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Different Types of Health Insurance Plans & Policies in India

We often hear people say, Dukh ke smay apne he kaam aate hain and that’s true! Your personalized types of health insurance can support you financially in case of medical emergencies.

From individual plans to family coverage, health insurance in India comes in various forms, with different coverages to protect what matters most—your health and your loved ones.

Here is a list of all the different types of health coverage plan in India that are available to meet your needs.

Team Digit

Types of Health Insurance
Importance of Health Insurance
Things to Consider
Frequently Asked Questions

Types of Health Insurance Policies Available in India

There are majorly seven types of Health Insurance Policies in India:

Types of Health Insurance Plans	Suitable for
Individual Health Insurance	Single person
Family Floater Health Insurance	Entire Family: spouse, children & parents
Group Health Insurance	Group of people in organizations: employees & their family
Senior Citizens Health Insurance	People 60 years and above who need specialized coverage
Maternity Health Insurance	Expectant parents looking for parental stage, delivery, and newborn coverage
Critical Illness Health Insurance	People looking for coverage of expensive treatments and surgeries
Top Up Health Insurance	People looking to increase their existing coverage

7 Major Types of Health Insurance Plans

We know one health insurance is never fit for all, and hence, there are seven different types of health plans to provide you with desired coverage. Let us discuss each of these plans in detail.

1. Individual Health Insurance

As the name suggests, an Individual Health Insurance policy is meant for a single person. This type of insurance policy covers your medical expenses for injury & illnesses-related hospitalization, surgery costs, room rent, daycare procedures and more.

Individuals like you who are above 18 years of age can choose to buy this plan and every Individual Health Insurance plan member will have an Individual Sum Insured.

For example, if you have an Individual health policy with a sum insured of Rs. 3 lakhs, you can claim up to 3 lakh anytime when needed. You can also buy individual plans for your spouse and kids. In this case, each person covered will have a particular sum insured of Rs.3 lakhs.

Features of Individual Health Insurance

It covers a single individual
The sum insured amount is separate for each individual
It provides coverage for costs related to hospital stays brought on by illnesses or injuries, surgeries, daycare, hotel rental, etc.
Individuals within the age above 18 years old can purchase this plan.

2. Family Floater Health Insurance

If you want an affordable health insurance policy for all family members, Family Floater Health Insurance should be your choice.

Under Family Floater Health Insurance, a single sum of insured floats for all the members covered under the policy. A Family Floater Health Insurance Plan is beneficial because the premium is comparatively lower than the Individual Health Insurance policy. This policy can cover you, your spouse, your children and your parents.

For example, if you have a family floater health insurance of Rs. 5 lakh for yourself, your wife and parents, your whole family will share this amount.

Features of Family Floater Health Insurance

One health insurance plan covers every member of the family.
Every individual will split the insured amount.
It provides financial protection against medical procedures, hospital stays, therapies, daycare, etc.

3. Group Health Insurance

A Group Health Insurance policy is designed for a group of employees working together. If you own a start-up or a corporate house, you should buy such plans for your employees. It is a kind of benefit offered to the employees. As an employer, you can buy the cover to boost employee retention rate.

Group Health Insurance Plan comes with a low cost premium. Some insurance companies allow to refill the sum insured, that too, unlimited times, if it is exhausted. A Group Health Insurance Plan covers you for hospitalization due to accident, illness, critical illness, psychiatric illness, and maternity.

Buying a Group Health Insurance policy not only offers coverage to your employees but also enhances the goodwill of your company. A very crucial point here is that the employees are covered only till the time they work with your company.

Features of Group Health Insurance

It provides health insurance for the employees and, in certain situations, their family members as well
Generally, the basic coverage is free for the employee
Value-added services like yearly examinations, online medical consultations, diagnostic exams, etc., might be provided
Pre-existing illnesses are also covered without a waiting period in health insurance*
No pre-medical tests are required before this coverage

* If there is a pre-existing condition, the claim cannot be made for that condition or illness until the waiting period has passed. However, at Digit, there is a PED waiting time waiver available if you want to cover more than 50 members.

