Types of Health Insurance

Health Plan Types	Who Can Benefit
Individual Health Plan	Tata AIG’s individual health plans are designed for a single person and provide coverage tailored to individual health needs.
Family Floater Plan	Our plan offers coverage for the entire family, including the policyholder, spouse, children and parents, under a single plan.
Senior Citizen Plan	This plan is specifically for people over 61, offering benefits suited to seniors' health requirements.
Critical Illness Plan	Tata AIG’s critical illness insurance provides financial protection against the high cost of treatment for critical illnesses like cancer, heart disease and more.
Mediclaim	This is just another term for a health insurance plan and focuses on covering in-patient expenses incurred during hospitalisation.
Personal Accident Cover Plan	Provides financial protection against partial or total disability and death resulting from an accident.
Group Health Plan	Such plans cover a group of people, such as employees of a company, offering collective benefits under a single policy.
Super Top-Up Health Plan	This is for individuals looking to enhance their existing medical coverage with additional benefits up to a specified limit.
Maternity Health Plan	This plan covers expenses related to prenatal care, delivery and post-natal care for expecting mothers.
Hospital Daily Cash	This offers a daily cash allowance to manage expenses for each day the insured person is hospitalised.
Coronavirus Health Plan	These are tailored to offer coverage for specific health conditions related to COVID-19.

Let us now discuss the different types of health insurance in India, as well as their features and examples, to help you better understand the differences.

Individual Health Plans

Individual Health Insurance Plans in India are designed to cover the medical expenses of a single person. These plans are ideal for young professionals and individuals who do not have dependents. The coverage typically includes hospitalisation, pre and post-hospitalisation expenses and day-care procedures.

Features:

Coverage: Specifically designed for a single person, covering their medical expenses.

Premiums: Calculated based on the individual's age, health history and coverage amount.

Benefits: Includes hospitalisation costs, pre and post-hospitalisation expenses and sometimes day-care procedures.

Example:

An Individual Health Insurance Plan might cover a young professional named Raj, aged 30, with a coverage of ₹5 lakhs, which includes hospitalisation for illnesses, surgeries and certain day-care treatments.

Family Floater Plans

Family Floater plans are one of the most common types of medical insurance that offer comprehensive coverage for the whole family under a single plan. These plans are economical and ensure that the sum insured can be utilised by any family member as needed. They are perfect for nuclear and joint families in India.

Features:

Coverage: Extends to the entire family, including the policyholder, spouse, children, and sometimes parents.

Sum Insured: A single sum insured is shared by all family members.

Benefits: Hospitalisation costs, maternity benefits and often newborn cover.

Example:

A family of four—Priya, her husband and their two children—might choose a Family Floater Plan with coverage of ₹10 lakhs, which can be utilised by any family member as needed.

Senior Citizen Plans

These plans are tailored for the elderly population in India, specifically those above the age of 61. Tata AIG’s senior citizen plans offer higher coverage for age-related health issues and often include regular health check-ups and domiciliary treatments included under coverage.

Features:

Eligibility: Tailored for individuals above 60 years of age.

Coverage: Includes regular health check-ups, hospitalisation and often domiciliary treatment.

Premiums: Higher due to increased health risks associated with age.

Example:

Mr. Sharma, aged 70, chooses a Senior Citizen Health Insurance Plan with a coverage of ₹3 lakhs. The plan covers his regular health check-ups and any hospitalisation required due to age-related illnesses.

Critical Illness Plans

Critical Illness Insurance provides financial protection against the high cost of treatment for severe and life-threatening illnesses. These plans offer a lump sum payment upon diagnosis, which can be used for treatment or other related expenses.

Features:

Coverage: Financial protection against critical illnesses like cancer, heart disease and stroke.

Lump Sum Payment: Upon diagnosis, a lump sum is paid, which can be used for treatment, recovery or other expenses.

Specified Illnesses: Covers specific critical illnesses listed in the policy.

Example:

Sunita, aged 45, opts for a Critical Illness Plan covering ₹10 lakhs. Upon being diagnosed with breast cancer, she receives a lump sum amount to cover her treatment and recovery costs.

