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Health Insurance

Protect yourself and your family from rising medical costs. Get comprehensive health coverage tailored to your needs — because good health is the foundation of everything.

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Basics

What is Health Insurance?

Health insurance is a policy that pays for medical expenses you incur. It provides financial protection to individuals and families against the high costs of healthcare services. In exchange for regular premium payments, health insurance policies in India primarily cover hospitalisation-related medical expenses. Coverage for outpatient care, medicines, and preventive health check-ups may be available under specific plans or optional add-ons.

Why Buy

Key Benefits of Health Insurance

Here's why investing in a health insurance policy is a smart move for every individual and family.

1

Financial Security

Life is unpredictable. With rising medical costs and soaring inflation, health insurance acts as your safety net during emergencies.

2

Preserves Your Savings

Protects your hard-earned savings from being consumed by unexpected medical bills, letting you focus on long-term goals.

3

Cashless Claims

At network hospitals, the insurer settles eligible expenses directly — no need to arrange cash upfront for hospital bills.

4

Early Disease Detection

Routine check-ups (if covered) help detect health conditions early, enabling more effective and timely treatment.

5

Protects Your Family

A family floater plan covers all eligible family members under one policy — ensuring loved ones get top medical care.

6

Tax Benefits

Under Section 80D of the Income Tax Act, claim deductions on premiums for yourself, spouse, children and parents.

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Timing Matters

Benefits of Buying At an Early Age

1
Diseases Can Strike Anyone

Young people are increasingly susceptible to health issues. Waiting until old age is not a strategic approach.

2
Avoid Long Waiting Periods

Buying early lets you complete applicable waiting periods sooner, ensuring broader coverage when you need it most.

3
Fewer Rejection Chances

When young and healthy, the underwriting process is simpler with minimal likelihood of policy rejection.

4
No Medical Checkups Required

Most insurers don't mandate medical examinations for younger applicants. Tests kick in typically after age 45.

5
Lower Premiums

Younger buyers lock in lower premiums and gain comprehensive coverage before health risks begin to rise.

6
Protects Long-Term Investments

Medical coverage shields your financial investments and assets from unforeseen health-related needs.

Why Early Buyers Win
Lower Premium
~40% Less
Full Coverage
From Day 1
No Medical Test
Under 45
Waiting Period
Served Early
Savings Protected
100%
2026 Edition

Top Health Insurance Plans In 2026

Features and limits listed are indicative. Actual coverage may vary by plan, sum insured, age, zone, and insurer updates. Verify latest policy wordings before purchasing.

