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Health Insurance is a financial safety net that helps cover your medical expenses. Whether it’s a routine doctor visit or a major surgery, your insurance plan helps pay the bills. You pay a regular premium, and in return, the insurance company helps cover your healthcare costs, making medical treatment more affordable.
A quick glance at how different types of health insurance plans differ from each other**.
PLAN TYPEs | Health and Wellness Plans | Top-up Plans |
---|---|---|
Best Suited For
|
Individuals seeking both medical cost coverage and rewards for maintaining a healthy lifestyle | Individuals with existing policies who want additional coverage |
Entry Age
|
Depends on the plan selected | Depends on the plan selected |
Ambulance Coverage
|
Included in some plans | Included |
Health Returnsᵀᴹ
|
Included | Included |
Cashless Hospitals
|
Included | Included |
Room Type
|
Any room category at the time of hospitalisation; varies from plan to plan | Restriction in some plans |
Wellness Coach
|
Included | --- |
Tax Benefits
|
Yes | Yes |
Day Care Treatments
|
Included | Included |
KNOW MORE | KNOW MORE |
Before you purchase Health and Wellness plan, ensure you qualify and have the necessary documents.
Evaluate your requirements - coverage, lifestyle, etc.
Explore different plans to find the right one for you
Ideally, choose a plan with lifetime renewability
Ensure the provider has network hospitals in your area
Assess available riders for added coverage
Ensure the provider has network hospitals in your area
Assess available riders for added coverage
Hear from our customers what they have to say about their experience.
As per the Income Tax Act, 1961, Section 80D provides for self, family, and parents
#Some plans may cover these. Please check the policy wording
With a few clicks on the ABCD app, you can get financial protection against medical emergencies with a health insurance plan.
Scan the QR code to download our Mobile App
You can rest easy knowing you will be covered in case of a medical emergency or accident.
You can avail of quality medical care, even if you are unable to afford it otherwise.
You can get cashless treatment at network hospitals with practically no expenses at all.
It encourages and helps you stay healthy with free annual check-ups and rewards for good health.
You can save tax on the premiums paid as specified in Section 80D of India's Income Tax Act1.
This is the ideal age to buy it because you are most likely healthy and thus your premiums are lower. Most plans also don’t require you to take a medical test.
You may have a family now and any medical costs can impact your finances significantly. It’s a good idea to invest in a plan that covers you as well as your family.
Consider a policy with a higher sum insured as you may start to develop certain health conditions now. Also, look for a plan with a refill benefit that will ensure you have enough coverage.
Consider a senior citizen health insurance policy with a critical illness rider. These policies typically have higher premiums, but they also offer more comprehensive coverage.
Only dental surgery or treatment that requires hospitalisation is covered under health insurance
These are health problems that are present at birth
These sexually transmitted diseases which are not covered
This is a general weakness or ill health and is not covered under health insurance.
Any injury that is intentionally caused by the insured person is not covered under health insurance
The cost of infertility treatment, such as in vitro fertilisation, is not covered under health insurance.
The cost of cosmetic surgeries, such as rhinoplasty and liposuction etc.
Health insurance plans typically have a waiting period of 12 to 48 months before they cover illnesses that were already present at the time of purchasing the policy.
The older you are, the higher the premiums are typically. It’s because, with age, your chances of falling sick also increase.
If you have any pre-existing health conditions, you may need to pay a higher premium or may not be eligible for coverage at all.
Your lifestyle choices, such as smoking, drinking, and being overweight can increase your risk of health problems, which can also affect your premiums.
The cost of healthcare varies from place to place, and the premiums in expensive areas are typically higher.
The type of policy you choose can also affect your premium. More comprehensive plans typically have higher premiums than basic plans.
It is the amount of money you have to pay out of pocket before your insurance company starts to pay. Higher deductibles typically lead to lower premiums.
In some cases, your gender may affect your premiums. For example, women may pay higher premiums for plans with maternity coverage.
The sum insured is the maximum amount your insurance policy will pay for your medical expenses. A higher sum insured will typically result in higher premiums.
Smoking and drinking alcohol can increase your risk of health problems and lead to higher premiums.
Having a family history of certain health conditions can increase your risk of developing those conditions yourself, which may lead to higher premiums.
