Because a medical emergency shouldn't become a financial one.
Health insurance is the one financial product that protects everything else you've built. One hospitalisation without cover can wipe out years of savings in a matter of days.
14%+
Medical inflation in India — double the rate of general inflation
₹10–20L
Recommended minimum cover for individuals
₹30–40L
Recommended minimum cover for families
0%
GST on health insurance premiums — making cover more affordable
Understanding Health Insurance
What exactly is health insurance?
Health insurance is a formal agreement between you and an insurance company, where the insurer agrees to pay or reimburse your eligible medical expenses in exchange for a premium you pay periodically.
When you take a policy, you choose a sum insured — the maximum amount the insurer will cover in a given year. If you're hospitalised, eligible expenses are settled up to this limit, based on the policy terms.
Think of it as a financial shield. It doesn't prevent you from falling sick but it makes sure that when you do, your savings stay intact and your family can focus on recovery rather than bills.
Buying health insurance early, while you are young and healthy, means lower premiums, more plan choices, and waiting periods completing before you actually need to make a claim.
How It Works — Step by Step
You pay a premium monthly, quarterly, or annually to keep your policy active.
You choose a sum insured — the maximum the insurer covers per policy year.
When hospitalised, you either go cashless at a network hospital or pay and claim reimbursement later.
Eligible expenses like room charges, doctor fees, medicines and tests are settled up to your sum insured.
Your cover renews each year, and the longer you stay insured, the stronger your coverage becomes.
The Problem
No health cover? Your savings pay the price.
Without a medical policy, every hospitalisation is paid from your own pocket. Medical costs in India are rising faster than ever and a single unexpected illness can quietly consume the savings you've spent years building.
Healthcare Inflation is Running at 14%+
While everyday prices rise at 6–7%, hospital and treatment costs are climbing at more than twice that rate with no signs of slowing.
Rising Treatment & Hospital Costs
Advances in medical technology, specialised care, and modern hospital infrastructure are all contributing to steadily higher treatment expenses across India.
Savings at Risk Without Cover
Many families end up liquidating FDs, retirement funds, or long-term investments to settle hospital bills, undoing years of financial discipline in a matter of days.
Government Has Acted — GST is Now Zero
Recognising the urgency, the government has removed GST on health insurance premiums making health insurance more affordable than ever before.
Coverage
What does health insurance actually cover?
In-Patient Hospitalisation
Room rent, ICU charges, doctor and surgeon fees, nursing care, operation theatre charges, and all treatment-related costs during your hospital stay.
Pre & Post-Hospitalisation
Diagnostic tests, consultations, and medicines before admission as well as follow-up visits and medication costs after discharge, for a defined period.
Daycare Procedures
Treatments like chemotherapy, dialysis, cataract surgery, and appendectomy that don't require a full 24-hour hospital stay are covered under good policies.
Domiciliary Treatment
When treatment is taken at home due to unavailability of hospital beds or mobility constraints, many policies now cover associated medical expenses.
AYUSH Treatments
Hospitalisation under Ayurveda, Yoga, Unani, Siddha, and Homeopathy — alternative medicine that is now recognised and covered by several insurers.
Accidents, Surgeries & Critical Illness
From unexpected accidents to major surgeries and long hospital stays — a comprehensive plan ensures you're never unprepared for a serious medical event.
Right Coverage
How much cover is actually enough?
Given rising hospitalisation costs, lifestyle illnesses, and medical inflation, having an adequate sum insured isn't optional — it's the whole point of having insurance.
For Individuals
₹10–20 Lakh
This range is a sensible starting point for most individuals, factoring in your age, city of residence, and health history. Higher coverage is advisable for older individuals or those in metros.
For Families
₹30–40 Lakh
A family floater with this coverage provides meaningful protection against major treatments like cardiac care, cancer and orthopaedic surgeries that can easily cross ₹20–25 lakh.
Higher coverage provides meaningful protection against long hospital stays and major treatments like cardiac care, cancer, or critical surgeries where bills routinely cross ₹10–15 lakh. Choose a sum insured that won't run out precisely when you need it most.
