Ultimate guide for individual health insurance plans

Given the rising healthcare threats and the equally rising medical inflation, we all realise how indispensable health insurance is. You cannot afford to have medical exposure without the cushion of an individual health insurance plan. A robust health insurance plan will keep you protected against the financial strain that a sudden medical emergency can cause. Depending on your age, health, familial responsibilities, other dependents, and your financial capacity along with that of other members of the family, you should make an aware choice of whether to buy individual health insurance or a family floater health insurance plan.

In this blog, we will help you break down all the relevant details surrounding individual health insurance plans.

What is an individual health insurance plan?

As the name suggests, individual health insurance is a health plan that essentially covers one single person – the policyholder. The health insurance coverage is extended to only one insured person under this type of health insurance plan. The coverage for a medical treatment, which includes diagnostic tests, doctor’s fees, pre and post-hospitalisation expenses, room rent, ICU charges, etc. –will be reimbursed only for the individual covered under the policy.

You can buy individual health insurance for yourself, your spouse or your children. But note that, your spouse or children won’t get any coverage under your individual health insurance. To have them covered under an individual health insurance plan, you will have to buy separate individual plans for each member.

What are the basic features of individual health insurance plans?

While the exhaustive features of an individual health insurance plan may differ from insurer to insurer, there are some aspects which are common to this kind of health insurance plan. Some of these are –

● Single-person coverage – An individual health insurance plan provides medical coverage to one person only – the policyholder. You cannot add co-beneficiaries to this health insurance plan. To extend coverage to other members of your family or dependents you would need a separate health plan for each individual.

● Adequate sum insured – The sum insured under individual health insurance is not divided amongst multiple members. So, whatever the sum insured, it is used for one individual which is more often than not adequate for the insured.

● Wide coverage – It is a typical feature of any health insurance plan and thus that of an individual health insurance policy, that it offers a wide range of coverage. This includes hospitalisation expenses, surgery costs, room rent, consultation fees, pre and post-hospitalisation charges and much more. You can avail of all these benefits for a premium amount which is usually fairly competitive for individual health plans.

● Additional cover – If the coverage of your individual health insurance policy is not adequate or you are seeking coverage for some particular condition, you can always look for add-ons or riders that caters to your need or preferences.

● Family discount – One interesting and highly beneficial feature of an individual health insurance plan is that many insurance providers allow you significant discounts if you buy multiple individual health plans for them. So, if you want to cover your family members as well, you can choose to buy the same insurance product and can get discounts on the same.

● Waiting period – The waiting period is a typical feature of any health insurance plan. Likewise, depending on your health and medical conditions, if there are any, the individual health plan may have a waiting period.

● Co-payment clause – Another common feature of an individual medical plan is the co-payment clause. More often than not, most of these plans come with this clause where you are required to bear a part of the expenses.

● Renewability – Most individual health insurance plans come with the benefit of lifetime renewability. This means you can renew your health plan lifetime without having to go through the hassles of requalifying for the health insurance plan.

What are the benefits of individual health insurance plans?

Listed below are the major benefits of an individual health insurance plan –

● Protection from health hazards – It is a no-brainer that assured protection from medical emergencies is the prime benefit of an individual health plan. You never know when a medical crisis can strike. Cushioning this uncertainty that can cause major financial and mental stress is a major relief.

● Low premium – One of the major benefits of an individual health insurance plan is that it comes with relatively much lower premiums. At a competitive premium payment, you get the benefit of wide medical coverage.

● Scope of multiple claims – Since you are not sharing your health insurance plan you have the possible advantage of making multiple claims in a year (if needed) and yet not exhausting the sum insured.

● Option to choose a basic plan – If you are in your younger years or you have good health otherwise and do not have any pre-existing diseases, you can choose a basic health insurance plan that offers decent coverage. You don’t have to shell out unnecessary money on buying high-coverage medical plans.

● Tax benefits – Getting an individual health insurance plan for yourself and your dependents can provide you with significant tax benefits. Under Section 80D of the Income Tax Act, depending on your age and that of your parents, you can get a tax relief of up to Rs 1,00,000 on the medical insurance premium.

Note that this Rs 1,00,000 is an overall limit and varies depending on the age of the insured.

● Possibility of NCB – When you buy individual health insurance for yourself and your family members, you have the opportunity to earn a No Claim Bonus (NCB) on the plan that has not been used to raise a claim. Whereas in a family floater plan, once you raise a claim, you lose the chance of earning or maintaining your NCB.

While you have understood the features and benefits of an individual health insurance plan, you must be wondering should go for an individual health insurance plan or not. Now, whether one should buy an individual health insurance plan or should they get a family floater plan – this decision depends on certain factors, like your age, your dependents, affordability, your health and that of your family members. Evaluate these parameters and make an informed choice to buy a health insurance plan that fits your needs and budget.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.