Health Insurance Plans
Buy/Renew your health insurance policy with Niva Bupa, and discover the enticing realm of medical insurance in India by safeguarding your well-being, enjoying tax benefits, a network of 10,000+ cashless hospitalisation, no claim bonus, co-payment and financial shelter.
Start your health cover with Niva Bupa today!
What is a Health Insurance Policy ?
A health insurance policy offers vital financial security against unforeseen medical expenses. It serves as an agreement between you and your insurance provider, assuring that the latter will provide financial assistance in case of a medical emergency. Like any wise investment, a health plan safeguards your hard-earned resources and requires ongoing contributions to maintain coverage. Recognising your unique needs, insurance companies offer a diverse range of health programmes in India, ensuring personalised solutions to your specific requirements.
As a wise customer:
- Free yourself from exorbitant medical expenses by selecting the finest health plan for you and your family.
- You will not only cover your medical bills with a health insurance policy but also enjoy the convenience of cashless treatment at our extensive hospital network.
- Embrace a future without worrying about medical costs by investing wisely in a health insurance policy for yourself and your loved ones.
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Key Benefits of Health Insurance Plans in India
There are several benefits one can enjoy while purchasing the best health insurance in India.
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Cashless Medical Treatment
In the sector of best health insurance in India, each insurer hospitals nationwide. So, if you find yourself admitted to any of these esteemed partnerships with a vast network of empanelled hospitals,you can bid farewell to worries about payment. Simply present your policy number, and your insurer and the hospital will shoulder all your expenses. Cashless claims reign supreme in health insurance policies, owing to their seamless process that eliminates hassles related to claim disbursement and tedious documentation.
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Post and Pre-Hospitalisation Coverage
Best health insurance in India goes beyond merely covering hospitalisation expenses, providing clients with comprehensive coverage. Today, traditional health plans extend their reach to include pre and post-hospitalisation expenses, ensuring a holistic approach to healthcare. Moreover, these plans offer benefits like medication costs, doctor consultations, ambulance charges, and much more, ensuring that individuals are safeguarded against various healthcare expenses.
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No Claim Bonus
Best health insurance in India gives policyholders an enticing perk known as a "no-claim bonus." This bonus rewards individuals who haven't made any claims during the previous year by offering them a discount on their premiums or an increase in their coverage. Upon renewing the policy, policyholders can take advantage of this appealing no-claim bonus, ensuring they are recognised and rewarded for their healthy track record.
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Medical Checkup Facility
Choosing the best health insurance in India that aligns with your needs not only grants you coverage when required but also opens the door to regular medical check-ups. In addition, as a valuable inclusion within your health plan, insurers understand the significance of proactive healthcare and provide this facility to ensure your well-being remains a top priority.
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Co-Payment
Co-payment is a valuable benefit offered by health insurance plans that helps individuals manage their medical expenses. With co-payment, policyholders must pay a fixed, predetermined amount out of pocket for specific healthcare services while the insurance company covers the remaining costs. This feature of the best health insurance plans in India ensures that individuals have affordable access to necessary medical treatments, consultations, or prescription drugs, promoting timely healthcare utilisation and reducing financial burden.
Family Health Insurance Plans
Discover our family health insurance plans that offer all-encompassing coverage for hospitalisation.
Reasons For Buying Health Insurance Plan
The top reasons to consider buying a health insurance plan:
Beating Medical Inflation:
Medical costs are rising due to technological advancements and treatment quality. However, health insurance provides coverage that ensures affordable healthcare without worrying about increasing medical expenses.
Safeguarding Your Wealth with a Health Insurance Policy:
Paying for hospitalisation out of your savings can leave a significant financial burden. Health insurance protects your money and assets, requiring only a small premium per policy period.
Protecting Your Family:
Ensure the well-being of your entire household by purchasing health insurance that covers every family member. Use the benefits to fulfil the medical needs of each individual.
Tax Benefits:
Medical insurance or health insurance policy premiums are tax-deductible under Section 80D, reducing your overall tax liability.
Individual Health Insurance Plans
Explore our range of individual health insurance plans that offer comprehensive coverage for hospitalisation.
How to Buy Health/ Medical Insurance Policy Online?
