Health Insurance

Getting a health insurance policy is key to securing quality treatment without worrying about its impact on your finances. On Bajaj Markets, you can get coverage of up to ₹2 Crores with affordable premiums starting at just ₹160 per month from leading insurers.

Different plans offer coverage for different expenses, so choose the best one for you by researching and comparing your options. The ideal policy is the one that offers an adequate sum insured at premiums that fit your budget.

This type of insurance plan reimburses you for certain expenses related to healthcare in return for an annual/monthly premium. It helps to protect your finances in the event that you are hospitalised, undergo treatment or require medicines, check-ups, or consultations with doctors.

Most insurance providers offer online facilities enabling you to choose an insurance plan in a few clicks. Here are some of the top reasons why it is smart to get health insurance online:

1. Plenty of Choices and Easy Comparison

You have easy access to more options in terms of plans and insurers online. With all the required details at your fingertips, you can compare them conveniently too. This facilitates informed decision-making and ensures you secure adequate coverage for the right price.

2. Cost-Effective 

Buying a policy offline usually involves an agent, while getting one online eliminates this middleman. By eliminating a commission for agents, you can get the policy more affordably online. 

The quick digital process also lowers other administrative costs of the insurer, which helps keep the premium amount low. You can thus get the same coverage and benefits at a reduced price.

3. Instant Access to Policy

Verification and other processes are faster when you choose the online mode. As soon as you submit the form and pay the premium, you will receive the health insurance policy on your email ID. There is less delay as you do not need to wait for it to be delivered to your home. 

4. Convenient and Simple

When you sign up for health insurance online, you are not bound by typical working hours. You can get it whenever you want, no matter where you are. 

Digital processes also do away with the need to take prints and carry physical copies of documents. Simply upload basic paperwork by following clear instructions and you can get a policy hassle-free. 

5. Safer 

Health insurance providers ensure their digital payment gateways are secure, which helps make sure your details are safe. Before you proceed, ensure that you are on the official website and that your connection is secure so you can pay stress-free.

Rather than delaying your purchase, get a health plan right away. Here are some of the benefits of acting fast:

1. Comprehensive Cover

Sourcing sufficient funds to finance timely treatment can be a strain. A health insurance policy comes in handy as the insurer covers medical costs as per the terms and up to the sum insured. 

Apart from hospitalisation costs, most plans cover diagnostic expenses, OPD, ambulance charges, and more. Most insurers charge nominal premiums so you can get comprehensive protection affordably. 

2. Superior Quality Treatment

Since the insurer pays for most medical expenses, you don’t have to rely on your savings. This eliminates finances from the equation and allows you to focus on choosing the best facilities for excellent treatment.

3. Tax Benefits

You can claim a deduction u/s 80D on health insurance premiums you pay for yourself and your family. The amount varies and can go up to ₹1 Lakh, which adds to your savings.

Your policy’s sum insured determines the maximum amount that your insurer will pay. If the amount is inadequate, you will have to pay out of your own pocket. So, choosing the right amount is crucial. 

However, since individual needs are different, the ideal coverage amount varies. Experts suggest that you should get medical insurance for at least 50% of your annual income. So, if you earn ₹15 Lakhs a year, your sum insured should be approximately ₹7.5 Lakhs.

Due to rising medical inflation, experts also suggest that if 50% is too low, your health insurance cover should be a minimum of ₹5 Lakhs. However, these are just general estimates. Consider the following to determine the ideal coverage for your needs:

• Medical history

• Age

• Family health history

• Preferred hospitals

• Lifestyle

1. Corona Rakshak Policy

This plan covers various needs related to COVID-19. In the event of a 72-hour hospitalisation due to COVID-19, you can claim the sum insured from the insurance company. You can also claim benefits that cover various protective items such as: 

• Personal Protective Equipment

• Ventilators

• Oxygen cylinders, etc. 

   

Each premium payment can help you subscribe to the Corona Rakshak policy for up to 9.5 months. You can claim its benefits and coverage if you are diagnosed with COVID-19 within that policy term.

2. Corona Kavach Policy

This benefit-based plan offers you wholesome coverage for hospital treatments, at-home COVID-19 care and AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) treatments. Under this policy, you can also claim coverage for protective items and other equipment used for COVID-19 treatment. 

Here are some common medical expenses that fall under the category of what’s not covered  under your health insurance:

1. Cosmetic Surgery

The insurer is not liable to cover the costs of plastic or cosmetic surgery unless it is required due to an accident.

