Overview of Individual Health Insurance:
Health insurance is an agreement between an insurance provider and an individual wherein the former guarantees to take care of certain medical costs of the latter based on the investment made. Some plans offer health insurance for individuals while others offer health insurance for family and group.
The Individual Health Insurance plan covers only one individual, the policyholder, who will gain the benefits of the health insurance for his investment.
- This kind of health insurance for individuals offers cover only for the insured individual.
- The insurance provider covers certain medical costs of the insured based on the premium paid.
- Hospitalization- The policy covers hospitalization charges.
- Lifetime renewal.
- Tax deductions under section 80D of the Income Tax act.
- Covers surgery costs, room rent, physician’s fee and laboratory tests.
- The insured has to pay a predetermined amount for certain health care services. This is called co-payment.
- Pre and post hospitalization expenses are covered under this plan.
- Provides coverage for critical illness.
Advantages of Individual Health Insurance Plan:
- In individual health insurance plan, the insured alone earns all the benefits under the plan.
- The individual will earn the benefit of individual sum assured rather than floating sum assured.
- Best suited for people with higher health risks.
- Parents and immediate family members can be added to the plan.
- No restrictions on the maximum age for the members for the renewal of the policy.
- There is no need to worry about making more than one claim in an year since the plan caters only to a single person.
Who should buy this plan?
- The plan is best suited for individuals with higher health risks.
- Single individuals with family members who are already insured.
- An individual who wants to earn the benefit of the sum assured rather than floating sum assured.
- Individuals who want to renew the policy without having to worry about any age restrictions.
- An individual who wants higher protection than what is offered under a family floater plan.
- Cashless facility for claim settlement can be availed in this plan.
Top Insurers Providing Individual Health Insurance:
There are a lot of insurance providers who offer individual health insurance. Listed below are the top five individual health insurance providers.
ICICI Lombard - Personal Protect Insurance Policy:
The key features of the ICICI Personal Protect Insurance Policy are:
- You can choose the coverage against Death or Permanent Total Disablement (PTD) due to an accident anywhere between Rs. 3 lakhs - Rs. 25 lakhs as a sum assured.
- The ICICI Personal Protect Insurance Policy will even provide insurance cover to individuals who can claim after being in an act of violence from acts of terrorism.
- There will no requirement for the individual to go through a health check in order to take up this policy.
- The policy has an easy claim process with the need of documentation to be minimal, the coverage for this policy will be worldwide.
- For the ICICI Personal Protect Insurance Policy an individual between the ages of 18 - 60 years, is eligible for a policy term of 1 - 5 years.
Bajaj Allianz - Individual Health Guard:
The key features of the Bajaj Allianz Individual Health Guard are:
- With this policy you will receive hospitalization charges and you will also receive 10% discount for family members. You can also get cashless hospitalization in the partner hospitals which are more than 3700 hospitals in the country.
- The policy will cover pre and post hospitalization expenses that are of relevance, which would have occurred 60 days prior to hospitalization or 90 days after hospitalization. This will also costs of the ambulance if there’s a case of emergency. The ambulance costs will be covered up to Rs. 1000/- .
- The sum assured will be in a range of Rs. 1.5 lakhs - Rs. 10 lakhs for an individual aged between 3 months - 55 years. And for an individual aged between 56 years - 65 years the sum assured will be from Rs. 1.5 lakhs - Rs. 5 lakhs.
- There are 130 day care procedures that will be covered under this policy.
- For the Bajaj Allianz Individual Health Guard an individual between the ages of 18 - 65 years, is eligible for a policy. For Spouse and parents as well. The proposer can also take up this policy for his/her children they will need to be between the ages of 3 months - 25 years.
Oriental Health Insurance - Individual Mediclaim:
The key features of the Individual Mediclaim Health Insurance are:
- This policy will offer cashless hospitalization and reimbursement hospitalization in the partner hospitals in the country.
- The policy will cover pre and post hospitalization expenses that are of relevance, which would have occurred 30 days prior to hospitalization or 60 days after hospitalization.
