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5 Top Features of Health Insurance in India

29 May 2022, 2:08 PM

When you are purchasing a health insurance policy, you are paying a considerable amount as your premium. As a result, you obtain a sum insured amount as a cover and this cover is used for making your medical payments.  Health insurance plans provide several benefits that can be helpful for you and your family.  Moreover, health insurance plans can act as a tax-saving tool as you can avail of tax deductions on the premium paid. 

Top 5 Features of Health Insurance in India

1. How much Coverage is Possible?

In general, health insurance coverage would include cover for the medical treatments, cover for pre-hospitalisation and post-hospitalisation expenses, cover for medicines, diagnostics, day-care procedures, etc. The health insurance policies in India would provide coverage for the expenses that are incurred in the medical treatment of the illness, the expenses incurred in various medical tests for diagnosis, medicines, and even the expenses incurred in the consultation of medical professionals or specialists. A large number of health insurance plans also offer the US or global coverage which can be of great help for you in case of some emergencies. You should always opt for a health insurance policy which has a sum insured i.e. nearly half of your annual income. The coverage of your health insurance policy must be able to protect you from the entire financial crisis that can occur due to medical emergencies.

2. Sub-limits

While making health insurance claims, there might be an association with the rent of the hospital room. This is determined by the sum insured of your health insurance policy. Suppose, the sum insured of your health insurance policy is INR 5 lakh and there is a cap of 1% on the room rent for each day. So, the room rent would be INR 5000. However, if you are opting for an expensive room with a higher room rent then the coverage for other medical expenses would reduce. In such cases, you would have to pay the medical expenses out of your own pockets. So, you must check with your health insurance provider on the sub-limits applicable and the way these sub-limits function. Moreover, it is advisable to opt for health insurance plans without sub-limits to avoid any capping and payment delays.

3. Annual Health Check-ups and Healthy Living Benefits

Many health insurance companies have introduced the feature of free annual health check-ups for the policyholders. By the free annual health check-up plans, it becomes quite easier to diagnose if you are suffering from any lifestyle ailment. Healthy living benefits or wellness benefits are other important features of health insurance policies today. You should check out if your health insurance policy is providing money annually for certain wellness services like a gym membership. 

4. OPD and Pre-existing Conditions

Most of the health insurance companies provide coverage against the expenses that are incurred during hospitalisation. But, a common man also needs to make arrangements for the coverage of the expenses incurred in general medication and doctor’s visit. There are a number of health insurance companies which do not take these expenses seriously and the payout is done from the own pockets of the individual. While purchasing a health insurance policy, you must ascertain that the OPD expenses are covered under the policy.

Pre-existing conditions exist before you have purchased a health insurance policy. These pre-existing conditions can be asthma, high blood pressure, heart ailments, etc. Usually, the pre-existing conditions would be covered under your health insurance policy only after a specific waiting period such as 2-3 years. You must check with your health insurance provider about the terms and conditions associated with the coverage of the pre-existing conditions.   

5. Pre-hospitalisation and Post-hospitalisation Expense Coverage

Pre-hospitalisation expenses would include the different types of charges that are associated with the medical tests before you are hospitalised. A series of tests are conducted by the concerned doctors or physicians to make a proper diagnosis of the individual’s medical condition. Health insurance companies provide cover for these pre-hospitalisation expenses; however, the number of days for which the coverage is provided varies from one health insurance provider to another. Generally, the pre-hospitalisation expenses incurred by an individual for around 30 days to 90 days are covered by health insurance companies. 

Post-hospitalisation expenses would include those expenses which are charged after an individual has been hospitalised. This can include various tests and consultation charges such as diagnostic fees, medicine charges, specialist consultation fees, etc. Usually, health insurance companies would provide coverage for these expenses for a period of 60 days after the individual is being discharged from the hospital.

The coverage provided for these expenses would act as a great saviour in times of medical emergency to avoid financial crises.  


So, in addition to the above-mentioned top features of health insurance plans, many other benefits can be availed by you through health insurance. You should make a well-informed decision while choosing your health insurance policy. Proper research and online comparison of policies would help you in buying the right health insurance policy.

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