10 Lakh Health Insurance

A 10 lakh mediclaim plan is a policy having an amount insured of ₹10 lakh, which implies it covers medical expenditures of a maximum of ₹10 lakhs. The premium for a 10 lakh mediclaim policy varies based on the insurance provider and the policy's coverage.

If you (or one of the covered family members) require medical treatment, this insurance policy with an amount insured of ₹10 lakhs may give adequate financial help.

To determine the amount of your 10 lac health insurance premium, you can take the assistance of our online health insurance premium calculator.

Having a 10 Lakh Medical Insurance Policy can offer several perks, including:

• Comprehensive coverage: A 10 lac health insurance plan covers various medical expenses, including hospitalisation, surgeries, diagnostics, medications, and more. It helps ensure you do not have to worry about unexpected medical expenditures.
• Critical Illness Coverage: A 10 Lakh Medical Insurance Policy can offer critical illness coverage to the policyholder. Critical illness coverage is a type of insurance that provides a lump-sum payment if the policyholder is diagnosed with a critical illness covered under the policy. Critical illnesses covered under a 10 Lakh Medical Insurance Policy may include cancer, heart attack, stroke, kidney failure, major organ transplant, and more. The policy will specify the critical illnesses covered and the coverage for each disease.
• Financial security: A 10 lakhs health insurance plan provides financial security in a medical emergency. With such a high sum assured, you can be sure that your medical bills will be covered, and you will not have to dip into your savings or take loans to pay for your medical expenses.
• Access to better healthcare: With a 10 lakh mediclaim policy, you can access better healthcare facilities and treatments. You can opt for private hospitals and specialised treatments without worrying about the high cost of medical treatment.
• Tax benefits: Everyone knows about health insurance tax benefits under Section 80D of the Income Tax Act. The 10 lakhs medical insurance premium you pay makes you eligible for a higher tax benefit, helping you reduce your tax liability.
• Cashless Facility: A 10 Lakh Medical Insurance Policy can offer cashless treatment benefits to the policyholder. Cashless treatment refers to the facility where the insurance company directly settles the medical bills with the hospital. The policyholder does not have to pay anything upfront, helping you focus on your health and recovery without considering the medical costs.
• Peace of mind: With a 10 lac health insurance plan, you can know you are adequately covered in a medical emergency. It can help in reducing stress and anxiety and improve your overall well-being.

Here are some key factors to consider while calculating the mathematics of a 10 Lakh Medical Insurance Plan:

• Premium amount: The premium is the cost the policyholder must pay the insurance company for the coverage. The premium amount for a 10 Lakh Medical Insurance Plan depends on factors such as age, health condition, medical history, and lifestyle habits. The premium amount for a 10 Lakh Medical Insurance Plan can range from a few thousand rupees to several tens of thousands per year.
• Deductible: A deductible is an amount the policyholder must pay out of pocket before the insurance coverage kicks in. A higher deductible can lower the premium amount but can increase the out-of-pocket expenses for the policyholder.
• Co-payment: A co-payment is a percentage of the total medical bill the policyholder must pay out of pocket. A higher co-payment can lower the premium amount but can increase the out-of-pocket expenses for the policyholder.
• Coverage: A 10 Lakh Medical Insurance Plan covers medical expenses such as hospitalisation, surgeries, diagnostics, medications, and more. The policyholder needs to check the coverage details carefully to ensure that the policy covers the medical expenses they need.

To calculate the mathematics behind a 10 Lakh Medical Insurance Plan, the policyholder must consider the premium amount, deductible, and co-payment and estimate the total medical expenses they may incur in a year. The policyholder can then compare the total cost of the insurance plan with the estimated medical expenses and decide whether the plan is affordable and provides adequate coverage.

Let's consider an example to understand the mathematics behind purchasing a 10 Lakh Medical Insurance Plan: Suppose a 30-year-old individual wants to purchase a 10 Lakh Medical Insurance Plan. After comparing different insurance plans, the individual selects a plan with a premium of ₹10,000 per year, a deductible of ₹5,000, and a co-payment of 20%. The policy covers hospitalisation, surgeries, diagnostics, and medications.

Let's assume the individual incurs a total medical expense of ₹2,50,000 annually. The insurance plan covers ₹2,00,000, and the individual has to pay the rest of ₹50,000.

