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Need assistance in choosing the right insurance plan? Get a call from our Expert.

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TATA AIA Life Insurance Co. Ltd will send you updates on your policy, new products & services, insurance solutions or related information. Select here to opt-in. T&C apply.

What Is A Comprehensive Health Insurance?

Comprehensive health policies offer coverage for hospitalisations, OPD treatments, ambulance transport costs and AYUSH treatments under one health plan. They ensure you and your family are covered for all medical emergencies while insured.   
 

Health insurance plans are an essential part of maintaining your health and well-being. They cover your medical expenses, and a comprehensive health insurance plan can act as a form of financial shielding when faced with a medical emergency.
 

Without health insurance, medical costs can quickly add up and land you in the red. To avoid this, getting comprehensive health coverage either as a standalone plan or as a rider with your life insurance policy can be a big help.
 

Read on to learn what a comprehensive health insurance plan is, its benefits, what coverage you can expect when you opt for one and why you should consider getting one for your family.

What is a Comprehensive Health Insurance Plan?

Comprehensive medical plans are all-inclusive health plans with extensive medical coverage that offer lifetime renewability to policyholders. Some even offer free annual health check-ups and access to wellness programs to help maintain a healthy lifestyle.
 

The premiums for these plans are generally higher as they offer more extensive coverage, but in exchange, you get coverage for in-patient treatment, consultations, OPD treatment, hospital stays, and medical testing.

Why Do You Need Comprehensive Medical Coverage?

A basic mediclaim plan will mostly cover in-patient treatments and emergencies requiring hospitalisation and is more beneficial for those with no dependants or chronic conditions. 
 

With comprehensive health coverage, you can get coverage for critical illness treatments, pre-existing disease coverage and even organ donor expense coverage. 
 

Hence, you should opt for a comprehensive health insurance plan if you want medical coverage for cost-intensive treatments like dialysis or chemotherapy. Comprehensive plans are also beneficial for senior citizens, as they will require regular medical treatments. 

What Does a Comprehensive Health Policy Cover?

The extent of coverage you will receive under your comprehensive health insurance plan will depend on your insurer and the plan you opt for. These are some general base covers you can expect under most insurers: 
 

  • In-Patient Hospitalisation

  • Day Care Treatment

  • Pre-Hospitalisation

  • Post-Hospitalisation

  • Organ Donor Expenses

  • Domiciliary Hospitalisation

  • OPD Treatment

  • AYUSH Treatment

  • Emergency Ambulance
     

Benefits of Comprehensive Medical Plans

  • Covers the Entire Family: Some of the best comprehensive health insurance plans allow you to insure your family under one plan. Hence, you can get extensive medical coverage for your spouse and children. Some plans allow you to extend the coverage to your parents and in-laws. 

    The sum insured here can be available on an individual or on a floater basis, depending on the type of comprehensive plan you opt for. 
     

  • Pre-Existing Disease Coverage: All comprehensive plans offer pre-existing disease coverage. Once you have completed the waiting period under the plan, you are covered for existing diseases. Generally, the waiting period for pre-existing diseases under health insurance is 1 - 4 years.

    Therefore, buying a comprehensive medical plan well before you require coverage for your condition is a wise decision. 
     

  • Riders/Add-On Covers: You can opt for add-on covers on policy purchase or renewal to extend your base coverage. Remember that these riders require an additional premium payment, so only opt for coverage you absolutely need to avoid overextending your budget. 

    Some of the popular health insurance riders are critical illness cover, maternity cover, personal accident cover, hospital daily cash, etc.
     

  • Cashless Treatment: Like regular health plans, you can claim cashless facilities under comprehensive health insurance at network hospitals. Here, your insurance provider will settle the bill directly with the hospital, mitigating the need for you to gather any last-minute funds. 

    This facility can be availed for planned and emergency hospitalisations so long as you or an insured family member is hospitalised at a network hospital. 
     

  • Cumulative Bonus: Most comprehensive health insurance plans come with a cumulative bonus that can be accrued for every consecutive claim-free year. When you renew your policy after a claim-free year, the cumulative bonus will get you a discount on the premium or increase your sum insured by a certain percentage.
     

  • Tax Benefits: Much like life insurance policies, you can be eligible for tax benefits on your annual health insurance premium payments. This benefit can be claimed under Section 80D of the Income Tax Act 1961. 

    You can get deductions up to ₹25,000/₹50,000, and you can also claim a deduction for a maximum of ₹5,000 for preventative health check-ups, which is included within the overall limit.
     

  • Outpatient Treatment: One key advantage of having comprehensive health coverage is that your insurer will cover OPD expenses. This means you are reimbursed for the OPD consultation cost incurred when you visit a doctor and do not require hospitalisation.

