Types of Health Insurance in India

With the rise in health-related issues, there is an extreme increase in the treatment costs, too. Moreover, there is an increase in the demand for Health Insurance Plans. Therefore, several types of insurance policies in the market help you save that extra burden on your pocket.

These insurance plans not only let you find the best treatment for your health problems but also keep you stress-free from an expenditure point of view. Buying the right insurance plan can be a bit complicated, as there are different types of Health Insurance plans in India. Health insurance plays a huge role in financial planning, offering protection against unexpected medical expenses.

With various health insurance products available, it’s essential to understand the options to choose the right plan. In India, health insurance policies are designed to cater to diverse healthcare needs, ensuring that individuals and families have access to quality medical care.

Different Types of Health Insurance in India

The section below highlights the most common types of insurance policies for your health in India.

1.      Individual Health Insurance

An Individual Health Insurance plan is meant for a single person. As the name suggests, it can be bought by a single individual. The individual who gets themselves insured with this plan is compensated for the expenses incurred for illness and medical expenses.

Such types of medical insurance plans cover all the hospitalisation, surgical, pre- and post-medication expenditures till the insured limit is reached. The premium of the plan is decided on the basis of the buyer's age and medical history.

Moreover, the insured individual can cover his spouse, his children, and his parents, too, by paying an extra premium under the same plan. However, if you get insured for any existing illness, there is a waiting period of 2-3 years for claiming the benefits.

Features of Individual Health Insurance Policy

1. Designed for a single person.

2. The sum assured is separate for each beneficiary.

3. Covers hospitalisation expenses such as surgery, daycare treatment, room rent, doctor’s consultation, and prescription medicines.

4. Applicable to individuals aged 18 to 65.

‘What is the cost of an individual health insurance policy?’ is a common question that people ask. Individual health insurance in India generally costs between ₹9,000 and ₹25,000 annually, depending on age, coverage, medical history, and insurer.

If you are a single individual, a young professional, a senior citizen, or anyone seeking personalised medical coverage, then getting this dedicated personal cover is the right choice. These plans provide financial protection against rising healthcare expenses and unexpected medical emergencies.

2.      Family Health Insurance

Popularly known as the Family Floater Plan, Family Health Insurance Policy secures your entire family under a single cover. Health insurance plans for families cover all the members of your family, including your spouse, kids, and elders.

Only one member of the family has to pay the premium, and the entire family gets insured under a single premium. In case two family members are getting simultaneous treatment, you can claim the insurance for both of them till the limit is reached. The premium is decided on the basis of the age of the eldest member to be covered under the plan.

So, try to avoid adding the members who are above 60 years in your family health insurance plan as they are more prone to illness, and thus, the premium will get impacted.

Also Read: How Can I Transfer My Health Insurance to Another Company: Step-by-Step Guidance?

Features of Family Floater Health Insurance Policy

1. Covers the entire family under a single plan.

2. The sum insured is shared among all beneficiaries.

3. Provides coverage for hospitalisation expenses, including doctor’s fees, daycare treatment, nursing, surgeries, and prescription medicines.

Family floater health insurance usually costs between ₹10,000 and ₹40,000 per year, based on family size, age, and coverage amount. It is best for families seeking affordable protection under a single policy.

These types of health coverage cover multiple members together, making healthcare management simpler and more cost-effective during medical emergencies.

3.      Critical Illness Insurance

The Critical Illness Insurance plan insures the person by offering a lump sum amount of money for life-threatening diseases. At the time of buying the insurance, the chosen health problems are included, and if you are affected by any of the pre-selected conditions, you can claim your insurance.

Hospitalisation is not required to file a claim under this type of insurance policy. Only the diagnosis of the disease can make you avail the benefits of the critical illness insurance. The amount to be paid is pre-decided irrespective of pre and post-hospitalisation expenses. Below is a list of all the critical diseases that are covered in the Critical Illness Insurance.

1. Major organ transplant

2. Cancer

3. Aorta graft surgery

4. Kidney failure

5. Stroke

6. Multiple sclerosis

7. Paralysis

8. First heart attack

9. Coronary artery bypass surgery

10. Primary pulmonary arterial hypertension

Features of Critical Illness Health Insurance Plan

1. Offers lump-sum payment upon diagnosis of a covered critical illness.

2. Eligible for lifetime renewal without age restrictions.

3. Requires the policyholder to survive for at least 30 days after diagnosis.

4. Includes complimentary annual health check-ups in some plans.

5. Policy terminates after a lump sum payment is made.

Critical illness health insurance typically costs between ₹3,000 and ₹20,000 annually, depending on age, coverage, and medical history. It is best for individuals with family medical risks, working professionals, and sole earners.

