Health Insurance: A Guide on Its Factors, Types, Value, & Benefits

Health Insurance: A Guide on Its Factors, Types, Value, & Benefits

Bajaj Finserv Health
February 16, 20225 mins read

Key Takeaways

  • Health insurance offers cover for emergency and planned treatment costs
  • Sum insured, premium, claim process are some essential factors of a policy
  • The premiums paid are eligible for tax deduction as per the IT Act, 1961

Health insurance is one of the most popular types of insurance available. The insurer covers your emergency or planned medical expenses. This benefit is applicable because you are required to pay a premium during the tenure of your policy. The premium amount is based on your policy, age, health and number of people covered. 

To meet the changing lifestyle requirements, there are different types of health insurance plans. With health insurance, you can cover your family’s healthcare expenses too. This may include certain medical conditions, critical illnesses, treatment done in a hospital, as well as pre-and post-hospitalization care. Irrespective of your health conditions, having health insurance is essential today. 

To be able to choose the best health insurance for your needs, it is important to understand the offering. To know more about the importance, benefits, factors, and facts of health insurance, read on.

Essential Factors

Sum Insured

The sum insured is the coverage amount you can claim under a given policy. You must finalize this amount after analyzing your health requirement and financial capabilities. A higher sum insured may need you to pay a higher premium amount.


This is the amount you pay at the time of purchasing a health insurance policy or during the policy period. Insurance companies require you to pay premiums in order to grant coverage. Several factors help decide the premium amount, some of which include your age, existing health conditions, policy type, and gender.

important documents for Health Insurance

Waiting Period

This is also known as the cooling period. It is the time you have to wait before you can make a claim. Your waiting period depends on your policy and insurance provider. Generally, there is an initial waiting period of 30 days [1].

Claim Process

The claims process is a key part of any insurance policy. Companies may offer both cashless and reimbursement claims. To make a reimbursement claim, you will have to pay the medical bills and then the insurer will reimburse you. Via the cashless option, your insurer will directly settle the bills with the hospital. You should research the claim settlement ratio (CSR) of an insurance provider. A high CSR indicates that the companies settle a high number of claims and that you can expect coverage when you need it.

Additional read: Health Insurance Myths and Facts

Additional Cover and Benefits

While purchasing a health insurance policy, you should also look for the following:

  • Pre-and post-hospitalization expenses
  • No cap on ICU and room charges
  • Ambulance cover
  • OPD cover
  • No claim bonus
  • Daily hospital allowance
  • Pre-existing disease
  • Maternity cover
Health Insurance: A Guide on Its Factors - 60

Types of Health Insurance Plans

Some of the different types of health insurance policies are:

Individual Plans

These plans are beneficial for a single person as they provide coverage for only one person. You can get this insurance for yourself, your parents, or your partner.

Family Floater Plans

In a family floater plan, you get coverage for your family members under a single plan. The number of people covered under a single plan is dependent on the insurance provider. 

Senior Citizen Plans

These plans are designed for senior citizens. It offers coverage for the treatment of ailments and illnesses that occur more frequently as people age. 

Critical Illness Plans

These cover critical illnesses like cancer, kidney failure, or other life-threatening conditions. The treatment for these conditions may be extensive and expensive. Buying a health insurance plan helps manage the cost affordably. 


Helps Deal with Lifestyle Ailments

With rapid changes in lifestyle choices, you may be more prone to some health conditions. A fast-paced life combined with rising pollution and increased stress can cause health problems. Having a health insurance policy works as a precautionary measure against some illnesses. Many insurance providers offer preventive health checkups or reimbursements on doctor consultations. This makes it easier for you to keep a track of your health and stay fit.

Protects Your Family’s Health

There are many types of health insurance plans available. One of these plans is family floater plans where you can cover members of your family. These plans are also more cost-effective than investing in individual plans.


Comprehensive Cover

Health insurance offers a complete cover for your health. Apart from covering the medical expenses, you can also buy plans that are tailored for you. You can also have add-on covers for a specific illness. This makes it easier to insure yourself especially if you have a family history of illness. 

Cashless Claim

Almost all insurance providers offer cashless claims with their policy. This means that your insurer will directly pay the hospital or medical center. You don’t have to pay any bills unless required. This is when your expenses exceed your sum insured. This is why you should also make sure that your sum insured is adequate for your needs. 

Additional read: How to compare health insurance

Tax benefits

Apart from being a source of investment, health insurance also has some tax benefits. The premium you pay for a health insurance policy is eligible for a deduction of up to Rs. 25,000 u/s 80D [2]. The deduction amount is dependent on the type of policy and the individuals paying the premium.

With a better idea of the importance and benefits of health insurance, make sure that your decision is based on your health needs. Compare and analyze different policies to ensure that your policy offers comprehensive care. While doing so, keep in mind the essential factors you need to look for in a policy. Also, check out the Complete Health Solution plans offered on Bajaj Finserv Health. There are so many health insurances available in the market Ayushman health account is one of them provided by the government. The four variants of this plan offer individual as well as a family cover of up to Rs.10 lakh. Apart from this, the platform also offers a 3-step simple process of buying health insurance. This way, you can get insured and safeguard your health in a hassle-free manner.

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Please note that this article is solely meant for informational purposes and Bajaj Finserv Health Limited (“BFHL”) does not shoulder any responsibility of the views/advice/information expressed/given by the writer/reviewer/originator. This article should not be considered as a substitute for any medical advice, diagnosis or treatment. Always consult with your trusted physician/qualified healthcare professional to evaluate your medical condition. The above article has been reviewed by a qualified doctor and BFHL is not responsible for any damages for any information or services provided by any third party.

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