Logo Plan Name Coverage & Key Highlights
Acko Platinum Health No room rent or ICU limits, full day care and domiciliary cover, unlimited modern treatments, unlimited restore for unrelated illnesses, no co-pay
Aditya Birla Activ Fit (Preferred) No room or ICU cap, long pre and post cover, full day care and domiciliary, bonus up to 500% with option, unlimited restore from second claim
Bajaj General Health Guard Gold No room or ICU limit, 399 day care procedures, no domiciliary cover, restore once per year, optional co-pay
Care Health Insurance Care Supreme No room or ICU cap, long post-hospital cover, full day care and domiciliary, restore from first claim for related and unrelated illnesses
Chola MS Flexi Health Supreme Plus No room or ICU limit, full day care and domiciliary, restore once for subsequent claims, no co-pay
Generali Central Health Total Vital No room or ICU cap, 409 day care procedures, domiciliary limited to 10% of SI, age-based co-pay for seniors
Go Digit Health (Infinity Wallet) No room or ICU limit, long post-hospital cover, modern treatments capped at 50% of SI, unlimited restore for unrelated illness
HDFC ERGO Optima Secure No room or ICU cap, long pre and post cover, unlimited restore as add-on, non-medical expenses covered
ICICI Lombard Health AdvantEdge Apex Plus Single private room limit, unlimited restore up to 100% of SI, non-medical cover in-built for higher SI, optional co-pay
IFFCO Tokio Individual Health Protector No room or ICU limit, 161 day care procedures, modern treatments capped at 50% of SI, short PED wait
Zurich Kotak Health Premier Advantage No room or ICU cap, 405 day care procedures, long PED wait of 48 months, no co-pay
Liberty General Health Connect Supreme No room limit, limited domiciliary cover up to 10% of SI, no non-medical cover, basic restore benefit
Magma HDI One Health Premium No room or ICU cap, 541 day care procedures, restore up to 5 times per year, optional co-pay
ManipalCigna ProHealth Prime (Advantage) Single private AC room, long post-hospital cover, limited domiciliary to 10% of SI, no co-pay
National Insurance Mediclaim Plus Strict room and ICU sub-limits, limited day care list, no restore or non-medical cover, co-pay for non-network hospitals
New India Assurance Floater Mediclaim Room and ICU capped, 226 day care procedures, no domiciliary or restore benefit, longer PED wait
Niva Bupa ReAssure 2.0 (Titanium+) No room or ICU cap, unlimited restore from first claim, bonus up to 1000%, robotic surgery excluded
Oriental Insurance Happy Family Floater Gold Room and ICU sub-limits, limited modern treatments, no bonus, basic restore once per year
Raheja QBE A La Carte Room and ICU capped, modern treatments via add-on, co-pay for 60 years and above
IndusInd General Health Gain (Power) No room or ICU limit, modern treatments capped at 50% of SI, partial restore with sub-limits
Royal Sundaram No room or ICU cap, steady bonus growth, optional co-pay, restoration once per year
Plans listed are not ranked in any specific order. Coverage details, benefits, limits and terms may vary based on the insurer, policy variant, sum insured, age and underwriting guidelines.
Categories

Types of Health Insurance Plans

1

Individual Health Insurance

Tailored to individual needs covering surgery, hospitalisation, pre & post-medical expenses. Offers flexibility to customise coverage.

2

Family Floater Insurance

Entire family covered under one policy sharing the sum insured. Pay one premium for the whole family with potentially lower rates.

3

Senior Citizen Insurance

Designed for individuals above 60 years. Covers hospitalisation, accidents, domiciliary care, psychiatric treatment and related costs.

4

Group Health Insurance

Offered by companies to employees — covering illnesses, accidents, maternity expenses, and critical illnesses at lower premiums.

5

Maternity Health Insurance

Covers pregnancy and childbirth expenses including delivery, prenatal/postnatal care. Many plans cover newborns for the first 90 days.

6

Top-Up & Super Top-Up

Additional coverage beyond your base health plan. Activates after base coverage is exhausted — cost-effective way to enhance protection.

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Requirements

Eligibility Criteria to Buy

A health insurance policy is available only to those who meet the eligibility requirements. Here are the key criteria:

Age Restrictions

Most plans are available for individuals from 18 to 65 years. Some extend up to 99 years. Children from 90 days old to 18–25 years may be covered. Special plans exist for seniors above 65. Age limits vary between insurers.

Medical History & Pre-Existing Conditions

Your health history is key in determining coverage. Having a medical history won't prevent coverage but may impact premiums. Specific conditions may be excluded or subject to waiting periods. Insurers may require health check-ups depending on age (typically 45+), sum insured, and plan type.

Documentation

Documents Required to Buy

The documents needed can vary among insurers. Here's a general checklist:

Identity & Address Proof
  • Aadhar Card
  • Passport
  • Driving Licence
  • Voter's ID
  • Birth Certificate
  • Electricity / Telephone Bill
  • Ration Card
Additional Documents
  • Salary Slip
  • Bank Statements
  • Medical Report
  • Passport Size Photos
Why It Matters

Importance of Health Insurance in India

Health insurance plays a crucial role in ensuring financial security and accessibility to quality medical care across India.

1

Copes With High Medical Costs

7 of 10 leading causes of death globally are non-communicable diseases. New treatments are expensive — health insurance helps manage these costs efficiently.

2

Protects Your Family

Prioritising family well-being is paramount. Health insurance ensures necessary medical care during unfortunate health issues.

3

Better Than a Healthcare Fund

Healthcare funds may not cover all medical and surgical costs. Insurance provides a more reliable and comprehensive financial safety net.

