What does health insurance cover?
A health insurance policy — still widely called mediclaim — pays for hospital treatment up to the sum insured. That includes room charges, doctor and surgeon fees, medicines, tests and procedures during admission, and usually medical costs for a set number of days before and after the stay.
You can buy it in a few forms:
| Type | Covers | Often suits |
|---|---|---|
| Individual | One person, with their own sum insured | Single adults, older parents |
| Family floater | One sum insured shared by the family | Young couples with children |
| Senior citizen plan | Designed for older adults | Parents above 60 |
| Maternity cover | Delivery and newborn costs, after a waiting period | Couples planning a family |
How recent IRDAI rules help you
IRDAI has made health policies noticeably more buyer-friendly in recent years:
- Waiting periods for pre-existing diseases are capped at three years.
- Insurers are expected to decide on cashless requests within an hour, and on final discharge within three hours of the hospital's request.
- You can port to another insurer and keep credit for the waiting periods you have already served.
Things to compare before you choose
The cheapest premium often hides limits that only show up at claim time. Look closely at:
- Room-rent limit: a cap on room category can reduce the payout on the whole bill, not just the room charge.
- Co-payment: common in senior citizen plans; you pay a fixed share of every claim.
- Sub-limits: caps on specific treatments such as cataract surgery.
- Restoration and no-claim bonus: how each works, and whether restoration applies to the same illness.
- Network hospitals: check the ones near your home and workplace.
Why your employer's cover is not enough
Group health cover from work ends when you leave the job, and its sum insured may be modest for a major hospitalisation in a large city. Buying your own policy while young and healthy also means the waiting periods are served long before you are likely to need them. If you already have employer cover, a personal base policy plus a super top-up is one way to keep protection continuous through job changes.
Our team compares plans from multiple insurers, helps you make complete disclosures, and supports you through cashless and reimbursement claims and every renewal.
