Individual Health Insurance
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What is an Individual Health Insurance Plan?
An Individual Health Insurance Plan is a type of health insurance policy that covers one person with their own fixed sum insured. This means the entire coverage amount is reserved only for that individual and is not shared with anyone else.
You can buy separate individual plans for each family member, where each person gets their own coverage, benefits, and claim limit under their respective policy.
For example: If Mr. Rahul buys an individual health insurance plan of ₹10 lakh for himself and a separate ₹10 lakh plan for his spouse. During hospitalisation:
- Rahul gets up to ₹10 lakh coverage
- His spouse gets up to ₹10 lakh coverage
- Both can use their full coverage independently
In simple terms, an individual health insurance plan ensures that one person gets full and dedicated medical coverage without depending on or sharing it with others.
Why is Individual Health Insurance Becoming Necessary in India Today?
Individual health insurance is becoming increasingly important in India due to the rising cost of medical treatment and changing healthcare needs, especially for individuals who want reliable and uninterrupted coverage for themselves.
Who Should Buy Individual Health Insurance?
Individual health insurance is ideal for anyone seeking personalised health coverage tailored to their specific needs and sum insured.
Whether you’re a young professional starting your career, a freelancer with no employer coverage, or a businessman looking for personal protection, an individual policy can offer different, tailored benefits. However, individuals who want better coverage options than their employer insurance should also consider buying an individual policy.
You may start with a family floater plan and upgrade later to individual plan if your medical needs are low, affordability is a concern, or you have corporate health insurance.
What is the Ideal Sum Insured for Individual Health Insurance?
The ideal sum insured for an individual health insurance plan should be from ₹10 lakh and can go up to ₹25 lakh or more, depending on your city, life stage, and health risks, so that it can comfortably cover at least one major hospitalisation without exhausting your sum insured.
Here’s a practical breakdown to help you choose the right sum insured in health insurance based on your age:
Here’s the right sum insured based on your life situation:
Disclaimer: These are broad indicative ranges, not financial advice. The right sum insured depends on age, medical history, lifestyle, city of residence, premium, hospital reference, and rising healthcare costs. It is advisable to know your family’s specific needs and read policy terms before making a final decision.
Why ₹25 Lakh Coverage Recommended in Infinity Wallet Plan?
A ₹25 lakh sum insured is highly recommended because:
- The medical inflation rate is rising yearly by up to 14%, increasing the cost of medical expenses and treatment. Hence, the Infinity Wallet plan provides adequate coverage to protect against the rising cost of hospital stays and treatment in Tier 1 and Tier 2 cities.
- It offers higher coverage at a minimal premium paid. It includes features like no room rent capping, cumulative bonus, health checkups, etc.
- Furthermore, financial protection and peace of mind are provided by having a ₹25 lakh sum insured, which lowers the possibility of unanticipated medical costs.
Bonus Point: Opting for a higher sum insured early on can also help you lock in better premiums while you're still young and healthy. It’s an investment in your future self.
How to Choose the Right Sum Insured for Individual Health Insurance?
It is important to choose an accurate sum insured under your individual health insurance plan because of the rising healthcare cost. Here are some factors that will help you choose the right sum insured:
- Age: The amount of sum insured you need depends mainly on your age. If you are in your 40s, you will require a larger sum insured to cover rising medical costs. If you are young and healthy, you can begin with a lower sum insured and raise it progressively over time.
- Health: Evaluate your health before choosing a sum insured. You might start with a lower coverage level if you're in good health because you might not need to visit the hospital frequently. On the other hand, you should select the insurance coverage amount appropriately if you feel that you may require specific medical operations in the future due to your poor health.
- City: Medical costs vary significantly depending on location. In metro cities like Mumbai, Delhi, or Bangalore, treatment costs are higher, so you should consider higher coverage compared to smaller cities.
- Existing Health Conditions: If you have a previous medical condition or any serious illness requiring frequent medical visits, you should choose a more significant policy with a higher sum insured to cover your medical costs.
- Lifestyle & Surrounding: When choosing the sum insured for your policy, you must also consider the city where you reside and your lifestyle. Living in a large metropolis like Delhi or Mumbai increases your chances of experiencing stress and pollution regularly. These cities have reasonably priced medical services. Thus, having a policy with a greater sum insured is essential.
What is the Difference Between Individual vs Family Floater vs Group Health Insurance?
Choosing the right type of health insurance depends on who is covered, how the sum insured is used, and how stable the coverage is over time. Here’s a clear comparison to help you decide:
Choosing the right health insurance plan depends on your life stage, number of family members, health conditions, and financial responsibilities. Each type of plan serves a different purpose, so the decision should be based on how you want your coverage to work in real-life situations.