This is the most common type of plan that provides coverage for a wide range of preventive and wellness services.
It provides financial assistance if diagnosed with cancer. They typically cover the cost of treatment and even the loss of income in some cases.
These are more specialised plans that provide coverage against more than 60 listed critical illnesses.
This plan provides coverage for accidental death, accidental permanent disability, and accidental hospitalisation.
These plans are designed for businesses that want to offer group health coverage to their employees.
This plan provides coverage for medical expenses incurred while travelling abroad. It also covers the cost of emergency evacuation and repatriation.
The time you have to wait before your health insurance coverage starts. Usually 30 days from the start date of the policy.
A type of health insurance claim where the insurance company reimburses the network hospital directly, so you don't have to pay out of pocket.
It is the share of the amount to be paid by you, in case of a claim.
It's a bonus offered in the form of increased sum insured if no claims were made during the previous policy term.
A health condition that you had before you got health insurance.
This refers to the medical expenses incurred before getting admitted to a hospital.
This refers to the cost of follow-up tests and consultation treatment charges incurred after getting discharged from the hospital.
It is a medical facility that has a tie-up with the health insurance provider where you can receive cashless treatment.
Medical costs are rising rapidly, and it can be difficult to keep up with the expense of medical care without health insurance. Health insurance can help protect your finances from the burden of medical inflation.
Health insurance can help you afford quality medical treatment, regardless of your income level. Without health insurance, you may be forced to delay or forgo necessary medical care, which could lead to serious health problems.
Lifestyle diseases, such as heart disease, stroke, and diabetes, are on the rise. These diseases can be expensive to treat, and health insurance can help you manage the costs.
A major medical expense can wipe out your savings, leaving you in financial hardship. Health insurance can help protect your savings by paying for covered medical expenses.
Many health insurance plans offer cashless hospitalisation, which means you don't have to pay upfront for your hospital stay. This can be a huge relief, especially if you're not prepared for a large medical expense.
The premiums you pay for health insurance are tax-deductible, which can reduce your taxable income and save you money on taxes.
Health insurance can provide you with peace of mind, knowing that you are protected from the financial burden of unexpected medical expenses.
Health insurance is a type of insurance coverage that provides financial protection against medical expenses incurred due to illness, injury, or hospitalisation. It helps individuals and families pay for medical treatments, hospital stays, prescription medications, and other healthcare services.
Aditya Birla's health insurance plans give you good coverage for quality healthcare. They have different options, so pick the one that fits your needs the best.
• Health & Wellness Plans: These plans provide coverage for a wide range of preventive and wellness services, such as doctor's consultations, annual health check-ups, diagnostic tests, and vaccinations. They also offer discounts on gym memberships and other health-related expenses.
• Cancer Secure Plans: These plans provide financial assistance if you are diagnosed with cancer. They typically cover the cost of treatment, including surgery, chemotherapy, and radiation therapy.
• Critical Illness Plans: These plans provide financial assistance if you are diagnosed with any of the 60+ critical illnesses covered in the plan, including heart attack, stroke, or kidney failure. They can help cover the cost of treatment as well as lost income and other expenses.
• Personal Accident Plan: This plan provides coverage for accidental death, accidental permanent disability, and accidental hospitalisation. It also covers the cost of ambulance charges, surgery, and ICU stays.
• Corporate Plans: These plans are designed for businesses and organisations, to protect their employees' health and well-being. They typically offer group discounts and other benefits, such as access to a wider network of hospitals and doctors.
• International Cover: This plan provides coverage for medical expenses incurred while travelling abroad. It also covers the cost of emergency evacuation and repatriation.
There are many benefits to having health insurance, including:
• Peace of mind knowing that you will be covered in case of a medical emergency.
• Access to quality medical care.
• Financial protection from high medical costs.
Most health insurance plans provide optional add-ons or riders or optional benefits to enhance your coverage. These may include maternity cover, critical illness cover, personal accident cover, and more. It is advisable to check with the insurance provider about the availability of customisation options.
Health insurance is vital for a variety of reasons, the most important ones are mentioned below:
• Peace of mind: Medical insurance gives you peace of mind knowing that you will be covered in case of a medical emergency. This can be especially important if you have a chronic illness or a family history of medical problems.
