đź§­ Beginner's guide to health insurance

New to health insurance? start here

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Buying health insurance for the first time can be confusing. But understanding a few key terms, features and options to choose can help you choose the right plan.

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Topic 1
topicSum Insured

Sum Insured - Choose the right coverage amount

The sum insured is the maximum amount your insurance will pay for medical expenses in a year.

When choosing coverage, think about:

Your family size
Your family size
The area or city you live in
The area or city you live in
Rising medical costs
Rising medical costs
exampleExample

In metro cities like Mumbai, Delhi or Bangalore, a single hospitalization can drain your long-term savings.

₹15–20 lakh

Good starting point for families in metro cities

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₹8–10 lakh

Suitable cover for smaller cities

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Note: Medical costs increase every year, so choosing a higher cover today can protect you in the future.

In case you prefer face to face expert guidance.

Don't worry, we’ve got you covered.

Topic 2
Important features

Important features your plan should have

Some features are essential in most good health insurance plans.

Must-have features

Must-have features

  • Cashless treatment at network hospitals
  • Coverage for expenses before and after hospitalization
  • Coverage for day-care procedures (treatments that don't need 24-hour admission)
  • No restrictions on room rent
Useful as per needs

Useful as per needs

  • Maternity and newborn cover / vaccinations
  • Critical illness cover
  • OPD consultations
Good to have

Good to have

  • Free annual health check-ups
  • Wellness rewards and discounts
  • Restoration benefit of coverage if the sum insured gets exhausted
Topic 3
topicCo-pay & Deductible

Understanding co-payment and deductible

These are two terms that affect how much you pay during a claim.

Co-payment

Co-payment

You pay a fixed percentage of the hospital bill.

exampleExample

If your bill is ₹10 lakh and your co-pay is 20%

₹2 lakh
You pay
₹8 lakh
Insurance pays
Deductible

Deductible

You pay a fixed amount first, and insurance pays the rest.

exampleExample

If your deductible is ₹1 lakh and the bill is ₹5 lakh

₹1 lakh
You pay
₹4 lakh
Insurance pays
Topic 4
topicCommon mistakes

Common mistakes first-time buyers make

Avoid these common mistakes when buying health insurance online:

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Choosing the cheapest plan without checking coverage
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Not checking waiting periods for pre-existing diseases
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Ignoring the network hospital list
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Not reading the key exclusions in the policy
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Buying very low coverage
Topic 5
topicChecklist

Quick checklist before buying

Before purchasing a plan, check these important points:

*
Quick Checklist

Coverage & Benefits

checkCoverage amount suitable for your city and family
checkList of network hospitals near you
checkWhat is covered and what is excluded

Claims & Access

checkList of network hospitals near you
checkClaim settlement record of the insurer
checkWaiting period for existing illnesses

This checklist helps ensure you pick a plan that actually works when you need it.

Topic 6
topicTop-up

Why top-up plans can be useful

Medical treatments can sometimes cost much more than your base coverage. Top-up or Super Top-up plans increase your protection at a low cost.

Coverage example

If your bill is ₹10 lakh and your co-pay is 20%

iconExample

If your deductible is ₹1 lakh and the bill is ₹5 lakh

Topic 7
topicExtra benefits

Extra benefits many people overlook

Many health insurance plans also offer additional benefits such as:

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Free annual health check-ups
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Rewards for healthy habits
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OPD reimbursements
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Maternity and vaccination benefits
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Coverage for AYUSH treatments (Ayurveda, Homeopathy etc.)
Topic 8
topicCashless claims

How cashless claims work

A cashless claim means you don't have to pay the full hospital bill upfront.

1
Get admitted to a network hospital
2
Hospital sends request to the insurer
3
Insurer approves the treatment
4
Treatment is done
5
Insurance company settles the bill with the hospital

Important: You only pay any non-covered expenses. This process removes anxiety and financial burden during medical emergencies.

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Now that you know about health insurance, let’s play a game

Explore real scenario and decide what’s right or wrong—before you choose a plan

Topic 9
topicNetwork hospitals

Check the network hospitals

Before buying a plan, check the network hospitals in your city.

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Good hospitals near your home are included
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Cashless treatment is available

Need help choosing the right health insurance plan?

Our experts can help you understand the options and find a plan that fits your needs.