Individual Health Insurance Plans 2025
Individual health insurance is a type of insurance plan that provides medical coverage to individuals based on their specific sum insured. Unlike group or family health insurance plans, individual health insurance requires separate purchases for each family member.
This allows for personalized coverage based on individual health needs, rather than covering the entire family.
Individual health insurance plans typically offer extensive coverage for emergency medical expenses, including hospitalization costs, day care procedures, road ambulance services, alternative treatments, organ donor expenses, and more. However, it's important to note that the premium and coverage of an individual health policy cannot be shared among family members.
Features & Benefits of Individual Health Insurance
The features and benefits of Individual Health Insurance are described below:
- Wider Coverage: Covers hospitalization, pre- and post-hospitalization expenses, daycare procedures, ambulance charges, and more.
- Solo Coverage: Allocates the sum insured exclusively to the policyholder, offering personalized coverage tailored to their unique health requirements.
- Multiple Claims: Allow multiple claims in a policy year as long as the sum insured is not exhausted, providing flexibility in accessing healthcare services.
- Suitable for Older People: Designed to cater to the health risks and requirements of elderly individuals, who may have unique healthcare needs and considerations.
- Family Discount: Many individual health plans offer a family discount if more than two family members are covered on an individual basis, making it more affordable to secure coverage for the entire family.
- Sum Insured: Depending on the chosen plan, individual health insurance policies can offer a maximum sum insured of up to Rs.1 crore, providing a significant level of coverage.
- Add-on Covers: Policyholders can enhance coverage by adding critical illness, outpatient, restoration, maternity benefits, and more, tailoring to their needs.
- Tax Benefits: Premiums paid for individual health insurance policies are eligible for tax savings under Section 80D of the Income Tax Act.
- Renewal for Life: Offer lifetime renewability, allowing policyholders to renew their policies indefinitely, providing long-term protection and peace of mind.
- Cumulative Bonus: Some individual health insurance plans offer a cumulative bonus, providing a premium discount if no claims are made in the previous policy year.
Individual Health Insurance: Inclusions & Exclusions
Inclusions | Exclusions |
✅ Pre- and Post-hospitalization Expenses | ❌ Self-Inflicted Injuries |
✅ In-patient Hospitalization Expenses | ❌ Injuries due to Participation in Dangerous Sports |
✅ Emergency Road Ambulance | ❌ Abuse of Alcohol or Drugs |
✅ Day Care Procedures | ❌ Injuries or Illnesses Due to War or Nuclear Perils |
✅ Preventive Health Check-up | ❌ Obesity Treatment |
✅ Organ Donor Expenses | ❌ Dental Treatment |
✅ Domiciliary Hospitalization | ❌ Cosmetic Treatment |
✅ COVID-19 Treatment | ❌ Infertility Treatment |
✅ Alternative Treatment (such as Ayurveda, Unani, Siddha, Yoga, and Homeopathy) | ❌ HIV/AIDS |
Best Individual Health Insurance Plans in India 2025
Bank | Individual Health Insurance Plan | Features |
HDFC ERGO Optima Secure |
| |
Tata AIG Individual Health Insurance |
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ICICI Individual Health Insurance |
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Star Comprehensive Insurance Policy |
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Arogya Supreme Health Insurance |
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How to Apply for Individual Health Insurance Online?
Here is a step-by-step guide on how to apply online for an individual health insurance plan:
- Step 1: Visit the official website of the insurance provider offering individual health insurance plans.
- Step 2: Look for the health insurance section on the website. This section will provide details about various health insurance policies available.
- Step 3: Choose the type of individual health insurance policy that suits your requirements and offers the desired scope of coverage. Consider factors such as coverage limits, benefits, and premium affordability.
- Step 4: Click on ‘Buy Online’. This will redirect you to a secure webpage where you can initiate the online purchase process.
- Step 5: Ensure that your browser is in secure mode, as you will be required to provide sensitive information during the application process.
- Step 6: Use the health insurance premium calculator provided on the website to determine the premium amount based on factors like the type of insurance (individual/family, floater), desired sum insured, and date of birth of the applicant. This will help you estimate the cost of the policy.
- Step 7: Fill in personal details accurately, including your name, correspondence address, contact details, and any history of ailments or diseases. Ensure that all information provided is correct and up to date.
- Step 8: Proceed to the secure payment gateway to make the necessary payment for the selected individual health insurance policy. Choose the payment method that is convenient for you.
- Step 9: Complete the payment process as per the instructions provided on the website. Ensure that you receive confirmation of the successful transaction.
- Step 10: Once the transaction is complete, you will receive a soft copy of your individual health insurance policy to your registered email address. Save this document for future reference.
Remember to carefully review the policy terms and conditions, coverage details, and exclusions before making the final purchase. If you have any questions or concerns, you can reach out to the insurance provider's customer service for assistance.
Eligibility for Individual Health Insurance
Eligibility for health insurance is open to almost everyone, based on factors like age and medical background. When applying for an individual health insurance plan, you will typically be asked to provide age proof, address proof, photographs, and a medical history.
- Individuals can enter an Individual plan from the age of 18, and the exit age varies between 65 and 70, depending on the insurer's terms. It is advisable to secure an individual health insurance plan at a younger age to benefit from lower premiums, as plans tailored for senior citizens tend to be costlier.