4

Preserves Hard-Earned Savings

Protects your savings meant for house purchase, children's education, or retirement from being wiped out by unexpected medical bills.

5

Early Buying Means More Benefits

Younger buyers get better premiums, skip medical tests, and complete waiting periods early — maximising benefits when they need them most.

6

Tax Benefits Under Sec 80D

Claim deductions on premiums for yourself, spouse, children and parents under Section 80D of the Income Tax Act, 1961.

Coverage

What's Covered & Not Covered

1
In-Patient Hospitalisation

Medical treatment expenses, room rent, ICU charges during hospital stays are covered.

2
Pre & Post-Hospitalisation

Blood tests, X-rays, OPD consultations before and follow-up visits, diagnostics after discharge.

3
Organ Donor Hospitalisation

As per IRDAI regulations, organ donor hospitalisation expenses related to the transplant are covered.

4
Day Care Treatments

Gallbladder removal, hernia, chemotherapy and other procedures completed within a few hours.

5
Domiciliary Hospitalisation

Treatment at home when hospital admission is not possible — covered by most policies.

This is not an exhaustive list. Scope of coverage varies across insurers. Please read the policy wording for complete inclusions.

Health insurance policies may not cover certain medical costs and treatments — these are known as exclusions.

Standard Permanent Exclusions (IRDAI Mandated)

1
Investigation & Evaluation

Hospital admission solely for observation or monitoring purposes.

2
Obesity / Weight Control

Treatment or surgery for weight control or obesity is not covered.

3
Cosmetic / Plastic Surgery

Treatments altering body characteristics or appearance for non-medical reasons.

4
Hazardous Adventure Sports

Treatment expenses from professionally engaging in rafting, mountaineering, scuba diving, horse racing, etc.

5
Narcotics / Substance Abuse

Treatment for addictive conditions like alcohol or drug dependency.

6
Unproven Treatments

Surgeries, medical procedures, or treatments not proven to be effective.

Waiting Periods

30
Days
Initial Waiting Period

Only accidents covered from day one. All other treatments subject to 30-day wait.

2–4
Years
Pre-Existing Diseases

Conditions diagnosed within 48 months before policy issuance — subject to PED waiting period.

2–4
Years
Specific Disease Wait

Hernias, haemorrhoids, chronic kidney disease, spinal disorders and similar conditions.

Claims

How to File a Health Insurance Claim

Two main claim types — understanding the process in advance makes difficult times much easier.

Cashless Claim

Seek treatment at a networked hospital. The insurer settles eligible medical expenses directly with the hospital, subject to policy terms, approvals, and admissibility. Saves you from tedious paperwork or paying cash upfront.

Reimbursement Claim

Pay the hospital bill upfront, then file for reimbursement directly with your insurer. Used for non-networked hospitals or when cashless settlement is not available. The insurer reimburses admissible expenses per policy terms.

Cashless Claim Steps
1
Confirm Network Hospital

Verify the hospital has a cashless arrangement with your insurer before admission.

2
Submit Pre-Authorization

Fill and sign a claims form at the hospital's insurance desk. For planned hospitalisation, submit 3–4 days prior.

3
Track & Submit Documents

Policy copy, medical records, KYC, and Police FIR (for accidents). Track progress on TPA app.

4
Discharge & Final Settlement

Submit final bill and discharge summary. Insurer approves and settles directly with hospital.

Reimbursement Claim Steps
1
Notify the Insurer

Call on toll-free number or email within 24 hours of admission. Ask about the submission timeline post-discharge.

2
Collect All Documents

Prescriptions, bills, test reports, discharge summary, itemised hospital bill — keep everything in a secure folder.

3
Fill Claim Form

Fill carefully with all details correct. Part of this form must be completed and signed by the treating doctor.

4
Settlement & NEFT Transfer

Insurer credits amount to your bank account via NEFT. Review the summary of deductions communicated.

Busted

Common Myths About Health Insurance

Myth 1

Young People Don't Require Health Insurance

Fact

Health is no longer tied to age. Medical emergencies can strike at any age. Regardless of how old you are, having health insurance is a smart choice.

