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Individual Health Insurance

Individual health insurance is a medical cover providing healthcare and financial security to a single person against medical emergencies. The policy includes an affordable premium while offering lifelong renewability.

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Ritika Malik
Written by:
Ritika Malik
Ritika Malik
Ritika Malik

Insurance Expert at Care Health Insurance

A highly skilled Insurance Specialist with a strong background in writing and research across various sectors, including medical and insurance fields. Expert at creating clear, engaging content that simplifies complex terminology while adhering to industry standards. Specialises in producing informative articles, blog posts, and marketing materials that effectively connect with the intended audience.

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Munmi Sharma
Munmi Sharma
Munmi Sharma

Sr. Health Insurance Expert at Care Health Insurance

Munmi is an insurance expert with a passion for storytelling and keen eye for detail. With 10+years of experience in the digital marketing industry, her expertise in the insurance domain combines with experience and perfection in refining written content. When not crafting and editing a piece of content, she also loves to paint the canvas, explore new places and people, binge watching, cooking and playing badminton.

What is an Individual Health Insurance?

As the name suggests, an individual plan is a type of medical insurance offering coverage, benefits, and security against medical emergencies to a single policyholder. An individual insurance policy acts as a personal safeguard against any expenses arising due to emergency hospitalisation, accidents, or other ailments. As an individual, you can customise the benefits of an individual mediclaim policy while enjoying a pocket-friendly premium.

A lower premium, extensive coverage, and several benefits together make an individual health insurance policy a popular pick among youngsters or individuals. One has to make an informed decision about buying a health insurance plan. With a highly flexible coverage, people of all ages – from young to middle age and elders – can opt for an individual policy to meet their specific medical care needs. Based on the selected plan, individual policy coverage can be extended to the individual's family. Care’s Supreme Health Insurance is a tailor-made individual health insurance policy that offers comprehensive coverage at an affordable cost. Find out why you should consider individual health cover over other options.

Select from the Best individual Health Insurance Plans

At Care Health Insurance, we meet the diverse healthcare needs of every household with some of our best individual health insurance plans in India. Here are some of our top-selling individual mediclaim plans:

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Look for best health plan that suits your need!
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Care Supreme

Ideal for families looking for capless coverage

  • 500% Boost in Coverage in 5 Years
  • Unlimited Automatic Recharge
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Care Freedom

Health Insurance for listed pre-existing diseases

  • Dialysis Cover 
  • Day Care Treatments
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Features of our Health Insurance for Individuals

Here are some prominent features of our personal health policies:

benefits of securing family health insurance benefits of securing family health insurance

Benefits of Individual Health Insurance

Individual health insurance offers personalised coverage, guaranteeing access to essential clinical care when needed. Here are other benefits our personal health insurance plan provides:

  • Cashless Hospitalisation- With our vast network of 21600 cashless healthcare providers, we promise quality medical care at the best price. Our network hospitals ensure your family members can avail of timely healthcare services without draining the family’s savings.
  • Cost-effective Plans- Health Insurance plan for individuals come with expansive benefits at affordable cost. You will not have to pay hefty premium cost to get covered against unforeseen medical emergencies.
  • Customisable Health Benefits- With Care's Family Health Insurance, you can customise the policy features according to your needs. You are free to opt for the right coverage amount and tenure while picking the additional benefits.
  • No Age Limit- There should be no age to feel protected against medical emergencies. With Care Health Insurance’s individual health insurance plan. Our plans ensure lifelong renewability.
  • Tax Benefit- If you ensure yourself under an individual health insurance plan, you will be able to save tax on the premium you pay and save your savings.

Types of Individual Health Insurance Plans

Individual health insurance plans are categorised into six different types, including:

The Indemnity Plan

The indemnity plan reimburses the insured for hospitalisation and medical treatment expenses up to the sum insured's limit. In addition to covering hospitalisation costs, indemnity plans offer coverage for post-hospitalisation treatments, such as doctor consultations and medical tests, within a specified period. After incurring medical expenses, the insured pays the hospital and submits claims for reimbursement from the insurer, subject to the plan's terms.