These types of insurance policies provide lump-sum financial support for serious illnesses such as cancer, stroke, or heart disease.

4.      Senior Citizen Health Insurance

As indicated by the name, such types of Health Insurance in India provides coverage to people who are 65 years and above. So if you are planning to buy an insurance policy for your parents or grandparents, then this is the best insurance policy for you.

The Senior Citizen Health Insurance will offer you coverage for the cost of hospitalisation and medicines, whether it arises from a health issue or any accident. It covers hospitalisation expenses and post-treatment costs too.

On top of this, some other benefits like Domiciliary Hospitalization and Psychiatric benefits are also being covered. The upper age limit has been marked at 70 years of age. Also, the insurer can ask for a complete body checkup before he sells the Senior Citizen Health Insurance. Moreover, the premium for this plan is comparatively higher as the senior citizens are more prone to illness.

Also Read: Wellness - A Strong Driver for Health Insurance Market in 2042

Features of Senior Citizen Health Insurance Plan

1. Specifically designed for individuals over 65 years of age.

2. Covers hospitalisation, domiciliary, psychiatric treatments, and medical expenses due to illness or accident.

3. Premiums are higher due to increased health risks.

Senior citizen health insurance generally costs between ₹15,000 and ₹60,000 per year, depending on age, pre-existing conditions, coverage amount, and insurer. Since insurers consider senior citizens to be a higher risk, the premiums are much higher.

It is best suited for individuals aged 60 years and above who require financial support for medical treatments, hospitalisation, and age-related healthcare needs. These types of insurace policies help reduce the burden of rising healthcare expenses during retirement.

5.      Top Up Health Insurance

An individual can buy the Top Up Health Insurance plan if he seeks coverage for higher amounts. But there is a “Deductible Clause” added to this policy. Therefore, when the claim is made, the payment done is over and above the pre-defined limit that is mentioned in the policy.

Moreover, there is also a Super Top-Up plan available for the individual. It provides additional coverage over the regular policy to increase the amount of sum insured. The Super Top-Up plan can only be used once the insured sum of the regular policy is exhausted.

Features of Top-Up Health Insurance Plan

1. Provides additional coverage beyond the base plan's sum insured.

2. Includes fixed deductibles.

3. Super top-up options are available for higher coverage.

Top-up health insurance plans generally cost between ₹2,000 and ₹10,000 per year. It depends on the deductible amount, age, and coverage selected.

These types of insurance policies are best for individuals or families who already have basic health insurance but want extra financial protection against high medical expenses and costly hospital treatments without significantly increasing premium costs.

6.      Maternity Health Insurance

Maternity health insurance is designed to cover the medical expenses associated with childbirth, ensuring financial security during this important phase of life. This insurance can either be a standalone plan or an add-on to a regular health insurance policy.

It provides comprehensive coverage for both pre-natal and post-natal care, delivery costs, and newborn care, reducing the financial burden on families.

Features of Maternity Health Insurance Plan

1. Covers pre-natal, post-natal, and delivery expenses.

2. Some plans include a waiting period.

3. May cover newborn baby expenses, such as vaccinations and paediatric care.

Maternity health insurance plans in India generally cost between ₹8,000 and ₹35,000 annually. However, it depends on coverage, waiting period, and insurer. They are best suited for married couples or women planning a family.

These types of health policy help cover pregnancy-related expenses, delivery costs, newborn care, and hospitalisation, reducing financial stress during childbirth and early parenthood.

7.      Personal Accident Insurance

The number of road accident cases have increased over the years, and that is why today, there are dedicated types of health insurance in India to protect the citizens. Thus, people end up losing their life or getting disabled, and bearing the treatment expenses can be a bit traumatising.

So, availing the personal accident insurance policy is a wise idea. This policy provides a lump sum amount to the victim or his/her family as support. Some of the plans also offer education benefits and orphan benefits meant to cover the expenses of the children.

Moreover, Bajaj General Insurance also provides add-on coverage like temporary total disablement, assistance service, worldwide emergency, and accident in-patient hospitalisation with personal accident plans. Other than this, if the insured suffers from an accident and has any loan obligations, it will also be taken care of by the insurance provider.