Myth 2

Health Insurance Covers All Medical Expenses

Fact

Not everything is covered. Certain treatments, pre-existing conditions, and specific procedures may have limitations or be excluded. Always read the terms and conditions.

Myth 3

Health Insurance Is a Costly Affair

Fact

There are diverse plans in India catering to various budgets. Compare and pick a plan aligning with both your budget and healthcare needs.

Myth 4

Waiting Period Doesn't Apply to All Plans

Fact

Waiting periods apply to pre-existing conditions, maternity coverage, specific surgeries and more. Understand the waiting periods applicable in your policy.

Myth 5

Cashless Hospitalisation = Zero Expenses

Fact

Cashless means no upfront payment, but you may still pay for deductibles, co-pays, or costs beyond your policy's coverage limits.

Myth 6

All Health Insurance Plans Are the Same

Fact

Plans differ in coverage, benefits, exclusions, and premiums. Compare policies, understand features, and make a thoughtful decision.

Myth 7

Pre-Existing Conditions Covered from Day 1

Fact

Pre-existing conditions are subject to waiting periods. Disclose all conditions truthfully when buying a policy and understand associated wait times.

Myth 8

Minimum 24 Hours Hospitalisation is Compulsory

Fact

Many insurers now cover day care procedures like chemotherapy, dialysis, eye surgery — without requiring overnight hospital stays.

Myth 9

Buy Insurance Just Before Hospitalisation

Fact

Pre-existing conditions get covered only after serving the waiting period. Buying right before surgery won't provide immediate coverage.

Switch Insurer

Health Insurance Portability

Not satisfied with your current insurer? Transfer your policy to another company while retaining accrued benefits.

1

Notify Your Insurer

Inform your insurance company at least 45–60 days before the renewal date about your decision to port.

2

Fill Forms & Submit Docs

Complete portability form, proposal form, and disclose all pre-existing conditions, past claims and health info.

3

Insurer Evaluation

New insurer assesses your risk profile within 15 days per IRDAI guidelines.

Enhance Coverage

Health Insurance Riders & Add-Ons

Riders give you the option to enhance your base coverage for specific situations at additional premium.

1

Maternity Cover

Covers pregnancy and childbirth expenses up to specified limits. Some plans extend coverage to infants for a fixed period.

2

OPD Cover

Covers regular check-ups, diagnostics, and pharmacy costs that don't require hospitalisation.

3

Global / Overseas Treatment

Covers medical expenses for treatment abroad when diagnosed with a condition in India requiring overseas treatment.

4

Critical Illness Cover

Pays a lump sum upon diagnosis of critical illnesses like cancer, severe heart stroke, brain tumour, multiple sclerosis, etc.

5

Personal Accident Cover

Provides a lump sum in case of an accident leading to disablement or fatality within a specified number of days.

6

Room Rent Waiver

Provides a higher sub-limit or no limit on room rent, so your insurer covers the room cost regardless of room type.

Pandemic Coverage

Does Health Insurance Cover COVID-19?

Yes. All standard health insurance plans, as mandated by IRDAI circular, cover hospitalisation expenses related to COVID-19. The COVID-specific products (Corona Kavach & Corona Rakshak) were short-term offerings introduced during the pandemic and may no longer be available for sale.

Corona Kavach

Short-term policy covering COVID-19 treatments. Covered actual hospitalisation expenses (24+ hours), PPE/mask charges, and co-morbidities even with pre-existing conditions. 15-day initial waiting period.

Corona Rakshak

Fixed cash benefit up to ₹2.50 Lakhs per person on testing positive and hospitalisation for 72+ hours. Acts as income replacement and covers large claim deductions. 15-day waiting period applies.