Maternity Plans

Maternity plans cover pregnancy, childbirth, and postnatal care expenses. These plans typically have a waiting period for maternity benefits, meaning they only cover pregnancy expenses after a certain period.

Top-up Health Insurance Plans

Top-up health insurance plans provide additional coverage above the limitation of a current health insurance policy. Since top-up plans have a high deductible, they have lower premiums than standard health insurance policies.

Senior Citizen Health Insurance

Senior citizen health insurance is for individuals aged 60 and above. These plans offer coverage for common medical issues related to ageing, such as heart conditions, diabetes, and arthritis. These plans assist individuals by providing coverage for hospitalisation, surgery, critical illness, and emergency medical evacuation.

Mediclaim Health Insurance

Mediclaim health insurance policies mainly cover hospitalisation expenses, including room charges, doctor fees, surgical costs, and medicines during the hospital stay. It also offers limited coverage for pre-hospitalisation and post-hospitalisation costs, including diagnostic tests, doctor visits, and follow-up treatments for a certain period.

Personal Accident Cover

Personal accident cover reimburses for injuries or deaths caused by accidents. It contains medical treatment costs, disability benefits, and compensation for loss of life or limb due to accidents. These inexpensive plans provide significant coverage for accident-related incidents, making them a convenient addition to a current health insurance policy.

What is Covered under Health Insurance for Individuals?

At Care Insurance, we offer comprehensive and customised policy for individuals under affordable premium rates with the following coverage benefits:

 

Coronavirus Treatment

Keep yourself safe against the COVID-19 risk with the coverage for standard coronavirus treatment expenses, including hospitalisation and medications.

 

No Claim Bonus

We reward you for staying healthy and raising no claims by increasing your sum insured under individual coverage by at least 10% of SI every policy year.

 

Pre and Post-Hospitalization Cover

We secure your hospitalisation to recovery journey with 30-day pre and 60-days post-hospitalization expenses covered under every individual plan.

 

Modern Day Care Treatment

Thanks to advanced medical technology, several medical treatments are completed within 24 hours. We cover expenses for such 540+ daycare procedures.

 

Auto Recharge of Sum Insured

To support you during frequent mediclaim needs, we ensure automatic recharge of your individual plan’s sum insured at least once in a policy year.

 

Annual Health Check-ups

We help you keep track of your health and take preventive measures with free annual health check-ups for insured members under our individual health covers.

 

Domiciliary Hospitalization Cover

We have your back when you need extra medical care at home. Our personal covers offer coverage for domiciliary care expenses as per policy terms.

 

In-Patient Care

We promise access to quality medical care with complete in-patient coverage, including ICU charges, doctor’s fees, etc., up to the individual plan’s SI.

What is Not Covered under Individual Insurance Plans

We shall not reimburse any claim amount for the following standard exclusions under individual plans:

  • Act of self-inflicted injury attempted suicide or suicide.
  • Any illness related directly to the consumption of Alcohol/Tobacco/Cigarettes, etc. or any sexually transmitted disease.
  • Cosmetic or plastic surgeries or related treatment.
  • Pregnancy, miscarriage, childbirth, maternity including C- section, abortion, or complications of any of these.
  • All the treatments required due to participation in hazardous activities.
  • Damage caused by a nuclear, chemical, or biological attack or weapons.
  • Illness or injuries caused due to any breach of law by the insured.

Individual Covers: Eligibility, Claim Process, and Other Details

While the entry age of our wide-ranging individual plans may differ among plans, below are the standard eligibility criteria and claim process common across mediclaim for individuals

Minimum Entry Age 18 years
Maximum Entry Age No upper age limit
Renewal Lifelong renewability
Waiting Period
  • 30 days for all illnesses, except for accidental injury
  • 2 years for Named Ailments
  • 4 years for pre-existing illnesses
Tenure Options 1/2/3 Years
Co-payment Clause While buying or renewing the policy at the age of 61 years & above, customers will have the choice to include or exclude the co-payment feature, implying:
  • Continuing the policy with 20% co-payment
  • Continuing the policy without 20% co-pay by opting for a waiver benefit
Claim Options Cashless and Reimbursement

Why Should You Opt for a Medical Insurance Plan for Individuals?