- The hospital charges for nursing expenses, room, boarding, etc for Rs. 5000/- or 1% of the sum assured whichever is less.
- For family members covered under this policy, they will receive a 10% discount.
- Any special fees for surgeons, ambulance, consultation etc will be covered under the policy.
- If the individual is in Intensive Care the cost of the Intensive Care Unit will be borne for up to 2% of the sum assured of Rs. 5000/- whichever is less.
- The sum assured will range from Rs. 50,000 - Rs. 5, 00, 00.
Star Health Insurance - Medi Classic Insurance:
The key features of the Medi Classic Insurance are:
- The insured individual will get protection under in patient hospitalization for a minimum of 24hours.
- Surgeon, Medical Practitioner, Anaesthetist, Specialist, Consultants Fees.
- In case of emergencies, charges for transporting the covered patient to a hospital in an ambulance is covered up to Rs. 750 per hospitalisation (maximum Rs. 1500 per policy period).
- Blood, Anesthesia, Oxygen, charges for Operation theatre, Pacemaker cost etc.
- Room charges, nursing expenses, boarding as provided by the Nursing Home or Hospital at also covered at 2% of the Sum Insured (maximum Rs.5,000 per day).
- Non-Allopathic treatments are also covered by this policy up to 25% of the sum insured (maximum Rs.25,000 per policy period).
- The policy term is one year but special discount of 5% is offered when premium is paid for two years in advance.
Understanding Individual Health Insurance:
Who does the individual health insurance plan cover?
The Individual Health Insurance plan covers only the policyholder.
What is the difference between Individual Health Insurance and Family Floater Health Insurance?
In individual health insurance plans, each individual of a family is entitled to a health cover of a certain sum; whereas in the family floater health insurance plan, the health cover of the same amount is shared by all the family members included in the plan.
What does individual health insurance plan cover?
The charges covered by individual health insurance are listed below.
- Medical examinations
- Emergency services
- Laboratory services
- Maternity and new born care
- Room, boarding expenses
- Physician fee
Is there an age limit to avail an individual health insurance?
No. Anyone can avail an individual health insurance.
Does the policy offer tax deductions?
Individual health insurance plan offers tax deductions under section 80D of the Income Tax Act.
Will there be additional costs other than regular premiums?
There are a few additional costs other than regular premiums that one has to pay: Deductibles, Co-payment,Coinsurance
Can my family members be included in the plan?
The main aim of individual health insurance is to provide complete protection just to the insured but the plan can be extended to parents and in-laws in certain cases.
Exclusions in Individual Health Insurance:
Though individual health insurance covers most of the medical expenses, there are some exceptions:
- Individual health insurance covers pre-existing diseases subject to a waiting period of 2 to 4 years which can prove to be a disadvantage to some.
- Cost of prescription glasses, lenses and hearing aids aren’t covered by this plan.
- Dental treatment.
- Naturopathy treatment.
- Certain ailments like cataract, hernia, sinusitis, etc. won’t be covered under first year of policy.
For instance, Mr. Bazi and Ms. Nidhi who were traveling in a car meet with an accident. After the treatment, the hospital bill comes up to Rs.1.8 lakh for each person. Mr. Bazi has a family floater health insurance which offers coverage of Rs.3 lakh for his family of three. Ms. Nidhi has an individual health insurance plan that offers a coverage of Rs.2 lakh. Ms. Nidhi manages to use her insurance to pay for the hospital bills. Unfortunately, Mr. Bazi’s family member had already made a claim of Rs.2.5 lakh the same year for a surgery. Hence, Mr. Bazi had to pay up Rs.1.3 lakh from his own pocket for the medical bills. Since he did not have an individual insurance plan he had to pay from his own pocket. This instance shows why exactly individual health insurance is a better option.
You may also be interested about:
|Family Floater Health Insurance Policies|
|Health Insurance Plans for Senior Citizens|
|Critical Illness Insurance Policies|
|Group/Employer Health Insurance|
|Cashless Health Insurance Policies|
GST rate of 18% applicable for all financial services effective July 1, 2017.
Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.