Choose an Individual Health Insurance Plan if:
*You want dedicated coverage for each person, without any sharing or dependency
*Any of your family member has pre-existing diseases or require frequent medical needs, increasing the chances of repeated claims
*You want long-term certainty, where your coverage remains fully available regardless of others’ usage
Choose a Family Floater Plan if:
*You are a young family with low medical risk, where the chances of multiple members needing hospitalisation at the same time are low
*You want a cost-effective way to cover multiple family members under a single policy
*You are just starting your health insurance journey and want basic protection for your family
A practical approach is not to rely on just one plan. Many individuals today combine an individual base policy for long-term security and a family floater for shared protection. This ensures you are covered across both planned and unexpected situations, without gaps.
Shubham Sinha
Product Manager - Health
Why Choose an Individual Health Insurance Policy at Digit?
- Simple Online Processes: From the process of buying a health insurance policy to making claims is paperless, easy, quick and hassle-free! No hard copies, even for claims.
- No Age-Based or Zone-Based Co-Payment: Digit plans come with no age-based or zone-based co-payment clause, so you don’t have to pay out of your own pocket. This means that during health insurance claims, you need not pay for age and zone-based copay from your pocket.
- Cumulative Bonus: Up to 50% cumulative bonus for every claim-free year (with a maximum benefit of 100%). This increases your total coverage over time without increasing your premium, helping you handle larger medical expenses in future years.
- No Room Rent Restriction: We understand that everyone has different preferences. That’s why we have no room rent restrictions. Choose any hospital room you prefer. It helps avoid hidden cost deductions that usually happen when room rent limits indirectly cap during a claim.
- Get Treated at Any Network Hospital: Choose from 9000+ network hospitals in India for a cashless treatment or opt for a reimbursement. This is important in an individual plan where your entire treatment journey depends on your own accessibility and speed of care.
- Add-Ons or Riders: Family Floater plans often include optional add-ons or riders that policyholders can customize to suit their needs. Some popular add-ons include consumable cover, network hospital discount, etc.
- Wellness Benefits: Get exclusive 12+ wellness benefits in health insurance on the Digit App in collaboration with top-rated health and wellness partners.
What’s Covered in Individual Health Insurance Plans Offered by Digit?
Coverages
Double Wallet Plan
Infinity Wallet Plan
Worldwide Treatment Plan
Important Features
This covers for all hospitalisation expenses including due to an Illness, Accident, Critical Illness or even pandemics like Covid 19. It can be used to cover for multiple hospitalisations, as long as the total expenses are up to your sum insured.
You need to wait for a defined period from the first day of your policy to get covered for treatment related to any non-accidental illness. This is the Initial Waiting period.
Exclusive Wellness Benefits like Home Healthcare, Tele consultations, Yoga and Mindfullness and many more available on our App.
We provide a back-up Sum Insured which is 100% of your Sum Insured amount. How does Sum Insured Back Up work? Suppose your policy Sum Insured is Rs. 5 lac. You make a claim of Rs.50,000. Digit automatically triggers the wallet benefit. So you now have 4.5lac + 5 lac Sum Insured available for the year. However, one single claim, cannot be more than the base Sum Insured as in the above case, 5 lac. .
No claims in the Policy year? You get a bonus -an additional amount in your total sum-insured for staying healthy & claim free!
Different categories of rooms have different rents. Just like how hotel rooms have tarrifs. Digit plans give you the benefit of having no room rent cap, as long as it is below your Sum Insured..
Health insurance covers medical expenses only for hospitalisations exceeding 24 hours. Day care procedures refer to medical treatments undertaken in a hospital, requiring less than 24 hours due to technological advancement such as cataract, dialysis etc.
Get a world class treatment with the Worldwide Coverage! If your doctor identifies an illness during your health examination in India and you wish to get a treatment abroad, then we’re there for you.You’re covered!
We pay for your health check-up expenses upto the amount mentioned in your Plan. No restrictions on the kind of tests! Be it ECG or Thyroid Profile. Make sure you go through your policy schedule to check the claim limit.
There may be emergency life-threatening health conditions which may require immediate transportation to hospital. We absolutely understand this and reimburse for expenses incurred for your transportation to a hospital in airplane or helicopter.
Co-Payment means a cost sharing requirement under a Health Insurance Policy that provides that the Policyholder/Insured will bear a specified percentage of the admissible claims amount. It does not reduce the Sum Insured. This percentage depends on various factors like age, or sometimes also on your treatment city called zone based copayment. In our plans, there is no age based or zone based Co payment involved.
