A health insurance plan of ₹ 5 lakhs is a policy for which the policyholder gets a sum insured of ₹ 5 lakhs. Basically, it means that the insured person gets a coverage ₹ 5 lakhs for healthcare expenditure, as per terms and conditions mentioned in their policy. A ₹ 5 lakhs health insurance plan safeguards you and your family against the financial burden of healthcare expenditure incurred as a result of a mishap, minor injury, illness, or other unexpected situation. A good health insurance policy that guarantees a sufficient sum insured can facilitate you in dealing with unforeseen health emergencies.
When you search for the best health insurance plan, you will be presented with a variety of options. But you need to careful before choosing the best health insurance. This can be done by keeping the following points in mind.
People who stay in metro cities, they need to keep in mind the high cost of treatment. So, if they are looking for an individual health insurance policy your sum insured should ideally range between 5 lakhs to 10 lakhs. In case of family health insurance, it should be above 5 lakhs. Choose a sum insured which should be enough to cover more than one hospitalization that may happen in a year.
Opting for a higher value sum insured health insurance policy means you have to pay higher premium. However, in case you want to lower the cost of premium, you can opt for co-payment clause. In a health insurance policy, the co-payment option means you share the healthcare expenses with your health insurance company. Thus, the premium you pay is lesser.
When buying a health insurance plan, check the list of network hospitals the insurance company has tie-up with. It is also vital to check if the list of network hospitals includes the ones that are nearby your residence. At HDFC ERGO, we have a wide network of 12,000+ Cashless Health care centers.
Healthcare expenses majorly depend on the room type and the ailment. It is wise to buy a health insurance plan that does not include sub-limits on hospital room rent so that you have the freedom to choose a room as per your comfort. Most of our policies also don’t imply disease sublimit; this is also an essential factor to keep in mind.
Your health insurance plan does not come into action while you are waiting period is not completed. Always check health insurance policies with lower waiting periods for pre-existing ailments and maternity cover benefits before buying a health insurance plan online.
Go for a health insurance company that has a good standing and reliability in the market. Other factors you need to keep in mind while choosing an insurance company is their customer base and claim settlement ability to know if the brand will be able to pay off the claims that you may make in future.
The best health insurance plans with a sum assured of Rs. 5 lakh are listed below.
Product Name | Minimum Entry Age | Maximum Entry Age | Policy Tern | Sum Insured (in Rs.) |
Optima Secure | Buyer: 18 years Dependent children: 91 days | 65 years | 1-3 years | 5 Lakh - 2 Crore |
Optima Restore | Buyer: 18 years Dependent children: | 65 years | 1 - 2 years | 5 Lakh - 50 Lakh |
my:health Suraksha | Buyer:18 Years Dependent adult:18 years Dependent child: 91 days | Buyer:Lifetime entry Dependent adult:Lifetime entry Dependent child: 25 years | 1 -3 years | 3 Lakh – 75 Lakh |
my:health Women Suraksha | 18 years | 65 years | 1 -3 years | 3 Lakh – 24 Lakh |
The best health insurance plan will include coverage for expenses like doctor fees, specialist fees, costs of medical and diagnostic tests, ambulance charges, in-patient expenses, hospital room rents, cost of surgery and even post-hospitalization expenses. Hence, when you choose the right mediclaim policy, it would help you during emergencies, without any financial stress.
With cashless treatment you just need to get your treatment done at a network hospital and the bills are settled directly by the insurance company. These days every good insurance plan provides cashless treatment benefits along with a strong network of hospitals.
Many health insurance plans offer coverage for pre and post-hospitalization charges up to 60 days, before and after the treatment, depending on the policy terms and conditions.
For every claim-free year, the health insurance company offers a discount on the premium costs for the subsequent year.
Under Section 80D of the Income Tax Act, Health insurance premiums paid are tax-deductible. Apart from this, premiums paid parents health insurance can also be claimed for tax deductions.
Alternative treatment procedures such as Ayurveda, Siddha, Homeopathy, Yoga, Acupuncture and others, have gained more relevance in the past few years. Many health insurance plans offer coverage for the costs of alternative treatment expenses up to a certain amount, as per the policy terms and conditions.
A lot of health insurance plans have extended the coverage to include treatment costs taken at home. However, there are certain terms and conditions that you need to check with your insurance company.
A medical insurance plan that safeguards you against a broad range of medical problems, and provides benefits like pre and post hospitalization, daycare expenses, etc, is ideal to purchase. In case you are purchasing a family health insurance plan, confirm if the policy meets the needs of each member of your family. List down your requirements, evaluate plans on benefits and costs, and then choose a plan that serves your needs.
