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Individual Health Insurance

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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.

Key Features:

  • 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. Including expenses such nursing expenses, room, board and surgeons, ambulance, consultation etc.
    • The cost of medication and other drugs required also will be covered.
    • The policy will cover pre and post hospitalization expenses that are of relevance, which would have occurred 30 days prior to hospitalization. Post hospitalization will be covered to a limit specified.
    • Under this policy up to 101 day care treatments will be covered.
    • This policy will cover non-allopathic treatments as well, covered up to specified limits.
    • The individuals eligible for this policy will be anyone within the age of 5 months - 65 years, with individuals over 50 years will need to have medical screening.

Understanding Individual Health Insurance:

  1. Who does the individual health insurance plan cover?

    The Individual Health Insurance plan covers only the policyholder.

  2. 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.

  3. What does individual health insurance plan cover?

    The charges covered by individual health insurance are listed below.

    • Medical examinations
    • Hospitalization
    • Emergency services
    • Laboratory services
    • Maternity and new born care
    • Room, boarding expenses
    • Physician fee
  4. Is there an age limit to avail an individual health insurance?

    No. Anyone can avail an individual health insurance.

  5. Does the policy offer tax deductions?

    Individual health insurance plan offers tax deductions under section 80D of the Income Tax Act.

  6. 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
  7. 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.

An Example:

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.

