Rising healthcare costs and unexpected medical needs make planning essential. An Individual Health Insurance Policy offers personalised protection without depending on employer or family coverage. It is designed around your age, lifestyle, and health requirements, giving you greater flexibility and control.

From hospitalisation expenses to advanced treatments and wellness benefits, the right cover ensures timely access to quality care. With customisable features and higher sum insured options, an Individual Health Insurance Policy safeguards both your health and long-term financial security.

Individual Health Insurance, also known as Personal Health Insurance, is coverage that a person purchases independently rather than through an employer or a government program. Unlike group plans offered by employers or government schemes, individual plans cater to your specific needs and provide financial protection in case of hospitalisation, illness, or accidents. You can choose the coverage level, sum insured, and riders that best suit your and your family's health requirements and budget.

Our Individual Health Insurance policy features provide a holistic health insurance solution. Read on to know more about our individual medical insurance policy and its key features:

Platinum Plan

Super cumulative bonus of 50% per claim-free year

Recharge Benefit

To take care of claims where the claim amount exceeds your sum insured

Multiple Sum Insured

Enjoy the flexibility to choose between 3 Plan variants along with the Sum Insured options ranging from 1.5 Lakh to 1 crore.

Covers Extended Family

This policy covers extended family members, including parents, in-laws and siblings, on an individual basis.

Covers Ayurvedic and Homoeopathic Treatment

As per the Gold & Platinum Plan of the policy, in-patient hospitalisation expenses up to Rs 20,000 incurred in a recognised Ayurvedic/homoeopathic hospital are covered if the admission period is not less than 24 hours.

Covers Daycare Procedures

This policy covers medical expenses incurred during the treatment of listed daycare procedures or surgeries.

Convalescence Benefit

You will be eligible for a benefit payout of up to Rs 7500 annually, in case of continuous hospitalisation for a period of 10 days or more and provided that your hospitalisation claim is admissible.

Bariatric Surgery Cover

Bariatric surgery is covered under medical advice, subject to certain terms and conditions.

Sum Insured Reinstatement

If you completely exhaust your sum insured along with the cumulative bonus (if any) during the policy year, we will reinstate the same.

Covers Pre and Post Hospitalisation

This policy covers pre- and post-hospitalisation expenses up to 60 days and 90 days, respectively.

 Covers Road Ambulance Expenses

This policy covers ambulance expenses incurred up to Rs. 20,000 during each policy period.

Covers Organ Donor Expenses

This policy covers expenses towards the organ donor's treatment for the harvesting of the donated organ.

Daily Cash Benefit

A daily cash benefit of Rs 500 per day, for up to 10 days, during each policy year, is provided as accommodation expenses for one parent/legal guardian to stay with a minor insured under the policy, for an admissible claim.

Maternity/Newborn Baby Cover

Under the Gold & Platinum Plan, maternity expenses and medical expenses towards the treatment of a newborn baby are covered, subject to certain terms and conditions.

Advantages of Buying an Individual Health Insurance Plan in India

Good health supports an active lifestyle, mental well-being, and long-term productivity. However, serious illnesses can cause emotional stress and quickly drain savings. In India, healthcare costs rise by about 11.5% due to advanced treatments and increasing lifestyle diseases.

Hence, having an individual health insurance plan is essential to manage medical expenses and stay financially prepared.

Cashless Treatment & Hassle-Free Claim Settlement

You can access a wide network of 18,400+ hospitals across India and avail cashless treatment during medical emergencies without making upfront payments. With an in-house claim settlement team handling approvals and payments directly with hospitals, the process remains quick, smooth, and stress-free, allowing you to focus entirely on recovery.

Pre and Post-Hospitalisation Coverage

Medical expenses do not begin or end with hospitalisation. This personal health insurance covers diagnostic tests, consultations, and medicines incurred up to 60 days before admission and 90 days after discharge, ensuring complete financial support throughout the treatment cycle.

No-Claim Bonus for Claim-Free Years

If you do not raise any claims during your policy tenure, you are rewarded with a no-claim bonus. This benefit helps reduce your future premium outgo or enhances coverage, encouraging long-term policy continuity while keeping costs under control.