You can buy health policies online with Niva Bupa. Compare medical policies and get access to benefits like cashless hospitalisation, medical expense cover & more. Prior to now, health insurance businesses in India had to invest in infrastructure and enlist the aid of several brokers, agents, and financial advisers in order to offer health insurance plans. The process was laborious, time-consuming, and involved mountains of paperwork.
But in the current digital era, obtaining a health insurance plan is virtually as simple as ordering a pizza. The internet can offer you a plethora of knowledge about different health insurance plans, their features, and advantages, as well as quick and easy instructions on how to purchase a health insurance plan online.
With very little paperwork and middlemen, the process has developed into one that is incredibly transparent, efficient, and cost-effective. The only remaining query is how to submit an application for an Indian health insurance plan?
1
🔎Discover a World of Insurance Options
Uncover a treasure trove of valuable insights about various health insurance policy providers right at your fingertips. Explore and compare all the available choices on multiple comparison portals tailored to your preferences, including premiums, coverage types, and more.
2
🌐Delve into Plan Details
After narrowing your options to a few promising health insurance plans, dive into the details by visiting the respective insurance provider's website. Arm yourself with the knowledge and understanding to make an informed decision. Access brochures and policy wordings for all Niva Bupa health insurance plans directly on our website.
3
📃Securely Provide KYC Details
When applying for health insurance policy online, provide your identity details and documents through the insurance provider's website. Avoid third-party websites to maintain security and peace of mind.
4
📑Uncover the Fine Print
Read the terms and conditions meticulously, paying close attention to exclusions and riders. Note vital factors such as premiums, sum insured, waiting periods, claim settlement processes, inclusions and exclusions, flexibility, renewal clauses, and additional benefits.
5
🛒Seal the Deal
Once you've selected your ideal plan and determined the desired sum insured, take the next step and effortlessly pay through the secure payment gateways on the insurer's website.
Health Insurance Policies for Large Family
Here are our health plans which provide comprehensive hospitalisation coverage to extended and large families.
Get a Health Insurance plan today!
Things to Consider Before Buying Health Insurance Policy in India
Choosing the right health insurance policy requires careful consideration in the vast landscape of best health insurance in India. Here are some major points to keep in mind:
- Sufficient Coverage: Ensure the policy you choose provides adequate coverage for yourself and your entire family.
- Individual Plans Matter: While employer-provided group health insurance is common, reviewing individual plans and their terms is beneficial to make an informed decision.
- Seek Additional Compensation: Add supplementary coverage such as hospital cash and critical illness benefits to compensate for non-payable losses.
- Update Existing Conditions: Keep your health insurer informed about any existing medical conditions to ensure seamless coverage.
- Understand Terms and Conditions: Familiarise yourself with the details of your health insurance, including deductibles, waiting periods, cumulative incentives, and pre-existing sickness provisions.
- Opt for High Sum Coverage: Given the rising medical costs, selecting a policy with a high sum coverage is advisable.
- Timely Renewal: Avoid gaps in coverage by renewing your health insurance policy promptly to maintain its benefits.
- Early Purchase Advantage: Secure health insurance early to enjoy a higher level of coverage while keeping your premiums affordable.
With these factors in mind, you can make an informed decision when choosing the best health insurance plan for your needs.
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Features You Should Know About
The below-mentioned features ensure that health insurance policies provide comprehensive coverage for various medical needs while considering factors like waiting periods, co-payments, and additional riders.
- Comprehensive Hospitalization Coverage: Medical expenses for in-patient care and hospitalisation are covered.
- Pre and Post-Hospitalization Coverage: Expenses incurred before and after hospitalisation for a specified number of days are included.
- Room Rent and ICU Charges: Coverage for hospital room rent and ICU charges, with or without sub-limits.
- Home Medical Treatment: Coverage for medical treatment at home when hospital beds are unavailable.
- Day Care Treatment: Coverage for outpatient department treatments, ENT, dental procedures, and other specified procedures.
- Cashless Health Check-ups and Diagnostic Tests: Convenience of cashless transactions for health check-ups and diagnostic tests.
- Emergency Ambulance Coverage: Coverage for emergency ambulance costs.
- Organ Donor Treatment: In-patient treatment related to organ harvesting for organ donors.
