Understand what health insurance covers, why every family needs it, and how to pick the right plan — explained simply for everyone.
Health insurance is a contract between you and an insurance company. You pay a small amount every year called a premium, and in return, the insurer pays your medical bills when you get sick, injured, or need surgery.
Think of it as a financial safety net. Without health insurance, a single serious illness — like a heart attack, cancer, or accident — can easily cost ₹3–10 lakh or more, wiping out your entire savings overnight.
With health insurance, you can focus on getting better instead of worrying about hospital bills.
Here are the top reasons why health insurance is no longer optional — it's essential.
A single surgery in India now costs ₹2–8 lakh. Medical costs are rising 14% every year — much faster than salaries.
One critical illness in the family can drain decades of savings. A health plan covers the whole family for one annual premium.
Save up to ₹75,000 in taxes every year under Section 80D — ₹25,000 for yourself and ₹50,000 for senior citizen parents.
When you're covered, you can visit the best hospitals without worrying about the bill. Focus on recovery, not finances.
A good health insurance plan covers far more than just hospital stays.
Room rent, ICU charges, surgeon fees, doctor visits, nursing charges — all covered when you are admitted for 24+ hours.
Over 500+ modern procedures like cataract surgery, chemotherapy, dialysis that don't need 24-hour admission are covered.
Medical tests, specialist consultations, and medicines taken 30–60 days before admission are reimbursed.
Follow-up consultations, medicines, and recovery costs for 60–90 days after discharge are also covered.
Emergency ambulance costs to transport you to the hospital are covered under most health plans.
Free yearly preventive health check-up for all insured members — catch problems early before they become expensive.
Choose the plan that best fits your age, family size, and health needs.
Covers only one person. Each family member gets their own separate sum insured. Best for single adults or when family members have different health needs.
One shared policy for the entire family — spouse, children, and parents. All members share the total sum insured. Best value for young families.
Specially designed for people aged 60 and above. Higher premium but covers age-related illnesses, pre-existing conditions, and domiciliary treatment.
Pays a lump sum on diagnosis of serious diseases like cancer, heart attack, kidney failure, or stroke — regardless of actual treatment cost.
An affordable add-on that activates once your base cover is exhausted. Gives you ₹10–50 lakh additional coverage at very low cost.
Covers delivery costs, pre & post natal care, and newborn baby coverage. Usually available as a rider with a waiting period of 2–4 years.
Follow these 5 simple steps and you'll never be confused again.
Minimum ₹5 lakh per person. Ideally ₹10–25 lakh for families in cities where private hospital costs are high. Remember — medical costs double every 5–7 years, so cover yourself generously.
Always verify that the insurer has good cashless tie-ups with quality hospitals in your city. The larger the network, the less hassle during emergencies.
Most policies have a 30-day initial waiting period (no claims), 2–4 year waiting for pre-existing diseases (diabetes, BP etc.), and 2 years for maternity. Buy early — so waiting periods are served while you're healthy.
A good insurer settles 95%+ of claims. Lower ratios mean claim rejections. Also check if they offer direct cashless settlement or require reimbursement — cashless is far more convenient.
This feature refills your sum insured if it gets exhausted during the year. A must-have for families — if one member uses the full cover in January, others still have coverage for the remaining year.
22+ years of insurance advisory experience
Buy health insurance when you are young and healthy. The premium is at its lowest, you won't face rejection due to pre-existing conditions, and waiting periods get served while you're still fit. A family floater of ₹10 lakh for a family of 4 costs just ₹15,000–20,000 per year — less than ₹50 per day — for complete family protection. The biggest mistake I see is people buying insurance after they fall sick. By then, it's either very expensive or the condition gets excluded entirely.
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Everything you need to know, answered simply
The best time is between 18–30 years. Premiums are lowest, no pre-existing conditions, and waiting periods get served while you're healthy. After 40, premiums rise sharply and medical underwriting becomes stricter.
Minimum ₹10 lakh for an individual in a metro city. For a family of 4, ₹15–25 lakh is recommended. Remember — a single serious surgery (bypass, cancer, organ transplant) can cost ₹5–15 lakh at a good hospital.
Yes! Most insurers now offer coverage for pre-existing conditions (PED) after a waiting period of 2–4 years. Some plans like HDFC ERGO Optima Secure cover PED from Day 1. Sachin can help you find the right policy.
Individual plans give each person their own dedicated sum insured. Family floaters share one combined pool among all members. Floaters are more economical but carry a shared coverage risk — if one member requires extensive hospitalisation, others may have reduced cover. For families with any pre-existing or chronic condition, individual plans offer more dependable, predictable protection.
Get admitted to a network hospital. Show your insurance card at the TPA/insurance desk. They verify your policy and pre-authorise the amount. You only pay co-pay (if any) and non-covered expenses. The insurer pays the rest directly to the hospital.
Common exclusions: cosmetic surgery, dental treatment (unless due to accident), infertility, obesity treatment, self-inflicted injuries, war-related injuries, and experimental treatments. Always read the policy wording before buying.
Yes! IRDAI allows policy portability. You can switch insurers without losing your earned waiting period benefits and no-claim bonus. Apply for porting at least 45 days before your current policy renewal date. Sachin helps clients port policies regularly.
Under Section 80D: ₹25,000 deduction for self/spouse/children premium, and ₹25,000 more for parents (₹50,000 if parents are senior citizens aged 60+). So you can save up to ₹75,000 in taxable income per year.
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