligible to get cashless insurance if you get your treatment in a network hospital.

  • If your hospitalisation is planned then you can inform your insurer in advance to seek authorisation for your treatment, and cashless, direct settlement can be done directly with the hospital.
  • If your hospitalisation is unplanned either due to an emergency or accident, you can inform within 24 hours of hospitalisation usually.

You and other members of your family who are on the policy are issued separate cashless health cards by the insurance company. You can simply approach the insurance desk in the hospital along with your cashless health card, investigative reports and doctors treatment recommendation. The hospital will then contact the insurance company to seek authorisation for the treatment.

Claim Settlement Ratio Explained

Health insurance claim settlement ratio is an important metric that must be considered before choosing the best insurance company. Claim settlement ratio indicates a number of insurance claims settled by an insurance company over the total number of claims received in a period of time. Higher claim settlement ration indicates a better track record of the company in settling the claims.

Claim settlement ratio =

Number of claims settled in a year
----------------------------------------- X 100
Number of claims received in a year

It does help to choose a company with the best claim settlement ratio in health insurance. However, higher claim settlement ratio does not guarantee that your insurance claim is automatically settled. Your insurance claim will be settled subject to the terms and conditions of your health insurance policy such as sum insured, waiting period, inclusions and exclusions.

Frequently Asked Questions

Are tax benefits or deductions available on health insurance plans?
Is GST applicable to premium payments?
What should I do if I have lost my original health insurance policy?
What is Co-payment? What are deductibles?
What is meant by ‘restoration’ or ‘reinstatement’ of sum assured?
What is domiciliary hospitalisation?
Can I claim insurance for Homeopathy treatments?
Can I get a refund of the premium if I do not make a claim during the policy period?
Can a person have more than one health policy?
What is the maximum number of claims allowed over a year?
Who is a health TPA?
Is cashless facility available across all hospitals?
How do I buy medical insurance for a diabetic patient?
Is Ayurvedic treatment covered in health insurance?

Call:1800-102-4488|1860-500-4488

Disclaimer: For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale.

UIN: IRDAI/HLT/RHI/P-H/V.II/253/16-17. UAN2: 18032484.

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