Also check: Pre Existing Disease Cover in Health insurance

4. Senior Citizens Health Insurance

The health insurance policy which is dedicatedly designed for old people above the age of 60 years is called a Senior Citizen Health Insurance Plan. If your parents or grandparents are above 60, then this cover is a good choice.

A Senior Citizen Policy will offer coverage for cost of medicines, hospitalization arising out of accident or illness, pre and post hospitalization and treatment. Along with these, some other benefits like Domiciliary Hospitalization and Psychiatric benefits are also covered.

Some insurers may ask for a complete body check-up before they sell a Senior Citizen Health Insurance Policy. The Government of India has recently removed the age limit for senior citizen health insurance which means any senior citizen can now by senior citizen health insurance at any age.

Features of Senior Citizen's Health Insurance

It is ideal for senior individuals above 60 years of age.
It provides coverage for medical care, psychiatric care, domiciliary expenses, and pre-and post-hospitalization costs brought on by illness or accident.
Given that older people are more prone to experience health problems, the premium may be greater than it would be for individual or family floater health insurance plans.

5. Maternity Health Insurance

A Maternity cover can be bought as a rider along with the basic health insurance plan. All the expenses incurred in the prenatal stage, delivery and post-natal stage are covered under this plan.

Newly married couples or families who are planning a baby in the coming years should buy this policy. It covers child-delivery (including medically necessary terminations), infertility expenses and coverage for the newborn baby up to its first 90 days. The Maternity Cover has a minimum waiting period of 2 years.

Features of Maternity Health Insurance

It pays for costs associated with the prenatal, postnatal, and delivery of the child.
Some policies may cover the newborn for a predetermined amount of time.
It comes with a specified waiting period (9 months to 2 years).

Disclaimer: Currently, at Digit, we are not offering any Maternity coverage with our Health Insurance.

6. Critical Illness Insurance

Critical illness insurance is provided to safeguard your finances in the case of life-threatening diseases.

Dedicatedly designed for middle-class families, this health plan covers diseases like:

Cancer
Stroke
Kidney Failure
Paralysis
Coronary Artery Bypass Surgery
First heart attack
Pulmonary Arterial Hypertension
Multiple Sclerosis
Aorta Graft Surgery

Getting treatment for these diseases is an expensive affair. Under the Critical Illness Plan as soon as you are diagnosed with the disease, it will pay you a predefined amount irrespective of the actual cost of treatment incurred.

Nothing can be a smart move than buying a Critical Illness Policy as it prevents any impact on your savings. The policy has lifetime renewability. If you take the Critical Illness Policy, then you should survive for 30 days after diagnosis of the illness.

It will be wise to buy this policy if you have had a family history of some diseases. Other than the lump sum amount, a Critical Illness Policy reimburses you the cost of care and hospitalization expenses. You can also avail the benefit of the complementary health check-ups.

Features of Critical Illness Health Insurance

This plan typically covers life-threatening diseases such as heart
There is a lifetime renewal feature on the insurance
At least 30 days should pass after the serious illness diagnosis
Coverage is provided if you are experiencing this covered surgical operation or critical illness for the first time in your life

7. Top-Up Health Insurance

You can buy a top-up policy if you seek coverage for higher amounts. But such plans come with a “Deductible Clause”. So, in case of a claim the payment will be made over and above a defined limit mentioned in the policy.

Like if you have taken a cover for 15 lakhs and it has a deductible of Rs.3 lakhs, then you will have to bear claim up to Rs.3 lakhs out of your pocket. The amount over and above this, will be paid by the insurer.

So, if you seek a wider cover over and above your basic health insurance policy, then you can buy this plan.