Buying an individual health insurance plan has several advantages for every individual, especially if you opt for this policy early. Here’s how one can make the most of it:

An Essential Choice for Working Professionals

Working professionals need the utmost security against rising medical costs and lifestyle diseases while saving for the future. An individual policy is the best choice to protect one’s needs. Also, the employer-provided group Mediclaim stops providing coverage when one exits the organisation, whereas a separate health plan can give lifelong coverage.

Lower Health Insurance Premium

The earlier you opt for an individual health plan, the better. Not only will you enjoy a lower premium, but you will also accumulate a significant no-claim bonus, given that you stay healthy for a long time. Even if you opt for personal health coverage in old age, you can waive the co-payment by opting for optional waiver benefits.

Suitable for the Elderly

Including elderly family members in a family floater plan may not be a good idea as it can increase the premium. So, get separate health coverage for your elders that meets their medical needs. With benefits like alternative treatment and annual health check-ups, it becomes easy for senior citizens to manage their health better.

Comprehensive Coverage and Flexibility to Customise

Whether young or old, the most significant advantage of buying individual health insurance is that you can customise the plan as per your health status and needs. For instance, people with diabetes can buy Mediclaim with pre-existing diseases. In contrast, people with a family history of heart or cancer diseases can opt for a critical illness cover.

Safeguard against Rising Health Issues

Long hours of work and inactivity cause households to struggle, including lifestyle diseases like diabetes, hypertension, etc. The pandemic has further increased health risks for everyone. Health insurance for individuals protects you from various health risks, regardless of age and health status.

Pre-existing Diseases and other Ailments Covered

Under a personal health insurance plan, you can get customised coverage for your pre-existing diseases. 

Better Tax Savings

Opting for a personal cover allows you to save tax individually. One can get a maximum deduction of up to Rs 25,000 annually, u/s 80D, on the insurance premium. Senior citizens can get a higher deduction of up to Rs 50,000. One can get total deductions of up to Rs 1 lakh if the proposer and insured are above 60 years.

Ability to Avail Higher Discounts

With a separate cover, you can avail yourself of special discounts on the premium policy paid. For example, if you are young, you can avail yourself of early bird discounts of up to 10% with Care Plus- Youth Health Cover – offered by Care Health Insurance. Besides, you can buy a multi-year senior citizen health insurance policy for elderly parents to avail of exclusive discounts on the premium amount. This way, individual covers for every member add to the discount percentage.

How Does Health Insurance for Individuals Work?

Health insurance for policyholders provides coverage for clinical expenses, guaranteeing that the individual fees are secure in case of a medical crisis such as illness or injury. You should follow this step-by-step guide to understand how an individual health insurance plan works:

  • Purchase the Insurance: The first step is choosing an individual health policy that fits your needs. Differentiate between various plans, emphasising coverage, benefits, exclusions, and premium costs.
  • Pay the Premium: After choosing an individual health insurance plan, you must pay a premium, depending on the terms, such as monthly, quarterly, or annual. The premium depends on age, medical history, coverage amount, and policy duration. You can pay the premium directly through the insurer's website or an agent.
  • Seek Medical Treatment: Once the policy is in place, you will be covered under the plan. You can instantly seek treatment at a network hospital if you experience any illness or injury or need medical attention.
  • File a Claim: If you plan to undergo any treatment under your policy coverage, you can file the claim. The insurance service provider may benefit you from cashless treatment at a network hospital for hospitalisation. If you're receiving treatment at a non-network hospital, you may have to pay upfront and file for reimbursement later.
  • Claim Settlement: After you file a claim, the insurer will review the provided documentation, such as medical reports, bills, and prescriptions. If your claim fulfils all the terms and conditions in the policy, the insurer will approve and settle the bill through direct payment at the hospital in case of a cashless claim or will reimburse the amount in the bank.

