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Benefits of Individual Health Insurance Coverage

Benefits of Individual Health Insurance Coverage

With healthcare expenses rising steadily in India, even one medical emergency can leave you with a significant financial burden, exhausting your savings and impacting your financial security.

Having medical insurance coverage for individuals is crucial for managing the financial complexities during medical emergencies. It provides a financial safety net to manage any unexpected medical expenses without compromising on the quality of healthcare and treatments. 

If you are looking for individual health coverage to safeguard your financial future in times of need, understanding the various benefits of individual health insurance is necessary. 

This comprehensive guide will help you choose the best healthcare plans for individuals. 

List of Benefits of Individual Health Insurance


Benefits of Individual Health Insurance

Description

Financial protection

Covers various medical expenses in case of emergencies 

Comprehensive coverage

Covers hospitalisation expenses, ambulance charges, treatment expenses and more

Customisable 

Allows you to customise plans as per specific requirements and budget 

Tax benefits 

Provides tax deductions under Section 80D

No Claim Bonus

Allows you to benefit from discounted premiums for every claim-free year

Cashless claims

Offers authorised network of hospitals for cashless claims and quality healthcare

 

Top Benefits of Individual Health Insurance


To understand better, let us look at each of the individual health coverage benefits in detail below. 

Financial Protection with Individual Health Insurance


When medical emergencies arise, they do not come with a fair warning but require extensive financial backing to cover the medical expenses of the required treatment. Individual health coverage offers policyholders a sum insured amount to cover these expenses easily without draining their financial resources.

 Comprehensive Coverage of Individual Health Insurance


One of the most significant benefits of individual health insurance is comprehensive coverage of medical expenses. Depending on the type of health insurance plan you choose for individual health coverage, the inclusions in the policy commonly include - 

  • In-patient treatments 

  • Pre and post-hospitalisation expenses

  • Ambulance charges

  • Daycare procedures 

  • Room rent charges 

  • Pre-existing diseases (varies from policy to policy)

  • Special medical treatments (varies from policy to policy)

  • Diagnostic tests charges

  • Doctor consultation fees, etc. 

Customisation Flexibility of Individual Health Insurance


For added convenience and to maximise health insurance coverage, you can customise your individual health coverage with a wide range of add-ons. These add-ons can be combined based on your specific coverage requirements with the base policy for an additional fee towards the premium amount. 

Some of the add-ons you can choose from include - 

  • Consumable cover

  • Vision correction cover

  • Second opinion cover

  • Vaccination cover 

  • Air ambulance cover 

  • Convalescence cover 

  • Hospital cash cover

  • Double cover for additional financial support 

  • Change in modern treatment limit cover 

  • Guaranteed cumulative bonus cover

  • Change in pre-post-hospitalisation limit cover, etc.

Tax Benefits of Individual Health Insurance


In addition to the financial benefits of individual health insurance plans, you can also receive significant tax benefits towards the premium payments. 

According to Section 80D of the Income Tax Act, you can benefit from a tax deduction of up to ₹1 lakh, with a limit of up to ₹25,000 for individuals below the age of 60 years, ₹50,000 for parents who are senior citizens above the age of 60 years.

Moreover, you can receive an additional ₹5,000 tax relief towards expenses incurred due to preventive health check-ups. 

No Claim Bonus


Many health insurance plans for individuals offer cumulative bonuses called No Claim Bonus for the policyholders. Under this inclusion, individuals who do not file any claim in one policy year benefit from discounted premiums for the same plan at the time of renewal. 

For every claim-free year, the renewal discount can increase, reducing the premium value for individual health coverage. Moreover, with this bonus, individuals practise healthy living to avoid making claims and reduce their risk of urgent medical treatments. 

Cashless Hospitalisation


For maximum claim convenience, you can avail of cashless claims with individual health insurance coverage at either a network hospital authorised by your insurer or any hospital of your choice in India.

With this convenience, the stress of immediate payment towards medical treatment and hospitalisation expenses will be dissolved as the insurer will pay the hospital on your behalf once your treatment is completed. 

Common Inclusions and Exclusions of Medical Insurance Coverage for Individuals


Inclusions 

Exclusions 

Pre and post-hospitalisation expenses

Wellness and rejuvenation expenses

Daycare procedures 

Self-inflicted injuries 

Injuries due to accidents 

Substance abuse

Burn injuries 

Cosmetic procedures 

AYUSH benefit 

Dietary substances

Ambulance cover

Non-allopathic treatments 

Room rent cover

Maternity expenses

Injuries incurred due to negligence from third parties

Dental procedures 

Critical illness cover (varies from policy to policy)

Voluntary participation in high-risk activities 

Pre-existing conditions (varies from policy to policy)

Infertility treatments 

Treatment-related expenses (doctor fees, medication charges, nursing care expenses, etc.)

