Best Health Insurance Plans in India: Which One Is Best For You?

Lifestyle diseases are rapidly increasing today, and, correspondingly, healthcare costs are also going up. A health insurance plan is a necessity today, not a luxury. It is an integral part of financial planning for individuals and families. A comprehensive health insurance policy provides a financial safety net during medical emergencies, offering peace of mind and allowing families to focus on patients and their recovery instead of medical bills.

There are so many insurance plans in the market today, and choosing the right one can seem challenging. This article tries to give you a detailed overview of some of the best health insurance plans in India, highlighting their key features, benefits, and waiting periods to help you make an informed decision.

Factors To Consider Before Choosing Health Insurance Plans in India

Selecting the most suitable health insurance plan for you requires careful consideration of various factors tailored to your needs and circumstances. Here are some crucial aspects to evaluate:

1. Claim Process

A smooth and hassle-free claim process is a critical factor. You should research the insurer’s claim settlement ratio (the higher, the better), the different ways to file a claim (cashless or reimbursement), and the documentation required. Choose insurers with a reputation for efficient and transparent claim settlement.

2. Insurance Amount (Sum/Amount Insured)

The sum/amount insured, or the maximum amount the insurer will pay for medical expenses, should be adequate to cover potential healthcare costs in your city and the type of medical treatments you require. Consider your age, health status, family size, and lifestyle when determining the appropriate coverage amount.

3. Lifetime Renewal

Choose health insurance plans that offer lifetime renewability. This ensures that your coverage continues uninterrupted throughout your life, regardless of age or any health conditions you may develop in the future. This is particularly important in the long run as healthcare needs increase with age.

4. Network Hospitals

Check the list of network hospitals associated with the insurance plan. A vast network of hospitals, especially those near your residence or workplace, and where cashless treatment is accessible means the insurer directly settles the bills with the hospital.

11 List of Health Insurance Plans in India

Here is a detailed look at some of the leading individual health insurance plans available in India, along with their key features, benefits, and waiting periods:

Name of Insurance Plan	Entry Age (Min-Max)	Sum Insured (Min-Max)
Aditya Birla Activ One NXT Plan	Adult: 18+ Child: 91 days – 25 years	₹5 Lakhs – ₹2 Crores
Bajaj Allianz Health Guard Plan	Adult: 18 years – 65 years Child: 91 days – 25 years	₹1.5 Lakhs – ₹35 Lakhs
Zurich Kotak Health Premier Plan	Adult: 18 years – 65 years Child: 91 days – 25 years	₹2 Lakhs – ₹2 Crores
Care Supreme Plan	Adult: 18 years – 99 years Child: 90 days – 24 years	₹7 Lakhs – ₹1 Crore
Digit Health Care Plus Plan	Adult: 18 years+ Child: 91 days	₹10 Thousand – ₹3 Crore
HDFC ERGO Optima Secure Plan	Adult: 18+ Child: 91 days – 25 years	₹5 Lakhs – ₹2 Crores
Star Health Comprehensive plan	Adult: 18 years – 65 years Child: 91 days – 25 years	₹5 Lakhs – ₹1 Crore
ICICI Lombard Elevate Plan	Adult: 18 years – 125 years Child: 30 years	₹5 Lakhs – Unlimited
IFFCO Tokio Individual Health Protector Plan	Adult: 18 years – 65 years Child: 91 days+	₹50 Thousand – ₹20 Lakhs
Tata AIG MediCare Plus Plan	Adult: 18 years – 65 years Child: 91 days – 5 years	Up to ₹1 Crore
Royal Sundaram NeXT Gen Health Insurance Plan	Adult: 18 years – 75 years Child: 91 days – 25 years	₹5 Lakhs – ₹1.5 Crore

1. Aditya Birla Activ One NXT Plan

The Aditya Birla Activ NXT One Plan is designed to promote a healthy lifestyle by rewarding policyholders for staying fit.

Features and Benefits:

1. Health Returns: By achieving pre-defined fitness goals, you can earn health returns of up to 100% of the premium, which you can use to reduce the subsequent year’s premium.

2. Modern Procedures: Offers coverage for advanced and robotic treatments for listed illnesses and treatments.

3. Day Care Procedures: Covers a wide range of daycare procedures that do not require 24-hour hospitalisation.

4. AYUSH Treatment: Coverage for inpatient treatment under Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy systems.