- Permanent Exclusions: Pre-specified list of diseases and medical conditions not covered by the policy.
- Waiting Periods: Waiting periods vary, with accident treatments typically having no waiting period and other treatments having a 30-day waiting period. Pre-existing conditions may have a longer waiting period of 2-6 years.
- Co-payment and Deductibles: Insurers offer options for co-payment percentages and deductible amounts, which can lower the premium. However, the deductible or co-payment must be paid out of pocket when making a claim.
- Additional Riders: Additional riders for special medical needs, such as critical illness coverage and hospital cash, can be purchased with an extra premium.
Plans For specific Needs
Niva Bupa (formerly known as Max Bupa) health insurance plans which takes away the financial pain of an accident or critical illness.
Choosing the Right Medical Insurance Plan
Variable | Consideration |
---|---|
Coverage | Evaluate the coverage provided by multiple plans and select or choose the one that reasonably meets your needs. |
Sum Assured | Take into account medical expenses when choosing the sum assured. Choose a sensible amount that ensures you are neither overinsured nor underinsured. Consider affordability as well. |
Hospital Coverage | Verify the insurer's extensive network of hospitals that accept cashless hospitalisation. |
Floater Over Individual Policy | If you need health coverage for your family, choose a family plan instead of individual policies. It can be more cost-effective. |
Lifetime Renewability | Opt for a health insurance policy with lifetime renewability to ensure coverage as you age |
Types of Health Insurance Plans in India
The below-mentioned features ensure that health insurance policies provide comprehensive coverage for various medical needs while considering factors like waiting periods, co-payments, and additional riders.
Individual Health Insurance Plans
As the name suggests, an individual health insurance policy provides coverage to an individual during medical emergencies, as stated in the policy wordings of the plan.
Note: The sum assured of the policy is directly dependent on the age, health and income level of the insured individual.
Family Floater Health Insurance Plans
A family floater policy is specially designed to cover the needs of your entire family. Most importantly, a family floater policy is significantly cost-effective and hassle-free when compared to an individual policy as it saves a lot of time, effort and money. Plans such as Niva Bupa's Heartbeat plan can even cover 19 relationships under a single policy.
Note: Keep in mind that the premium of a family floater policy is heavily dependant on the age of the oldest family member covered under the plan.
Senior Citizen Health Insurance Plans
As you age, health issues become more common, and consequentially, treatments also tend to get complicated and expensive. Thus, these health insurance plans are specifically designed, keeping in mind the needs of senior citizens. The insurer may also introduce a co-payment clause in the policy contract for senior citizens as these plans tend to be more expensive since senior citizens are more susceptible to health issues.
Note: Anyone above the age of 65 can opt for such a cover.
What is Covered in Health Insurance Plans?
Eager to know what's covered under your health insurance? We've got all the answers! Here are the guaranteed inclusions and exclusions in a standard health insurance policy. While this list gives you an idea, it's essential to double-check with your provider and carefully read your policy documents for complete clarity.
- Inpatient hospitalisation
- Pre and post-hospitalisation care
- Daycare procedures
- Ambulance charges
Health Insurance Inclusions:
- Inpatient hospitalization
- Pre and post-hospitalization care
- Day care procedures
- Ambulance charges
- Covid-19 coverage
Health Insurance Exclusions
- Dental treatment (unless cancer/ acute trauma relate).
- Purchase of external devices like spectacles, hearing aid, artificial limbs, crutches, artificial teeth, veneers, are all excluded.
- Instances of self-inflicted injury are not covered by a health insurance policy.
- Any type of cosmetic surgery such as plastic surgery or botox, are excluded. Exceptions include surgery for burns or accidental bodily injuries or surgeries for the treatment of cancer.
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Want to know more about buying health insurance online
Go to www.nivabupa.com or call 1860-500-1000 to find out moreWellness Plans
Top Up Plans
Understand Eligibility for Health Insurance
Eligibility for a medical insurance policy is determined based on the following criteria:
Age:
Typically, the entry age for the insured ranges from 18 to 65 years, but it can extend to 70 years in some cases. Children aged 16 days to 18 years can also be covered, and there may be provisions for newborn and post-natal care.