Here's how the mathematics of the insurance plan works out:

• Premium: ₹10,000
• Deductible: ₹5,000 (the individual has to pay this amount out of pocket before the insurance coverage kicks in)
• Co-payment: 20% (the individual has to pay 20% of the total medical bill out of pocket)
• Total medical expense: ₹2,50,000
• Insurance coverage: ₹2,00,000
• Amount to be paid by the individual: ₹50,000 (20% of the remaining medical expense after deducting the insurance coverage)

So, the total cost for the individual for this 10 Lakh Medical Insurance Plan would be:

• Premium: ₹10,000
• Deductible: ₹5,000
• Co-payment: ₹40,000 (20% of ₹2,00,000, which is the insurance coverage)
• Out-of-pocket expense: ₹50,000

Therefore, the total cost for the individual for this insurance plan would be ₹1,05,000. In this example, the individual must pay a total of ₹1,05,000 for the insurance plan, including the premium, deductible, co-payment, and out-of-pocket expenses. This cost may vary depending on the medical expenses incurred and the terms and conditions of the insurance plan.

The Indian healthcare system is expanding rapidly due to its broad coverage, improved services, and increased spending by both public and private entities. Hospitals in India today provide specialist care such as cancer treatments, high-end heart procedures, transplants, neurosurgery, trauma-related orthopaedic surgery, spine surgery, and IVF. It has increased medical expenses. Healthcare inflation in India has been gradually and frighteningly growing. It is growing at the double the pace of India's general inflation.

Furthermore, India ranks as one of the highest levels of out-of-purse spending, which contributes directly to the high prevalence of catastrophic expenses and poverty. As a result, obtaining a health insurance policy with a 10 lakhs sum insured is essential, especially if you live in a metropolis where the cost of treatment is greater. There are several reasons why one should consider getting a health insurance policy with coverage of 10 lakhs (1 million) in India. Some key reasons include:

• Rising healthcare costs: The cost of healthcare services and treatments in India has steadily risen over the yea₹ A health insurance policy with a coverage of 10 lakhs can help you mitigate the financial burden of expensive medical procedures.
• Protection against critical illnesses: A policy with 10 lakh coverage can also protect against critical illnesses, such as cancer, heart attack, and kidney failure, which can require expensive treatments and long-term care.
• Extensive Coverage for Health Expenditures: The greatest health insurance plan will cover doctor fees, specialist fees, ambulance charges, medical and diagnostic test prices, in-patient expenses, hospital room rents, surgical costs, and even post-hospitalisation bills. As a result, getting the correct mediclaim coverage will assist you during crises without putting you in financial jeopardy.

A 10 lakh mediclaim policy typically includes coverage for a wide range of medical expenses, including:

• Restore Benefits: It allows the policyholder to restore the sum insured amount after it has been exhausted during the policy year. This means that if the policyholder has utilised the entire sum insured amount during a medical emergency, the restore benefit feature allows them to restore the sum insured amount to its original amount, so they can avail of additional coverage for any other medical expenses that may arise during the same policy year.

• Consumables Benefit: It provides coverage for the cost of medical consumables used during hospitalisation. Medical consumables are items used during medical treatment or surgical procedures, such as syringes, gloves, gauze, dressings, and other materials.

• Day Care Procedures: It provides coverage for medical treatments or procedures that do not require hospitalisation for more than 24 hou₹ These procedures are usually performed in a hospital or daycare centre, and the patient is discharged on the same day.

• In-Patient Treatment: It provides coverage for medical expenses incurred during hospitalisation. In-patient treatment refers to medical treatment where the patient requires admission to a hospital and stays there for at least 24 hou₹

• Organ Donor Expenses: These cover medical expenses incurred by the organ donor during an organ transplant surgery. This coverage is important as organ transplant surgeries can be expensive and can cause a financial burden on the donor or their family.

• Compassionate Travel: It covers for travel expenses incurred by the policyholder's family member or companion when accompanying the policyholder during medical treatment in another city or country. This coverage is usually provided in case of critical illness or medical emergency that requires the policyholder to seek medical treatment outside their hometown or country.

• Pre- and Post-hospitalisation Medical Expenses: These cover medical expenses incurred by the policyholder before and after hospitalisation.

• Pre-hospitalisation expenses are medical expenses incurred by the policyholder before being hospitalised for treatment. These may include expenses for medical tests, consultations with doctors, or medications.

• Post-hospitalisation expenses are medical expenses incurred by the policyholder after being discharged from the hospital. These may include follow-up consultations with doctors, medications, or rehabilitation expenses.

• Domiciliary Treatment: It provides coverage for the policyholder's medical treatment at home for a medical condition that would otherwise require hospitalisation. Domiciliary treatment refers to medical treatment provided at home due to the patient's medical condition, and it's not feasible for the patient to be hospitalised.

• Ambulance Cover: It covers the cost of ambulance services to transport the policyholder to the hospital in case of a medical emergency. The cost of ambulance services can be significant and add to the overall medical expenses incurred by the policyholder.