Individual Health Insurance Reviews

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  • United India Health Insurance
    "Good Claim Experience"
    0.5 5.0/5 "Blown Away!"
    I got group insurance from company, on time I got policy. My father was not good at the time I have used the policy. I got the reimbursement around Rs. 23,000 the total value is Rs. 33,000. I went to shobha hospital they don't have tie up with United India, hence I got the reimbursement.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 18, 2019
  • Max Bupa Health Insurance
    "Good Claim Experience"
    0.5 5.0/5 "Blown Away!"
    I have medical cover with Max bupa, they gave me the coverage value of Rs. 5 lakhs its covers for entire family. One time I claimed for my mother for the eye surgery, I got the reimbursed within 30 days with 90% of amount, the total experience was good.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Jan 18, 2019
  • New India Health Insurance
    "Yet to experience the policy"
    0.5 5.0/5 "Blown Away!"
    My company has provided me a health insurance policy from new India. As per company norms, they have given me a coverage value of Rs. 5 lakhs. My entire family has been covered in this policy. They are offering a cashless treatment facility.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 18, 2019
  • United India Health Insurance
    "Very Good Service"
    0.5 4.0/5 "Great!"
    I had taken this insurance policy in the year of 2018 and the the premium has been deducting from my salary. The premium amount has not been too high and there has been many hospitals collaborated within my locality. There has also been some cashless treatment available with this policy as well.
    Was this review helpful? 0
    , chennai
    Reviewed on Jan 17, 2019
  • Star Health Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have my health insurance with Star health insurance, i had claim experience with it, my experience was good, they have good tie up with my hospital and they have mailed me about the location of it, and i am happy with there service, they have charged me premium amount on yearly basis, and the premium amount is nominal for me, and i use to pay through on line mode.
    Was this review helpful? 2
    , chennai
    Reviewed on Jan 17, 2019
  • Max Bupa Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have taken my health insurance with Max BUPA , i have not opt there policy yet and i use to pay premium on monthly bases , and it use to get auto debit from my account and while i applied for health insurance customer service had explained me about all procedure , so far the process went smoothly and it good.
    Was this review helpful? 0
    , new delhi
    Reviewed on Jan 17, 2019
  • Max Bupa Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I got the health insurance with Max bupa health insurance, there service is good, they have charged me premium nominal ,and the premium is on yearly basis, and they have tie up with many hospital , and had shared the details via mail, and i pay premium amount through on line mode.
    Was this review helpful? 0
    , new delhi
    Reviewed on Jan 17, 2019
  • HDFC Ergo Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I got the health insurance with HDFC Ergo, they got tie up with many hospitals, and they have shared me location on those hospital in mail, and they have charged me nominal premium amount ,they have charged me up to 17000-18000 as premium, it is on yearly basis, and i use to pay the premium on an on line basis.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 17, 2019
  • SBI General Health Insurance
    "Bad experience"
    0.5 1.0/5 "Really Bad"
    I got the health insurance with SBI, they got tie up with many hospitals. I Felt the medical cover its less and i am not happy with there support team ,like if i want to call the customer care there number would not be reachable and they use to mail me PDF after paying premium amount,it would not get open, they have charged me premium amount on yearly basis,i have bad experience with this bank.
    Was this review helpful? 0
    , gurgaon
    Reviewed on Jan 16, 2019
  • HDFC Ergo Health Insurance
    "Very good benefits"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance from HDFC ERGO which was purchased by me in the year of 2018 because the benefits are very good. The claim process was simple and they have more number of hospitals for cashless. I have paid 18,800 for one year and took 3 years policy for myself and my wife. The medical coverage is 10L for myself and 5L for wife.
    Was this review helpful? 2
    , bangalore
    Reviewed on Jan 14, 2019
  • HDFC Ergo Health Insurance
    "Good"
    0.5 3.0/5 "Satisfactory"
    I have taken health insurance from HDFC Ergo which was offered along my personal loan. I have received the insurance paper and its been couple of months. It covers critical illness and need to go through the policy benefits. Always the customer is good.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 14, 2019
  • Tata AIG Health Insurance
    "Great company"
    0.5 5.0/5 "Blown Away!"
    I have taken health insurance from tata aig. I did take health insurance from tata aig for my parents and The Process was so simple. Customer representative is good. The customer service and response was on time, never had any issues. Now I feel safe for my family Thank you tata aig.
    Was this review helpful? 1
    , solapur
    Reviewed on Jan 12, 2019
  • ICICI Lombard Health Insurance
    "Good Health insurance provider"
    0.5 3.5/5 "Pretty good"
    This policy was part of my employment, I took the medical coverage of Rs. 5 lakhs for the tenure of one year, this medical benefits for my entire. They have good networks of hospital with major disease cover. But I think it doesn't have no claim bonus.
    Was this review helpful? 0
    , chennai
    Reviewed on Jan 11, 2019
  • Reliance General Health Insurance
    "On time approval with reliance"
    0.5 4.0/5 "Great!"
    For my spouse operation I used the health policy, I approached them for the claim through hospital. I submitted the form and they send the papers to the Reliance insurance company. I got the cash less treatment, but I paid some amount which was not covered. But they gave me the on time approval.
    Was this review helpful? 1
    , kolkata
    Reviewed on Jan 11, 2019
  • Cigna TTK Health Insurance
    "On time service"
    0.5 5.0/5 "Blown Away!"
    On time Cigna TTK have activated the policy which provided by the company, the policy which I hold it has the coverage of Rs. 4 lakhs its covers for me. They are providing coverage for the pre existing with the tax benefits but there is no claim.
    Was this review helpful? 1
    , dandeli
    Reviewed on Jan 10, 2019
  • Cigna TTK Health Insurance
    "Its Good"
    0.5 5.0/5 "Blown Away!"
    In Cigna TTK, they are providing pre existing disease cover, but they don't have no claim bonus features. The response is good they have good customer care working 24/7 , the medical coverage is good for me and entire family. They have many hospital which they got tie up in Mumbai.
    Was this review helpful? 0
    , mumbai
    Reviewed on Jan 10, 2019
  • Apollo Munich Health Insurance
    "Excellent Service"
    0.5 5.0/5 "Blown Away!"
    I had taken this insurance policy a while back and i had been paying the premium amount on an annual basis. The premium method has been convenient and the premium amount has not been high. There has been many hospitals covered in my locality and their customer support has also been helpful.
    Was this review helpful? 2
    , pune
    Reviewed on Jan 09, 2019
  • ICICI Lombard Health Insurance
    "Good policy"
    0.5 4.0/5 "Great!"
    My organization has provided me a health insurance with ICICI Lombard. I have not claimed anything from this policy. My entire family has been covered in this policy. They have given me a coverage value of Rs. 3 lakhs. This is a cashless policy.
    Was this review helpful? 0
    , new delhi
    Reviewed on Jan 09, 2019
  • Star Health Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    My company has offered a health insurance from Star Health with the coverage of 1L, its for the family, Still I have not used the policy and am gone utilize the policy within 15 days for my family.They covers a major disease. I have called the customer service and the response is good. I am planning to go for reimbursement, they do have minor network of hospitals for cashless. I can recommend after completing my claim.
    Was this review helpful? 1
    , chennai
    Reviewed on Jan 09, 2019
  • National Insurance Health Insurance
    "Good"
    0.5 5.0/5 "Blown Away!"
    My company has provided me a health policy from National insurance with the coverage of 2L. It is for the family members and no claim. I never contacted the customer service. Every year it was renewed by the company. They have limited networks of hospitals for cashless. It does not cover only eye problems, if we got admitted in hospital for 24hrs then applicable for claim.
    Was this review helpful? 0
    , pondicherry
    Reviewed on Jan 09, 2019
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