- Parents have the option to purchase a separate health insurance policy for their children once they reach the age of 18.
- Basic medical tests may be part of the application process for an individual health insurance plan.
Documents Required
When purchasing individual health insurance, certain documents are typically required for the application process. These documents may vary slightly depending on the insurance provider and specific requirements. Here are some common documents that are often needed:
- Identity proof
- Age proof
- Address proof
- Proposal Form
- Medical Reports
- Passport-Sized Photographs
How to Renew Individual Health Insurance Online?
- Step 1: Go to the official website of the insurance company.
- Step 2: Once you are on the insurance company's website, look for the health insurance renewal section. This section is usually prominently displayed on the homepage or can be found under the ‘Services’ or ‘Renewals’ tab.
- Step 3: Click on the health insurance renewal section to proceed with the renewal process.
- You will be required to provide certain information to access your policy such as your previous policy number and your registered mobile number associated with the policy.
- Step 4: Now click on the ‘Submit’ or ‘Proceed’ button to proceed to the next step.
- Once your policy details are verified, you will be able to review the policy details and the renewal premium. Take your time to carefully go through the policy terms and conditions, coverage limits, and any changes in the policy if applicable.
- Step 5: If you are satisfied with the policy details and the renewal premium, proceed to make the payment. Most insurance companies offer multiple payment options, including credit/debit card and Net banking. Choose the payment method that is convenient for you.
- Step 6: Enter the necessary payment details as requested on the secure payment page. Ensure that the information is accurate to avoid any payment issues. Once the payment is successfully processed, you will receive confirmation of your health insurance renewal. This confirmation may be displayed on the website or sent to your registered email address and mobile number.
How to Claim Individual Health Insurance?
Here is a general step-by-step guide on how to file an individual health insurance claim:
Determine the type of claim process: Decide whether you want to opt for a cashless claim process or a reimbursement claim process. This choice may depend on the hospital you visit and your insurance policy.
Cashless Claim Process
- Step 1: Visit a hospital that is a part of the insurer's network. Present your health card or provide your policy number/details.
- Step 2: Identify and coordinate with the Third-party Administrator (TPA) at the hospital. The TPA acts as a link between you and the insurance company.
- Step 3: Comply with the TPA's requirements, such as providing necessary documents and sharing relevant information.
- Step 4: Undergo the required treatment. If there are any deductibles or additional costs, you will be responsible for paying them. The remaining approved expenses will be taken care of by the insurance company.
Reimbursement Claim Process
- Step 1: Visit any hospital of your choice and inform the insurance company directly or through a Third-party Administrator (TPA).
- Step 2: Receive the necessary treatment and pay the entire bill at the hospital.
- Step 3: Collect detailed receipts and bills from the hospital, including medical reports and prescriptions.
- Step 4: Apply for a claim by submitting the required documents and the completed claim form to the insurance company or TPA.
- Step 5: The insurance company will review your claim and process it accordingly.
- Step 6: Once your claim is approved, you will receive the settlement amount from the insurance company in your bank account.
FAQs on Individual Health Insurance
- Which plan is best for an individual health insurance plan?
The best health insurance plan is one that offers comprehensive coverage based on your lifestyle, medical history, and financial status. Choose a plan that suits your requirements.
- What is meant by an individual health insurance plan?
An individual health insurance plan provides coverage to a single person. The sum insured is not shared and can be used solely by the policyholder. Discounts may be offered for claim-free periods.
- Does individual health insurance come with maternity coverage?
Not all individual health insurance plans include maternity coverage. Separate maternity covers are available, but they may have waiting periods. Contact the insurance company for more information.
- How to find the best health insurance companies for individuals?
Search for health insurance plans online, compare policies, and check the credibility of insurance companies through their social media handles. Choose a plan that suits your needs and has competitive premiums.
- How long must a person wait to purchase individual health insurance?
Usually, there is a minimum 30-day waiting period at the beginning of an individual health insurance plan. However, the waiting periods for pre-existing conditions vary between one and four years, and they are often between one and two years for specific disorders.
- When should I purchase a private health insurance policy?
It is advised to purchase individual insurance coverage as soon as possible. Even if your employer provides health insurance, you must choose an individual policy for comprehensive coverage. Despite having a pre-existing condition, anyone can acquire this insurance policy.
- What is the eligibility criteria to purchase individual health insurance?
Individual plans typically have age restrictions ranging from 18 to 60. The eligibility requirements, however, differ from one plan to another.
- What does Domiciliary Hospitalisation mean?
Domiciliary hospitalisation occurs when a covered person cannot be transported to the hospital because of their health or when care is given at home since there aren't enough hospital beds available.
- Does getting individual health insurance have any tax benefits?
Under the 1961 Income Tax Act (Section 80D), you can claim a tax deduction of up to Rs.25,000 on the premium amount paid for your individual health insurance coverage. You can also claim a tax deduction for the insurance claimed for your Parents.
- What do pre-existing conditions mean in terms of individual health insurance?
When purchasing medical insurance, you must undergo a medical exam. Pre-existing medical conditions are those that you already have, such as diabetes, cancer, or hypertension. There are insurance companies that do not cover pre-existing medical conditions for a certain period of two to four years. After the waiting period, your health insurance must cover any pre-existing diseases you may have.
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