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A Quick Guide on Individual Health Insurance Policy

12 October, 2018

If there is one insurance policy that is a must have for everyone, it is health insurance. Simply understood, health insurance is a contract between the insurance provider and policy holder wherein the former agrees to cover the medical costs of the latter, in exchange of regular premiums. Health insurance policies are offered in two major categories: individual and for family/group.


Individual health insurance policy provides coverage for the medical needs of only one individual which is the policyholder. While group or family floater policies cover a group of people, like spouse, grandparents, children, etc. The best thing about an individual policy is that you get to choose the one that perfectly fits your bill. This type of flexibility is not possible with family floater and group health insurance policy. Read on to know more the key features of individual health insurance policies.



How Individual Health Insurance Policy Works?



Individual health insurance is a type of insurance policy where you buy separate policies for each family member. It could be children, parents or both spouses. This means, the premium paid will be as per the person’s age and respective sum assured. In fact, insurance companies give a discount of total 10 percent on the total premium if more than one family member is insured.



What’s covered under Individual Health Insurance?



Here’re the few things covered under individual health insurance –



  • It covers in-patient hospitalization expenses
  • Ambulance charges cover
  • Pre and post hospitalization expenses
  • Preventive healthcare and wellness
  • Domiciliary hospitalization charges
  • Complete health check-up
  • All day care procedures
  • Vaccination in case of animal bite
  • Any surgery such as treatment of hernia, piles, hernia, psychiatric disorders, cataract are covered after waiting period.
  • Maternity Benefits



What’s not covered under Individual Health Insurance?


  • Certain diseases like Benign Prostatic Hypertrophy, Cataract, Chronic Renal Failure, and Knee Hip Replacement are not covered under individual health insurance are not covered for the first two years of buying an insurance.
  • Medical cover availed due to ageing and puberty, artificial life maintenance, congenital conditions, HIV and AIDS, OPD Treatment, obesity, wellness clinic, preventive care, sexual problems and gender issues, stem cell transplant, drugs and dressing for OPD treatment, etc.
  • Individual health insurance covers pre-existing medical conditions only after 48 months of the uninterrupted policy coverage.



Features of Individual Health Plans


  • These plans provide medical coverage for only the insured policyholder, based on the premium paid.
  • While the coverage may vary from plan to plan, it usually includes pre and post-hospitalization charges, surgery costs, doctor’s fees, lab tests and post-treatment care.
  • The coverage is not definite and includes many exclusions, such as cosmetic treatments, pre-existing medical conditions, therapies, injuries caused due to self-harm or suicide attempts.
  • Health plans also have a standard waiting period for before a claim can be made. However, some companies offer to reduce the waiting period if certain premium amount is paid.
  • Health plans are also applicable for tax deductions under Section 80D of the Income Tax Act.


Benefits of Individual Health Plans


  • In an individual policy, the sum insured is not divided between multiple people – the insured alone benefits from the full coverage.
  • Higher coverage is beneficial for people with higher health risks and medical ailments.
  • There is no set limit on the maximum age for the renewal of the policy.
  • Family members or dependents can also be added later to the plan.


Why is it important to have an Individual Health Insurance Plan?


There are several factors that make it important to buy an individual health insurance policy.


  • Financial Stability: An individual health insurance plan assists customers in achieving financial stability. Many insurance companies offer discounts that helps customers to save time in case of hospitalization or during health check-up.
  • Peace of mind: People without an adequate health insurance plan have to go through double stress and may not even receive proper treatment due to insufficient funds, whereas people who are insured get the quality health care at the right time. Thus, an individual health insurance plan offers both financial stability and peace of mind.
  • It covers medicine cost and drug cost: It is quite difficult for customers to buy medicines for several ailments under normal circumstances owing to the high costs. But, under individual health insurance plan, mostly insurance companies cover such medical expenses.
  • It provides preventive Medicare: An individual health insurance plan offers good access to healthcare facilities. Even there are several health insurance companies that send alerts to the customers such as when and where they can undergo the diagnostic screenings.



Who should invest in this plan?


Here’s why you should invest in an individual health insurance plan –


  • Individual health plan is meant for people with greater health risks.
  • If a person wants to get the benefits of individual sum assured rather than floating sum assured
  • If you are looking for higher protection as compared to what is offered under a family floater plan
  • If you want to renew your policy without worrying about any kind of age restrictions
  • It is meant for single individuals with family members who are insured already
  • This plan let you avail cashless facility for claim settlement process




Your individual health insurance plan can serve as the best investment plan. So, insure yourself as well as your whole family. Besides, if you are looking to buy individual health insurance policy online, then go for Royal Sundaram; it offers flexible and affordable plans that is Arogya Sanjeevani Policy with a wide range of benefits to take care of you and your family.