Comparison

Health Insurance vs Cancer Insurance vs Critical Illness

ParametersHealth InsuranceCancer InsuranceCritical Illness Insurance
Type of PolicyIndemnity-basedBenefit-basedBenefit-based
CoverageWide range of illnesses, injuries, and accidents per policy termsExclusively upon cancer diagnosis — stages vary by insurerListed critical illnesses like heart attacks, cancer, etc.
Waiting Period30 days initial; 2–4 years for PED and specific treatments90–180 days for early-stage diagnosesTypically 90–180 days from policy commencement
Survival PeriodNot applicableApplicable — varies by policy and insurerTypically 15–30 days; subject to policy conditions
ExclusionsIRDAI standard + additional permanent + non-standard exclusionsExclusions differ among insurersSelf-injury, alcohol/drugs-related issues; vary by policy

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Save on Tax

How to Save Tax with Health Insurance

Under Section 80D of the Income Tax Act, health insurance premiums qualify for tax deductions, subject to certain limits.

CategoryTax Benefit
You and your parents are below 60 yearsUp to ₹25,000 for self/spouse/children + ₹25,000 for parents = Max ₹50,000
You below 60 & parents above 60 yearsUp to ₹25,000 for self + ₹50,000 for parents = Max ₹75,000
You and your parents are above 60 yearsUp to ₹50,000 for self + ₹50,000 for parents = Max ₹1,00,000
HUF Member (below 60 years)Up to ₹25,000 deduction on premiums paid
HUF Member (above 60 years)Up to ₹50,000 deduction on premiums paid
Non-Resident Indian (NRI)Up to ₹25,000 for self/spouse/children + ₹25,000 (parents under 60) or ₹50,000 (parents above 60)
Tax deductions are only available on premiums paid by bank transfer, credit card, cheque, or demand draft. Cash payments are not eligible except for preventive health check-ups (up to ₹5,000).
Before You Buy

Checklist for Buying Health Insurance

1
Plan for Future Healthcare Costs

Choose a sum insured adequate for 20–30 years considering inflation. Upgrading later may be challenging due to age and health.

2
Check Room Rent Limitations

Room rent limits affect entire hospital bills proportionately. Opt for policies with no or low room rent limits where possible.

3
Specific Treatment Limits

Some insurers impose financial limits on certain diseases. Review fine print to avoid unexpected out-of-pocket expenses.

4
Copayment Clauses

Co-pay means you pay a portion of every claim. Opt for the lowest or zero co-pay policy where possible.

5
All-Inclusive Day Care Coverage

Choose a policy covering all day care procedures. Beware of inflated procedure counts that mask limited coverage.

6
Organ Donor Expenses

Consider plans with organ donor cover to ensure both receiver and donor hospitalisation expenses are covered.

7
Restore / Refill Benefit

Ensures your sum insured is replenished after exhaustion. Prefer built-in, unlimited restoration for related and unrelated conditions.

8
Non-Medical Expenses Coverage

Add consumables cover for gloves, masks, oxygen kits, and other items that quickly accumulate during hospitalisation.

What Affects Cost

Factors Affecting Health Insurance Premiums

Sum Insured

Higher coverage means higher premiums. Choose wisely to avoid coverage gaps.

Age

Older applicants face higher premiums due to increased health risks.

Pre-Existing Diseases

Conditions like diabetes, hypertension result in higher premiums.

Medical History

Family history of serious illnesses can increase your premium.

Lifestyle Habits

Smoking, tobacco consumption raise premiums due to higher illness risk.

Add-Ons / Riders

Each additional rider increases the total premium proportionately.

Co-payment

Higher voluntary co-pay reduces premium; lower co-pay means higher premium but less at claim time.

Occupation

High-risk jobs like factory work or firefighting attract higher premiums.

Save Money

How to Reduce Your Premiums

1
Smart Cost Sharing

Voluntarily opt for deductibles and co-pays to reduce your overall premium.

2
Avoid Unnecessary Riders

Include only relevant add-ons. Excess riders inflate premiums without benefit.

3
Multi-Year Policy Discount

2–3 year policies offer attractive discounts and shield you from annual renewals.

4
Family Floater Savings

Insure your entire family under one floater plan for lower per-person premiums.

5
Know Your Room Rent Limit

Some add-ons can lower room sub-limits — cost-effective if you don't need luxury rooms.