• Access to quality medical care: A good health insurance plan can give you access to quality medical care, even if you are unable to afford it otherwise. This includes access to hospitals, doctors, and other healthcare providers.
• Financial protection from high medical costs: Medical expenses can be very expensive, even for a minor illness or injury. Medical insurance can help to protect you from these costs, so you don't have to worry about going into debt to pay for your medical care.
• Access to a network of healthcare providers: A good medical insurance plan will give you access to a wide network of healthcare providers, which means you can go to any doctor or hospital in the network without having to worry about whether your insurance will cover it.
• Tax benefits: You can avail of tax benefits*, as specified in Section 80D* of India's Income Tax Act, subject to the fulfilment of the criteria mentioned in it.
Here are some tips on how to choose the right health insurance plan in India:
• Consider your needs and budget: What types of medical expenses do you need coverage for? How much can you afford to pay in premiums?
• Compare different plans: There are many different health insurance plans available in India, so it's important to compare them before you choose one. Look at the coverage, premiums, and deductibles of each plan.
• Choose a plan with a wide network: A wide network means that you will have access to a wider range of hospitals and doctors.
• Read the fine print: Make sure you understand all of the terms and conditions of the plan before you sign up.
There are two ways to purchase health insurance in India:
• Offline: You can purchase health insurance from a traditional insurance agent.
• Online: You can purchase health insurance online from the website of an insurance company.
To purchase health insurance online, you will need to provide some basic information, such as your name, age, and address. You will also need to choose a plan and pay the premium.
To buy an online health insurance plan in India, you can follow these steps:
1. Visit the website of an insurance company.
2. Choose a suitable Health Insurance plan..
3. Enter your personal information.
4. Pay the premium.
5. Receive your policy document via email or post.
Everyone should buy a health insurance plan. Healthcare costs are rising rapidly in India, and a health insurance plan can help you protect yourself from financial hardship in the event of a medical emergency.
Buying a health insurance plan at an early age is important for several reasons:
• Premiums are typically lower for younger people.
• You are more likely to be in good health. Younger people are typically healthier than older people, which means that you are less likely to have pre-existing conditions that could affect your coverage.
• You can build up a lifelong coverage history. If you buy a health insurance plan when you are young, you can build up a lifelong coverage history. This can be helpful if you develop a chronic health condition later in life.
Health insurance premiums in India are determined based on various factors, such as the age of the insured individuals, the sum insured, the coverage type, pre-existing conditions, and the geographical location. Premiums may also vary depending on the insurer and the specific benefits offered by the policy.
The cost and coverage of health insurance in India varies depending on the plan that you choose. However, most plans will cover the cost of hospitalisation, surgery, and other major medical expenses. The sum insured under an employer’s health insurance is usually between ₹ 2 lakh and ₹ 5 lakh, which might not be sufficient under the current medical inflation. To cover the various expensive treatment costs, it is important to have a separate health insurance plan of a minimum of ₹ 10 lakh.
The eligibility criteria for health insurance in India vary depending on the insurance company. However, most insurance companies will require you to be a resident of India and to be between the ages of 18 and 65 years old.
There are no documents required as such for purchasing a health insurance plan in India. You may only have to undergo a pre-policy medical check-up if you are a senior citizen. However, you must have a valid proof of your identity, address, age, etc. when you need to file a claim with your insurer.
The premium for your health insurance plan is calculated based on several factors, including your age, gender, health status, and the type of plan you choose. You can use an online health insurance calculator to get an estimate of your premium.
Comparing health insurance plans online is the most comprehensive way to find the best plan for your needs and budget. You can compare the coverage, premiums, and deductibles of different plans side-by-side.
To renew your health insurance plan online, you can visit the website of your insurance company. You will need to enter your policy number and pay the premium.
Any claims arising out of congenital disorders, venereal diseases, general debility, sexually transmitted disease, or dental treatment/surgery (unless required as a part of treatment) are excluded from Health Insurance coverage. But do check your policy wording to know more about the detailed list of exclusions in a Health Insurance plan.