Features of Personal Accident Insurance Policy

1. Covers accidental death and permanent or partial disability.

2. Offers weekly compensation for disabilities.

3. Provides a lump-sum payment to the family in case of death or permanent disability.

Depending on age, occupation, and coverage amount, personal accident insurance costs can range between ₹500 and ₹5,000 per year. If you are in a high-risk job, are a commuter or someone seeking financial protection against accidental death, disability, or injury, then this plan is the right choice for you.

These types of insurance policies provide lump-sum compensation to support income loss and medical expenses after accidents.

8.      Group Health Insurance

Group Health is one of the up and coming types of health insurance plans trending these days. Many medium and large-scale enterprises are offering this insurance policy to the employees.

This type of health insurance is bought by the employer of the company for its employees. The premium of this policy is comparatively lower than the Individual Health Insurance Policy. It is offered to the group of employees to meet the financial crisis and prudence in the company.

Features of Group Health Insurance Plan

1. Provides coverage for employees and possibly their families.

2. Basic coverage is free; additional premiums may apply for family coverage.

3. No waiting period required.

4. Covers hospitalisation expenses, maternity care, outpatient treatment, and more.

5. May include online doctor consultations, annual health check-ups, and lab tests.

Also Read: Does Alcohol Consumption Adversely Impact Your Health Insurance Premiums?

9.      Disease-Specific (M-Care, Corona Kavach, etc)

Nowadays, people are prone to get infected by an array of illnesses, and one of them is Covid-19. Thus, treatment for such infections can be a bit heavy on your pocket. Therefore, to make it easy for the people to avail treatment Bajaj General Insurance has introduced some disease-specific insurance policies.

Therefore, you must think of buying a health insurance policy that helps you in such severe health problems. Disease-Specific comes under the situation-oriented types of medical insurance policy that provides you coverage for specific diseases. One of the insurance policies is Corona Kavach that provides a fund of ₹50,000 to ₹5,00,000 to the person insured. The age limit is set between 18 to 65 years. It is a type of Family Floater Policy.

If we talk about M-Care Health Insurance Policy, it provides insurance to the insured person against the diseases caused by mosquitoes. There are different types of mosquito-borne diseases that include Dengue Fever, Malaria, Chikungunya, Zika virus, etc. Thus, M-Care offers you coverage for these diseases.

Features of Disease-Specific Health Insurance Plan

1. Covers consumables like PPE kits, masks, and gloves.

2. Policy duration can be 105, 195, or 285 days.

3. Available as individual or family floater plans.

4. Single premium payment with no renewal option.

10.  Hospital Daily Cash

Another segment is the different types of health insurance policy providing an innovative solution is the Hospital Daily Cash. If you feel insecure about buying an insurance policy, then you should go further with this plan and learn about how these health insurance policies work.

This plan can help you to protect yourself from unexpected expenses during your hospitalisation. Once a person gets hospitalised, the routine hospital expenses are not fixed, and they tend to change as per the condition. In such a situation, the Hospital Daily Cash works the best for an individual.

In this plan, the individual gets a daily cash benefit of ₹500 to 10,000, as per the coverage amount selected at the time of insurance. Convalescence benefits are also offered in some of the plans if the individual gets hospitalised for more than seven days. Other add-ons include Parental accommodation and a wellness coach.

Features of Hospital Daily Cash

1. Double daily cash benefit during ICU hospitalisation, subject to policy terms.
2. Lifetime renewal option for uninterrupted coverage, subject to policy conditions.
3. 5% family discount when covering two or more eligible members.
4. Renewal discount for maintaining a healthy lifestyle during the policy period.

11.  Mediclaim

Illnesses and accidents do not come with a pre-notification. The same goes for the expenses that one has to bear once the person gets hospitalised for any of these. Therefore, one should go for buying a Mediclaim Policy.

The Mediclaim Policy ensures compensation for your hospitalisation expenses in case of any illness and accident. It provides coverage for the in-patient expenses that include surgery expenses, doctor’s fees, nursing charges, oxygen, and anaesthesia.

The Mediclaim Policy is available in the market as group mediclaim, individual medical insurance, overseas medical insurance, etc.

Features of Mediclaim Insurance Plan

1. Covers only in-patient hospitalisation expenses such as doctor’s fees, nursing, surgeries, anaesthesia, and oxygen.

12.  Arogya Sanjeevani Health Insurance Policy

Introduced by the Insurance Regulatory and Development Authority of India (IRDAI), the Arogya Sanjeevani Health Insurance Policy is a standardised health insurance plan that offers health coverage in an affordable and accessible way. Among the various types of insurance policies available, it offers uniform coverage across all insurers, making comparisons easier for buyers.