Vision improvement treatment for refractive error less than 7.5 diopter

Doctor fees

Nuclear attacks or war

Restoration benefit cover

Many health insurance plans offer an easy restoration benefit that allows you to instantly restore your sum insured amount for the same claim in emergencies


How to Choose the Best Healthcare Plans for Individuals?

  1. Premiums - When purchasing any type of insurance policy, cost is the primary factor to consider. The premium amount can vary depending on the insurer. However, based on your individual coverage needs and budget, assess which policy aligns with your requirements and budget. 

  2. Specific Inclusions and Exclusions - As a customer, you also have the right to verify the exact constraints or restrictions in your health insurance policy. You must check for the inclusions and exclusions available with different plans to shortlist the best healthcare plans for individuals based on your requirements. 

  3. Coverage for Pre-Existing Conditions - When purchasing individual health insurance coverage, check the coverage for pre-existing conditions if you have one. This will help you finalise a plan that provides maximum coverage for your medical needs without the risk of unexpected claim rejections later on.

  4. Claim Convenience - Assess the different insurers available to you based on the claim convenience they offer in terms of procedures to follow for online and offline claims, claim settlement formalities, waiting periods, customer support for claims, etc. This will allow you added convenience in times of emergencies.

  5. Reviews and Claim Settlement Ratio - Check online customer reviews and testimonials and assess the claim settlement ratio of various insurers to determine which one promises the best individual health coverage as per your needs. 

  6. Policy Purchase and Renewal Support - With digitisation taking over the world, look for individual health insurance plans that offer online convenience for policy purchase and renewals. This helps save a lot of time and effort and allows easier comparisons between different plans before final purchase. 

Other Types of Health Insurance Plans

An individual health insurance plan is best suited for people looking for a financial safety net to protect themselves from medical expenses during emergencies. However, there are various other plans that offer comprehensive coverage for individuals and families.

Let us take a look at them below. 

Types of Health Insurance Plans

Purpose 

Individual Plans

Suitable for individuals under the age of 65 years to get financial coverage for medical emergencies. 

Family Floater Plans

Affordable health insurance plan to provide comprehensive coverage for the entire family (self, spouse, children and parents) under a single policy. 

Senior Citizen Plans

Suitable for senior citizens above the age of 65 years looking for extensive coverage for pre-existing conditions along with a financial safety net for new medical issues.

Personal Accident Insurance Plans

A specific health insurance plan that covers damage or loss (partial or complete disability and death) incurred by the policyholder. It also pays for the education of up to two children of the policyholder.

Critical Illness Insurance Plans

A specialised health insurance plan that provides a sum amount towards various critical illnesses to cover the cost of treatment, other medical fees and loss of income. 

Super Top-Up Insurance

It is a back-up plan for your health insurance plan in case your sum insured amount does not cover the incurred medical expenses. 


Conclusion

Managing the financial and mental burden of medical emergencies can be daunting. However, with an individual health insurance plan, you can bid goodbye to the financial stress and handle medical emergencies with peace of mind.

With the various benefits of individual health insurance plans, you must invest in one at the earliest to enjoy additional perks of discounted premiums due to age, location, etc. For families, you can also compare Family Floater vs Individual Health Policy benefits to choose and safeguard yourself and your family with the right health insurance. 

Reliance General Insurance offers a wide range of comprehensive health insurance plans, such as the Health Infinity Insurance plan, to cater to the specific needs of individuals and families. You can further customise your chosen plan with various add-ons to increase the base policy coverage for additional coverage requirements and convenience. 

Frequently Asked Questions

  1. What factors determine the individual health insurance premium value?

    Some factors that impact the premium amount for your individual health coverage include your age, your medical history, your family's medical history, pre-existing illnesses, lifestyle, habits​, location of residence and the list of add-ons combined with the base policy.

  2. Why should I choose family health insurance over individual health insurance for each family member?

    If you are looking to get health insurance for your entire family, you can either choose individual medical coverage for each member or get them all insured under one plan called family health insurance.

    The benefits of a family health insurance policy include the following -

    • Increased affordability when compared to individual plans for every member

    • Individual sum insured for each family member under one plan

    • Easier management 

    • Convenient renewals

  3. How to assess the ideal coverage for my individual health insurance plan? 

    To assess the ideal coverage for an individual health insurance plan, you must understand your coverage needs and budget, consider your lifestyle habits and medical history, check the kind of additional benefits you require, and evaluate the deductible and copayment you can afford.

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