Yes, premiums paid for health insurance plans are eligible for tax benefits under Section 80D of the Income Tax Act in India. Individuals can claim tax deductions for the premiums paid for themselves, their spouses, children, and parents, subject to specified limits.
For yourself and your family (All members below 60 years), the maximum amount that can be saved under Section 80D is ₹25,000.
For self, family, and family + parents (All members below 60 years), the maximum amount that can be saved under Section 80D is ₹50,000 (₹25,000+₹25,000).
For yourself and your family (all members below 60 years) with senior citizen parents, the maximum amount that can be saved under Section 80D is ₹75,000 (₹25,000 + ₹50,000).
For self and family (with the eldest member above 60 years) with senior citizen parents, the maximum amount that can be saved under Section 80D is ₹1,00,000 (₹50,000 + ₹50,000).
Aditya Birla's digital services make it easy to file and track health insurance claims. You can do this through the Active Health App, online, or by calling the toll-free number 1800 270 7000.
There are two types of health insurance claims:
• Cashless claims: If you are admitted to a network hospital, Aditya Birla will pay your medical bills directly to the hospital. To file a cashless claim:
1. Go to a network hospital.
2. Verify your identity with your health card or other valid ID.
3. Fill out and submit a pre-authorization claim form.
4. Get your claim processed and settled.
• Reimbursement claims: If you are admitted to a non-network hospital or cannot file a cashless claim, you will need to file a reimbursement claim. This means that you will pay your own medical bills, and then Aditya Birla will reimburse you for your expenses. To file a reimbursement claim:
1. Notify the company within 48 hours of an emergency hospitalisation or 3 days before a planned hospitalisation.
2. Submit all relevant documents.
3. Get your health insurance claim processed and reimbursed.
The reimbursement claim process is simple and hassle-free. Aditya Birla will provide you with all the information and assistance you need to file and track your claim.
Health insurance, cancer insurance, and critical illness insurance serve unique purposes, each with a specific focus; its basic differences have been highlighted below:
• Health insurance plan: A health insurance plan covers the cost of hospitalisation, surgery, and other major medical expenses.
• Cancer insurance: A cancer insurance plan covers the cost of treatment for cancer, including chemotherapy, surgery, and radiation.
• Critical illness insurance: A critical illness insurance plan covers the cost of treatment for a number of critical illnesses, such as cancer, heart disease, and stroke.
Here are some of the most common myths about health insurance:
• Myth: Health insurance is expensive.
• Fact: The cost of health insurance varies depending on the plan you choose and your individual circumstances. However, there are many affordable health insurance plans available.
• Myth: I don't need health insurance because I'm young and healthy.
• Fact: Anyone can get sick or injured, regardless of their age or health status. Having health insurance can protect you from financial hardship in the event of a medical emergency.
• Myth: Health insurance is only for people with pre-existing conditions.
• Fact: Health insurance is for everyone, regardless of their health status. However, you may have to pay a higher premium or have a waiting period before certain services are covered if you have pre-existing conditions.
• Myth: Health insurance is too complicated to understand.
• Fact: Health insurance policies can be complex, but there are many resources available to help you understand your coverage. You can talk to your insurance agent, read your policy documents, or visit the website of your insurance company for more information.
• Myth: I can wait until I'm older to buy health insurance.
• Fact: It's best to buy health insurance when you're young and healthy. Premiums are typically lower for younger people, and you'll have less chance of being denied coverage due to a pre-existing condition.
In all our Health Insurance Policies, we cover the treatment for Corona Virus-COVID-19, when the treatment is taken as an inpatient.
Whether or not a medical test is mandatory to buy a health insurance policy depends on the insurance company and the specific policy you are applying for. In general, medical tests are not mandatory for young, healthy individuals who are applying for basic health insurance plans. However, medical tests may be required for older individuals, individuals with pre-existing medical conditions, or individuals who are applying for more comprehensive health insurance plans. If a medical test is required, it will typically be a blood test or a physical examination. In some cases, additional tests, such as an electrocardiogram (ECG) or X-ray, may be required. Even if a medical test is not mandatory, it is generally recommended to get one before purchasing a health insurance policy. This is because a medical test can help to identify any pre-existing health conditions that may not be covered by the policy. It can also help to determine the appropriate sum insured for the policy.
