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What is Individual Health Insurance

Taking care of one’s health has never been easy. Health being compared to wealth is an accurate assessment of how much you need to care about it. However, with technology escalating, the kind of diseases we see also escalate. And the more sophisticated the technology, the more expensive the treatment for illnesses. This is why individual health insurance emerged. Today, insurance is the primary way for people to take care of themselves during a medical emergency. It ensures financial stability in otherwise completely unstable times.

So, what was the need for individual health plans?

  • Health plans for individuals made it possible for people to avoid financial ruin during a medical emergency. The primary need was the financial cover, which health insurance provided. Therefore, it was natural that this insurance would gain popularity.
  • Before health insurance for individuals, a lot of people had to take extreme care of their health. They were constantly at risk of getting an illness. They did not have sufficient money to cover even ambulance charges. Individual insurance countered this risk by providing coverage. The coverage is often extensive so that the individual feels secure with their plan.
  • Often, companies offer a host of benefits along with individual insurance. These may include an increase in the sum assured and other such benefits. Such features make individual insurance desirable, particularly for individuals who are at a higher risk.

Cover 360 brings you the ideal individual plans that meet your needs. We compare and contrast them, giving you the policy you deserve!

Why Buy Individual Health Insurance

Individual Health Insurance is a favourite of a large segment of the Indian population. With a rising population, climate change, and other such anxieties, health concerns also spike. The problem is that healthcare is very expensive. Although necessary, the sophistication of treatments takes a significant toll on the individual. Therefore, having a way of covering the costs matters. And this is where individual health plans come in. So, why should you buy an individual plan?

You never know when a medical emergency will strike. That's why it is called a crisis, after all. Imagine if you carefully plan your finances for the next ten years and then tragedy strikes? That would be terrible. It completely throws your planning out of the window. With individual insurance, you cover your losses. Not completely but at least partially. Therefore, it is an effective tool in countering such financially challenging times.

The number of new diseases doctors discover rises every year. You are always susceptible to a whole host of diseases. You may never have even heard of some of these diseases. But your insurer has, and they provide cover for it.

Getting better technology and learning finer techniques takes money. So hospitals raise treatment costs in response. There has been an upward trend in treatment prices. You need to mitigate these costs, and insurance allows you to do this.

While tax benefits are required by law, there are several other policy benefits you get from choosing individual insurance. The sooner you start looking at individual health plans, the better you are covered. You get more financial benefits.

Cover 360 is here to ensure you are buying the right individual health insurance for your needs, so you get the maximum benefits!

Types of Individual Health Insurance

Individual health insurance is one of the major backbones of the economy. With healthcare prices skyrocketing, losing all your savings in a single medical emergency is a major possibility. Individual health plans prevent such financial ruin. Especially if the individual is the only person with an income or is continuously in a high-risk environment, in such cases, having individual healthcare makes sense. You never know when tragedy will strike. Therefore, you should always be prepared.

There are also different types of individual insurance. And you need to choose one based on your needs.

The standard one with basic coverage is individual insurance. This is what you should ideally get if you are in a high-stress job or a similar environment. Or if you are likely to have smaller problems like failing eyesight. In such cases, your insurance would presumably cover hospitalisation or ENT clinic visits. This is, therefore, a good way of keeping yourself covered as an individual.

Senior citizens are often at a higher risk of falling sick. And their treatments may also cost more due to their age. If you have a parent or grandparent who would benefit from such an insurance policy, get this one. It typically covers individuals of 60 and above, ensuring that they can avail the best care for a lower price.

When buying insurance, always look at family history. If your family has a history of critical illnesses, i.e. terminal illnesses, you may want this policy instead. Critical illness insurance covers a single person by offering a lump-sum payout at the time of diagnosis. Critical illness treatments are typically more expensive than regular treatments so getting cover specifically for that makes sense. Additionally, these policies often do not cover pre-existing illnesses. This means you need to account for the waiting period and get your insurance accordingly.

Maternity insurance is quite popular and is usually offered as a benefit along with a pre-existing policy. It covers the mother’s hospitalisation during childbirth and sometimes also covers newborn expenses for a few weeks. It is quite expensive due to the nearly 100% claim rate but greatly lowers the financial burden of new parenthood once purchased.

This is a unique cover that ensures you or your family are financially secure in the case of an accident. Accidents can cause disabilities or even death. This policy accounts for that and covers hospitalisation charges. It may also offer a fixed monetary benefit in some cases.

Choosing the right plan from the immense number of individual health plans is difficult. You need a clear idea of what you need. And that’s what our specialists at Cover 360 help you with! We ensure you get exactly what you need by analysing and comparing various plans!