Get reimbursed for the expenses of road ambulance, in case you are hospitalised.
This cover is for all expenses before and after hospitalisation such as for diagnosis, tests and recovery.
Other Features
The disease or condition that you are already suffering with and have disclosed to us before taking the policy and has been accepted by us has a waiting period as per plan opted and mentioned in your Policy Schedule.
This is the amount of time you need to wait for, until you can make a claim for a specific illness. At Digit it is 1-3 years and starts from the day of policy activation. For the full list of exclusions, read Standard Exclusions (Excl02) of your policy wordings.
If You sustain an Accidental Bodily Injury during the Policy Period, which is the sole and direct cause of Your Death within twelve (12) months from the date of accident, then We will pay 100% of the Sum Insured as mentioned in Policy Schedule against this cover and as per plan opted.
Your organ donor gets covered in your policy. We also take care the pre and post hospitalisation expenses of the donor. Organ donating is one of the kindest deeds ever and we thought to ourselves, why not be a part of it!
Hospitals can go out of beds, or the patient’s condition may be rough to get admitted in a hospital. Don’t panic! We cover you for the medical expenses even if you get treatment at home.
Obesity may be the root cause of so many health issues. We absolutely understand this, and cover for Bariatric Surgery when it is medically necessary and advised by your doctor. However, we DONOT cover if hospitalisation for this treatment is for cosmetic reasons.
If due to a trauma, a member has to be hospitalised for a psychiatric treatment, it will be covered under this benefit, upto INR 1,00,000. However, OPD consultations are not covered under this. The waiting period for Psychiatric Illness Cover is same as Specific Illness waiting period.
Before, during & after hospitalisation, there are many other medical aids & expenditures such as walking aids, crepe bandages, belts, etc.,which need your pocket’s attention.This cover takes care of these expenses that are otherwise excluded from the policy.
What’s Not Covered in Individual Health Insurance Plans Offered by Digit?
What are Add-on Options for Individual Health Insurance with Digit?
Enhance your individual health insurance policy with add-ons at Digit. These add-ons are subject to underwriting approval and your eligibility at the time of purchase or renewal. Here’s a list of add-ons available that provide additional layers of protection beyond the basic coverage of your policy:
Key Benefits of Health Insurance for Individual by Digit
Your health insurance plan with Digit extends several exclusive benefits that enhance your coverage. Here are the key benefits:
* These add-ons are subject to underwriting approval and your eligibility at the time of purchase or renewal
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What are the Benefits of Buying Individual Health Insurance?
An individual health insurance plan offers dedicated, reliable, and long-term financial protection by ensuring that your entire coverage is reserved only for you, without any dependency on others.
What is the Premium for Individual Health Insurance?
The premium for an individual health insurance plan can start from a few thousand annually and vary depending on the sum insured, city you live in, add-ons, health risks, etc.
Let’s look at a real-world example to understand how premiums in health insurance change based on the sum insured.
Suppose you are 25 years old, living in Bangalore (a Tier 1 city), and planning to buy an individual health insurance plan. Here’s an approximate idea of how your premium may vary for Infinity Wallet Plan at Digit with different coverage amounts:
Note: The premium values mentioned are for Tier 1 cities only. Actual premiums may differ based on factors such as age, medical history, location, chosen benefits, and insurer underwriting.
What are the Eligibility Criteria for Buying Health Insurance in India?
You must always check the eligibility criteria before buying an individual health insurance policy. Here are the general eligibility criteria to get individual health insurance.
How to Buy Individual Health Insurance Online?
Buying an individual health insurance policy online from Digit is a quick and fully online process designed to help you get covered in just a few steps. Follow these simple steps to buy an individual health plan:
Enter Basic Details
Visit the Digit app or website. Enter your PIN code and mobile number, select your preferred health insurance plan and provide age details, family members covered, etc.
Choose Plan & Add Member Details
Compare & select the plan, sum insured, add-on covers and apply any available discounts to get the final premium amount. Further, provide the member details for everyone you’re covering under your policy.
Make Payment & Submit KYC
Once done, proceed to make the premium payment and submit your KYC documents to complete the purchase process.
Final Review & Processing
Now, your application undergoes a brief review process. Digit may request a health declaration, lifestyle information, or medical details & reports if required. Now, based on your medical underwriting, your policy will be issued and sent to your email. You can also access it anytime through the Digit app.
What are the Documents Required to Buy an Individual Health Insurance?
When purchasing an individual health insurance policy, insurers typically require some basic documents for verification. Below is a list of optional documents that can be needed at the time of purchasing a policy:
Identity/Age Proof
Address Proof
Income Proof
Previous Medical Reports (If any)
KYC Documents
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Why Buy Individual Health Insurance Online?