Mediclaims

Mediclaims focus primarily on covering hospitalisation expenses. These plans offer cashless insurance treatment at all hospitals or reimbursement of hospitalisation costs, making them ideal for covering sudden medical emergencies.

Features:

Coverage: Focuses on hospitalisation expenses.

In-patient Costs: Covers in-patient treatment, surgeries, room charges and doctor consultation fees that led up to hospitalisation.

Reimbursement or Cashless: Offers reimbursement or cashless treatment at all recognised hospitals.

Personal Accident Cover Plans

Personal Accident Cover offers financial protection against accidental injuries, disability and death. These plans are essential for individuals who are at higher risk of accidents due to their profession or lifestyle.

Features:

Coverage: Financial protection against death or disability resulting from an accident.

Benefits: Cover medical expenses, disability compensation, and accidental death benefits.

Scope: Can include partial or total disability coverage.

Example:

Arjun, who works in construction, opts for a Personal Accident Cover from Tata AIG with ₹5 lakhs coverage. This plan ensures financial support in case of an accidental injury leading to disability or death.

Group Health Plans

Employers usually provide these plans to their employees as part of the employee benefits package. These plans are cost-effective and offer a wide range of benefits, including hospitalisation, maternity and sometimes dental and vision care.

Features:

Coverage: Provided to a group of people, usually employees of a company.

Benefits: Hospitalisation, maternity and often dental and vision care.

Cost-Effective: Generally, it is more affordable due to the lower collective risk.

Example:

ABC Corporation offers a Group Health Insurance Plan to its employees from Tata AIG, covering hospitalisation, maternity benefits and annual health check-ups for a collective coverage amount of ₹20 lakhs.

Top Up Health Plans

Tata AIG’s Super Top-up Health Insurance Plans are known as MediCare Plus. This plan provides additional coverage over and above an existing health insurance policy. These plans are economical and take effect once the base policy's threshold limit is exhausted.

Features:

Additional Coverage: Provides extra coverage over and above an existing health insurance policy.

Threshold Limit: Only comes into effect after the threshold limit of the base policy is exhausted.

Affordable: Generally cheaper than increasing the sum insured of the base policy.

Example:

Ravi has an Individual Health Insurance Plan from Tata AIG with a coverage of ₹5 lakhs. He opts for a Top-up Plan with an additional ₹5 lakhs, which activates once the initial coverage is exhausted.

Maternity Health Plan

Such a plan covers the medical expenses related to childbirth and post-natal care. Tata AIG’s maternity plans are highly beneficial for couples planning to start a family, covering prenatal and postnatal expenses along with delivery costs.

Tata AIG offers maternity coverage under our individual and group health insurance plans.

Features:

Coverage: Expenses related to prenatal care, delivery and post-natal care.

Benefits: It covers delivery costs, prenatal check-ups, and sometimes newborn coverage.

Waiting Period: Often has a waiting period (4 years) before benefits can be claimed. Our group policies offer coverage from day 1.

Example:

Meera and Jai, who are planning to start a family, opt for a Tata AIG Maternity Health Insurance Plan with coverage of ₹3 lakhs. The plan covers her prenatal check-ups, delivery costs and postnatal care after a four-year waiting period with Tata AIG.

Hospital Daily Cash

This plan provides a fixed daily allowance to manage additional expenses incurred during hospitalisation. It is a good supplement to regular health insurance policies, covering miscellaneous costs like transportation and food.

Features:

Daily Allowance: Provides a daily cash allowance during hospitalisation.

Flexibility: It can be used for various expenses like transportation, food or any additional costs.

Supplementary: Works as a supplement to other health insurance plans.

Coronavirus Health Plan

This COVID-19-specific plan from Tata AIG provides targeted coverage for specific health conditions related to COVID-19. These plans are highly beneficial for individuals at high risk or during an outbreak of Coronavirus.

Features:

Targeted Coverage: Provides coverage for specific symptoms and treatments related to COVID-19.

Benefits: Hospitalisation, treatment costs and sometimes post-treatment care.