Tests:
Some insurers may require favourable medical test results, including routine blood and urine tests, as well as tests related to major organs. Applicants below the age of 45 generally do not need to undergo medical tests.
Medical Condition:
Pre-existing health conditions must be disclosed during the application process. This disclosure may trigger a waiting period and can affect the calculation of the premium.
Ensure you meet the eligibility criteria specified above to avail the benefits of a medical insurance policy.
Save Tax with a Medical Insurance Policy
Maximize your savings with the power of a health insurance policy. In accordance with section 80D of the Income Tax Act, individuals and HUFs can enjoy deductions on medical insurance premiums paid. Here's how it works:
- For self, spouse, and dependent children, claim a deduction of ₹25,000.
- For parents who are not senior citizens, claim an additional deduction of ₹25,000.
- For senior citizen parents, boost your deduction to ₹50,000.
- If both you and your spouse are senior citizens, enjoy a combined deduction of ₹50,000.
That's not all! Eligible expenses for deductions include not only the premium but also preventive health check-ups, medical expenditure on uncovered senior citizen health insurance, and contributions to the government or notified health insurance schemes
Health Insurance Portability
Does Health Insurance Cover Covid-19?
Health Insurance Claims
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Discover the nearest network hospital through the Niva Bupa Health app for seamless cashless claims.
- Get your health insurance forms from the hospital, complete them, and submit them back. Required documents may include your policy number, photo ID, and other proofs.
- ● When we receive your documents, our internal claims committee will assess your claims based on treatment, documents, and coverage of the health insurance policy. In the rare event of rejection, you can appeal to our grievance team for a thorough review.
- Once your claims are approved, enjoy medical treatment without any upfront payments to the hospital, except for consumables or specific items/procedures mentioned in the exclusions charter.
- Upon discharge, we will carefully review your discharge summary and documents before processing the claim. Stay informed about your claim's progress at every stage through the Niva Bupa website. Rest assured, Niva Bupa aims to process cashless claims in 30 minutes or less, providing swift assistance.
Health Insurance Myths
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Let's bust these myths about best health insurance plans in India once and for all:
Myth 1: Health insurance is unnecessary for the young and healthy.
➔ Reality: Waiting until you're older to get health insurance can lead to higher costs and potential exclusions. Buying insurance while you're young ensures lower premiums and the opportunity to build up a substantial sum insured.
Myth 2: Health insurance covers all healthcare costs.
➔ Reality: While most insurance companies do cover a wide range of healthcare costs, there can still be exclusions and limitations. These may include war-related medical emergencies, self-inflicted injuries, and more. Understanding your policy's exclusions is vital to avoid surprises.
Myth 3: Group coverage eliminates the need for an individual health insurance plan.
➔ Reality: Group health insurance often provides limited coverage and a smaller sum insured compared to individual plans. Depending solely on a group policy can leave you and your family underinsured.
Health Insurance Terms
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Understanding insurance terms is vital before selecting a policy. Explore the language of health insurance to make informed decisions.
Insurance Term | About the Term |
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Room Rent Limits | A cap on the amount a policyholder can claim per day for room rent linked to the Sum Insured. |
Sub-limits | Coverage limits for specific conditions or costs, such as surgical fees or doctors' fees. |
Co-Payment | The percentage of the claim money that the policyholder pays while the insurer covers the rest. |
Deductible | The initial or primary amount the policyholder must pay before the insurer starts covering the claim. |
How to Calculate Health Insurance Premiums?
Calculate health insurance premiums easily and accurately using a premium calculator, a convenient tool from top insurers and third-party websites.
Simply input your age, family size, respective ages, location, and desired sum assured into the calculator to obtain an estimated premium amount. Location is considered due to potential variations in premiums between metro and non-metro areas.
Alternatively, you can visit the insurance company's website and provide details such as the number of members, their ages, desired sum assured, and personal information to request an online quote. Some websites may also inquire about pre-existing conditions and lifestyle habits to ensure a more precise premium estimate.
● Note: While the premium amount is important, it should not be the sole criterion for selecting a policy. Instead, considering the extent of coverage, special features, and exclusions is equally crucial.
Factors Affecting Health Insurance Premiums in India
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Below mentioned factors play a crucial role in determining health insurance premiums. By understanding their impact, you can make well-thought-of decisions regarding your coverage.