2. Specific Illnesses

There are some specific medical conditions that the insurer will not cover. These include hernia, STIs, joint problems, and more. The list will be mentioned in the policy document.

3. Self-Injury

Insurance providers are not liable to pay for treatment that arises due to any self-inflicted injuries. 

4. Dental Expenses

These expenses are generally outpatient procedures, meaning they do not need hospitalisation. As such, the health insurance plans do not cover them.

5. War and Related Perils

Any insurance policy will not cover the expenses related to the treatment of diseases or injuries resulting from war or other related circumstances.

6. Injuries Inflicted Due to Dangerous Activities

Your health insurance will not cover expenses for treatment of injuries resulting from dangerous activities, such as racing, adventure sports, and more.

7. Emergencies Led by Substance Abuse

Misuse of substances such as alcohol, drugs, or other addictive substances leading to medical conditions or emergencies is also not covered by insurance.

Covid-19, or coronavirus, is not a pre-existing disease. As such, basic hospitalisation expenses resulting from it are covered by most insurers. However, if you get health insurance after testing positive, the insurer may not cover the expenses.

Additionally, the insurer is not liable to pay for the treatment cost during an active waiting period. To ensure you have coverage, opt for special policies exclusively designed to cover expenses arising out of treating it.

Most insurers focus on your age and your health when determining your policy terms. Here is an overview of some crucial eligibility factors:

1. Age

The majority of insurers offer coverage to infants as old as 15 days and late adolescents up to 18 years. The maximum age is 65 to 70 years, depending on the insurer and policy you choose.

2. Medical Test Results

Most insurers require you to undergo tests to determine your health if you are aged 40 to 45 and above. Based on the results, your insurance cover and premiums are decided. 

Some insurers may also assess pre-existing diseases to determine if you qualify for coverage. While most providers offer coverage with a waiting period, some even add a co-payment clause.

Evaluating different plans is crucial because it helps you make an informed decision that prioritises your health and finances. Here are some reasons why you should do it online:

• It is easier as you need to visit a few websites instead of physical branches

• You do not pay anything to compare different policies online 

• The facilities are available around the clock, so you can do it at any convenient time 

• Online comparisons are quicker because you do not have to travel or wait for anyone

• The options you can compare online are more extensive, giving you the power of choice, which helps you choose the best health insurance policy suited to your needs

An easy way to calculate the premium of your health insurance policy is to use a premium calculator available online. This automated tool is easy to use and requires minimal details. 

Here are the steps to follow on Bajaj Markets:

1. Visit the ‘Health Insurance Premium Calculator’ page

2. Enter the necessary details of the person to be insured, like age, address, and mobile number

3. Click on ‘Get Quote’ and see the plans available to you

4. Pick one that best suits your requirements and add riders too

5. Based on your choices, the premium amount you are liable to pay will be displayed

You can modify your choices to compare the premiums and select the most suitable plan.

The premium you pay in exchange for health coverage depends on various factors. Understanding them will help you optimise your plan and get the best health insurance policy as per your financial and medical needs:

1. Your Age

If you are young, the premium will likely be lower and vice versa. In general, older people are more susceptible to health issues and will likely make more claims.

2. Pre-Existing Diseases

Insurers will likely charge a higher premium if you have any PEDs because of the increased possibility of filing a claim.

3. Type of Plan

There are different types of insurance plans which come with different coverage and terms. The policy you choose influences the premium you will pay.

4. Add-on Covers

Enhanced coverage comes at a price, and the type and number of riders you choose affects the cost of your insurance policy. 

5. Sum Insured and Policy Duration 

When you choose a higher coverage amount, the insurer will charge a higher premium. Additionally, if the term of your policy is longer, the insurer will likely charge a lower amount. Keep this in mind to choose ideal terms that make your policy pocket-friendly while fulfilling your needs. 

6. Lifestyle 

Your lifestyle affects your health and, therefore, your insurance premium. If you lead a risky life, such as holding a dangerous job or indulging in frequent smoking, the premium will be higher. 

The more vulnerable you are to health issues, the higher your likelihood of filing a claim, and thus, the higher your premium will be.

There are two types of claims you can file, cashless and reimbursement. Here is a guide to filing both these claims:

• Cashless Claim Process

1. Choose a network or non-network hospital 

2. Inform your insurer in advance for planned treatment or within 48 hours for unplanned treatment

3. Fill out the cashless claim form

4. Submit your medical and policy details to your insurer or third-party administrator 

The insurer will review your request and directly pay for the expenses covered under your policy if approved. If rejected, you can file a reimbursement claim or shoulder the expenses yourself. 