Who Should Buy Individual Health Insurance Policy?

While the policy is suitable for people from all walks of life, individuals under the following circumstances should certainly consider buying an individual health insurance policy:

 

People at a Higher Health Risk

People who are susceptible to increased health risks owing to an unhealthy lifestyle and stressful occupations

 

Ageing Parents

Elderly parents and family members with specific medical conditions, like diabetes, hypertension, etc.

 

Uninsured Individuals

If you are uninsured while your family is already insured under a policy, you should get a personal health cover.

 

People Needing Separate Coverage

Individuals who need a separate sum insured and benefits instead of a shared policy under family floater.

 

Individuals Suspecting Critical Illnesses

If you have a family history of serious diseases like cancer, etc., you should opt for a policy covering similar conditions individually.

How to File a Claim?

Filing a claim under a health insurance plan for individuals is easy and quick. Remember, in case of an emergency hospitalisation, you need to intimate our claims department within 24 hours of hospital admission.If it is a planned hosptialisation, kindly intimate us 48 hours prior to the admission date. Here are the steps to follow under the cashless and reimbursement claiming processes-

Cashless Claim Process Reimbursement Claim Process
Step 1: Go to a listed in-network hospital. Step 1: Submit your claim form along with other required documents.
Step 2: Fill out the proper forms at the insurance desk. Step 2: You'll get an approval letter when your claim is verified.
Step 3: Send the completed form to our claim management team. Step 3: Respond to queries raised by the claim management team.
Step 4: You'll get an approval letter when your claim is verified. Step 4: Get approval from the claim management team.
Step 5: Respond to queries from the claim management team. You will receive communication about whether your cashless claim is approved or rejected within the standard TAT. Step 5: Our claims team will contact you if there are specific reasons for rejecting your claim.

Documents Required to File Health Insurance Claim

  • A duly filled and signed claim form
  • Insured person’s details like name, policy number, nature of the illness, address, etc.
  • All the diagnostics and medical test reports
  • Original payment receipts, hospital bills, and discharge summary papers
  • Original pharmacy bills with prescriptions
  • Doctor’s referral letter
  • Police FIR and post-mortem report in case of personal accident
  • Death certificate

Which Plan Should You Choose: Individual or Family Health Insurance Plans?

It is always beneficial to evaluate health insurance early in your financial journey. This can be done easily by actively comparing different plans. The question of which health insurance might suit you, depends on the following situations:

  • Young Individuals: Young professionals who are just entering the workforce are the prime candidates for individual health insurance. The premium amount will be significantly lower as their age is considered to be a reduced risk factor.
  • Young Families With Children: Such families would be better off choosing family health insurance plans. The premium is determined by the age of the oldest member in the plan, but this is an effective way to ensure that your family is protected against unforeseen emergencies.
  • Your Parents: If you have elderly parents who have reached retirement age, then an individual health insurance plan or a Senior Citizens Health Insurance plan is the ideal option for them. The low-costs involved with family health insurance plans leave you with enough budget to buy separate health insurance for parents.

Advantages of Buying Individual Health Insurance Online

In an effort to help you choose and buy best individual health insurance coverage, we have enhanced our digital portals with end-to-end support features and services, including the following facilities:

 

Secure Payment Modes

We back our digital portals with secure payment options, helping you complete the transaction from anywhere, any time.

 

Quick Chat Support

Our in-house claims and customer support team resolves all your policy-related queries instantly through our chat service.

 

Instant Premium Calculation

Our digital premium calculators help you estimate the policy’s cost while comparing premium rates against policies and benefits.

 

Convenient Policy Selection

You can easily study, evaluate, and compare individual health plans by accessing policy documents through our official website.

 

Value Added Services

While buying or renewing personal covers online, you can easily modify optional benefits like OPD, etc., to enhance the coverage.

How to buy Individual Health Insurance Online?

Getting your personal health plan is the safest way to protect your health and finances as it provides coverage against any possible certain or uncertain risks. Here is a quick guide to buying online insurance for yourself:

1

Step 1

Visit our website and select a suitable health policy.