Factors | All About the Factors |
---|---|
Age | One's age is a significant factor influencing health insurance premiums, with costs increasing as you grow older. |
Pre-existing illness | Any pre-existing health conditions can lead to higher premium costs. Opting for insurance before developing such illnesses helps avoid elevated premiums. |
Family history | A family history of chronic illnesses like diabetes, cancer, or stroke may increase insurance premiums due to increased risk. |
City of residence | The city or tier of the residence can impact premium costs, with Tier 1 or metropolitan cities generally having higher medical expenses. |
Body mass index (BMI) | Individuals with a high BMI may have to pay higher premiums due to the increased risk of chronic illnesses associated with weight-related conditions. |
Smoking and drinking | Smokers and chronic drinkers are considered a higher risk, leading to elevated insurance premiums. In addition, such habits increase the likelihood of severe respiratory and liver diseases. |
Documentation Required
In cashless hospitalisation, the network hospital directly sends documents to the insurer. You must submit specific documents for reimbursement that the insurer will review before approving your claim. These include:
- Completed and signed claim form
- Discharge certificate from the hospital
- Doctor's consultation notes and receipts
- Hospital bills with proper stamps and signatures
- Reports and diagnostics including X-ray films, blood tests, urine tests, etc.
- Invoices for medications and any other relevant treatment documents.
Why Should One Buy a Health Plan at an Early Age?
The advantages of purchasing the best health insurance plans in India at a young age are:
- Lower premiums due to the policyholder's younger age.
- Early protection with health coverage ensures you are safeguarded from potential risks.
- Reduced likelihood of pre-existing diseases as they tend to develop with age. If you have pre-existing conditions, the waiting period will be over while you are young.
- Longer duration for claiming tax deductions on health insurance premiums.
Compare Health Insurance Plans Online
You can now easily compare top health insurance plans online:
- Visit the official websites of specific insurers to compare their policies using the provided compare option. Alternatively, explore insurance aggregator websites and apps for comparing health insurance policies from multiple insurers.
- After determining your desired sum assured, compare premiums from different insurers. Evaluate their features, coverage, exclusions, network hospitals, and terms and conditions. Additionally, research the insurer's reputation and claim settlement ratio before making a purchase.
Who are Third Party Administrators in Health Insurance?
When it comes to purchasing a health insurance policy, third-party administrators (TPA) hold significant influence over your experience. They are the crucial agencies you'll directly interact with when making claims. So, if you're planning to secure a health insurance policy soon, the TPAs will play a vital role in your journey.
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TPA
The third-party administrator, or the TPA, is not an employee of any health insurance company but an independent and separate entity that acts as the bridge between you and your insurance provider. The TPA is licensed by the IRDAI to execute this task for insurers across categories, and not just for players engaged in health insurance. It can be an individual, an agency or could be a company that is retained by the insurer to perform several administrative services such as managing customer services on its behalf. Typically, it receives a fee of 5.5% of the premium amount. However, for the customer, the services provided by the third-party administrator are for free – there is no hidden cost in the contract.
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Scope Of Work for a TPA
The tasks that make TPA a key cog in your relationship with your health insurance provider is primarily customer service. This includes claims processing which makes it necessary for you to interact with a TPA. Insurers across verticals, including health insurance companies, outsource their claims process (a portion of it or entirely) to a TPA of their choice. In the case of health insurance-related claims though, the third-party administrator also coordinates with the network hospital or any other hospital where the policyholder has undergone treatment before filing their claim. In India, many health insurance companies have their own dedicated departments for claims processing. For instance, NivaBupa health insurance processes your claims without any TPA, which significantly reduces the time taken to process your claims.
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Role/Importance Of TPA
While some of the functions of the third-party administrator have been touched upon earlier, let's get into further details for a better insight. Broadly, the TPA is supposed to- Promote cashless facilities Provide customer service Process claims
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Customer Service
The work of the third-party administrator – vis-à-vis you – begins the day the policy is sold to you,i.e. when you enter your health insurance provider’s database. Any service of your’s which is due, is now the responsibility of the TPA. Some of these services include- delivery of the health/identity card, attending to your grievances if any and of course, settling claims. The TPA streamlines costs and services and keeps you posted on network hospitals and addresses any concern that you may have. The TPA also makes payments to the hospital (in the case of non-cashless cases) and aids the reimbursement process with the help of your provider.
