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A Health Insurance Policy would normally cover expenses reasonably and necessarily incurred under the following heads in respect of each insured person subject to overall ceiling of sum insured (for all claims during one policy period).

a. Room, Boarding expenses
b. Nursing expenses
c. Fees of surgeon, anesthetist, physician, consultants, specialists
d. Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pace maker, Artificial limbs, cost or organs and similar expenses.

Cumulative Bonus (CB): Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal subject to a maximum percentage (generally 50%). In case of a claim, CB will be reduced by 10% at the next renewal.

Cost of Health Check-up : Health policies may also contain a provision for reimbursement of cost of health check up. Read your policy carefully to understand what is allowed.

Minimum period of stay in Hospital : In order to become eligible to make a claim under the policy, minimum stay in the Hospital is necessary for a certain number of hours. Usually this is 24 hours. This time limit may not apply for treatment of accidental injuries and for certain specified treatments. Read the policy provision to understand the details.

Pre and post hospitalization expenses : Expenses incurred during a certain number of days prior to hospitalization and post hospitalization expenses for a specified period from the date of discharge may be considered as part of the claim provided the expenses relate to the disease / sickness. Go through the specific provision in this regard.

Cashless Facility : Insurance companies have tie-up arrangements with a network of hospitals in the country. If policyholder takes treatment in any of the net work hospitals, there is no need for the insured person to pay hospital bills. The Insurance Company, through its Third Party Administrator (TPA) will arrange direct payment to the Hospital.

Expenses beyond sub limits prescribed by the policy or items not covered under the policy have to be settled by the insured direct to the Hospital. The insured can take treatment in a non-listed hospital in which case he has to pay the bills first and then seek reimbursement from Insurance Co. There will be no cashless facility applicable here.

There are varieties of Health Insurance Products design to meet your insurance needs. Compare and choose the best health insurance plan for Individual Health Insurance offered by leading insurers in India.


Apollo Munich



Max Bupa

National Insurance

Plan Name/Features

Optima Restore-Individual

Religare Care

My Health Medisure Classic Insurance Heartbeat -Individual- GOLD Plan

Heartbeat -Individual- GOLD Plan

Mediclaim - Individual

Room Rent

No Capping

Single private room

1% of sum insured max. 4000 per day ICU 2% of sum insured max. 6000 per day

No Capping

1% of S.I.(Max Rs. 5000)/-day I.C.U 2% of S.I.(Max Rs. 10000)/-day

Pre-Existing Disease Cover

After 3 Years

After 4 consecutive year of insurance

After 3 consecutive year of insurance

After 4 Years

After 4 Years

Maternity Benefits

Not covered

Not covered

After 4 years

If S.I. 5 Lacs , Rs 40000, S.I. 7.5 Lacs , Rs 45000, S.I. 10 Lacs , Rs 50000, Upto 2 deliveries (After 2 years)

Not covered

Ambulance Charges

 Upto Rs.2,000 per hospitalization

Upto Rs.2000

Upto Rs. 1500


Upto Rs. 1000

Cashless Benefit

In network Hospitals

In network Hospitals

In network Hospitals

In network Hospitals

In network Hospitals

Domiciliary Hospitalization


Upto 10% of sum insured


If S.I. 5 Lacs , Rs 25000, S.I. 7.5 Lacs , Rs 37500, S.I. 10 Lacs , Rs 50000


Free Health check up

Not covered

Every year

1% of sum insured (after 4 claim free years)

Yearly at the time of renewal

1% of the Sum Insured for the block of 4 claim free years

Tax Benefit






Sum Insured 5 Lakh/ Age 25 yrs






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