Guide

Learn health insurance

Four simple ideas that explain almost everything. Takes 3 minutes to read.

1. Coverage: what the plan pays for

Hospital stays of 24 hours or more — room, ICU, doctor fees, medicines, tests.
Day-care treatments like cataract or dialysis that don't need an overnight stay.
Costs before and after hospitalisation (usually 30–60 days before, 60–180 days after).
Sum insured is the most the insurer pays in a year. For a family in a big city, ₹10 lakh or more is sensible.
Watch out for waiting periods (e.g. 2–4 years for existing illnesses), room-rent limits and co-payment.

The premium is the yearly price of the plan. It depends on age, city, cover amount and family size.
Most family plans cost about the same per day as a cup of chai.
Premiums go up as you get older, so buying young locks in lower waiting-period risk.
You can save tax under Section 80D on premiums paid for yourself, family and parents.
Never pay premium to a personal account — only to the insurer or the registered intermediary.

Cashless: at a network hospital, show your health card at the insurance desk. The insurer pays the hospital directly.
Planned treatment: tell the insurer at least 48–72 hours before. Emergency: within 24 hours of admission.
Reimbursement: at a non-network hospital, pay first and then send bills, reports and discharge summary within the deadline (often 30 days).
Keep every original bill, prescription and test report.
If a claim is rejected, ask for the reason in writing. You can complain to the insurer, then the Insurance Ombudsman.

After you receive a new policy, you get at least 30 days to read it (IRDAI rule).
If you don't like it, you can cancel and get your premium back, minus a small deduction for days covered and any medical tests.
The free-look period applies to new policies, not renewals.
Ask for cancellation in writing to the insurer within this window.

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This guide is general information, not advice. Always read your policy wording.