Benefits of Buying Individual Health Insurance

Individual health insurance gained massive popularity with good reason. Acting as a financial cover during uncertain times, it ensures that you do not go bankrupt. And with hospitalisation costs, ambulance charges and treatment prices continually rising, its popularity makes sense. Several people opt for individual health plans because they better cater to their needs. An individual plan offers greater coverage, therefore being better than a group plan. It is recommended for people at high risk or sole breadwinners of families.

There are obviously a lot of benefits to buying individual insurance. So let’s see what they are!

Depending on your insurer, you can avail cashless treatment or hospitalisation. This means that you do not pay for anything. Instead, your insurer directly transfers the amount for your treatment to the hospital. All you need to do is give them your bills. Cashless treatment is considered a great benefit since you do not have to wait for reimbursements or anything of that sort.

A lot of times, pre and post-hospitalisation charges are the most financially draining. They require coverage too. Any expenses related to the covered disease may be covered under this clause.

Suppose you buy individual health insurance and then do not claim it. So then your insurer increases your base sum assured as a bonus. This is called the no-claim bonus. It is a huge benefit which ensures that you are covered by an even higher sum when you do claim insurance.

Sub-limits are a clause present in nearly all individual health plans. These limits indicate the extent to which you are financially covered. The room rent sub-limit also indicates this. For example, if your sub-limit is Rs. 3000 and you incur a daily room rent of Rs. 5000, you cover the remaining Rs. 2000 from your own pocket. But this is still a considerable saving, making this a great benefit.

Ambulance charges are also quite expensive. Some people skip ambulances because of the expenses. But if your ambulance ride is covered under your plan, there is no reason you should skip this benefit.

Co-payments take the concept of sub-limits and apply it to the entire policy. This lowers the cost of your insurance since you and your insurer share the cost of treatment. If co-payment is not availed, then you pay much more for your insurance.

A lot of policies include annual health check-ups for free. This means you can ensure that you are healthy and, therefore, can avail your no claim bonus, too.

TPAs are a godsend in today’s world. Insurers and hospitals outsource some of the insurance work to them. This includes claim validations, premium collections etc. Having a TPA makes the entire insurance process faster and more efficient. This means your claim request is judged faster and your settlement is quicker.

Like other health insurances, individual health insurance also offers tax benefits. Under Section 80D of the Income Tax Act, all premiums are tax-deductible. Therefore, you save more money in the long run!

Cover 360 keeps all these benefits in mind when choosing the ideal policy for you. We ensure that you are truly satisfied with your policy by giving you the maximum benefits at the minimum limitations!

Exclusions in Individual Health Insurance

Individual health insurance is a type of insurance that only covers one person. It is quite extensive and prevents your savings from drying up in case of a medical emergency. Due to this, it is massively popular. Some people even choose individual health plans despite being under a group plan. These are typically high-risk individuals who need extra cover.

Individual plans offer extensive cover. But this kind of cover comes at a cost. Since the insurer needs to pay for your medical needs, they cannot cover everything. Even with a co-payment scheme, complete coverage for everything is not possible. Therefore, in order to provide maximum coverage, they need to exclude certain illnesses.

  • Typically, no cover is provided during the waiting period unless an accidental emergency occurs. The waiting period is usually for about 30 days.
  • Generally, critical illness cover and pre-existing illness cover is subject to a 2-4 year-long waiting period.
  • Injuries caused by war/terrorism/suicide attempts/nuclear disasters
  • Terminal illnesses such as AIDS which only have treatments but no cures
  • Cosmetic surgery, hormonal replacements, sex change operations etc.
  • Non-allopathic treatment
  • Foreign treatment or tests and treatments which are done by an under-qualified doctor
  • Dental or eye surgery
  • Bedrest/hospitalisation and rehabilitation, common illnesses etc.

While the exclusions differ from policy to policy, these are some standard exclusions. We recommend that you look at the list of inclusions and exclusions carefully before making your decision.

We at Cover 360 also follow these rules so that we can ensure maximum coverage for you with minimum limitations!

Things to Consider Before Buying Individual Health Insurance

Individual health insurance is meant for people who are at high risk. This may be based on several factors, and individual insurance often gives the right amount of cover. Individual health plans come in many forms such as senior citizen insurance, critical illness insurance etc. You need to choose the one you think would best benefit you.

So how do you know which insurance policy to buy? What should you consider before buying individual health insurance?