With this policy, the beneficiaries will get coverage of up to ₹10 lakh. Like other healthcare policies, it also covers hospitalisation expenses, pre- and post-hospitalisation costs, daycare procedures, and AYUSH treatments, which include treatments for Ayurveda, Yoga and Naturopathy, Unani, Sidha and Homoeopathy.

Features of Arogya Sanjeevani Health Insurance Policy

1. This policy is available as an individual and family floater option.
2. You can pay the premium in Full or in instalments, such as half-yearly, quarterly, or monthly.
3. Policyholders up to the age of 45 years do not have to undergo any pre-policy medical check-up.
4. You can enjoy the lifetime renewal benefit under this policy.

Stop struggling with finances for your health expenses. Get a quote from Bajaj General Insurance and watch your worries disappear!

Indemnity vs Fixed Benefit Plans

Among the different types of health insurance plans, indemnity and fixed benefit plans are two of the most popular options. These two plans are generally different from each other based on the coverage and payout methods.

1.      Indemnity

Indemnity plans are those types of health insurance plans where the policyholder can claim the hospital expenses up to a fixed limit.  The policyholder can make multiple claims only till the maximum limit is reached. There are two different ways by which your insurance provider will provide you with your medical expenses:

1. Reimbursement Facility- The bills are first paid by you, and then the insurance provider reimburses those bills.

2. Cashless Facility- Where you do not have to pay any bills as the insurance provider pays them directly to the hospitals.

The types of medical insurance policy that fall in the category of Indemnity plans are as under:

1. Individual Health Insurance

2. Family Floater Plan

3. Group Health Insurance

2.      Fixed Benefits

Fixed Benefits offers you a definite amount of money for specific health issues caused due to accidents or illness. It covers those health conditions that are listed at the time of buying the policy. The popular Health Insurance Policies that are covered in the fixed benefits are listed below;

1. Personal Accident Plan

2. Critical Illness Plan

3. Hospital Cash Plan

What is Not Covered in Different Health Insurance Plans in India?

Although you can get comprehensive financial protection with different types of health insurance plans, certain treatments and situations are typically excluded from their coverage. Here is a list of common exclusions of health insurance plans:

1. Cosmetic Procedures: If the policyholder seeks any treatments for cosmetic surgery, hair transplants, and skin enhancement for non-medical reasons, they will usually be excluded.
2. Dental Treatments: Routine dental care, cosmetic dental procedures, and the cost of supplements purchased without a prescription from a certified doctor are not covered in any policy.
3. Self-Inflicted Injuries: Medical expenses arising from self-harm, attempted suicide, or hazardous activities are strictly excluded from any healthcare plan.
4. Treatment for Substance Abuse: The costs of medical emergencies resulting from alcohol or drug abuse, addiction treatment, or rehabilitation are generally not covered.
5. Experimental or Unproven Treatments: In case the policyholder voluntarily agrees to procedures that are experimental, investigational, or not medically established, they will not get coverage.
6. Non-Medical Expenses: If the policyholder does not opt for the Non-Medical Expense Rider, the costs of consumable items, such as gloves, syringes, and bandages, are usually not covered.
7. Infertility Treatments: Expenses related to infertility treatments, IVF, or assisted reproductive technologies are generally excluded unless offered as an optional benefit.

What Factors Should You Consider When Purchasing the Best Health Insurance Plan?

Whether you choose an individual health insurance policy or a family floater policy, there are certain factors you must consider in your health insurance policy to get adequate financial protection without any hassles.

1.      Sum Insured

With the medical inflation rate in India rising 12%-15% annually, your sum insured must perfectly cover your medical needs. Therefore, while choosing the coverage amount, consider your medical history and healthcare needs to avoid paying any amount out-of-pocket.

2.      Waiting Period

To get the necessary benefits without any delay, you must choose a policy with a shorter waiting period. In most cases, the initial waiting period is 30 days, while waiting periods for pre-existing diseases like diabetes or hypertension are 12 to 36 months.

3.      No of Network Hospitals

You can receive cashless treatment facilities only at network hospitals. This is why, while purchasing a health insurance policy, ensure your insurer is associated with more than 10,000 hospitals near your location. With this facility, you can reduce the hassle of upfront payment during any medical emergency.

4.      Co-payment and Sub-limit Clause

If a health insurance policy comes with a co-payment and sub-limit clause, it means the policyholders have to bear a fixed percentage of the treatment or have limits on room rent, ICU charges, or specific medical procedures. Therefore, you should try to choose policies with no sub-limit or co-pay to reduce out-of-pocket expenses.