Features of Top-Up Health Insurance

It provides an option for a higher sum covered amount beyond the basic plan
It supplements your existing plan, ensuring you are covered when the hospital bills are high
This policy only becomes active after you have paid a set deductible amount under this plan
For a larger sum insured, you can also choose the Super Top-up Health Insurance Plan

Add-Ons Available with Different Types of Health Insurance Plans

When it comes to health insurance, add-ons are just like the extra toppings on your pizza - they make the experience even better. Add-ons, often known as Riders, allow you to customize your health plan based on your specific needs. Here are some health insurance add-ons available on different types of health insurance plans.

Health Insurance Add-ons	Description
Hospital Daily Cash Cover	Hospital daily cash pays a set sum of money for each day a patient is admitted to the hospital due to a disease or accident.
Personal Accident Cover	A Personal Accident Coverage (PA) protects against situations like accident-related mortality and partial or complete disability.
Disease Specific Coverage	Some medical treatments can drain your finances due to their high expenses. Take COVID-19 treatment, which is covered by Corona Kavach or Corona Rakshak.
Room Rent Waiver	The hospital room rent that is covered by a regular health insurance policy is limited. Such health insurance policies either have an increased limit or no limit when you add a room rent waiver add-on.
Zone Upgrade Cover	With this add-on, the insured person can receive additional financial support based on the zone in which they are receiving treatment.
AYUSH Cover	With this add-on, you are financially covered for complementary and alternative therapies (Ayurveda, Yoga, Unani, Siddha, and Homeopathy).

Disclaimer: The Add-Ons offered by various insurance companies vary from one another. Contact the insurer to find out all the information regarding the Add-Ons that your insurer offers. Currently, at Digit, we are only providing a Consumable Cover add-on.

Why Having a Health Insurance is Highly Important?

You must have read and heard too much about buying health insurance as early as possible in life.

Buying a health plan at an early age has its benefits as you get rid of the waiting period at an early stage of your life when the chances of attracting diseases are less, you earn a good amount of Cumulative Bonus, and you can increase the sum insured over the years.

But you should also know the other important aspects of having a health insurance policy as:

It gives you peace of mind and financial security from high treatment costs.
You get better health facilities because the insurance company will cover the cost.
If health insurance comes as a Group Insurance from your employer, then you can improve your savings.
Some health insurance companies offer complementary annual health check-ups.
It acts as your savings for a time of distress. You will pay a premium, but the financial help you receive is much greater.
Buying a health insurance policy will offer you a tax benefit under Section 80D of the Income Tax.
The plans can be customized according to your specific requirements.

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Things to Consider When Buying Health Insurance Plans

When many health insurance companies are in the market, choosing one health insurance plan according to your needs can be challenging. But here is a quick checklist to consider before you finalize your insurance product.

1. Sum Insured

Be sure of the Sum Insured chosen. Think about whether it will be sufficient for you or your family members. Set the right Sum Insured limit for your dependent parents if they are included in the policy.

2. Medical History of the Family Members

Check for the medical history of the included individuals, the sum insured they would require, and any specific add-on that they might require. A medical history might also raise the policy premium.

3. Waiting Period

Most insurance plans have a waiting period for pre-existing diseases and certain other medical conditions. Choose the plan with the minimum waiting period.

4. Check for the maximum age-renewal

Since age of the insured members plays a vital part in the health coverage, check for the maximum age for which the renewal option, i.e. coverage, is available.

5. Claim Settlement

Buy health insurance policies from companies with a high claim settlement ratio and a fast claim settlement process. This reflects their trust and hassle-free claim process.

6. Network Hospitals

A wider range of network hospitals make sure you get the best possible treatment without loading you with financial burden. Choose the insurance company that has the widest network of the hospital on their list.

In India, having health insurance coverage has become nearly mandatory due to the country's skyrocketing medical costs. Whether you are a young professional or a family man, there is a health insurance plan just designed for you. By understanding the different types of health insurance, you can find the perfect fit for your needs.

FAQs about Types of Health Insurance

All

Is ULIP a Type of Health Insurance Plan?

No. ULIP is an investment product that is a combination of investment and life insurance. Hence, it is not categorised under health insurance.

