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Individual Health Insurance Policy

Individual health insurance is a popular pick among those looking for a broad range of highly flexible and cost-effective insurance policies. Depending on the plan that has been selected, the coverage for individual health insurance can sometimes be extended to the family of the individual availing the policy as well. Read on to find out why it might be appropriate for you to consider individual health insurance over all the other options available in the market.

Super Saver

Care 3 ( 4 Lac )

Elite

Care 4 (5,7,10 Lacs)

Elite Plus

Care 5 (15,20,25,30,40 Lacs)

Global

Care 6 (50,60,75 Lacs)

Global Plus

Care 7 (1,2,3,6 Cr)

Features/ Plan (SI) Care 3 ( 4 Lac )
Super Saver
Care 4 (5,7,10 Lacs)
Elite
Deductible in policy period Yes, Rs.10,000 No deductible
In patient hospitalization Upto Sum Insured Upto Sum Insured
Pre-hospitalization 30 days 30 days
Post-hospitalization 60 days 60 days
Day Care Treatments Yes Yes
Room Rent 1% of SI per day Single Private Room
ICU charges 2% of SI per day No Sub-Limit
Ambulance Cover Rs.1,500/ hospitalization Rs.2,000/ hospitalization
Daily Allowance Rs.500/ day upto 5 days -
Domicilliary hospitalization Upto 10% of SI Upto 10% of SI
Health Check-up Yes, all members Yes, all members
Recharge of SI Yes Yes
No Claim Bonus Yes Yes
Organ Donor Cover Rs.50,000 Rs.100,000
Second opinion Yes Yes
Alternative Treatments Upto 15,000 Upto 20,000
Features/ Plan (SI) Care 4 (5,7,10 Lacs)
Elite
Care 5 (15,20,25,30,40 Lacs)
Elite Plus
In patient hospitalization Upto Sum Insured Upto Sum Insured
Pre-hospitalization 30 days 30 days
Post-hospitalization 60 days 60 days
Day Care Treatments Yes Yes
Room Rent Single Private Room Single Private Room
(upgradable to next level)
ICU charges No Limit No Limit
Ambulance Cover Rs.2,000/ hospitalization Rs.2,500/ hospitalization
Domicilliary hospitalization Upto 10% of SI Upto 10% of SI
Health Check-up Yes, all members Yes, all members
Recharge of SI Yes Yes
No Claim Bonus Yes Yes
Organ Donor Cover Rs.100,000 Rs.200,000
Second opinion Yes Yes
Alternative Treatments Upto Rs.20,000 Upto Rs.30,000
Features/ Plan (SI) Care 5 (15,20,25,30,40 Lacs)
Elite Plus
Care 6 (50,60,75 Lacs)
Global
In patient hospitalization Upto Sum Insured Upto Sum Insured
Pre-hospitalization 30 days 30 days
Post-hospitalization 60 days 60 days
Day Care Treatments Yes Yes
Room Rent Single Private Room
(upgradable to next level)
Single Private Room
(upgradable to next level)
ICU charges No Limit No Limit
Ambulance Cover Rs.2,500/ hospitalization Rs.3,000/ hospitalization
Domicilliary hospitalization Upto 10% of SI Upto 10% of SI
Health Check-up Yes, all members Yes, all members
Recharge of SI Yes Yes
No Claim Bonus Yes Yes
Organ Donor Cover Rs.200,000 Rs.300,000
Second opinion Yes Yes
Alternative Treatments Upto Rs.30,000 Upto Rs.40,000
Care Anywhere - Yes
Maternity Cover - Upto 100,000
Features/ Plan (SI) Care 6 (50,60,75 Lacs)
Global
Care 7 (1,2,3,6 Cr)
Global Plus
In patient hospitalization Upto SI Upto SI
Pre-hospitalization Upto SI ,30 days Upto SI , 30 days
Post-hospitalization Upto SI ,60 days Upto SI , 60 days
Day Care Treatments Upto SI Upto SI
Room Rent Single Private Room
(upgradable to next level)
Single Private Room
(upgradable to next level)
ICU charges No Limit
Ambulance Cover Rs.3,000/ hospitalization Rs.3,000/ hospitalization
Domicilliary hospitalization Upto 10% of SI Upto 10% of SI
Health Check-up Yes, all members Yes, all members
Recharge of SI Yes, Up to SI (Once in a Policy Year) Yes, Up to SI (Once in a Policy Year)
No Claim Bonus Yes Yes
Organ Donor Cover Rs.300,000 Rs.500,000
Second opinion Yes Yes
Alternative Treatments Upto Rs.40,000 Upto Rs.50,000
Care Anywhere Yes Yes
Maternity Cover Upto 100,000 Upto 200,000
Vaccination Cover Yes, Upto Rs. 10,000
Global Coverage: (excluding USA) Coverage outside India & USA - 45 continuous days in a single trip; Max. 90 days on a cumulative basis, in a Policy Year Up to SI for Hospitalization Expenses & up to the limit specified under `Maternity Cover` towards Maternity expenses; With a 10% co-payment per Claim
Special Add on cover:
Global Coverage - Total Geographical scope of Benefit `Global Coverage (excluding USA)` is extended to USA also Up to SI for Hospitalization Expenses & up to the limit specified under `Maternity Cover` towards Maternity expenses; With a 10% co-payment per Claim