5. Mental Wellness and Obesity: Coverage for hospitalisation due to mental illness and for bariatric surgeries medically necessary for obesity.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2 years for diseases like cataracts, hernias, etc.
• Pre-existing Conditions: 4 years.

2. Bajaj Allianz Health Guard Plan

The Bajaj Allianz Health Guard Plan offers a wide range of coverage options and benefits.

Features and Benefits:

1. Inpatient Hospitalisation: Covers expenses for room rent, boarding, nursing, ICU, and medical practitioners’ fees.
2. Pre and Post-Hospitalisation Expenses: Covers medical expenses incurred for a specified period before and after hospitalisation.
3. Day Care Procedures: Covers expenses for 399 daycare procedures except the outpatient department.
4. Sum Insured Restoration: Covers 100% sum insured restoration.
5. Organ Donor: Covers organ donor’s treatment up to the sum insured.
6. Ambulance Cover: Covers the cost of ambulance services of up to Rs.20,000.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2 years for specified illnesses.
• Pre-existing Conditions: 4 years.

3. Zurich Kotak Health Premier Plan

The Zurich Kotak Health Premier Plan is designed to offer premium healthcare benefits, focusing on comprehensive coverage and customer convenience.

Features and Benefits:

1. Inpatient Treatment: Covers medical expenses for hospitalisation of a minimum of 24 hours.
2. Day Care Treatment: Covers expenses for 405 listed day care procedures that require less than 24 hours of hospitalisation.
3. Restoration Benefit: Provides a 100% restoration of the base sum insured once per policy year if the original sum and any cumulative bonus are insufficient due to previous claims.
4. Annual Health Check-up: Includes one free health check-up per insured person above 18.
5. Cumulative Bonus: Policyholders can earn a cumulative bonus of up to 50%/100% of the sum insured for claim-free years at 10% per year.
6. Health & Rewards: This policy rewards policyholders for maintaining their health and fitness through regular preventative and fitness habits. Reward points can be redeemed against various medical expenses.
7. Pre and Post-Hospitalisation Medical Expenses: Covers medical expenses for a specified number of days before and after hospitalisation, based on the chosen plan.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2-4 years, depending on the illness.
• Pre-existing Conditions: 3-4 years.

4. Care (Formerly Religare) Supreme Plan

The Care Supreme Plan is known for its comprehensive coverage and focus on providing quality healthcare access.

Features and Benefits:

1. Cumulative Bonus Super: This policy offers a cumulative bonus of up to 500%, boosting the sum insured.
2. No Sub-limits or Caps: There are no sub-limits or caps on various expenses such as hospitalisation, AYUSH treatment, domiciliary hospitalisation, and organ donor cover.
3. Unlimited Automatic Recharge: The policy provides an unlimited automatic recharge of the sum insured to ensure continuous coverage.
4. Wellness Benefits: The company encourages fitness by offering wellness benefits that can lead to discounts of up to 30% on premiums.
5. Unlimited E-consultations: Policyholders have access to unlimited online medical consultations.
6. Discount Connect: Provides special discounts on diagnostics, pharmacy, and consultations.
7. Comprehensive Coverage: While not a single feature, combining the above points towards a comprehensive coverage design.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2 years for specified illnesses.
• Pre-existing Conditions: 3 years.

5. Digit Health Care Plus Plan

The Digit Health Care Plus Plan is designed to be customer-friendly, with a focus on simplicity and comprehensive benefits.

Features and Benefits:

1. Hospitalisation Cover: This covers expenses for room rent, ICU charges, doctor’s fees, medication, diagnostics, and operation theatre costs for hospitalisation lasting at least 24 hours. It includes cover for both accidental hospitalisation and hospitalisation due to illness.
2. Day Care Procedures: Covers the costs of medical treatments and procedures that don’t require a 24-hour hospital stay.
3. Pre and Post-Hospitalisation Expenses: Covers medical expenses incurred for a specified period before and after you are hospitalised.
4. Second Medical Opinion: Offers the option to get a second medical opinion for major accidental injuries that require specialist (tertiary) care.
5. Refill Benefit: Under certain conditions, if your sum insured is exhausted, it can be refilled.
6. Daily Hospital Cash Allowance: Provides a daily cash allowance for each continuous 24-hour period of hospitalisation due to accident or illness.
7. Road Ambulance Cover: Covers the expenses of using a road ambulance in an emergency.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2 years for specified illnesses.
• Pre-existing Conditions: Up to 4 years.