Plan Types
Not all health plans work the same way.
Individual
Individual Health Plan
A dedicated policy for one person with their own sum insured — no sharing with family members. Clean, straightforward, and full coverage reserved entirely for you.
Family
Family Floater Plan
A single policy covering your entire family under one shared sum insured. Cost-effective, but coverage can deplete fast if one member makes a large claim in a year.
Group
Group / Employer Plan
Employer-provided health cover is a great perk — but it ends when your job does. It's a starting point, not a substitute for personal coverage.
Critical Illness
Critical Illness Plan
Pays a lump sum on diagnosis of serious illnesses like cancer, heart attack, or stroke — regardless of the hospital bill. Covers income loss and lifestyle disruption, not just treatment.
Top-Up
Super Top-Up Plan
Kicks in once your base policy is exhausted — across multiple claims in the year. An affordable way to significantly increase your total coverage without high premiums.
Senior Citizen
Senior Citizen Plan
Designed for individuals aged 60 and above, with age-appropriate coverage. Premiums are higher and may include co-pay clauses — but dedicated plans offer better terms than general family floaters for seniors.
Policy Checklist
Before you sign — check these features carefully.
Two policies with the same premium can behave very differently at claim time. These are the features that separate a good policy from a frustrating one.
Must-Have Features
Good to Have
1
No Co-Payment Clause
A co-pay forces you to bear a portion of every bill — 10%, 20%, sometimes 30%. Over multiple claims, this adds up quickly. A clean policy with zero co-pay means the insurer settles the full eligible amount every time.
2
No Room Rent Restrictions
A room rent cap sounds minor — until you're hospitalised. If you exceed the limit, insurers proportionally reduce all other expenses too, not just the room. This can leave you paying a substantial chunk of the bill.
3
No Disease-Wise Sub-Limits
Some policies advertise a ₹10 lakh cover but cap what's payable per disease — say ₹1 lakh for cataract or ₹2 lakh for knee replacement. Check sub-limits carefully before buying.
4
Pre & Post-Hospitalisation Coverage
Getting diagnosed, admitted, and then recovering all cost money beyond just the hospital stay. A good policy covers at least 30–60 days pre-admission and 90–180 days post-discharge expenses.
5
Low Waiting Period for Pre-Existing Conditions
If you have diabetes, blood pressure, or thyroid issues, your insurer may make you wait before covering related claims. Policies with waiting periods under 2–3 years give you coverage sooner.
6
Daycare Treatment Coverage
Procedures like dialysis, chemotherapy, and minor surgeries often take less than 24 hours. Ensure your policy specifically covers daycare treatments — not all of them do.
7
Restoration Benefit
If one family member exhausts the cover and another falls ill shortly after, a restoration benefit kicks the sum insured back to its original amount. This is particularly important for family floater plans.
1
No Claim Bonus
Some insurers reward claim-free years by increasing your sum insured at no additional cost. This effectively grows your coverage over time — a meaningful benefit for healthy individuals.
2
Free Annual Health Check-ups
A few good policies pay for your preventive health check-ups every year. It's a small perk that encourages staying on top of your health and can catch issues before they become expensive.
3
Consumables Cover
Gloves, syringes, PPE kits, masks — most insurers exclude these, leaving you to pay 5–10% of the total bill. Newer comprehensive policies now include consumables cover as a built-in feature.
4
Domiciliary Coverage
If you receive medical treatment at home due to limited hospital beds or mobility challenges, domiciliary cover ensures the insurer pays for equipment, practitioner fees, and related expenses.
5
Alternative Treatment (AYUSH) Cover
If you prefer Ayurveda, Unani, Siddha, or Homeopathy, check whether your policy includes AYUSH hospitalisation. Not all plans extend coverage here but the better ones do.
Get Protected
The right cover, chosen right.
Health insurance is one decision worth getting right the first time.
Let the DhanONE team help you find a plan that fits your life — not just your budget.
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