5.      Claim Settlement Ratio

The claim settlement ratio showcases the number of claims your insurance company has successfully settled in a policy year. Therefore, the higher CSR ratio indicates your insurer's reliability and increases the chances of your claim being approved faster without complications.

Conclusion

The progressively rising costs of medical treatments have made it mandatory for people to buy Health Insurance Policies for themselves and for their family members too. Bajaj General Insurance offers different types of insurance policies in India, covering every type of ailment, condition, and incident.

Many individuals complain about paying an extraordinary amount of premium and getting less in return. This happens when a person does not gather the required information about all the insurance plans and companies. Hence, you need to understand the ins and outs of all types of medical insurance policies to ensure that you choose the plan that fits well.

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FAQs

1.      Can I Combine Different Types of Health Insurance Plans?

Yes, you can combine multiple health insurance plans, such as employer-provided and personal coverage. In the case of a claim, you can use one policy to cover part of the expenses and the other to cover the remaining costs.

2.      Are There Tax Benefits for Different Types of Health Insurance?

Yes, health insurance premiums qualify for tax deductions under Section 126 of the Income Tax Act, 2025. The deduction varies based on the policyholder's age and coverage, providing tax relief on premiums for the self, family, and parents.

3.      Are pre-existing diseases covered under every type of health insurance plan?

Most plans cover pre-existing diseases after a waiting period that can range from 2 to 4 years or more. Disclose medical history accurately, read waiting period clauses, and pick a health insurance plan that fits your timeline.

4.      How does coverage differ between various health insurance plans?

Coverage differs by plan type, sum insured, room rent limits, co-pays, sub-limits, and add-ons. Compare inclusions like day-care procedures, maternity, AYUSH, and OPD to match a health insurance plan with your needs.

5.      Which type of health insurance plan is the most expensive?

Plans with high sums insured, wide benefits, low co-pays, and comprehensive add-ons usually cost more. Senior citizen and critical illness policies can also be pricier due to higher risk and broader health insurance coverage.

6.      What are the two most common types of health insurance?

The most common are indemnity plans, which reimburse hospital bills up to the sum insured, and fixed benefit plans, which pay a lump sum on diagnosis or defined events. Many buyers use both for balanced health insurance protection.

7.      At what age does health insurance typically become more expensive?

Premiums generally rise with age, often stepping up after 45 and again after 60. Buying health insurance earlier helps lock in lower premiums, complete waiting periods sooner, and secure broader coverage options.

8.     What are the four most widely used health insurance plans?

Common choices include Individual, Family Floater, Group, and Critical Illness plans. Each health insurance type serves different needs, from personal cover to family pooling, employer benefits, or lump-sum protection for major illnesses.

9.      Does a Unit Linked Insurance Plan (ULIP) count as health insurance?

No. A ULIP is primarily an investment-linked life insurance product. It is not a substitute for health insurance, which specifically covers medical expenses and offers hospitalisation benefits and related healthcare features.

10.  How is the premium for a family floater health insurance calculated?

The premium of a family floater health insurance policy depends on several factors, including the age of the eldest member, the number of members covered, the sum insured, add-ons, lifestyle, and overall medical history.

11.  Which family members can be included in a family floater health insurance plan?

 A family floater health insurance policy can cover you, your spouse, your dependent children, and your parents. Some plans also allow dependent siblings or in-laws, ensuring Senior Citizens Health Insurance coverage under one policy.

12.  Do family floater plans offer cashless hospitalisation?

Yes, family floater health insurance plans do offer cashless hospitalisation, and with Bajaj General Insurance, you can avail this benefit at over 18400 network hospitals across India. This means your medical bills are settled directly with the hospital, so you or your family members do not need to pay upfront during treatment.

13.  Who is eligible to be covered under a family floater plan?

Most family floater health insurance policies cover adults aged 18–65, including Senior Citizens Health Insurance, along with dependent children. Bajaj General Insurance tailors coverage to suit nuclear and joint families for complete protection.

14.  Can I convert an individual health insurance policy to a family floater plan?

 Yes, Bajaj General Insurance allows policyholders to shift from individual health cover to a family floater health insurance policy, offering cost savings and consolidated benefits under one comprehensive plan for the entire family.

15.  Can I add or remove members during the policy tenure?

 Yes, you can add a newborn or dependent and remove members as needed. Bajaj General Insurance makes modifications simple, ensuring your family floater health insurance policy evolves with your family’s changing needs.

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