6. HDFC ERGO Optima Secure Plan

The HDFC ERGO Optima Secure Plan is designed to provide enhanced coverage with innovative features.

Features and Benefits:

1. Secure Benefit (2x Coverage): Your policy coverage doubles automatically from day one for all claims.
2. Value Buy: You can reduce your premium by up to 50% by opting for a voluntary aggregate deductible.
3. Protect Benefit (Coverage for Non-Medical Expenses): This feature covers non-medical expenses during hospitalisation, such as gloves, masks, and syringes.
4. Plus Benefit (Increase in Sum Insured): Your sum insured increases by 50% for every claim-free year.
5. Automatic Restoration Benefit: If your sum insured is partially or fully exhausted due to claims, it will be automatically restored.
6. Preventive Health Check-ups: The plan allows for annual preventive health check-ups.
7. No Room Rent Limit: The policy covers the actual cost of the hospital room without any capping.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2 years for specified illnesses.
• Pre-existing Conditions: 3 years.

<h3>7. Star Health Comprehensive plan

The Star Health Comprehensive plan is one of Star Health and Allied Insurance’s flagship plans, known for its wide-ranging coverage.

Features and Benefits:

1. Hospitalisation Expenses Cover: Covers standard hospitalisation costs, including room charges, nursing expenses, and specialist fees.
2. Pre- and Post-Hospitalisation Charges: These include expenses incurred up to 60 days before and 90 days after hospitalisation.
3. AYUSH Hospitalisation Cover: Provides coverage for hospitalisation under Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy systems.
4. Outpatient Medical Consultation Expenses: Covers outpatient medical consultation costs, excluding dental and eye-related treatments. This is less common in standard health insurance plans.
5. Bariatric Surgery: Expenses on hospitalisation for Bariatric surgical procedures are covered up to specific limits.
6. Dental/Ophthalmic OPD Treatment: This benefit covers outpatient dental and eye treatments once every three years. It is an additional benefit not typically found in all health insurance plans.
7. Hospital Cash Benefit (Unusual Feature): Provides a daily cash benefit for a maximum of 7 days per hospitalisation and 120 days for the entire policy period to help with incidental expenses.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2 years for specified illnesses.
• Pre-existing Conditions: 3 years.

8. ICICI Lombard Elevate Plan

The ICICI Lombard Elevate Plan is designed to offer a high level of coverage with various customer-centric benefits.

Features and Benefits:

1. Hospitalisation and Day Care Treatment Cover: Covers expenses for inpatient hospitalisation and day care procedures.
2. Unlimited Reset of Sum Insured: If your remaining sum insured isn’t enough for a claim, it will reset to the base sum insured for future claims, which can happen unlimited times.  
3. Cashless Everywhere: Offers cashless treatment at any hospital across India.
4. Unlimited Coverage for Any One Claim: You get unlimited coverage for any single claim you choose during the entire policy lifetime.
5. Power Booster (Super Loyalty Bonus): Earn a cumulative bonus of up to 100% of your annual sum insured each policy year.
6. Worldwide Cover: This policy offers coverage up to INR 3 crore on a cashless basis for hospitalisation abroad, including planned treatments.
7. 100% Sum Insured Increase Every Year: Your sum insured increases by 100% yearly, regardless of whether you make a claim.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2-4 years, depending on the illness.
• Pre-existing Conditions: 3-4 years.

Highlight: Specific details on the features and waiting periods for the ICICI Lombard Elevate Plan require further in-depth research beyond the provided links.

9. IFFCO Tokio Individual Health Protector Plan

The IFFCO Tokio Individual Health Protector Plan is designed to provide essential health coverage at an affordable price.

