இந்தியாவில் மருத்துவக் காப்பீட்டு பாலிசிகளின் வகைகள் மற்றும் நன்மைகள்

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 Health Insurance Policies in the market help you save that extra burden on your pocket.

These insurance plans just not let you find the best treatment for your health problems but also keep you stress-free from the 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.

What is Health Insurance in India?

Health insurance is a contract in which the insurer agrees to cover medical expenses arising from illness, injury, or specified health conditions, as per the policy terms.

In India, health insurance plans include individual, family floater, group, senior citizen, critical illness, top-up, and disease-specific options. Key benefits often comprise cashless treatment at network hospitals, pre- and post-hospitalisation coverage, day-care procedures, ambulance services, and tax deductions under Section 80D of the Income Tax Act.

Coverage depends on the sum insured, waiting periods, sub-limits, and policy exclusions, so comparing features and costs is essential. Bajaj General Insurance offers multiple health insurance plans that can be tailored to age, budget, and medical needs, helping policyholders manage rising healthcare expenses efficiently.

மேலும் படிக்க: Critical Illness Policy Comparison in India

இந்தியாவில் மருத்துவக் காப்பீட்டின் வகைகள்

To help you out, we have listed all 11 types of plans and have described all significant elements of a health insurance policy so that you may buy a plan that is best for you.

இந்தியாவில் பல்வேறு வகையான மருத்துவக் காப்பீடுகள்

தனிநபர் மருத்துவக் காப்பீடு

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 himself insured with this plan is compensated for the expenses incurred for illness and medical expenses.

Such types of medical insurance plan 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 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.

தனிநபர் மருத்துவ காப்பீட்டு பாலிசியின் சிறப்பம்சங்கள்

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.

குடும்ப மருத்துவக் காப்பீடு

Popularly known as the Family Floater Plan, Family Health Insurance Policy secures your entire family under a single cover. Health insurance plans for family covers 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 in 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 up in 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.

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

ஃபேமிலி ஃப்ளோட்டர் மருத்துவக் காப்பீட்டு பாலிசியின் சிறப்பம்சங்கள்

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 plans cover multiple members together, making healthcare management simpler and more cost-effective during medical emergencies.

தீவிர நோய் காப்பீடு

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 get 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. புற்றுநோய்

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

தீவிர நோய் மருத்துவ காப்பீட்டு திட்டத்தின் சிறப்பம்சங்கள்

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 plans provide lump-sum financial support for serious illnesses such as cancer, stroke, or heart disease.

மூத்த குடிமக்களுக்கான மருத்துவக் காப்பீடு

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.

மேலும் படிக்க: Wellness - A Strong Driver for Health Insurance Market in 2042

மூத்த குடிமக்கள் மருத்துவ காப்பீட்டு திட்டத்தின் சிறப்பம்சங்கள்

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 plans help reduce the burden of rising healthcare expenses during retirement.

டாப் அப் ஹெல்த் இன்சூரன்ஸ்

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.

டாப்-அப் மருத்துவ காப்பீட்டு திட்டத்தின் சிறப்பம்சங்கள்

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.

They 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.

மகப்பேறு மருத்துவக் காப்பீடு

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.

மகப்பேறு மருத்துவ காப்பீட்டு திட்டத்தின் சிறப்பம்சங்கள்

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 plans help cover pregnancy-related expenses, delivery costs, newborn care, and hospitalisation, reducing financial stress during childbirth and early parenthood.

தனிநபர் விபத்து காப்பீடு

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 of 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 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.

தனிநபர் விபத்து காப்பீட்டு பாலிசியின் சிறப்பம்சங்கள்

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.

The plan provides lump-sum compensation to support income loss and medical expenses after accidents.

குழு மருத்துவக் காப்பீடு

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.

குழு மருத்துவ காப்பீட்டு திட்டத்தின் சிறப்பம்சங்கள்

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.

மேலும் படிக்க: மது அருந்துதல் உங்கள் மருத்துவ காப்பீட்டு பிரீமியங்களை பாதிக்கிறதா?

நோய்-குறிப்பிட்ட (எம்-கேர், கொரோனா கவச் போன்றவை)

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 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.

நோய்-குறிப்பிட்ட மருத்துவ காப்பீட்டு திட்டத்தின் சிறப்பம்சங்கள்

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.

மருத்துவமனை தினசரி ரொக்கம்

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 wellness coach.

மெடிகிளைம்

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.

மெடிகிளைம் காப்பீட்டு திட்டத்தின் சிறப்பம்சங்கள்

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

Here is a glance at all the types of health insurance policies:

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

இழப்பீடு vs நிலையான நன்மை திட்டங்கள்

இழப்பீடு

இழப்பீட்டுத் திட்டங்கள் என்பது பாலிசிதாரர் மருத்துவமனை செலவுகளை ஒரு நிலையான வரம்பு வரை கோரக்கூடிய மருத்துவ காப்பீட்டு திட்டங்களின் வகைகள் ஆகும். அதிகபட்ச வரம்பை அடையும் வரை மட்டுமே பாலிசிதாரர் பல கோரல்களை மேற்கொள்ள முடியும். உங்கள் மருத்துவ செலவுகளை உங்கள் காப்பீட்டு வழங்குநர் உங்களுக்கு வழங்கும் இரண்டு வெவ்வேறு வழிகள் உள்ளன:

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.