Features of Individual Health Insurance

Here are a few features to consider while purchasing a personal health insurance policy:

  • Cost Effectiveness: The premium to be paid in an individual health insurance plan is lower as compared to that in a family floater cover. The premium is based on the age of the individual whereas in a family floater, it is dependent on the age and medical condition of the eldest member.

  • An additional coverage of INR 20,000 to 30,000 is extended to alternative treatments above the standard cover provided for hospitalization-related charges.

  • There is no maximum age bar for those intending to purchase this policy.

  • If the insured amount is below 15 lakhs or the individual is below the age of 45, he/she is not required to undergo any kind of medical test.

  • Our Individual Health Insurance plan has a provision for organ donor cover of ₹1,00,000, unlimited coverage of ICU charges, and free health check-ups.

  • Under Section 80D of the Income Tax Act, one can avail tax benefits on the premium paid.

How does Individual Health Insurance work?

As the name suggests, personal health insurance or individual insurance can only be associated with a single person. The premium for each person is based on their age and the sum insured. This policy is quite beneficial in the case of extended families with massive disparities in age. The premiums might be higher than a family policy, but insurers often give a 10% discount if more than one member of the family gets insured simultaneously.
In case of any claims made by one individual in a family, the sum insured for others is not affected. Only the person in whose name the health insurance exists can claim the full benefits of the policy.

Individual health insurance vs. family floater cover

While individual health insurance has innumerable benefits, family floater cover might be a better option in certain circumstances. Here are a few differences to consider before picking either of the plans:

  • Sum Insured: In a family floater plan, the entire family is insured under a single sum. The entirety of the amount can be availed by one individual or the whole family. The amount will keep reducing as each member makes a claim. Under medical insurance plans for individuals, the sum insured for each member remains intact when a claim is made by one member.

  • Premium: In the case of a family floater plan, the premium is entirely dependent on the age of the oldest member in the plan. As for individual policies the premium is dependent on the age of the individual. Family floater plans are a comparatively more affordable option, the differences in premium can be as high as 20% when compared to an individual policy. If you have a younger family, then floater plans are a good option. If there are elder members present and are already suffering from ailments, then an individual policy might be the better alternative.

  • Coverage: As compared to an individual policy, in a family floater plan the coverage is extended to the insured members of the family as well. Although additions are limited, there are certain policies that allow you to add extended family members.

There are certain drawbacks in family floater plans such as:

  • Insurers offer renewals up to a certain age and if a senior member of the plan breaches the age limit, none of the other members can take advantage of the policy.

  • If children are covered and they migrate to individual plans, they will fail to take benefits of the credit for the waiting periods.

  • If the claim on a family floater plan is made by even one individual, the No-Claim Bonus (NCB) gets nullified.

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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