Is Hospital Daily Cash Cover Type of Health Insurance?

Hospital Daily Cash Cover is an Add-On to the health insurance plan. You can buy it as an Add-On.

What Are the Maximum Number of Claims Allowed in Any Health Policy?

There is no upper limit on the number of claims. However, the total claim amount must be within the total Sum Insured Limit of your health insurance policy.

Are Alternative Treatments Like Naturopathy and Homeopathy Covered Under Standard Health Insurance Policy?

Standard health insurance policies do not cover alternate treatments. However, now most of the insurers provide their coverage either as a built in feature or as an add-on like the AYUSH benefit.

What are the different types of health insurance and why do you need it?

There are 7 different types of health insurance in India, which includes individual health insurance, family floater health insurance, maternity health insurance, group health insurance, senior citizen health insurance, top-up health insurance and critical illness health insurance.

Some reasons why you need health insurance include:

Provides you with financial protections against medical expenses
It helps you get better quality treatment without worrying about the cost
Covers the costs of treatments, surgeries and critical illness
Provides tax benefits on premiums paid under section 80D of income tax
Offers coverage for preventive checkups and timely management of disease

What are tips to consider before buying health insurance for a family?

If you are buying health insurance for your family, here are some tips:

Get insurance for every family member.
Choose a large sum insured since it will be divided among all family members.
If your plan is a floater, consider a Restoration Benefit plan.
Verify the waiting period for each benefit that is being provided.
If you intend to insure your parents, check to see if typical treatments like knee replacement and cataract surgery are covered.

What is the difference between an HMO and a PPO plan?

The term HMO refers to a Health Maintenance Organization for which coverage limits patients to a specific network of doctors. PPO stands for Preferred Provider Organization, and it gives customers the freedom to select any doctor they want, either within or outside of their network.

How does a high-deductible health plan (HDHP) work?

A high-deductible health plan (HDHP) is a health insurance plan with a larger deductible and a lower monthly premium than a typical plan. The goal of HDHPs is to increase customer cost consciousness for healthcare services.

It generally works in 3 major steps:

First, you pay all your medical expenses until you reach a fixed amount
Second, after you meet your deductible, you will only pay a small portion of your expenses; your insurer will pay the rest
Lastly, once you reach the maximum amount you paid, your insurer will cover all the expenses.

What is a health savings account (HSA)?

You can open a Health Savings Account (HSA) as a personal savings account to cover specific medical expenses. If you utilize an HSA to pay for certain medical expenses, such as deductibles, copayments, coinsurance, and more, you can save money and take it out tax-free.

Can I get health insurance for Cancer treatment?

Yes, you can buy critical illness health insurance to cover the cost of cancer treatment. This insurnace can cover the cost of care and hospitalization expenses. You can also avail the benefit of the complementary health check-ups.

What is a catastrophic health insurance plan, and who is it for?

A catastrophic health insurance plan features relatively high deductibles and cheap monthly fees. They protect against the worst-case situations, such as becoming ill or accident.

Healthy people under 60 years of age who qualify for a hardship exemption exam are eligible for this health insurance plan.

What are the benefits of purchasing a Maternity health insurance?

There are many benefits of purchasing maternity health insurance, which include:

Provides financial security for the future
Provides peace of mind as it covers expenses related to newborn babies up to 90 days
Some insurance provides additional benefits for the second child
In case the need arises, the insurance can be terminated as well

What are the benefits of a family health insurance plan?

A family health insurance plan provides you protection for all your family members in case of emergencies. Its benefits include:

Covers all members in the family under the same sum insured
The premiums paid are affordable when compared to other health insurance
Covers all kinds of major and minor medical expenses
Provides tax benefit under 80D of income tax

What does group health insurance cover?

A group health insurance provides coverage to all the employees working in a company. It covers hospitalization costs, daily hospital cash cover, critical illness, preventive care, maternity cover, etc.

What is a point of service (POS) plan?