6
Wellness Programs

Some insurers offer renewal discounts for participating in health and wellness programs.

Smart Decision

Why Compare Health Insurance Plans?

Ease of Convenience

All policy features, prices, and benefits available at your fingertips — compare from the comfort of your home.

Value for Money

Strike the right balance between cost and coverage. Ensure your hard-earned premiums deliver maximum value.

Customised to Your Needs

Compare pros and cons across plans to easily find the one that caters to your unique healthcare requirements.

Better Decision Making

Understand benefits, waiting periods, room rent limits, and claim procedures before committing to a plan.

Our Network

Partner Insurance Companies

All listed insurers are IRDAI registered at the time of publication. Verify current status on the IRDAI website.

Key Terms

Common Health Insurance Terms

1
Exclusions

Conditions or treatments not covered by your policy under any circumstances. Review before choosing a plan.

2
Free Look Period

15–30 days after receiving policy to review terms. Get a premium refund if no claims are made (minus admin charges).

3
Grace Period

Timeframe after premium due date to renew without losing benefits. No coverage provided during the non-payment period.

4
Medically Necessary Hospitalisation

Treatment required to manage illness, recommended by an independent doctor, and in line with accepted medical standards.

5
Network Provider

Hospital approved by insurer/TPA to provide medical services without requiring upfront payments from the patient.

6
No Claim Bonus (NCB)

Discount or increased sum insured offered on renewal for not making any claims during a policy year.

7
Portability

Transferring your health insurance policy to another insurer. Notify current insurer 45–60 days before renewal.

8
Pre-Existing Diseases (PED)

Any ailment, injury, or disease diagnosed or treated within 48 months before the policy's issuance date.

9
Waiting Period

Time frame during which certain conditions are not covered. After the period, temporary exclusions are lifted.

10
Reasonable & Customary Charges

Standard fees for services in line with prevailing charges in the geographical area for similar medical services.

Keep It Active

Health Insurance Renewal Guide

Policies expire after their validity period. Renew on time to continue enjoying coverage without interruption.

1
Add / Remove Family Members

Add spouse, newborns, or remove members in case of death. Adjust coverage accordingly during renewal.

2
Enhance Your Sum Insured

Analyse if current coverage is sufficient for the next 20–30 years accounting for medical inflation.

3
Track T&C Changes

Insurers can modify policy terms with IRDAI approval. Check changes with your advisor before renewing.

4
Consider Portability

Unhappy with services or features? Port to another insurer while retaining accrued benefits. Notify 45 days before renewal.

5
Add Relevant Riders

Renewal is a good time to add riders like critical illness, maternity cover, or accidental death benefit.

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Our Promise

Why Choose SMC Insurance?

Unbiased Advice

Our recommendations are solely aimed at helping you find the perfect policy — without favouring any particular insurer.

Respected Privacy

We value your privacy and guarantee a spam-free experience. We will only contact you when requested.

Comprehensive Claim Support

We stand by you throughout the entire claims process — guiding your family to receive the financial support they deserve.

Get Started

How to Buy Health Insurance from SMC

1
Visit smcinsurance.com

Go to Health Insurance section

2
Enter Family Details

Select members and enter ages

3
View Quotes

Enter pincode & mobile number

4
Compare Plans

Compare up to 4 plans side by side

5
Customise

Adjust sum insured, term & add-ons

6
Review Brochures

Check features & exclusions

7
Buy Now

Proceed with your application

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Customer Stories

What Our Customers Say

Real experiences from people who found the right plan with SMC Insurance.

★★★★★

"The SMC team helped me compare 8 plans in 20 minutes. I ended up saving ₹4,200 on annual premium for a better plan than what I had. Their claim support team was excellent when my father was hospitalised."

R
Rajesh Gupta
IT Manager, Bangalore
★★★★★

"I had no idea what restore benefit meant until the advisor explained it patiently. Now I know exactly what I'm paying for. The cashless process at Apollo was seamless — truly zero stress."