Affordable: Generally, it is cheaper than comprehensive plans.

Example:

During the COVID-19 pandemic, Rahul opted for a Coronavirus Health Plan from Tata AIG with coverage of ₹2 lakhs. This plan covered his treatment and hospitalisation costs when he contracted COVID-19.

Protection Against High Medical Costs

Medical treatments can be expensive, especially for serious illnesses or emergencies. Health insurance plans cover hospitalisation costs, surgeries, doctor fees and other medical expenses. Having the right health plan from us ensures that you do not have to dip into your savings or take on debt to pay for medical care.

Access to Quality Healthcare

With our health insurance options, you have access to a network of hospitals and healthcare providers. Our plans offer cashless treatment at all hospitals, meaning you do not have to worry about making upfront payments. This access to quality healthcare ensures timely treatment, which can be critical in emergencies.

Coverage for Pre and Post-Hospitalisation Expenses

Tata AIG’s health insurance plans often cover not just the hospitalisation costs but also the expenses incurred before and after the hospital stay. This includes diagnostic tests, medications and follow-up visits, which can add up significantly.

Preventive Healthcare

Our health insurance plans offer preventive healthcare services, including annual check-ups and screenings. Regular check-ups help detect illnesses early, allowing for timely intervention and better health outcomes.

Tax Benefits

Under Section 80D of the Income Tax Act, you can claim a deduction for the premiums paid for health insurance. This provides a financial incentive to invest in a health plan while ensuring you and your family are protected.

Peace of Mind

Knowing that you have health insurance from Tata AIG will offer you peace of mind. You can focus on recovery rather than worrying about how to pay for medical expenses. This assurance is invaluable, especially in times of health crises.

Deductibles: Ensure you check the deductible amount stated in the policy. A deductible is the amount you must pay out-of-pocket before the insurance company starts covering the remaining expenses. Understanding this can help you avoid surprises during claim settlement.

Sum Insured: Evaluate if the coverage amount is sufficient for you and your beneficiaries. The sum insured should be adequate to cover potential medical expenses to avoid financial stress during claim settlement.

Waiting Period: Review the waiting periods for coverage of certain pre-existing conditions and for maternity coverage. Opt for health insurance policies with minimal waiting periods.

Medical History of Family Members: Consider the medical history of all beneficiaries. If any beneficiaries have a history of medical conditions, this could affect the premium. Ensure the policy covers these conditions adequately.

Age of the Beneficiaries: The age of the beneficiaries significantly impacts the premium, waiting period and renewability of the policy. Choose a plan that offers favourable terms for the age group of your beneficiaries.

Exclusions: Understand the policy's exclusions and what is not covered. This will help you choose a plan that meets your needs and avoids unexpected issues during claim settlement.

Claim Settlement Process: Examine the insurer's claim settlement process. A straightforward and transparent process ensures quicker and hassle-free claim settlements.

Check the insurer's claim settlement ratio and customer reviews for better insight. Tata AIG’s claim settlement ratio for the FY 23-2024 was 96.70%. This reasserts our commitment to serving our customers in the best way possible.

Annual Health Checkups and Value-Added Services: Look for plans that offer annual health checkups and additional services like online doctor consultations, lab tests and discounts on medicines. These added benefits enhance the value of your health insurance plan.

Maternity Cover: Not all health insurance plans include maternity coverage. If you are planning to start a family, choose a plan that offers maternity benefits or allows you to add this coverage.

Lifetime Renewability: Check the plan's renewability options. Plans with lifetime renewability ensure continuous coverage without age restrictions, providing long-term security.

Network Hospitals: A wide network of hospitals provides easy access to medical care. Ensure the insurer has a vast network of hospitals, including those near your location, to make treatment facilities convenient.

When you buy health insurance online, you should be well aware of its types and meanings. This will help you understand their scope of coverage better. Each plan, whether it's individual, family floater, senior citizen, critical illness or any other, offers unique benefits tailored to specific needs.

By evaluating your health requirements, financial situation and future goals, you can choose the best type of medical insurance plan from Tata AIG for you and your family.