Preventive Care, Regular Check-ups & Wellness Rewards

The plan promotes proactive healthcare by offering free preventive health check-ups after every continuous coverage period. In addition, maintaining good health can earn you wellness benefit discounts of up to 12.5% on policy renewal, making healthy living financially rewarding.

Tax Savings under Section 80D

Individual health insurance plans help reduce your taxable income under Section 80D of the Income Tax Act. You can claim deductions of up to ₹25,000 for premiums paid for yourself and your family. If you also insure senior citizen parents, the deduction can go up to ₹75,000, and up to ₹1,00,000 if you are above 60 years of age.

Lifetime Renewability & Long-Term Policy Options

You can renew your Individual Health Insurance policy for your entire lifetime, ensuring uninterrupted coverage as healthcare needs increase with age. Additionally, the policy can be purchased for 1, 2, or 3 years, helping you lock in coverage and reduce renewal hassles.

Portability Without Losing Accrued Benefits

If you are insured under another health insurance policy, you can switch to this plan while retaining accrued benefits such as waiting‑period credits (and other continuity benefits), subject to regulatory guidelines. This allows flexibility without compromising continuity.

Discounts That Reduce Overall Premium Cost

Opting for longer policy durations or family coverage helps you save through multiple discounts, including family and long‑term policy discounts, co‑payment discounts, and other applicable offers.

How Does an Individual Health Insurance Policy Work?

When you purchase individual health insurance, you enter into a legal contract with your insurer. The agreement of individual health insurance plans covers medical care costs, limits on the sum insured, and policy terms and conditions. You just have to pay premiums on time to enjoy coverage benefits.

Suppose you purchase a comprehensive individual medical health insurance plan with a sum insured of ₹15 lakhs. It covers solo protection from accidents or illness. Post-purchase, once you're admitted to a hospital for any critical illness or treatment, your single health insurance manages overall medical expenses as per policy guidelines.

If your hospital bill reaches around ₹5 lakhs, this plan commits to settling the bill with the network hospital. At the same time, your remaining sum insured drops to ₹10 lakhs for your policy and continues protection for the future.

Why Buy Individual Health Insurance Online?

Secure Payment

No need to visit insurance company agents or offices for purchasing individual health insurance. You can relax and browse the internet to compare plans. Company websites offer secure transactions and individual health insurance plan applications anytime, anywhere.

Convenience

You can read the fine print of your policy purchase confirmation online to avoid queries. You do not have to pay personal health insurance premiums via cheque or cash. Go digital with a few clicks and a password, and make payments through secure net banking services.

Expectations vs. Reality

You don't have to wait for physical documents of your personal health insurance. You will receive a PDF of the policy via mail as soon as you complete the online premium payment.

Instant Quotation and Issuance

Online plan comparison and purchase come with an instant premium calculator. You can add or remove family members, customise plans, and check insurance coverage online in a few steps to buy the best individual health insurance policy.

Value-added Services

The online process provides access to brochures or policy documents via web applications or health service mobile apps. Through health service mobile applications, you can download wellness apps to monitor calorie intake, book consultations online, and keep track of your health.

How Much Individual Health Insurance Coverage Should You Have?

The right amount of Personal Health Insurance coverage depends on several factors:

1. Medical History: Consider any pre-existing conditions and potential future healthcare needs.

2. Hospitalisation Costs: Research your area's average hospital room rates and surgical costs.

3. Lifestyle: Healthy lifestyle choices can lower health insurance costs and improve coverage options.

4. Financial Goals: Balance affordability with adequate protection. Consider how much you can comfortably afford as a premium.

Individual Health Insurance Premium Calculator

Many insurers offer online premium calculators that help you estimate the cost of an Individual Health Insurance plan based on your age, location, desired coverage, and sum insured. This allows you to plan your budget and compare policies before purchasing a policy.