Checking your family history is of the utmost importance when deciding which insurance policy to buy. Your family history will give you an idea of what kind of coverage you need. Genetics plays a huge role in what diseases you could get. So you need to be prepared.

Your environment can also affect your health. For example, if you are in a high-pressure job, the chances of contracting a stress-related illness are higher. You need to account for that and choose your policy accordingly.

Even if you do not have the chance of contracting an illness, coverage is important. Choose a plan with the maximum possible coverage and the minimum limitations. Or ensure that the list of exclusions will not be overwhelming.

Every policy has clauses, and a lot have sub-limits. Sub-limits are how much the insurance covers—the remaining amount you have to cover. Based on your financial situation and the kind of situation you foresee in case of a medical emergency, choose a plan.

Most policies have a waiting period. Waiting periods can range from 30 days to a few years. They also differ based on the illnesses. For example, the waiting period for pre-existing illness cover or maternity cover might be longer than for the illnesses covered in your insurance. Therefore, you need to look at all the waiting periods for the individual health plans you are considering.

Getting insurance does not matter if your insurer never settles their claims. Especially in the case of reimbursement-based policies, you need a dependable insurer. A sure sign of dependability is if your insurer has a separate internal claim settlement team or relies on third-party administrators. This is generally a sign that the process will be faster. The bottom line is, choose someone with a high claim settlement ratio - someone you can trust.

Premium loading is a feature of some policies where the premium is increased if the individual is considered to be at a higher risk. In this case, the premium increases by a certain percentage with each claim settlement. Premium loading is usually in the fine print so ensure you always read that. While it may seem reasonable right now, it often becomes a point of upset later.

Checking the age limits on a policy is important. Also, checking your policy term is important. These two features have a close relationship. They determine how long and when you can renew your policy. Renewal is typically when the premium is paid. Usually, if the policy term is longer than a year, you get additional benefits. These are all in the fine print and, therefore, need to be closely examined before purchasing your individual health insurance.

Many times, you may choose an insurance policy and then want to switch to a different policy. Earlier, switching this way was not allowed. Now, as switching becomes more prevalent, health insurance providers allow you to change companies without losing the waiting period. To make this process easier, certain policy providers also have a free-look period of about 15 days. During this time, you are covered by the policy and can decide whether it fits your needs. If it does not, you can leave the policy for a different company without losing your money.

The final thing you need to keep in mind is the kind of coverage you get. Is it a reimbursement process or a cashless treatment process? In a reimbursement process, you bear the costs and the insurance company reimburses you. In a cashless treatment scheme, your insurance provider directly pays the hospital. You only bear the costs as per the co-payment or sub-limit clauses.

Cover 360 ensures you account for all these things before you choose from the many individual health plans out there. Part of trusting us with your history and your needs is that we ensure you are well-covered and we promise nothing less!

Advantages of Individual Health Insurance

Individual health insurance was introduced so that individuals could feel more secure in terms of medical expenses. Medical inflation is rising prices all over the world. The costs for treatments and medications are sky-high. If you are not wealthy, one medical emergency could put a huge dent in your savings. All that financial planning you did for years can completely go to waste! This is why individual health plans came up. Today, they cover a vast range of ailments. Therefore, you are well-covered all the time.

So what are the advantages of choosing individual health insurance?

  • You get reliable financial security in financially uncertain times. Medical emergencies can drain your savings. Having an insurance plan safeguards you against that.
  • You can purchase a range of add-ons, including critical illness cover and maternity cover. This ensures that you are well-covered and ready for anything.
  • A significant advantage is that the entire sum assured covers an individual. A lot of individual insurance plans have similar base sums assured to family insurance schemes. However, by applying entirely to an individual, the individual plan offers more safety.
  • An insurance policy has many benefits. These include features like a no-claim bonus where your assured sum increases if you do not claim it during the policy term. Some providers include a portability feature where you can change insurance companies without having to restart the waiting period. You also may get free health checkups and other such benefits under a policy.
  • You get tax benefits since your insurance premiums are tax-deductible under Section 80D of the Income Tax Act. This is usually up to Rs. 25,000 for individuals. Such features draw more people to the insurance option.

These are just some of the advantages that individual plans generally give you. Your specific plan will be better. Especially with Cover 360 by your side, you will get the greatest advantages and benefits from your individual insurance plan with the fewest possible limitations!

Best Plans in Individual Health Insurance

Individual health insurance is a plan which only covers an individual. Today, it is probably the most popular form of insurance. Individual health plans offer a specific sum if a medical emergency strikes. This sum ensures that you do not fall into a financial crisis during health issues.