While you cannot equate money with care for your health, because people want to cure themselves and their loved ones at any cost, but it is important to buy a health plan that is affordable for you. Budget plays a vital role when buying health insurance. However, you should check the benefits stated in the mediclaim policy before the price of it. The best tip is to buy a practically priced health cover at the beginning to ensure you are covered properly and the premiums are also affordable. Then going forward, you can assess your plan and raise the cover as per the increase in your income, family size, and requirements.
If you are single and don’t have to bear family responsibilities, it is practical to opt for individual health insurance plans. But, if you are thinking of including your family members in your medical insurance policy, it is better to buy a family health plan to enjoy maximum benefits at a more affordable price.
At the time of buying a health insurance plan, make sure you check if you plan has lifetime renewability feature or not. It is practical and much more valuable to purchase a mediclaim policy which offers you the option of lifetime renewability since you are most likely get be affected by health ailments as you age. Hence, choose health plans which offer lifetime renewability.
When you buy a health insurance plan, it is extremely important to check their list of network hospitals. The best health insurance in India provides you with a large network hospital options. Also, check the number of network hospitals which are nearby your residence. With HDFC ERGO health insurance plans, you can choose from nearly 12,000+ cashless networks where you can avail quick, convenient and cashless claims settlement!
The claim settlement ratio is the number of claims settled by the insurance provider over the total received claims. When choosing a health insurance plan, go for the insurance company that has a high claim settlement ratio.
The above points will help you gain maximum benefits when you look for a health insurance. Buying health insurance is basically an important investment that you are making to protect yourself from the financial load
of high healthcare costs. So, it is important that you invest in the right plan and with the right insurance company.
Health care cost is currently sky-rocketing and it will further increase in the future. Treatment in the private sector has always been expensive and it will only go up with time. So, buying a health insurance for yourself and your family is necessary. Hospitalization costs can cause a huge financial dent in your savings and make your life chaotic. Further, if the sole earning member of the family falls ill, it causes even more mental and financial stress. All of this can be avoided by purchasing and paying the premium for a health insurance that will cover your medical expenses in the event of an emergency. Whether you buy a ₹5 Lakh health insurance plan or of a higher amount, it all depends on your health requirements.
Just like every other health insurance plan, we also cover your hospitalization expenses such as room rent, ICU, investigations, surgery, doctor consultations etc due to illnesses and injuries seamlessly.
We believe mental healthcare is just as important as hospitalization due to physical illness or injury; hence, we cover hospitalization expenses incurred for treating mental illnesses.
It means all your pre-hospitalization expenses upto 60 days of admission and post-discharge expenses till 180 days get covered, like the costs for diagnostics, physiotherapy, consultations, etc.
Medical advancements help in wrapping up important surgeries and treatments in less than 24 hours, and guess what? We cover you for that as well.
In case of hospital bed non-availability, if the Doctor approves treatment at home we cover you for that as well. So that, you get medical treatment right at the comfort of your home.
This benefit acts like a magical backup, which recharges your exhausted health cover to treat the next hospitalization. Basically, we ensure uninterrupted medical coverage at the time of need.
Organ donation is a noble cause and we cover the medical and surgical expenses of the organ donor while harvesting a major organ from the donor’s body.
If you stay in a hospital for more than 10 days at a stretch, then we pay for other financial losses that might have happened due to your absence at home. It helps to take care of other expenses during your hospitalization.
Let your belief in alternate therapies like Ayurveda, Unani, Siddha, and Homeopathy stay intact as we cover hospitalization expenses for AYUSH treatment as well.
Get a free health check-up within 60 days of renewing your policy with us.
Once you get yourself secured with, our health insurance plan there is no looking back. Our health plan continues to secure your medical expenses for your entire lifetime on break free renewals.
If there is no claim in the first year, in the next policy year, the sum insured will grow by 50%. It means, instead of ₹ 5 Lakh, your sum insured would now stand at ₹ 7.5 Lakh for the second year.
The above mentioned coverage may not be available in some of our Health plans. Please read the policy wordings, brochure and prospectus to know more about our health insurance plans.
Adventures can give you an adrenaline rush, but when coupled with accidents, it can be hazardous. Our health insurance plan does not cover accidents encountered while participating in adventure sports.
If you ever end up causing injury to your precious self, then unfortunately our health insurance plan will not cover for self imposed injuries.
War can be disastrous and unfortunate. However, our health insurance plan does not cover any claim that is caused due to wars.
Our health insurance plan does not cover accidental injury while you are participating in defence (Army/Navy/Air Force) operations.