• Under a 10 lakh mediclaim policy with ambulance cover, the policyholder can claim for the cost of ambulance services used during a medical emergency up to a certain limit specified in the policy. The policy may cover both land and air ambulance services depending on the policy terms and conditions.

• AYUSH Benefit: The AYUSH benefit provides coverage for medical treatment received by the policyholder under alternative systems of medicine like Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy. These alternative systems of medicine are becoming increasingly popular as more people seek natural and holistic approaches to healthcare.

• Health Checkup: It provides coverage for medical checkups and health screenings for the policyholder. Regular health checkups are an important part of maintaining good health and can help detect health issues early.

• Cumulative Bonus: It offers the policyholder a bonus amount that increases for each claim-free policy year. This bonus incentivises policyholders to maintain good health and avoid making claims for minor health issues.

• While a 10 lakh medical insurance plan provides extensive coverage for medical expenses, some things may not be included in the policy coverage. These can vary depending on the insurer and the specific policy, but some common exclusions may include:

• Pre-existing conditions: Most health insurance policies have a waiting period before pre-existing conditions are covered. This means that any medical conditions the policyholder had before taking the policy may not be covered for a certain period, typically ranging from 2-4 yea₹

• Cosmetic treatments: Medical treatments performed for cosmetic or aesthetic purposes, such as plastic surgery, may not be covered under a standard health insurance policy.

• Non-medical expenses: Expenses unrelated to medical treatment, such as travel or food expenses, may not be covered under a health insurance policy.

• Self-inflicted injuries: Injuries or illnesses caused intentionally by the policyholder, such as self-harm or substance abuse, may not be covered under a health insurance policy.

• Note: It's important to read the policy terms and conditions carefully and understand the exclusions to avoid surprises during a medical emergency.

A 10 lakh health insurance plan is recommended for anyone who wants to ensure their medical expenses are adequately covered in an unforeseen medical emergency. Some specific groups of people may benefit from a 10 lakh health insurance plan:

• Individuals with dependents: If you have dependents, such as elderly parents or young children, a 10 lakh health insurance plan can provide financial security in case any of them require medical treatment.
• Self-employed individuals: Self-employed individuals may not have access to group health insurance plans provided by their employers and, therefore, may need to purchase individual health insurance plans. A 10 lakh health insurance plan can provide sufficient coverage in case of medical emergencies.
• Individuals with pre-existing conditions: If you have a pre-existing medical condition, you may need a higher coverage amount to ensure that your medical expenses are covered adequately.
• High-net-worth individuals: High-net-worth individuals may have higher medical expenses due to their lifestyle and may need a higher coverage amount to ensure they are covered in a medical emergency.
• Individuals with a history of medical issues in their family: If your family has a history of medical issues, a 10 lakh health insurance plan can provide you with peace of mind knowing that you are covered in case of a medical emergency.

Choosing the best 10 lahks medical insurance policy can seem overwhelming, but a few key factors help you make an informed decision. Here are some tips on picking the best 10 lakhs medical insurance policy:

• Coverage: Check the coverage offered by the policy, including inpatient treatment, day-care procedures, pre- and post-hospitalisation expenses, organ donor expenses, and more. Also, check if the policy offers a restore benefit or a cumulative bonus to increase your coverage over time.
• Network hospitals: Check the list of network hospitals covered under the policy to ensure sufficient hospitals in your area where you can avail of cashless treatment.
• Premium: Compare the premiums of different policies to find one that fits your budget. Also, check if the policy offers discounts or no-claim bonuses to reduce your premium.
• Claim settlement ratio: Check the insurer's claim settlement ratio to ensure that they have a good track record of settling claims quickly and efficiently.
• Exclusions: Read the policy terms and conditions carefully to understand the exclusions of the policy, such as pre-existing conditions, non-medical expenses, and alternative treatments, among othe₹
• Customer service: Check the customer service offered by the insurer, including the availability of a 24x7 helpline, the ease of claim submission, and the speed of claim settlement.
• Reputation: Check the reputation of the insurer in the market and their track record of providing quality health insurance products and services.

The premium for a 10 lakh health insurance policy is determined by several facto₹ Here are some factors determining the 10 lakh health insurance premium:

• Age: The premium for a 10 lakh health insurance policy is higher for older individuals as they are considered at a higher risk of medical complications.
• Medical history: Individuals with a history of medical issues or pre-existing conditions may have to pay a higher premium as they are considered at a higher risk of making a claim.
• Lifestyle habits: Insurers may consider lifestyle habits such as smoking, drinking, and obesity when determining the premium, as these factors increase the risk of medical complications.
• Coverage amount: The premium for a 10 lakh health insurance policy is higher than a policy with a lower coverage amount, as the insurer has to bear higher costs in case of a claim.
• Deductible: Opting for a higher deductible can lower the premium as it means that the policyholder is willing to bear a part of the medical expenses.
• Type of plan: The health insurance plan also affects the premium. A family floater plan may have a higher premium compared to an individual plan as it covers multiple individuals.
• Policy term: The premium may vary based on the policy term. Long-term policies may offer a discount compared to annual policies.

