Health Insurance · Medical Protection · Individual Cover
Individual Health Insurance
Health insurance designed to provide financial protection against eligible medical and healthcare expenses.
Medical Cover
Protection against eligible healthcare expenses.
Hospitalisation
Coverage for eligible hospitalisation expenses.
Cashless Care
Cashless treatment at eligible network hospitals.
Financial Protection
Helps reduce unexpected medical expenses.
Tax Benefit
Eligible premiums may qualify under Section 80D.
Overview
What is Individual Health Insurance?
Individual Health Insurance provides financial protection against eligible medical and healthcare expenses incurred by an insured individual.
Each insured person generally has a separate sum insured, subject to the policy terms, conditions and exclusions.
Common Coverage
Hospitalisation expenses
Pre- and post-hospitalisation expenses
Day-care treatments and procedures
Diagnostic tests and investigations, where covered
Ambulance expenses, subject to policy terms
AYUSH and advanced treatments, where covered
Actual coverage, exclusions, sub-limits, deductibles, co-payments and waiting periods depend on the specific policy.
Eligibility
Who Can Buy Individual Health Insurance?
- Adults may purchase individual health insurance
- Eligibility depends on the insurer and product
- Entry age limits may apply
- Medical history may be considered
- Existing conditions may affect underwriting
- Residential status and product rules may apply
KYC
Documents Generally Required
- PAN, Aadhaar, Passport or other accepted identity proof
- Address proof for KYC
- Age proof such as Aadhaar, passport or birth certificate
- Medical history and existing illness details
- Medical reports or tests, where requested
- Income or supporting documents where required
Key Benefits
Why Choose Individual Health Insurance?
- Personalised coverage based on healthcare requirements
- Separate sum insured for the insured individual
- Financial protection against eligible medical expenses
- Cashless treatment at eligible network hospitals
- Coverage for pre-existing diseases after applicable waiting periods
- Policy renewal and continuity benefits subject to applicable rules
Medical Protection
Coverage for Eligible Medical Expenses
Depending on the policy, coverage may include hospitalisation, surgery, day-care procedures, diagnostic investigations, ambulance expenses, AYUSH treatment and other specified medical expenses.
Hospitalisation
Eligible inpatient medical expenses according to the policy.
Day Care
Covered procedures that do not require extended hospital stay.
Diagnostics
Tests and investigations where covered by the policy.
Cashless Facility
How Does Cashless Treatment Work?
Network Hospital
Eligible expenses may be settled directly
Where a cashless facility is available, eligible treatment expenses may be settled between the hospital and insurer or claims administrator.
Important
Cashless does not mean everything is covered
Expenses outside the policy's payable conditions may still have to be paid by the insured.
Waiting Period
Understand Waiting Periods
- Initial waiting period may apply
- Specified diseases or treatments may have separate waiting periods
- Pre-existing diseases may be covered after the applicable waiting period
- Continuous renewal may help preserve accumulated waiting-period credits
Continuity
Portability, Migration & Renewal
Health insurance policies may provide portability or migration options under applicable regulations and policy conditions. Portability can allow certain accumulated credits, including waiting-period credits, to be transferred when moving between eligible policies or insurers, subject to applicable rules.
Renewing the policy on time is important for maintaining continuity and applicable accumulated benefits.
Where to Buy
Insurance Companies & Authorised Channels
Insurance Companies
Purchase directly through insurer websites, branches or authorised channels.
Agents & Brokers
Registered agents, brokers and authorised digital platforms may also offer health insurance.
Verify that the insurer or intermediary is appropriately registered or authorised before purchasing.
Tax Treatment
Tax Benefits Under Section 80D
Premiums paid for eligible health insurance policies may qualify for deductions under Section 80D of the Income-tax Act, subject to applicable limits, conditions and tax laws in force.
Tax provisions may change based on amendments and the applicable tax regime.
Before You Buy
What Should You Check?
- Choose a suitable sum insured
- Understand initial and disease-specific waiting periods
- Disclose medical information accurately
- Check the insurer's network hospitals
- Review co-payment, deductibles and sub-limits
- Check room-rent and ICU limits
- Understand permanent and temporary exclusions
- Compare benefits, premiums and claim servicing
Medical Disclosure
Disclose Your Medical Information Correctly
Provide complete and accurate information about existing illnesses, previous treatments, surgeries, hospitalisation history and current medication. Incorrect or incomplete disclosure may affect underwriting or claim settlement, subject to applicable laws and policy terms.
Policy Conditions
Understand Co-payment, Deductibles & Sub-limits
Co-payment
A specified portion of an eligible claim that may be paid by the insured.
Deductible
An amount the insured pays before the policy benefit becomes payable.
Sub-limits
Limits that may apply to specific treatments or expenses.
Things to Know
Before Buying Individual Health Insurance
- Do not select a policy based only on the lowest premium
- Check the sum insured against your expected healthcare costs
- Review waiting periods and exclusions carefully
- Check room-rent, ICU and disease-specific limits
- Verify network hospitals and cashless conditions
- Understand co-payment and deductible requirements
- Compare claim servicing and renewal terms
- Read the complete policy wording before purchase
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