இழப்பீட்டுத் திட்டங்களின் வகையில் வரும் மருத்துவக் காப்பீட்டு பாலிசியின் வகைகள் கீழே கொடுக்கப்பட்டுள்ளன:

1. Individual Health Insurance

2. Family Floater Plan

3. Group Health Insurance

நிலையான நன்மைகள்

விபத்துகள் அல்லது நோய் காரணமாக ஏற்படும் குறிப்பிட்ட மருத்துவ பிரச்சனைகளுக்கு நிலையான நன்மைகள் உங்களுக்கு ஒரு குறிப்பிட்ட தொகையை வழங்குகின்றன. பாலிசியை வாங்கும் நேரத்தில் பட்டியலிடப்பட்டுள்ள அந்த மருத்துவ பிரச்சனைகளை இது உள்ளடக்குகிறது. நிலையான நன்மைகளில் காப்பீடு செய்யப்படும் பிரபலமான மருத்துவ காப்பீட்டு பாலிசிகள் கீழே பட்டியலிடப்பட்டுள்ளன;

1. Personal Accident Plan

2. Critical Illness Plan

3. Hospital Cash Plan

மருத்துவக் காப்பீட்டின் நன்மைகள்

1. Health insurance provides financial security by covering hospital health insurance costs, ensuring medical emergencies don't drain your savings

2. Coverage varies between plans, with different inclusions and exclusions. Some policies might not cover all hospitalisation expenses or may have specific limits.

3. Comprehensive health insurance plans often cover pre- and post-hospitalisation, day-care procedures, and ambulance charges. However, not all policies offer these benefits; some might have exclusions or limits.

4. Many plans offer cashless treatment options at network hospitals, reducing upfront payments. However, treatment at non-network hospitals requires the policyholder to pay first and seek reimbursement.

5. Tax benefits are available under Section 80D of the Income Tax Act. The amount depends on the policyholder's age and the premium paid:

6. Up to ₹25,000 for individuals below 60 years.

7. Up to ₹50,000 for senior citizens.

**நடைமுறையிலுள்ள வரிச் சட்டங்களுக்கு ஏற்ப வரிச் சலுகைகள் மாற்றத்திற்கு உட்பட்டவை.

மேலும் படிக்க:  ஓய்வூதியத்திற்கு பிறகு மருத்துவக் காப்பீடு ஏன் தேவைப்படுகிறது?

முடிவுரை

The progressively rising costs in medical treatments have made it mandatory for people to buy Health Insurance Policies for themselves and for their family members too. Bajaj General offers comprehensive health 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, one needs to understand the ins and outs of all types of medical insurance policy to ensure that you choose the plan that fits well.

Download the Bajaj General App today!

பொதுவான கேள்விகள்

மருத்துவக் காப்பீட்டை எப்படி கோருவது?

To claim health insurance, notify your insurer, submit required documents like medical reports and hospital bills, and choose either a cashless claim at network hospitals or reimbursement after paying the bills upfront.

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.

Are There Tax Benefits for Different Types of Health Insurance?

Yes, health insurance premiums qualify for tax deductions under Section 80D of the Income Tax Act. The deduction varies based on the policyholder’s age and coverage, providing tax relief on premiums for self, family, and parents.

Which is better: Mediclaim or health insurance?

Mediclaim generally covers inpatient hospitalisation only. Health insurance can offer broader benefits like pre- and post-hospitalisation, day-care, ambulance, and optional add-ons. Choose based on the breadth of coverage you need and your budget.

Do all health insurance plans provide cashless hospitalisation?

Many health insurance plans offer cashless treatment at network hospitals. At non-network hospitals, you usually pay upfront and seek reimbursement. Always check the insurer’s latest network list and claim process before hospitalisation.

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.

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.

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.

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.

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.

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.

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.

When is the best time to buy health insurance in India?

The best time is now, while you are healthy. Early purchase of health insurance means lower premiums, shorter waits for pre-existing coverage, and uninterrupted protection against rising medical costs and emergencies.

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.

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.

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.

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.

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.

 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.

*நிலையான விதிமுறைகள் மற்றும் நிபந்தனைகள் பொருந்தும்

காப்பீடு என்பது தேவையின் பொருள். நன்மைகள், விலக்குகள், வரம்புகள், விதிமுறைகள் மற்றும் நிபந்தனைகள் பற்றிய மேலும் விவரங்களுக்கு, விற்பனையை முடிப்பதற்கு முன்னர் விற்பனை சிற்றேடு/பாலிசி விதிமுறைகளை கவனமாக படிக்கவும்.