Eight Critical Factors to Compare Health Insurance Plans in India

A Health Insurance policy is a financial backup that allows you to receive immediate treatment from the best hospitals in case of an injury or accident without hurting your wallet. Because of the ever-increasing medical cost, health insurance plans have become one of the essential financial necessities in today’s world. Nowadays, you can purchase online health insurance within hours, but you can get it offline if you prefer. However, these plans come with different sets of benefits and restrictions. So, not all insurance plans are suitable for you. In this article, we will discuss seven critical factors you need to take into consideration to compare health insurance plans and select the right one according to your needs. Let’s dig in.

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1) The Scope of the Coverage:

The scope of the coverage is one of the most important factors you need to keep in mind while comparing various health insurance plans in India. Even if the insured sum is the same, the risk coverage can greatly vary depending on the insurance company. 

A good insurance plan must have comprehensive risk coverage and include the following benefits:

  • Critical illness coverage
  • Ambulance services
  • OPD cover
  • Pre-existing illness coverage

2) Network of Hospitals:

The health insurance companies offer cashless hospitalization if you decide to admit to a medical center from their network of hospitals. Therefore, you must always check the network of hospitals of different companies before buying a medical insurance policy.

Try to pick health insurance from a company that has an affiliated hospital near your residence. This allows you to enjoy immediate cashless hospitalization in the case of an emergency, so you can get the treatment first and worry about the money later. For more information on the hospital network, check the website of insurance providers.

3) Lifetime Renewability:

You should go for medical insurance that offers lifetime renewability or at least offers a higher renewal period to deal with the health complications that can show up with old age. Health insurance with lifetime renewability will give you lifetime health coverage. So, if possible, you should always purchase insurance coverage with this added benefit.

4) Waiting Periods:

Waiting for something can get pretty boring. But waiting for the benefits of the medical insurance plans is way more annoying. Every health insurance plan has a particular waiting period. During this time, you can neither claim the benefits covered under the insurance policy nor the insurance company will settle any of your claims.

The waiting period of different health insurance varies depending on the benefits the policy offers. Here are the most common waiting periods:

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  • Initial Waiting Period: Whenever you buy health insurance online or offline, it comes with an initial waiting period. The insurance company will not accept any claim from you during this time period, except for the claims made in the case of an accident.
  • Maternity Benefits: The insurance companies now offer maternity benefits, which you can claim after a waiting period ranging from 9 months to 4 years.
  • Pre-existing Conditions: If you had an ailment before purchasing your health insurance policy, there would be a waiting period of 2-4 years before you can make any claim related to the pre-existing ailment. In simple words, any pre-existing ailment before getting your medical insurance will not get immediate coverage.

5) Sub-limit:

Many insurance companies have a clause, sub-limit, which is usually applied to doctor visits, bed changes, room fees, and some restricted ailments. The insurance companies put a limit on the total expense they will cover for the items and ailments included in the sub-limit clause. In other words, if the expanse goes over the sub-limit for certain items and ailments, you need to cover the additional cost from your own wallet.

To avoid unpleasant surprises, read the details of the sub-limit clause and, if possible, choose an insurance policy without any sub-limit. This way, you can get the best medical insurance, which is tailor-crafted for you.

6) Premium

You should always go for the best insurance coverage suited for your unique needs by paying a premium you can afford. Insurance policies with maximum benefits and coverages usually have a hefty premium that might be difficult to afford. So, choose an insurance policy that covers your medical needs and has a premium that won’t break your bank.

7) Super Top-up Plans:

Some companies offer super top-up plans on top of the actual medical insurance policy. With these plans, even if the medical expenses exceed the limit of the financial coverage of your insurance policy, the insurance company will pay the additional cost. Plus, the premium of these super top-up plans is quite low. So, if you are unable to afford an insurance policy with a high premium, you should purchase these super top-up plans on top of an insurance policy with a moderate premium.

8) Exclusions:

All health insurance plans in India come with a set of conditions under which you are not allowed to raise a claim. And even if you raise a claim under these conditions, the insurance company will most likely reject it. These conditions are known as exclusions. That’s why you must always read the terms of the insurance policies carefully to understand the exclusions before making a purchase decision.


Many people in India avoid buying individual health insurance policies because of costly premium rates. Or they choose an insurance policy with a lower premium. While weighing the premium is important, this is the last thing you should worry about when you’re purchasing health insurance. Your life is precious, and so is your health. So, whether you buy online health insurance or get an offline one, make sure that you consider the critical factors mentioned in this guide before making the purchase.