A point-of-service (POS) plan is a form of managed-care health insurance plan that provides varying benefits based on whether the policyholder uses in-network or out-of-network healthcare providers.

What are the advantages of having supplemental health insurance?

Supplement health insurance coverage is the additional coverage you add to your regular health insurance plan. Some of it’s advantages include:

Comes with affordable premiums
It can be purchased as a rider or add-on
Easily renewable for life

What is the children’s health insurance program (CHIP)?

CHIP is a combined state and federal program that covers households with incomes too high for Medicaid but too low for private insurance. CHIP provides free or inexpensive health coverage, which can vary for different states.

Which insurance should parents over 70 years of age buy?

A senior citizen health insurance plan is perfect for parents who are 60+ years old. This type of health insurance covers the cost of medicines, hospitalization arising from accident or illness, etc.

What should I consider when choosing a health insurance plan?

Considering the factors below will help you assess and choose India's best health insurance plan.

Coverage Benefit: Look for a plan that provides you with the highest coverage for a minimum amount
Premium Paid: Choose a premium depending on your income and affordability
Waiting Period: Consider a plan with a minimum waiting period that can instantly cover your cost
Claim Settlement: Research the insurance company and know how instantly they settle a claim
Customization Option: Look for a plan that allows you to customize it according to your needs.

Are dental and vision insurance included in health insurance plans?

Yes, dental and vision insurance are included in health insurance plans under the OPD charges and accidental coverage. However, not all insurance provides coverage for dental and vision. So, it is recommended to read your policy document before buying.

What is the difference between employer-sponsored and individual health insurance?

Individual health insurance and employer-sponsored health insurance (group health insurance) differ based on premium, coverage, and cost. Let’s understand them:

Employer-sponsored: In this type of health insurance, the employer pays the premiums and costs less.
Individual: In this type of health insurance, the policyholder pays the premium, which can be high depending on the plan.

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Different Types of Health Insurance Plans & Policies in India

Table of Contents

Types of Health Insurance Policies Available in India

7 Major Types of Health Insurance Plans

1. Individual Health Insurance

Features of Individual Health Insurance

2. Family Floater Health Insurance

Features of Family Floater Health Insurance

3. Group Health Insurance

Features of Group Health Insurance

4. Senior Citizens Health Insurance

Features of Senior Citizen's Health Insurance

5. Maternity Health Insurance

Features of Maternity Health Insurance

6. Critical Illness Insurance

Features of Critical Illness Health Insurance

7. Top-Up Health Insurance

Features of Top-Up Health Insurance

Add-Ons Available with Different Types of Health Insurance Plans

Why Having a Health Insurance is Highly Important?

Digit makes it to the headlines!

Things to Consider When Buying Health Insurance Plans

1. Sum Insured

2. Medical History of the Family Members

3. Waiting Period

4. Check for the maximum age-renewal

5. Claim Settlement

6. Network Hospitals

FAQs about Types of Health Insurance

Is ULIP a Type of Health Insurance Plan?

Is Hospital Daily Cash Cover Type of Health Insurance?

What Are the Maximum Number of Claims Allowed in Any Health Policy?

Are Alternative Treatments Like Naturopathy and Homeopathy Covered Under Standard Health Insurance Policy?

What are the different types of health insurance and why do you need it?

What are tips to consider before buying health insurance for a family?

What is the difference between an HMO and a PPO plan?

How does a high-deductible health plan (HDHP) work?

What is a health savings account (HSA)?

Can I get health insurance for Cancer treatment?

What is a catastrophic health insurance plan, and who is it for?

What are the benefits of purchasing a Maternity health insurance?

What are the benefits of a family health insurance plan?

What does group health insurance cover?

What is a point of service (POS) plan?

What are the advantages of having supplemental health insurance?

What is the children’s health insurance program (CHIP)?

Which insurance should parents over 70 years of age buy?

What should I consider when choosing a health insurance plan?

Are dental and vision insurance included in health insurance plans?

What is the difference between employer-sponsored and individual health insurance?

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