Buying individual health insurance online has become the preferred choice for many individuals because it offers speed, transparency, and better control over your decision-making. Some benefits of buying an individual health insurance plan online include:
- Ease of comparison
- Easy access to information
- Flexibility
- Convenience in buying
- Customization
- Accessing everything at one click
- Time saving
- Paperless process
- Instant quotes
What are the Things to Check Before Buying Individual Health Insurance?
Once you’ve decided your coverage, the next step is to evaluate the policy carefully. These checks help ensure that your plan is easy to use, reliable during claims, and free from surprises. Here are some things you must remember before buying any individual health insurance policy:
- Coverage Benefits: Always consider the coverage you’re getting and whether that’s enough for you. Consider your age, health condition, lifestyle, and estimated medical treatment cost to finalize what coverage you need. This can include pre and post-hospitalization, critical illness treatment, medical benefits, etc.
- Sum Insured: Select a sufficient sum insured to cover any necessary medical costs. Think about the long-term rise in healthcare expenses and inflation. The amount of insurance should be enough to pay for both current and anticipated medical costs over the upcoming years.
- Premium Cost: Examine the premiums offered by various insurance companies. Select a policy that strikes a balance between the premium cost and the amount of coverage. Ensure that the policy you choose is affordable and provides you with maximum benefits.
- Network Hospitals: Know about the network hospital list to see if you qualify for a cashless claim. Make sure the hospitals in the network are convenient and near your location. Check whether the hospital has the required specialists and equipment to perform any surgery in the future.
- Waiting Period: Making a decision would be easier if you were aware of the waiting period clause. During a waiting period in health insurance, the insurer will not accept any claims resulting from specific illnesses, pre-existing conditions, or claiming for maternity benefits. Furthermore, the benefits will only become available to you once this time has passed
- Claim Process: The purpose of buying health insurance is to benefit from making medical claims. Therefore, look at the claim processes involved with your insurer. Make sure the policy provider has a high claim settlement ratio and a less time-consuming process.
- Policy Inclusions and Exclusions: Carefully review what is covered and what is not. Many policies look attractive but may have hidden conditions or limitations that affect claim eligibility. Opt for additional coverage options your insurer provides to get additional basic coverage.
- Lifetime Renewability: Consider choosing a policy that allows for lifetime renewals to have coverage in later years. This process ensures that you can keep your insurance for your future as you get older and health problems become more common and serious.
- Customer Reviews & Testimonials: Trust the people who have already purchased any insurance from the insurer. Look for reviews on social media or your insurance service provider’s website to learn more about people’s experiences with the said brand.
How to Save Income Tax with an Individual Health Insurance Policy?
Apart from safeguarding your health, an individual medical health insurance also benefits you in maximizing your savings further by giving you the benefit of tax exemptions. This can be done in the following ways:
- Through Preventive Health Checkups: As per the Income Tax Act, Section 80D an individual can get a tax exemption of up to Rs 5,000 on the expenses incurred for preventive health checkups in one policy period.
- Include your parents in your health insurance plan: According to Section 80D in the Income Tax Act, if you include your dependent parent in a health insurance plan or pay premiums for their health insurance, they can be exempted from taxes up to Rs 50,000 every year.
#Remember: To claim tax exemptions on your health insurance, it’s necessary that all payments towards your health insurance premium must be made through bank transfers, debit/credit cards or online/net banking methods since cash payments won’t be considered for your tax savings.
Individual health insurance has become a practical necessity in today’s environment, where medical costs are rising and health risks are becoming more unpredictable. Having a plan dedicated to you ensures that your coverage remains fully available, without being affected by family usage or external factors like job changes.
The key to making the most of an individual health insurance plan lies in choosing the right coverage, understanding your needs, and evaluating policies carefully before buying. Starting early not only helps you lock in lower premiums and better benefits but also ensures you are financially prepared for future healthcare needs.
Read More about Health Insurance Tips
FAQs about Individual Health Insurance
Can I increase my sum insured later on an individual health insurance policy?
Does individual health insurance cover pre-existing health conditions?
Can an individual have more than one personal insurance policy?
Do I need to have a medical test done before buying an individual health policy?
Is group health insurance cheaper than individual health insurance?
Can I renew individual health insurance with add-on covers?
What is the Best Age to Buy Individual Health Insurance?
How can a single person save on individual health insurance?
A single person can save on health insurance by:
- Practicing a good lifestyle habit reduces the chances of illness and diseases.
- Lowering the number of claims in a year to get cumulative benefits.
- Choose the best policy with maximum coverage in a limited amount.