P
Priya Menon
Teacher, Chennai
★★★★★

"We ported from our old policy after the SMC advisor showed us we were paying for a plan with room rent sub-limits. The porting process was smooth and we kept our full PED waiting period credit."

A
Anil Sharma
Business Owner, Delhi NCR
FAQs

Frequently Asked Questions

1. What is the difference between health insurance & mediclaim?
Mediclaim and Health Insurance policies are essentially the same. Health insurance was termed 'mediclaim' in the past. Both cover treatment and hospitalisation costs due to accident, illness, or injury — including hospitalisation, pre/post-hospitalisation, doctors' fees, and medicine costs.
2. What are pre-existing diseases in health insurance?
As per IRDAI, a pre-existing illness is any medical condition, illness, disease, or injury diagnosed and treated within 48 months before purchasing a health insurance policy.
3. How will health insurance pay for my emergency medical expenses?
Health insurance claims are of two types — cashless (insurer settles directly with the hospital) or reimbursement (you pay first, then claim back from the insurer).
4. What should I consider before buying health insurance?
Key factors include your medical needs, family members to cover, type of plan, premium, benefits, sum insured, network hospitals, financial limits, exclusions, insurer reviews, Claim Settlement Ratio, solvency ratio, and IRDAI approval.
5. What is a sum insured in health insurance?
The sum insured is the maximum amount your insurance company will pay in case of a claim due to illness or accidental injury. It represents the maximum coverage your policy provides.
6. What is a waiting period in health insurance?
A waiting period is a specific time frame during which certain diseases or conditions are not covered after you purchase the policy. After this period, coverage becomes effective for those conditions.
7. What does a family floater policy mean?
A family floater health insurance policy covers you and multiple family members under a single policy. Unlike individual plans, a family floater provides comprehensive coverage for the whole family sharing one sum insured.
8. What is the free-look period in health insurance?
The free-look period is typically 15 days after receiving the policy document to review the terms. If no claims are made and you decide not to proceed, you get a premium refund minus stamp duty, admin charges, etc.
9. Can I switch my health insurance plan to another insurer?
Yes, through the portability process. Compare benefits, coverage, and terms between current and prospective insurers to ensure a seamless transition while retaining accrued benefits.
10. Are pre-policy medical check-ups mandatory?
It depends on factors like age, medical history, and sum insured. Insurers may request medical examinations for individuals above a certain age or those with pre-existing conditions. Requirements vary by insurer.
11. What is the significance of a network hospital?
A network hospital has a tie-up with your insurance company. Choosing a network hospital provides cashless services, making the claims process smoother and eliminating the need for upfront payment.
12. What is co-payment in health insurance?
Co-payment is a cost-sharing arrangement where you pay a certain percentage of the approved claim amount and the insurance company covers the remaining amount.
13. Can I include maternity coverage in my health insurance plan?
Yes, many health insurance plans offer maternity coverage either as an in-built or optional benefit. Be aware of waiting periods (typically 9 months to 4 years) and other terms associated with such coverage.
14. How does the claim process work for non-network hospitals?
At non-network hospitals, you follow the reimbursement process — pay medical expenses upfront, then submit necessary documents to the insurance company for reimbursement of admissible expenses.
15. Are alternative therapies covered by health insurance?
Coverage for alternative therapies like Ayurveda, Yoga, and Homeopathy varies among policies. Check the policy documents to understand whether these are included in your coverage.

Disclaimer: The information provided on this platform is intended for general awareness and educational purposes. While every effort is made to ensure accuracy, some details may change with policy updates, regulatory revisions, or insurer-specific modifications.

All views and analyses are based on publicly available data and internal research at the time of writing. These do not constitute professional advice, recommendations, or guarantees of any product's performance. Customers are advised to review official sales brochures, policy documents, and disclosures before proceeding with any purchase.

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SMC Insurance Brokers Pvt. Ltd.
SMC Metro Mall, Near Pratap Nagar Metro Station, Pratap Nagar, New Delhi-110007
Registration No: 289, Registration Code No: IRDAI/DB-272/04/289, Valid till: 27/01/2029, License category: Composite Broker, CIN: U66000DL1995PTC172311
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