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Cashless Service
The TPA is also responsible for building the network of hospitals for the health insurance company. In the process, it brings the cashless facility to you as the insured. It takes the call on empanelling a hospital-based on its service track record, infrastructure and facilities, management background and IT infrastructure.
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Claims Processing
This is the role that the TPA is most known for. It coordinates with the hospitals for claim settlements, verifies bills for treatments, checks for false claims and even settles payments with hospitals in case of cashless facilities.
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IRDAI Amendments
Until recently, a policyholder had to accept any third-party administrator their health insurance provider chose. This changed on December 3, 2019, when the IRDAI announced amended regulations giving customers the right to choose a TPA from the list suggested by their health insurance provider. To be precise, “The policyholder can choose a TPA of their choice from amongst the TPAs engaged by the insurer” as stated in the notification on the website. Keep in mind though that as a policyholder, you can only choose the TPA from the list suggested at the time of buying or renewing the policy. If you do not choose any of the suggested TPAs, then the health insurance company can allot you a TPA of its own choice. IRDAI also allows the health insurance company to limit the TPA list based on the health insurance product and geographical location of the policyholder. Hence, if the insurer engages the services of only one TPA because of those factors, you will have no option but to go along with that particular TPA. The regulator also says that it is the insurer’s “prerogative” to engage or discontinue the services of a TPA for a particular health insurance product. Also, the only time you can choose (an alternate) TPA is if the services of the original TPA are terminated during the period of your health insurance coverage.
What Makes Niva Bupa one of the Best Insurance Company in India?
Niva Bupa Health Insurance is one of the leading health insurance providers in India, serving customers since 2008. With a remarkable customer base of over 1.4 cr. individuals, it boasts an impressive claim settlement ratio of 92%, successfully settling claims totalling 1,141 crores since inception. What sets Niva Bupa apart is its direct claim settlement process, eliminating the need for third-party administrators (TPA). Moreover, Niva Bupa offers critical illness insurance coverage across a vast international network spanning 190 countries.
With an extensive network of 10,000+ hospitals nationwide, accessing cashless treatment through Niva Bupa is incredibly convenient. In addition, the company has embraced digital solutions for the seamless handling of medical needs and insurance processes, ensuring efficiency, shorter turnaround times, and an exceptional consumer experience.
Niva Bupa is a joint venture with Bupa Singapore Holdings, a well-established British healthcare services company, and Fettle Tone LLP, an experienced private equity firm with a successful track record of transforming over 50 Indian companies. Driven by a vision to become India's most admired and best health insurance company, coupled with customer-centric features, Niva Bupa emerges as an ideal choice in the Indian health insurance sector.
Why Choose Niva Bupa?
Niva Bupa Health Insurance policy is the top choice for health coverage, offering an extensive range of policies to cater to diverse needs. Niva Bupa has everything from individual plans to family floater options and senior citizen coverage to critical illness policies.
What sets Niva Bupa apart is the attractive benefits offered across their policies, making them among the best in India. For example, you can enjoy a generous 30% renewal premium discount, no restrictions on room rent, coverage for alternative treatments, access to a daily health coach, international coverage, travel insurance , refill benefits, no-claim bonuses, e-consultations, and coverage for various medical expenses beyond hospitalisation.
Senior citizens are well cared for with premium services that include coverage for road and air ambulances, organ donors, AYUSH therapy, daycare treatments, and ongoing treatments. In addition, accident plans offer comprehensive benefits such as permanent disability coverage, child education, and death benefits. Moreover, Niva Bupa covers 20 critical illnesses and provides long-term discounts and lifetime renewal options.
With all these advantages, it's no wonder that Niva Bupa is the go-to choice for health insurance seekers. Experience peace of mind and comprehensive coverage with Niva Bupa Health Insurance.
Frequently Asked Questions
Why Do You Need Health Insurance?
How can I buy this policy?
How to calculate health insurance premium?
How to renew your health insurance policy?
What documents do you require to buy health insurance?
What are the eligibility criteria for health insurance?