This puts individual health insurance in high demand. Insurers have responded to these demands by introducing a variety of plans. This makes choosing the perfect plan difficult. Well, not to worry, because we have put together some of the best available individual health plans. With these as a starting point, you know exactly what to look for!

HDFC Ergo Health Insurance – Optima Restore Plan
  • Sum Insured: Rs. enhance from 5 lakh– 50lakhs.
  • Entry Age: 5 – 65 years for individual;91 days – 25 year for floater children.
  • Pre and Post-Hospitalisation: 60 days and 180 days, respectively.
  • Renewability: Lifelong
  • Policy Term: 1 – 2 years.
  • Coverage: Daycare treatments; domiciliary treatments; Organ donors; Health checkups offered based on sum insured.
  • Ambulance Cover: Rs. 2000 / hospitalisation
  • Benefits: Cashless hospitalisation; Restore benefit; Portability, i.e. switching to this policy from your previous policy; No-claim bonus; Treatment expenses for the organ donor at the time of organ transplant is covered.
Religare Health Insurance – Care Health Plan
  • Sum Insured: Rs. 4 lakhs – 6 crores.
  • Entry Age: 5 – no age limit for individual; 91 days – 25 year for floater children.
  • Pre and Post-Hospitalisation: 30 days and 60 days, respectively.
  • Renewability: Lifelong
  • Policy Term: 1 – 3 years.
  • Coverage: Daycare treatments, room rent (coverage depends on sum insured), doctor’s fees, medical charges, maternity cover, annual health checkup, second opinion cover, domiciliary cover.
  • Ambulance Cover: Rs. 1500 – 3000/hospitalisation
  • Benefits: Covers non-allopathic treatments; Restore benefit; No-claim bonus; Treatment expenses for the organ donor at the time of organ transplant is covered.
Oriental Health Insurance – Individual Mediclaim Plan
  • Sum Insured: Rs. 1 – 10lakhs.
  • Entry Age: 18 – 65 years.
  • Pre and Post-Hospitalisation: 30 days and 60 days, respectively.
  • Renewability: Lifelong
  • Policy Term: 1 year.
  • Coverage: Room, boarding, nursing expenses; Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Fees; Domiciliary treatments.
  • Ambulance Cover: Rs.2,000 or 1% of the sum insured whichever is less per hospitalisation subject to aggregate expenses not exceeding Rs. 4000 under the policy.
  • Benefits: Free-look period; Cashless hospitalisation; Pre-existing disease cover after the 4th renewal; Portability; Daily cash allowance.
Bajaj Allianz Health Insurance – Health Guard Insurance Plan
  • Sum Insured: Rs. 3 – 50lakhs.
  • Entry Age: 18 – 65years; 3 months – 30 years for dependent children/grandchildren.
  • Pre and Post-Hospitalisation: 60 days and 90 days, respectively.
  • Renewability: Lifelong
  • Policy Term: 1 – 3 years.
  • Coverage: Room, Boarding and Nursing Expenses as provided by the Hospital/Nursing Home up to 1% of sum Insured per day (Excluding Cumulative Bonus) or actual, whichever is lower. If admitted in ICU, they will pay up to actual expenses provided by Hospital; Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees; Anesthesia, Blood, Oxygen, Operation Theatre Charges, surgical appliances, Medicines & Drugs; Dialysis, Chemotherapy, Radiotherapy, Cost of Artificial Limbs, Cost of Prosthetic Devices implanted during surgical procedure like Pacemaker, orthopaedic implants, infra cardiac valve replacements, vascular stents, relevant laboratory diagnostic tests, X-ray and such similar expenses that are medically necessary.
  • Ambulance Cover: Rs.20,000 per policy year.
  • Benefits: Sum-Insured Reinstatement; Portability; Daily cash allowance; Convalescence benefit; Preventive health checkups; Maternity cover and newborn baby cover; No-claim bonus; Free-look period; Portability.

While these are only some examples of individual health plans, they provide a good starting point for comparisons. They cover some things you need to look for when choosing your policy.

Cover 360 uses these parameters to compare various plans before choosing the ideal one for you!

Eligibility for Individual Health Insurance

Individual health insurance has gained massive popularity due to its appeal during financial crises. Individual plans can literally save you from draining your savings during a health crisis. This is because they cover your medical expenses. Therefore, in times of emergency, they are an excellent fallback option. They become a financial safety net. Due to this, more and more individual health plans are emerging all over the place.

With the growing demand for them, the obvious next step is wondering if you are eligible. Like any other insurance, there must be some criteria. Well, the good news is that meeting the requirements is very easy.