• Reimbursement Claim Process

1. Settle all the bills at the hospital during the time of discharge

2. Inform the insurer of your admission and begin the claim process

3. Fill out and submit the reimbursement form

4. Submit the form and required documents

Once the insurer approves the claim, the settlement amount will be transferred to your account. 

When filing either claim, make sure you begin the process as per the timeline provided by the insurer. For instance, most insurers require you to notify them of treatment 3 days in advance in case of planned treatment. 

In case of an emergency admission, inform them as soon as possible. For reimbursement claims, you generally need to start the process within a week of discharge. You can find the exact timeline in your policy documents or by contacting the insurer.

When filing a reimbursement, you will likely have to submit extensive paperwork as compared to a cashless claim. Here is an overview of the documents you will need to furnish: 

• Signed claim form

• Identity proof

• Diagnosis and treatment documents (x-rays, blood tests, sonography, etc.)

• Prescriptions and bills

• Ambulance receipts

• Discharge card or report

• FIR, if required

• Policy details

The insurer may ask for additional documents to review and process your claim, in which case you will be notified. Be sure to submit them on time to avoid delays.

The list of documents varies depending on the insurer. However, most require you to furnish some basic paperwork, which includes:

• Identity proof

  • Passport

  • Voter ID

  • PAN card

  • Aadhaar card

  • Driving license

• Age proof

  • Passport

  • Birth certificate

  • Driving license

  • PAN card

  • Voter ID

  • Aadhaar card

• Address proof

  • Utility bills (telephone, electricity, etc.)

  • Passport

  • Driving license

  • Voter ID

  • Aadhaar card

  • Ration card

• Medical reports

• Proposal form

• Photographs (passport-size)

Knowing certain technical terms will help you better understand the policy and ensure that you choose the best one. Here are some must-know terms:

1. No Claim Bonus

This is a benefit that the insurer offers when you do not file a claim during the policy period. It is offered in the form of an increase in your sum insured without any increase in your premium amount. 

For instance, if your current sum insured is ₹5 Lakhs, the insurer may offer NCB up to ₹5 Lakhs. So, your new sum insured can be up to ₹10 Lakhs without any increase in premium amount, apart from the standard hike, if any.

2. Dependents

These are financially dependent family members that you want to cover under your insurance plan. It is generally limited to your spouse, children, and parents. 

3. Grace Period

This refers to the time during which you can renew your expired policy without losing your benefits. Simply put, your policy will not lapse if you renew during this period. It can range from two weeks to a month or more, depending on the insurer. 

4. Premium

This is the amount that you pay in exchange for the coverage and other benefits of a health insurance policy. It is generally a one-time payment, and the amount depends on various factors, including the insurer you choose. 

5. Pre-existing Disease (PED)

This refers to medical conditions that were diagnosed prior to you getting health insurance. Generally, insurers cover such conditions after a waiting period. Note that for the purpose of insurance, a condition is considered a PED if it is diagnosed two to four years before the date of purchase.

6. Portability

This is a facility through which you can switch insurers without losing any benefits like NCB. All insurance providers offer this option. However, you can opt for it only while your policy is active. Ideally, you should begin the porting process at least 45 days prior to the end of your policy term.

7. Waiting Period

In some cases, insurers cover the costs for medical conditions only after a certain period, which is known as the waiting period. It starts from the start date of your policy and can go up to 4 years, based on your policy and insurer. 

8. Exclusions

Insurers do not cover all medical expenses, which are referred to as exclusions. You must check this list before getting insurance to ensure you have the right cover and can have a stress-free experience when filing claims. 

9. Insurer

This is the company that provides insurance and covers the cost of your medical treatments. 

10. Network Hospital

Insurance providers have tie-ups with hospitals to settle cashless claims. The hospitals that they partner with are known as network hospitals. You must check this list to ensure that your preferred hospital is a part of the insurer’s network. Today, you can benefit from cashless claims even at a non-network hospital. 

11. Sum Insured

This is the maximum amount that the insurance provider will offer against a claim. For instance, if your expenses are ₹7 Lakhs and your sum insured is ₹5 Lakhs, you will only get ₹5 Lakhs from the insurer. 

12. Free Look Period

This is the time during which you can terminate the policy with the insurer without any penalties. It generally goes up to 30 days but can vary depending on the insurer. This facility enables you to take the time to go through terms and conditions before finalising a policy.

Health Insurance Partners Available at Bajaj Markets