We do understand the criticality of your disease. However, our health insurance plan does not cover venereal or sexually transmitted diseases.
Treatment of obesity or cosmetic surgery is not eligible for coverage under your health insurance plan.
Eligibility criteria and the age limit to buy a mediclaim policy are two of the most common questions that comes a potential buyer’s mind. Usually, most insurance companies have an age limit of 65 years. Beyond that age, it is a bit difficult to get a health insurance plan because the more you age, you are more prone to health risks and that increases the risks for health insurance companies as well. For the eligibility criteria for buying health insurance plans, below are two of the most factors that decide it:
You need to completely honest while buying a health insurance policy. Pre-existing illnesses, if any, need to be stated clearly. These do not mean common diseases like fever, flu, or headaches. But, if in past you have ever been diagnosed with any disease, birth defects, undergone surgery, or cancer of any severity it is important to inform your medical insurance company. These need to be declared because many ailments are listed under permanent exclusion, few are covered with a waiting period and few others are covered by charging additional premium with a waiting period.
Any person who is 18 years or above can easily buy a health insurance plan. Health insrance plans also cover newborn babies but the parent needs to have a health insurance policy with the insurance company. Senior citizens can get themselves insured upto the age of 65 years.
Observing the current economic scenario, and the rate at which medical inflation is increasing steeply, it is safe to say that health insurance has become a necessity. This shields you and your loved ones during health emergencies, while also helping you plan your finances better. Now, the amount of health insurance you opt for depends on your health requirements and how much you can afford. For example, a young professional may opt for a health insurance plan for 5 lakhs. But for a middle-aged person having two kids, a 5 lakh health insurance may not be sufficient. However, due to a sudden rise in critical illnesses such as cancer, tumours, cardiac arrests and so on, having a lumpsum amount like 5 lakh health insurance or above is the need of the hour.
Medical history is a key factor that affects your insurance premium. While buying a health insurance policy it is absolutely compulsory to submit your health records. If you have had certain health issues in the past then the insurance company can either choose to allow it in or decide not to allow it in their policies. If the insurance company does not bear the cover of a certain disease then the policy holder usually bears the cost. This eventually increases or affects the amount for premium.
Genetics do play a role in shaping up your personality and over all life structure. Even your physical and emotional health is greatly affected by your family history. In case your family history records illnesses like heart disease, diabetes or cancer then insurance companies assume that the probability of you contracting these diseases are also pretty high. In that case the size or amount of your premium is going to be higher than the amount that you needed to pay in case your family would not have any such problem.
One of the most vital factors that can affect your health insurance premium is your age. It is a matter of common sense that a younger person runs lower health risk in comparison to a person who is older. Eg: A 22-year-old woman falling sick because of a heart condition is certainly less likely than a man of 65 years. However there may be exceptions. However, the general rule stays that people who are younger have lower chances of falling sick or visit doctors. Hence health insurance premium payable for a younger person is lesser than an older man.
Your choice of profession can also affect your health insurance premium. People working in profession which expose them to hazardous environment like constructions, radiation, substances are at high risk of falling prey to various diseases like cardiovascular and various other life threatening diseases.
Not just for a 5 lakh health insurance, but in general, when buying a mediclaim policy, the following documents need to be kept handy.
Age proof - You need to provide the age proof of all the members to be insured under the health insurance policy that you have chosen. A copy of any of the following documents is valid:
Address Proof – There are various communications that the health insurance company will need to send to your postal address and they also need it for their records. Following documents for address proof can be submitted:
The sole purpose of buying a health insurance plan is to get financial support at the time of medical emergency. Hence, it is important to read the below steps to know how Health Insurance claims process works differently for cashless claims and reimbursement claim requests.
Fill up the pre-auth form at the network hospital for cashless approval
Once hospital intimates us, we send you the status update
Hospitalisation can be done on the basis of pre-auth approval
At the time of discharge, we settle the claim directly with hospital
You need to pay the bills initially and preserve the original invoices
Post hospital discharge send us all your invoices and treatment documents
We verify your claim related invoices and treatment documents
We send the approved claim amount to your bank account.
Optima Secure
Optima Restore
my:health Suraksha
my:health Koti Suraksha
my:health Women Suraksha
my:health Medisure Super Top-up
Critical Illness Insurance
iCan Cancer Insurance
Health Plan guards an individual medically and financially. In case of emergency, when any family member is hospitalised – there is no pressure on the breadwinner to bear heavy, expensive bills. A health plan
pays the amount on their behalf. Therefore, a health plan is a must for individuals to take. However, there are specific eligibility criteria for purchasing a health plan. This criterion differs with the type of
plan. For instance, a person planning to buy a 5 lakh health plan should be at least 21 years. Rest dependents can be of any age. An infant above 3 months is also eligible to participate in a 5 lakh health plan.