  • Ensure you are within the entry age bracket. Most plans have 18-80 as the minimum and maximum entry age. They offer lifelong renewability, so having coverage throughout is not a problem.
  • If you are getting insurance for your child or a dependent person of your family, ensure they fall within the entry age bracket. This could be anywhere between 91 days to 30 years, depending on the policy.
  • Getting a policy that covers you adequately is essential. Some insurers require a health checkup and then decide your premium based on that. Keeping good health ensures you remain eligible for the lower premium.
  • If you have an illness in your family medical history, get a plan that covers you. This way, you are never caught unaware.

At Cover 360, we help you meet the eligibility criteria of the individual health insurance policy of your choice. Or you can give us your requirements, and we match you with the policy that would bring you the most benefits. Either way, we ensure you remain well-covered through and through!

How to Buy Individual Health Insurance

Individual health insurance protects the insured during a medical emergency. Since medical emergencies can completely wipe out a person's savings, coverage is essential. It prevents complete financial ruin. This is why most insurers offer individual health plans today. These comprehensive plans cover a range of illnesses and medical services. This way, you have nothing to worry about!

Here is how you can buy your health insurance from Cover 360:
  • Step One: Look at our website for the health insurance section.
  • Step Two: Provide the details about your age, etc., which are asked to collate the best options for you.
  • Step Three: Compare the various health plans offered by different insurance providers. This page should give you an overview of the features that attracted you to your insurer in the first place.
  • Step Four: Shortlist a few plans based on your needs and locate their brochures. Most insurers have a very comprehensive brochure dictating precisely what you get from the policy.
  • Step Five: Download the brochure and read it thoroughly. Usually, on the last page, there is a section about both about buying and claiming.
  • Step Six: Make a note of all the documents your healthcare provider needs. If you need to get a health check-up done or get a doctor’s note about any pre-existing condition, this section will tell you.
  • Step Seven: Buy your health insurance!

You can also call us directly to get all the right insurance advice you need.

Cover 360’s experts know every individual plan on the market and can connect you with the one most suited to you.

Individual Health Insurance vs Family Health Insurance

Individual health insurance may be one of the most popular types of health insurance. However, it is far from the only type. Another incredibly popular health insurance is family health insurance. Often, when someone is deciding about health insurance, they wonder if individual health plans are worth it. While the answer is usually yes, you also need to understand why you should choose individual plans.

So, how do individual plans and family plans differ?

  • Coverage: The most significant difference is in terms of coverage. A family health insurance policy may be more extensive because it helps more people. Individual insurance can afford to be more specific in its coverage.
  • No. of Premiums: In a family health plan, the entire family is covered under a single premium. Meanwhile, if you purchase multiple individual policies, you need to pay multiple premiums.
  • Who Benefits: While feature-wise, the two may be mostly the same, they benefit people in different ways. If you have an individual cover of Rs. 50 lakhs, you are the only person covered by that. A family cover of Rs. 50 lakhs means every family member is covered under the same amount. You need to factor in the risk to your health and choose accordingly. A high-risk individual would benefit more from the individual plan.

Cover 360's insurance specialists understand these differences. Therefore, it is our job to guide you in the right direction, so you get the policy which is best suited to yours and your family's needs!

The benefit of Buying Individual Health Insurance From Cover360.in

Individual health insurance is well-known for its ability to curb financial distress. It acts as a safety net when a medical emergency strikes. Due to this, there are a huge number of individual health plans on the market today. This can be exceedingly intimidating.

How do you choose the right plan?

How do you know whether or not a plan is right?

What do you do if your individual health insurance is bad?

Not to worry, Cover 360 is on the case!

  • Earlier, you had to do all your homework about insurance policies. Now, our experts do it for you!
  • With a comprehensive and expansive database of all the best-selling insurance policies, we bring you your ideal options.
  • Our highly qualified analysts identify key differences between policies. They compare and contrast various policies, this way determining which features are desirable.
  • Then we take your details and your medical history so we can decide which insurance policy is best for you.
  • Don't like it on the first go? Not to worry! We are here for you, even after that. If you drop out during the free-look period, you have nothing to worry about!
  • If your policy does not initially have a free-look period, we help shift you to a policy with a portability clause. This way, you do not worry about the waiting period!
  • We regularly follow-up with you and make sure you are satisfied with your policy. We are here to answer any questions you have at any point during your insurance policy!

Reach out to us with any query at any point, and we are here to help. After all, we care about your health. We are not just getting you covered and then leaving you. You deserve security, and we ensure that it is what you get. The maximum-security at the minimum limitations!