 
2

Step 2

Click on ‘Get Quote’ and provide relevant details.

 
3

Step 3

Enter the required information and customise your policy.

 
4

Step 4

Make payment through any secure digital payment modes.

 

Once approved, you will get the new health policy documents on your registered email address.

Things to Keep in Mind While Buying Health Insurance for Individuals

Individual medical insurance gives you a financial cushion during a medical emergency and reduces monetary stress. Thus, it's essential to opt for a personal cover wisely. Consider these below things while buying it:

  • Check the minimum age criteria to buy the policy.
  • Look for a sufficient sum insured that meets your healthcare needs.
  • Opt for the plan that costs you a lower premium and does not overburden your pocket.
  • Check if there is a requirement for pre-medical tests to get the individual health policy.
  • Go with an extensive coverage policy that includes in-patient hospitalisation, pre and post hospitalisation, ambulance, second opinion, alternative treatment, and more.
  • Avail of add-on benefits such as no claim bonus, automatic recharge, global coverage, and international second opinion to enhance the coverage.
  • Check the tax exemption eligibility under individual plans

 

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Zeroing in on a health insurance plan for your family is a tricky choice, given the number of insurers in the market who offer similar policies. It is not wise to simply choose the policy with the lowest amount of premium. You need to compare different policies, their features and benefits. Care Health Insurance (CHI) is a specialist Health Insurer and offers products keeping in mind the needs of a customer in the event of a medical exigency. CHI offers a distinct set of benefits giving a clear choice for providing you with the best possible health insurance.

Awarded As Claims

Best Health Insurance
Company of the Year*

Total Claims Paid

48 Lakh + Claims Settled**

Cashless Claim

24800+
CASHLESS HEALTHCARE PROVIDERS^^

**Number of claims settled as of 30th March 2024     *India Insurance Summit & Awards 2023

FAQ on Individual Health Insurance

Q. What is beneficial for me - floater insurance or individual insurance?

As a general rule, younger and nuclear families should opt for family floater plans. But if you have specific medical conditions and a complex medical history, you should always choose individual plans for every member.

Q. Do I get tax benefits under an individual insurance policy?

Yes, you can avail up to Rs. 25,000/-as tax benefits under the policy.

Q. Do I get a cashless hospitalisation facility under individual plans?

Yes, you will get the cashless hospitalisation facility across our 9400+ network hospitals.

Q. I am covered in an employee health insurance policy; would I still have to get a health cover?

Yes, given the rising health risks, it is better to have a separate health cover. That’s because employee health policies will cease to provide coverage if you leave or switch jobs and may prove inadequate to cover your major medical expenses.

Q. How much coverage do I need?

Ideally, the selection of the right sum insured for your medical needs will depend on several factors. It is advisable to consider your present age and medical condition, and medical treatment costs when deciding the coverage amount.

Q. Do I need to go through medical check-up before buying individual health coverage?

If the insured amount is below 15 lakhs or the individual is below 45 years of age, the person is not required to undergo any medical test. However, the underwriter may suggest a pre-policy check-up subject to certain exceptional medical cases and policy terms.

Q. At what minimum age can I add my children to my individual health cover?

You can include your kid under an individual health insurance plan if the age is 5 years or above. If the age is less than 5 years, you can include them in a family floater plan with other family members who are 18 years old or above.

Q. Can an individual have more than one insurance policy?

Yes, you can have multiple health insurance plans. If you have opted for more than one indemnity-based plan with other insurers or us, then you can select any of these plans to settle your claims, provided that the claim amount payable is up to the sum insured of such policy.

Disclaimer: Underwriting of claims for Individual health insurance is subject to terms and conditions.

~Tax benefit is subject to changes in tax laws. Standard T&C Apply

**Number of Claims Settled as of 31st March 2024

^10% discount is applicable for a 3-year policy

^^Number of Cashless Healthcare Providers as of Feb 2025

*Premium calculated for an individual (Age 18) for sum insured 5 Lakhs in Zone 2 cities, 10% discount is applicable for a 3-year policy.

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