In case the person buying a health plan is above 56 years. They will have to undergo a medical examination.
Health insurance protects one from unplanned medical expenses. It provides monetary security. We are all aware of how expensive medical costs are today. A health plan makes these procedures affordable since the insurer
pays the expenses. A 5 lakh health plan is, therefore, the best option. For instance, if you are your family's sole provider, the financial burden of any member's illness falls on you. It might result in significant
debt to the only provider.
Additionally, a sizable health plan of 5 lakh ensures that your savings are sufficient, so you no longer need to set aside money for medical expenditures or worry about paying medical
bills.
With a demanding lifestyle, stress is inevitable for everyone. Physical problems are caused by psychological stress. But getting a 5 lakh health plan from HDFC ERGO, this may be readily decreased. In other
words, your only concern should be your job, not medical bills.
Purchasing a 5 lakh health plan is usually smart because it provides superior coverage.
The COVID-19 problem affects everyone. We've all experienced this predicament at least once in our lives. We have learned the value of life and health due to the epidemic. Indeed, it has also helped us understand the
importance of money. Many people lost their lives because they could not afford medical bills.
The greatest option in these circumstances is a health plan. The full COVID-19 therapy is covered by a 5 lakh
Health Plan from HDFC ERGO. The expense of treating COVID-19 needs hospitalisation, which might cost a chunk. Other health issues caused by this virus include lowered immunity and the emergence of new illnesses
and disorders. A health plan of 5 lakhs is adequate to protect you and your family against it. It is now made mandatory by the IDRAI to include COVID-19 in all health plans.
Health plans have a time limit. You will be required to enroll in a health plan for specific years during the purchase. Renewing the strategy is necessary when these years are over. The insured can become unwell or
forget to renew; nevertheless, this does not mean the plan has ended.
All insurance providers provide their clients with a grace period during which they can renew their health insurance. A 5 lakh health plan
operates in the same manner. A grace period of 30 days is offered to anyone who cannot renew the plan by the designated date. The insured must make sure they pay the necessary sum to revive their health plan. The
fact that any illness, hospital fees, or other medical costs won't be covered during this period is crucial to remember. This grace period enables one to keep their health coverage.
A vital component of a health plan worth 5 lakh is value-added services. For instance, the HDFC ERGO 1 CR Health plan comes with a health counsellor and a Wellness service.
The health coach service includes programs
for losing weight, recuperating from illnesses, and revitalising oneself via psychological counselling are a few examples. The insured must make a call to use this service, which is covered by the 5lakh Health plan.
In a similar vein, additional health services are included in value-added services. It covers pharmacy, diagnostics, outpatient department expenses, nutrition counselling, and other medical guidance. As this
service supports preserving health and balance, it is especially advantageous during pregnancy.
The likelihood of you having any medical condition is higher if someone in your family has a history of illness. A sizable health plan covers medical costs.
Midlifers often have back, knee, and blood pressure
issues. At this stage of life, they begin to form. Therefore, choose a sizable health plan, so you have something to fall back on when smaller problems start to get larger.
Stress makes a person irritable
and has an impact on their health. You need to enrol in a 5 lakh health plan if you believe that stress is having an impact on you. It will relieve your tension and give you confidence that even if you are sick,
the health plan will take care of you.
The family's sole provider of income must take into account a 5 lakh health plan. It will protect you and your loved ones in case of medical emergencies.
People
who fit this description must purchase a 5 lakh health plan.
There are generally no restrictions on it. You are allowed to submit as much as you like at once. However, this may vary from one plan to the next. Even the insurance provider has established guidelines in this regard.
You will be questioned about the claiming procedure when you purchase a 5 lakh plan. Your choice will influence how your claim is handled. You can submit claims indefinitely until all of your money is fully
covered. You may, for instance, make a claim each time you visit the OPD.
Therefore, it is important to thoroughly study the terms and conditions before acquiring a 1 CR Health plan. Additionally, while purchasing
a 5 lakh health plan, consideration must be given to the claiming procedure's relationship to income tax advantages.
In a nutshell, a 5 lakh health insurance policy may be sufficient for some and not be enough for some. You need to make a careful and calculated choice before deciding on the amount you are ready to invest on a health insurance policy. The amount will also depend on you and your loved ones’s medical requirements. However, the most important thing is having a good health insurance plan. A healthcare emergency can occur any time and a mediclaim policy helps you to deal with such situations. So, keep the above points in mind to make an informed decision.