Difference Between Group and Individual Health Insurance

Eligibility Criteria for Individual Medical Health Insurance

Eligibility criteria for Personal Health Insurance coverage can vary by insurer, but generally include:

1. Age: Most plans cover individuals between 18 and 65 years old, with senior citizen plans available for those above 65.

2. Location: You must reside within the geographical area serviced by the insurer.

3. Medical History: Pre-existing conditions might require waiting periods or exclusions. Disclose all medical history accurately.

4. Occupation: Certain high-risk occupations might have limited coverage options or higher premiums.

Essential Considerations When Choosing an Individual Health Insurance Plan

Choosing the right Individual Health Insurance plan requires careful thought. Consider these factors:

1. Sum Insured: Sum insured is a crucial factor in selecting an individual health insurance plan. You can choose a minimum sum insured policy, but it may not cover your entire treatment with long-term medication or higher medical bills. Choose an affordable personal health insurance plan with wider coverage for better protection.

2. Scope of coverage: Check the policy you're choosing. Decide the type of surgeries and illnesses you can claim during the policy tenure. Closely review coverage benefits like hospitalisation expenses, critical illness cover, regular health checkups, medication, maternity cover, etc.

3. Waiting period: Your individual health insurance policy provides financial support once the initial waiting period is over. Waiting period also applies to pre-existing diseases like blood pressure, thyroid, diabetes, etc., and specific treatments or illnesses. Choose a plan with a minimal waiting period.

4. Network hospitals: Opt for a single health insurance policy that offers a wide range of network hospitals to enjoy claims. A wider network reflects better chances of availing cashless treatment and hospitalisation care services.

Happiness is good health that is protected by a comprehensive health insurance policy. A health insurance plan is a must-have to guard yourself and your loved ones from sky-high medical bill expenses. Our Individual Health Insurance plan ensures that you are covered in case of a medical emergency, and proper care is available to you without exhausting your finances. You can also avail of our Health Insurance policy for each of your family members. We cover your medical expenses incurred due to hospitalisation. What’s more, you can also avail Cashless Treatment at over 18,400 + network hospitals* with a Bajaj General health insurance plan.

Types of Individual Health Insurance Claims

Individual health insurance plans cover two main types of claims:

Cashless Claims

These allow you to avail of medical treatment at network hospitals without upfront payments. The insurer settles the bill directly with the hospital.

Reimbursement Claims

If you have not availed of the cashless facility due to the non-availability of the network hospital or for any other reason, you can submit the claim documents to your insurer. The insurer will process your claim and settle it with you.

1. Original pre-numbered hospital payment receipt duly sealed and signed.

2. Original prescriptions and pharmacy bills.

3. Original consultation papers (if any).

4. Original investigation and diagnostic reports, along with original bills and payment receipts for the investigation done within and outside the hospital.

5. If you availed a cashless claim but did not utilise it, a letter from the hospital stating so.

6. A letter from the treating doctor mentioning incident details (in case of an accident).

7. Hospital registration certificate and hospital infrastructure on the letterhead.

8. A cancelled cheque bearing the IFSC code and the name of the insured.

Indoor case paper copy attested from the hospital from the date of admission to the date of discharge, with detailed medical history and doctor’s notes with temperature, pulse and respiration charts.

1. X-ray films (in case of a fracture).

2. Obstetric history from the treating doctor (in maternity cases).

3. FIR copy (in accident case).

4. Additional requirements for some special cases.

5. In case of a cataract operation, a lens sticker with a bill copy.

6. In case of a surgery, implant a sticker with a bill copy.

7. In case of a heart-related treatment, a stent sticker with a bill copy.

All original documents need to be submitted to the following address: Bajaj Insurance House, Airport Road, Yerawada, Pune-411006. Mention your Policy Number, Health Card Number and Mobile Number clearly on the face of the envelope. Note: Keep a photocopy of the documents and the courier reference number for your records.

The claim process for single health insurance plans can vary by insurer, but generally involves: 

1. Intimation: Inform your insurer about the hospitalisation within the stipulated time frame.

2. Submit Documents: Provide necessary documents like the claim form, medical bills, investigation reports, and discharge summary for processing your claim.