Considering these factors, individuals can determine the premium for a 10 lakh health insurance policy and choose a plan that fits their budget and requirements.

Listed below are the steps on how a 10 lakh medical insurance policy works:

• Admission to hospital: The person is admitted to a hospital that is part of the insurer's network, or they may opt for a non-network hospital, in which case they would have to pay the expenses upfront and then claim reimbursement from the insurer.
• Pre-authorisation: If the hospital is part of the insurer's network, the person may inform the insurer of the hospitalisation and obtain pre-authorisation for the medical treatment.
• Treatment and expenses: The person receives the necessary medical treatment, and the hospital submits the bills to the insurer for payment.
• Payment of expenses: The insurer settles the eligible expenses up to the limit of the sum insured under the policy. The policyholder may have to pay the expenses not covered under the policy, such as deductibles, co-payments, or expenses exceeding the sum insured.
• Claim process: If the person opts for a non-network hospital, they must pay the expenses upfront and then claim reimbursement from the insurer. The person must submit the original bills and documents to the insurer and a claim form. The insurer verifies the claim and settles the eligible expenses.

It is important to note that the policyholder must inform the insurer about the hospitalisation as soon as possible and follow the claim process as per the policy terms to ensure a timely claim settlement.

You can purchase a 10 lakh health insurance plan from Tata AIG online by following these steps:

• Visit the official website of Tata AIG General Insurance.
• Click the 'Health Insurance' tab from the top navigation menu.
• Select the type of health insurance plan you want to purchase, such as individual, family, or critical illness insurance.
• Enter the required information, such as your age, gender, and health condition, to get a quote for the policy.
• Choose the sum insured (10 lakhs in this case), policy term, and other features per your requirement.
• Review the policy terms and conditions and the premium amount.
• Click on the 'Buy Now' button and enter your details, such as name, contact details, and address.
• Pay for health insurance premium for the 10 lakh policy online using your credit card, debit card, or net banking.
• Once the payment is processed, you will receive an email confirmation with the policy documents.

You can also contact the customer support team of Tata AIG General Insurance to assist you with the policy purchase process or answer any queries you may have.

Obtaining a Tata AIG 10 lakh mediclaim policy can provide a range of benefits, including:

• Hospitalisation Expenses: Tata AIG typically covers numerous hospitalisation expenses up to the policy limit like room rent and boarding expenses, surgeon's, doctor, and anaesthetist's fees, nursing and intensive care charges, blood, oxygen, and other medical supplies, as well as diagnostic tests.
• Pre- and Post-Hospitalisation Expenses: The Tata AIG policy covers the cost of medical treatment and diagnostic tests incurred in the days leading up to the hospitalisation. Typically, these expenses are covered for a period of up to 30 days prior to hospitalisation. The policy also covers the cost of medical treatment and diagnostic tests incurred after the policyholder’s discharge from the hospital. Typically, these expenses are covered for up to 60 days after hospitalisation.
• AYUSH Cover: The Tata AIG 10 lakh health policy covers AYUSH treatments taken in government hospitals or any institute recognised by the government and accredited by the Quality Council of India/National Accreditation Board on Health (NABH). It also covers AYUSH treatments up to the sum insured specified in the policy, subject to the terms and conditions of the policy.
• COVID-19 Coverage: Tata AIG provides coverage for COVID-19 treatment in their health insurance plans, subject to the terms and conditions of the policy. The coverage typically includes hospitalisation expenses such as room rent, doctor's fees, nursing charges, PPE kits, oxygen masks, gloves, etc. The coverage is subject to a waiting period of 15 days from the start of the policy.

"I recently bought a Tata AIG health plan and am very pleased with its coverage and benefits. The policy purchase went smoothly, and the customer assistance team was extremely helpful in answering my questions."

~ Gajendra Singhania

"I had to file a claim under my Tata AIG health insurance coverage owing to sickness, and I was pleasantly impressed by the quick and easy claims procedure. The insurance company reimbursed my claim swiftly and without any fuss."

~ Dhriti Nagpal

"I have been a Tata AIG customer for a few years now, and I have to say that their health insurance plans are very comprehensive and provide excellent value for money. The coverage covers various medical expenses, including pre-and post-hospitalisation fees and critical illness protection."

~ Amrita Datta