Parents can add their newborn children to their family floater health insurance policies by notifying the insurance company and paying an additional premium.
Yes, a person can have more than one health insurance policy. This is known as dual coverage or excess coverage. Dual coverage can be beneficial in some cases, but it can also lead to higher out-of-pocket costs and potential coordination issues between the two insurers.
Here are some specific situations where dual coverage may be beneficial:
You have a high-deductible plan: If you have a high-deductible plan, you may want to consider adding a secondary policy with lower deductibles to help cover your out-of-pocket costs.
You have pre-existing conditions: If you have pre-existing conditions, you may want to consider dual coverage to ensure that you have adequate coverage for those conditions.
Yes, health insurance plans typically cover diagnostic charges like X-rays, ultrasound, and MRI. However, the specific coverage for diagnostic charges varies depending on the plan and the insurance company. Some plans may have limitations on the number of diagnostic tests you can receive per year, or they may have sub-limits for specific types of tests.
In general, health insurance plans will cover diagnostic charges if they are ordered by a doctor and are considered medically necessary. This means that the test must be necessary to diagnose a medical condition or to monitor a patient's treatment.
The maximum number of health insurance claims allowed in a year depends on the specific policy and insurance company. In some cases, there is no limit on the number of claims that can be made, as long as the claims do not exceed the sum insured by the policy. However, some plans may have limits on the number of claims that can be made for certain types of medical expenses. For example, a plan may only allow a certain number of claims for hospitalisation or for specific types of treatments. If you are unsure about the maximum number of claims allowed under your health insurance policy, you should contact support or check the policy documents.
If you miss the health insurance policy premium renewal date, your policy will lapse, meaning it will no longer be in effect. This means you will not have coverage for any medical expenses you incur until you renew your policy.
Here are the consequences of missing your health insurance policy premium renewal date:
Loss of coverage: You will no longer be covered for any medical expenses you incur, including hospitalisation, doctor visits, prescription drugs, and other medical services.
Late payment fees: You will be charged late payment fees for each day your premium is past due.
Potential denial of coverage for pre-existing conditions: If you have any pre-existing conditions, your insurance company may deny you coverage for those conditions if you renew your policy after it has lapsed.
Higher premiums: You may be charged higher premiums if you renew your policy after it has lapsed.
To avoid these consequences, it is important to renew your health insurance policy on time. Most insurance companies will send you a reminder to renew your policy before it expires. You can also set up a reminder on your calendar or pay your premium online or through your insurance company's app.
If you do miss your premium renewal date, you should contact your insurance company immediately to renew your policy. They may be able to reinstate your coverage without any penalties if you pay your premium within a certain grace period.
Yes, most health insurance companies offer a grace period for health insurance renewal. This is a period of time after the premium due date during which you can still pay your premium and have your coverage reinstated without any penalties.
The length of the grace period varies depending on the insurance company and the type of policy. However, it is typically 30 days. This means that you have 30 days after your premium due date to pay your premium and avoid having your coverage lapse.
If you pay your premium during the grace period, your coverage will be reinstated as if you had never missed a payment. However, you will still be responsible for paying any late payment fees that may have been incurred.
If you do not pay your premium during the grace period, your coverage will lapse. This means that you will no longer be covered for any medical expenses you incur. You will also have to apply for reinstatement, which may result in higher premiums or denial of coverage for pre-existing conditions.
Health insurance plans usually cover all kinds of medical expenses, including hospitalisation, health-checkups and day-care procedures among others; the most common ones are listed below.
It’s best to do all your research before making your final Health Insurance purchase. Make sure to check the following things:
Choosing the right health insurance is important and needs careful thought. Some of the important things to think about when picking a health insurance plan are listed below:
• Check the Scope of Coverage: It's crucial to thoroughly review the scope of coverage offered by the health insurance plan. This includes understanding the types of medical expenses covered, exclusions, and any limitations or sub-limits. Ensure the plan covers your primary healthcare needs and any pre-existing conditions you may have.
• Adequate Sum Insured: The sum insured is the maximum amount the insurance company will pay for covered medical expenses. Choose a sum insured that adequately covers your potential medical needs, considering factors like age, lifestyle, and family medical history.