Conclusion

Buying a comprehensive health insurance plan can be one of the best things you can do for your family. Once you secure their life with life insurance, you should opt for buying health insurance to safeguard them from any medical emergency and unforeseen hospitalisation costs. You can also buy targeted health riders or life + health insurance combination plans for comprehensive protection under a single plan.
 

Tata AIA Life Insurance in India offers a range of health riders as well as life insurance plans with inbuilt health and wellness benefits. For example, Tata AIA’s Pro-Fit offers OPD coverage for outpatient consultations, physiotherapy sessions, pharmacy and a diagnostic cover under its comprehensive health coverage.  
 

Check our website or get in touch with us today for more details.

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Tata AIA Life Insurance

A joint venture between Tata Sons Pvt. Ltd. and AIA Group Ltd. (AIA),  Tata AIA Life Insurance  is one of the leading life insurance providers in India. We post everything you need to know about life insurance, tax savings and a variety of lateral topics such as savings and investments in this space. You can access and read a host of different blogs, articles and pages at the Tata AIA Life Insurance Knowledge Center or get in touch with us with any queries or questions!

View all posts by Tata AIA Life Insurance

Frequently Asked Questions

What is the difference between a regular and comprehensive health insurance plan?

Both plans will cover basic hospitalisation expenses for medical emergencies, but regular plans will have a more limited sum insured and may not cover certain conditions. 
 

Comprehensive coverage in health insurance will cover the cost of medical check-ups, OPD treatments, hospitalisations, daycare procedures and alternative treatment options.

How much does comprehensive health insurance cost?

The premium rates for comprehensive medical insurance can vary depending on your age, the insurer, and coverage. Generally, annual premiums can start as low as ₹7,000 and upwards.

What to consider before purchasing comprehensive health insurance?

Here are some key factors to look into before buying a comprehensive health insurance plan:

  • Sum Insured/Coverage Range offered by the insurance provider.

  • Add-ons and rider plans that can be added to the health insurance plan.

  • Maximum and minimum entry/exit age.

  • Waiting periods for pre-existing and critical illness coverage. (e.g. availability of maternity cover)

  • Policy Wordings (exclusions, terms, and conditions).

  • The insurer’s claim settlement ratio (CSR).

  • The insurer must have an easy claims process.

  • Available value-added services like discounts, preventive health check-ups, restoration benefits, cumulative bonuses@, etc.

Can I claim tax deductions under a health insurance policy?

Health insurance tax deductions can be claimed under Section 80D for annual premium payments.

What is not included under comprehensive medical coverage?

Like policy coverage, this will vary across insurers, but general exclusions under most health insurers are:

  • Surgery for purely cosmetic/aesthetic purposes and not for reconstruction due to damage/injuries sustained from an accident. 

  • Suicide attempts or self-induced injuries. 

  • Sexually Transmitted Diseases (STDs) or STIs.

  • Treatments and procedures related to sterility and infertility. 

  • Unproven medical treatments, procedures or medication that lack significant medical documentation to support their effectiveness.

  • Injuries that result from violating/breaching the law.

Disclaimers

  •  Insurance cover is available under the product.

  •  The products are underwritten by Tata AIA Life Insurance Company Ltd.

  • The plans are not a guaranteed1 issuance plan, and it will be subject to Company’s underwriting and acceptance.

  • For more details on risk factors, terms and conditions please read sales brochure carefully before concluding a sale.

  • This blog is for information and illustrative purposes only and does not purport to any financial or investment services and do not offer or form part of any offer or recommendation. The information is not and should not be regarded as investment advice or as a recommendation regarding any particular security or course of action.

  • Please know the associated risks and the applicable charges, from your Insurance agent or the Intermediary or policy document issued by the insurance company.

  • Every effort is made to ensure that all information contained in this blog is accurate at the date of publication, however, the Tata AIA Life shall not have any liability for any damages of any kind (including but not limited to errors and omissions) whatsoever relating to this material.

Other Disclaimers

  • Tax:*Income Tax benefits would be available as per the prevailing income tax laws, subject to fulfilment of conditions stipulated therein. Income Tax laws are subject to change from time to time. Tata AIA Life Insurance Company Ltd. does not assume responsibility on tax implications mentioned anywhere in this document. Please consult your own tax consultant to know the tax benefits available to you.

  • #Riders are not mandatory and are available for a nominal extra cost. For more details on the benefits, premiums and exclusions under the riders please refer to the Rider Brochure or contact our Insurance Advisor or visit our nearest branch office.

  • Bonus@:These bonuses are not guaranteed in nature. The Company may declare Cash Bonus rate annually in advance. The Cash Bonuses if declared, will be applicable provided all due premiums have been paid.