What are the benefits of comparing health insurance plans online?
Do health insurance plans cover Ayurveda and other alternative treatments?
Which medical insurance plan is best for you?
Save Tax in India with Health Insurance Plans
Why buy health insurance online?
How to buy health insurance online?
Can I buy a Health Insurance Plan for my whole family?
Is a Health Insurance Policy the Same as a Family Floater?
What is the waiting period for critical illnesses under a Health Insurance Plan?
Can I add a rider to a Health Insurance Plan?
Does the Health Insurance Plan offer maternity benefits?
Can I change my existing policy to Niva Bupa Health Insurance Policy?
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What is the difference between health insurance and mediclaim policy?
When you decide to sign up for health insurance and begin researching the best plan for you, you may come across several phrases that confuse you. Most articles use the terms' health insurance 'and mediclaim' interchangeably. This is due to the widespread assumption that mediclaim is associated with health insurance. However, this is not the case. While they both serve the same aim of providing financial assistance during a medical emergency, their coverage is vastly different. Continue reading to compare the two:
Health Coverage:
Health insurance covers the majority of healthcare expenses, including pre-hospitalisation, post-hospitalisation, and critical illness. You have the option of filing cashless claims, in which the insurance company contacts your healthcare provider immediately and pays the money owed (if the healthcare provider is a part of the network hospitals of the insurance company). If that is not possible, you can pay your medical expenditures in advance and seek reimbursement from your insurer.
Niva Bupa health insurance policies include value-added advantages such as free medical exams, no-claim bonuses, health coaches, and so on. You can also tack on extra coverage such as personal accident and maternity insurance.
Mediclaim:
Mediclaim insurance is just for hospitalisation expenditures - they only cover your hospital/treatment costs after an accident or a certain condition. Other medical expenses are not covered as a result. However, similar to a health insurance plan, you can pick between reimbursement and cashless claim settlement methods.
When it comes to health insurance, it is vital to select a plan that meets your specific requirements. A comprehensive health insurance plan with pre-existing disease inclusions and add-ons may be your best bet if you have pre-existing diseases.A mediclaim policy, on the other hand, may be a possibility if you require basic and low-cost coverage.
Here are the fundamental distinctions between health insurance and mediclaim:
Health Insurance | Mediclaim | |
---|---|---|
Coverage | Comprehensive medical and surgical coverage, including hospitalisation, diagnostic tests, medicines, ambulance services, daycare treatments, AYUSH treatments, e-consultation, modern treatments, OPD etc. | Limited to hospitalisation expenses and pre-existing diseases. Extends coverage for treatment due to accidents and specific diseases |
Add-on coverage | A range of additional covers available, including personal accident insurance, accidental disability coverage, maternity coverage etc. | No add-on covers available |
Flexibility | Customers can opt to increase their sum insured. They can customise their plan by opting for additional benefits like health coach, hospital cash, enhanced geographical cover etc. | No possibility of changing the premium amount or extending the term of the policy. And not much flexibility is offered in terms of benefits |
Cost | Costs more than mediclaim as it provides comprehensive coverage | Costs less than health insurance as it offers limited coverage |
Plan features | Health insurance policy features are mostly similar across different health insurance providers. And they all offer comprehensive coverage with beneficial features | Features can vary widely from provider to provider and plan to plan |
Claims | In critical illness cover and personal accident cover, the sum insured is paid in lump sum, and claims can be made only once during a policy year. In other plans, claims can be made until the total sum insured is exhausted. Moreover, with Niva Bupa's ReAssure and Refill Benefits, a policyholder's sum insured is restored upon exhaustion during a policy year for treatment of the same or different disease | Policyholders can file claims until the total sum assured is exhausted. Once exhausted, no more claims can be filed during the same year |
Critical Illness Cover | Covers a range of critical illnesses such as cancer, heart attacks, kidney failure, liver failure, lung diseases, multiple sclerosis, different types of organ transplants, etc. | Critical illness coverage is not available |
Sum Insured | High sum insured - up to Rs. 6 crores | Low sum insured options - up to Rs. 5 lakhs |
Hospitalisation | Everything from pre to post hospitalisation, including hospital cash, ambulance charges etc. | Only the actual hospitalisation expense |