Get up to ₹1 crore health cover with Niva Bupa’s special group health insurance plan only for Apollo users!

It is the best health insurance plan for you if you:

• Have higher health risks.
• Uninsured, but your family members are insured.
• Prefer a fixed-sum insured over a floating-sum insured.
• Wish to renew your insurance policy regardless of your age.
• Need more protection than a family floater plan offers.
• Prefer cashless and prompt claim settlements.
• Fall into categories such as students, self-employed individuals, or those aged between 18 and 26 years.

Under this policy, you will receive reimbursement for the expenses incurred during hospitalisation resulting from illness or injury. It will cover all the hospitalisation, surgical, room rent, and pre and post-medication charges until the insured limit is exhausted. The premium will depend on individual factors, such as your age and medical history.

As this health insurance policy promises financial aid for an individual's medical emergencies, you can customise it according to your medical needs. You can choose a comprehensive plan or consider extra coverage.

For example, when you purchase family floater health insurance of Rs. 10 lakhs for yourself, your spouse, and your children, every family member can claim the sum insured until the insured limit is exhausted. For instance, if you get admitted to the hospital for an angioplasty costing Rs. 3 lakhs. The insurance company settles the claim. Later, in the same year, your family got into a minor accident, requiring them to be admitted. Collectively, all of you can claim the remaining Rs. 7 lakhs from the insurance policy. But if the hospital bill exceeds Rs. 7 lakhs, you need to bear the expenses from your pocket.

The benefits of a family health insurance policy include:

• As it covers your entire family under one plan, it simplifies the process of managing the policies of different family members.
• It shares the sum insured, ensuring each member can access sufficient coverage during medical emergencies.
• The premiums are lower than individual policies (as you have to buy a single policy compared to 3-5), providing a cost-effective solution for families.

In this policy, the age of the eldest member determines the premium. So, consider taking separate individual policies for members over 60, as they are more prone to illness, which will affect the premium amount.

As the name suggests, this plan is for individuals over 60 or 65, depending upon the policy's terms and conditions. If you, your parents, or your grandparents fall into this category, you can consider a senior citizen health insurance plan. It provides health check-ups and cashless hospitalisation at the insurer's network of hospitals. The coverage includes hospitalisation costs, critical illnesses, pre- and post-hospitalisation expenses, online consultations, modern and alternative treatments, daycare, and domiciliary treatment. Notably, the premium for this plan is also higher than other types of insurance.

Why choose a senior citizen health insurance policy?

• Your retirement savings might not suffice due to rising medical costs, inflation, and unforeseen emergencies.
• The plan offers critical illness coverage, which becomes necessary with age.
• The policy, designed for illnesses like cancer, heart issues, and kidney failure, also includes age-specific and pre-existing conditions like blood pressure, diabetes, and cholesterol.
• Most plans allow for free annual health check-ups, enabling early detection of diseases, and prompt treatment.
• With the help of this policy (along with yours), you can claim a tax deduction of up to Rs. 75,000 under Section 80D of the Income Tax.

The policy covers the policyholder (employee or member) and their dependents, such as spouses, children, and sometimes parents. The inclusions and exclusions depend on the chosen plan and group agreement.

The benefits of a group health insurance policy are as follows:

• The plan improves employee retention by providing health coverage for employees and their dependents. It fosters a sense of security, enhancing long-term employee commitment.
• Offering features like teleconsultations with mental health professionals helps employees manage stress effectively.
• It includes fitness tracking and quick access to doctors, enabling preventive healthcare measures to maintain a healthy lifestyle.
• All members within your group receive the same level of coverage, regardless of age, medical history, or pre-existing conditions.
• A group health insurance plan for families often covers a broader range of medical expenses, including hospitalisation, pre- and post-hospitalisation care, daycare procedures, maternity care, and specific illnesses.
• The group administrator handles general tasks like enrollment and claim processing, making it easier for you.

• Covering treatment expenses: Critical illnesses often require specialised care and expensive procedures that can significantly strain your finances. The payout from the plan can help bear the expenses of the treatment.
• Maintaining your lifestyle: During an illness, you might need to take time off work or adjust your lifestyle. The payout from medical health insurance can help you retain financial stability and continue providing for your family.
• Managing debt: Critical illnesses can lead to mounting medical bills, potentially leading to debt. The payout can help you manage existing debt or avoid taking on new debt during a challenging time.

Given below are the key features of critical illness plans:

• Coverage for specific illnesses: These plans cover a defined list of critical illnesses, including cancer, heart attack, stroke, kidney failure, and others. The number of illnesses covered varies depending on the plan.
• Lump sum benefit: Upon diagnosis of a covered illness, the plan pays out a lump sum amount, regardless of the actual treatment cost. This amount can be used for any purpose as per your needs.
• Optional riders: Many plans offer riders, such as early-stage critical illness benefits, waivers of premiums, and accelerated benefits for specific illnesses, that you can opt for.

Consider your age, health, family history, and financial situation to determine the level of coverage you need.

However, watch out for certain exclusions, such as expenses for supplements, diagnostic tests during pregnancy, infertility treatments, costs associated with harvesting and storing stem cells, and costs incurred during the waiting period before the policy becomes active.

A maternity health insurance policy is recommended for women planning to start a family or who are already pregnant. However, consider purchasing one as soon as you are married, as most plans have a waiting period before the coverage becomes effective. Additionally, you must usually be between 18 and 45 years old to qualify.

Here are some factors you should take into account:

• Compare policies from different insurance companies to find the most suitable coverage according to your needs.
• Understand the waiting period and exclusions of the policy to avoid surprises during the claim process.
• Assess your healthcare needs and select coverage for comprehensive protection throughout your maternity journey.
• Make a well-informed decision regarding maternity health insurance for financial security and peace of mind during this significant phase of life.

Maternity health insurance plans can also be added to a basic policy.

Unlike regular health insurance plans, top-up insurance is a layered product. It's an addition to your existing primary policy, be it an individual or family floater plan. It gets activated after your primary plan's sum insured is exhausted.

The plan comes with a deductible, a fixed amount you need to pay out of pocket at the time of purchase before the top-up coverage kicks in.

The key features of top-up health insurance are:

• Increased Coverage: Top-up plans offer a significantly higher sum insured than their premiums, making them cost-effective ways to boost your overall coverage. You can choose the sum insured, ranging from Rs. 5 to 50 lakhs or even higher, as per your needs and budget.
• Flexibility: You can add top-ups to either individual plans or floater plans covering your entire family. They are also renewable, allowing you to continue the coverage.
• Affordability: Compared to upgrading your primary plan to a higher sum insured, these plans offer significantly lower premiums. This makes top-ups an effective option to increase your coverage without breaking the bank.

When selecting an insurance plan, consider the deductible carefully. Opting for a higher deductible reduces premiums but ensures they remain manageable in emergencies. In addition, be mindful of coverage exclusions, such as pre-existing conditions or specific treatments outlined in the policy.

Here are some key points to consider when choosing between a top-up and a super top-up health insurance plan:

• Deductible: Top-up plans typically have a per-claim deductible, while super top-up plans have a per-policy deductible.
• Premium: The premium for a top-up plan is usually lower than that of a super top-up plan, as it provides less coverage.
• Coverage: Super top-up plans provide more comprehensive coverage than top-up plans. They may have higher limits on the amount of coverage they provide.

Ultimately, the best health insurance plan for you will depend on your needs and budget. If you are concerned about incurring high medical expenses, a super top-up plan may be a good option for you. However, if you are on a tight budget, a top-up plan may be a more affordable option.