• Policy Type: Health insurance plans come in various types, each with different benefits and structures. Compare individual, family floater, and senior citizen plans to find the one that best suits your needs and budget.
Individual health insurance covers only one person with a fixed sum insured, while a family floater plan covers the entire family under a shared sum insured, offering cost savings and flexibility.
Assess factors like sum insured, coverage for critical illnesses, network hospitals, claim settlement ratio, waiting periods, and exclusions before making a decision.
Consider factors like medical inflation, hospitalisation costs in your city, family medical history, and existing health conditions to select an adequate sum insured.
A top-up plan covers medical expenses beyond a deductible per claim, while a super top-up plan considers cumulative medical expenses in a policy year, making it a better choice for frequent hospitalisations.
A health insurance wellness programme is a type of health insurance plan that rewards members for taking steps to improve their health. These programmes typically offer incentives such as premium discounts, cash back, or gift cards for completing certain health activities, such as exercising regularly, eating healthy foods, and getting preventive care screenings.
To participate in a health insurance wellness programme, you must typically enrol in the programme through your health insurance provider. Once you are enrolled, you will need to complete certain health activities to earn rewards. The specific activities that are covered by the programme will vary depending on the provider, but they may include things like:
• Tracking your daily steps or exercise minutes
• Eating healthy foods and logging your meals in a food diary
• Getting preventive care screenings, such as annual checkups and flu shots.
• Completing health assessments
There are many benefits to opting for health insurance wellness programs. Some of the key benefits include:
• Improved health: Wellness programmes can help you to improve your overall health and well-being by motivating you to make healthy choices.
• Reduced healthcare costs: By helping you to stay healthy, wellness programmes can help reduce your healthcare costs in the long run.
• Lower premiums: Many health insurance providers offer premium discounts to members who participate in wellness programmes.
• Other rewards: In addition to premium discounts, some wellness programmes also offer other rewards, such as cash back, gift cards, or access to exclusive discounts and promotions.
The specific services and activities that are covered by health insurance wellness programmes will vary depending on the plan and the provider. However, some common examples include:
• Fitness classes and gym memberships
• Weight loss programmes
• Expert health coach
• Stress management programmes
• Mental health programmes
• Annual health assessments
The Insurance Regulatory and Development Authority of India (IRDAI) has issued guidelines for health insurance wellness programs. These guidelines are aimed at ensuring that wellness programmes are fair and transparent and that they do not discriminate against members with pre-existing health conditions.
The IRDAI guidelines require health insurance providers to:
• Disclose all of the terms and conditions of the wellness programme to members before they enrol.
• Make it easy for members to participate in the programme and earn rewards.
• Offer a variety of health activities that are accessible to all members.
• Not to discriminate against members with pre-existing health conditions.
There are many reasons why one should opt for a medical insurance wellness program. Some of the key reasons include:
• To improve overall health and well-being.
• To reduce healthcare costs in the long run.
• To save money on health insurance premiums.
• To earn rewards for making healthy choices.
• To have access to exclusive discounts and promotions.
Aditya Birla Capital currently offers 12 health and wellness plans:
• Activ Fit: Health Insurance + Health Benefits + Rewards
• Activ Health Platinum Enhanced: Health Insurance + Wellness Benefits + Chronic Care
• Activ Assure Diamond + Super Health Topup: Health Insurance + Affordable Comprehensive Health Cover
• Activ Assure Diamond: Budget-friendly health insurance with 360˚ protection
• Activ Care Classic: A comprehensive health insurance plan that provides 360˚ care for your parents
• Activ Health Platinum Essential: Health Insurance, Wellness Benefits + Chronic Care
• Activ Health Platinum Premiere: Health Insurance + Wellness Benefits + Chronic Care
• Activ Care Standard: A comprehensive health insurance plan that provides 360˚ care for your parents
• Activ Care Premier: A comprehensive health insurance plan that provides 360˚ care for your parents
• Aarogya Sanjeevani: Health insurance + All day care procedures covered + AYUSH in-patient treatment cover
• Corona Kavach: A comprehensive health insurance plan that provides 360˚ Covid-19 coverage
• Ekam Suraksha: Health insurance + AYUSH coverage + Cataract treatment cover up to ₹ 40,000 per eye