Features and Benefits:

1. Comprehensive Coverage Beyond Hospitalisation: The policy covers medical expenses, including pre-and post-hospitalisation and hospital bills.
2. Post-Hospitalisation Support: Covers nursing and medical expenses up to 60 days after discharge.
3. Daily Allowance for Hospitalisation: Provides a daily allowance (0.20% of the sum insured daily) during hospitalisation.
4. Pre and Post-Hospitalisation Expenses: Covers expenses incurred 45 days before hospitalisation and 60 days after.
5. Ambulance Charges Reimbursement: The policy reimburses ambulance charges up to a certain limit (1% of the sum insured or ₹2,500 per episode).
6. Day Care Surgeries Coverage: Covers a significant number of daycare procedures.
7. Cumulative Bonus for No-Claim Years: Adds 5% of the basic sum insured to your coverage for each claim-free year, up to a maximum of 50%.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 3 years for specified illnesses.
• Pre-existing Conditions: 3 years.

Highlight: Specific details on the features and waiting periods for the IFFCO Tokio Individual Health Protector Plan require further in-depth research beyond the provided links.

ALSO READ: How Health Insurance Price is Calculated?

10. Tata AIG MediCare Plus Plan

The Tata AIG MediCare Plus Plan is a top-up health insurance plan offering many benefits and coverage options.

Features and Benefits:

1. Longer Policy Tenure Options: You can choose a policy tenure of up to 3 years, providing longer-term coverage and potentially locking in premium rates.
2. Higher Sum Insured Options: This policy offers a high sum insured option of up to ₹1 Crore, providing extensive coverage for significant medical expenses.
3. Optional Global Cover: You can include coverage for inpatient and daycare hospitalisation expenses incurred outside India, provided the initial diagnosis was made in India.
4. Higher Cumulative Bonus: Accrues a cumulative bonus of 50% for every claim-free year, up to a maximum of 100% of the sum insured.
5. AYUSH Benefit: Covers medical expenses for inpatient or daycare treatment in hospitals or daycare centres practising Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy.
6. Deductible Options: The company offers a wide range of deductible options, from ₹2 Lakh to ₹20 Lakh, which can help reduce the premium.
7. Consumables Benefit: Covers the expenses of specified consumables used during hospitalisation that are directly related to your treatment.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2 years for specified illnesses.
• Pre-existing Conditions: 3 years.

11. Royal Sundaram NeXT Gen Health Insurance Plan

The Royal Sundaram NeXT Gen Health Insurance Plan is designed to cater to the evolving healthcare needs of individuals and families.

Features and Benefits:

1. Inpatient Care: Covers expenses for room rent, boarding, nursing, ICU, and medical practitioner fees during hospitalisation.
2. Pre-Hospitalisation Expenses: Covers medical expenses incurred for a fixed period of 30 days before the date of admissible hospitalisation.
3. Post-Hospitalisation Expenses: This covers medical expenses incurred 60 days after the date of discharge from the hospital.
4. Modern Treatments Coverage: This includes coverage for advanced medical procedures like Robotic surgeries, Stereotactic radio surgeries, and Stem cell therapy.
5. Day Care Treatment: Covers expenses for medical treatments and procedures that do not require 24-hour hospitalisation.
6. Reload Benefit: Restores the sum insured up to 100% of the base sum insured once in a policy year if the initial sum insured and No Claim Bonus are insufficient due to previous claims. This benefit does not apply to the first claim in a policy year.
7. No Claim Bonus: Increases the sum insured by 10% of the base sum insured per policy year, up to 50% of the expiring base sum insured, for every claim-free year upon renewal.

Waiting Periods:

• Initial Waiting Period: 30 days for all illnesses except accidental injuries.
• Specific Illnesses/Procedures: 2 years, depending on the particular illness.
• Pre-existing Conditions: 3 years.

Conclusion

Choosing the best health insurance plan in India requires a thorough understanding of your healthcare needs and carefully evaluating the various options available. The types of health insurance plans discussed above represent some of the leading choices in the market, each offering a unique set of features and benefits. Before making a final decision, it is crucial to compare these plans based on factors such as coverage, premium, network hospitals, claim process, and waiting periods.

Frequently Asked Questions

<h3>How to select a top health insurance company in India?

Research the company’s claim settlement ratio (the higher, the better). Check for a network of hospitals offering cashless treatment, especially near your residence or workplace. Evaluate the company’s reputation for transparent and hassle-free claim settlement.

Which health insurance is best for claim settlement in India?

Research the claim settlement ratio of different insurers. A higher ratio generally indicates better claim processing efficiency. Choose insurers known for their efficient and transparent claim settlement processes.   

Which is the right cashless health insurance policy in India?

The right cashless policy has a wide network of hospitals where treatment can be obtained without upfront payment.