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What Our Plans Cover
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Hospitalisation for 24 hours or mo...
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Pre-hospitalisation expenses
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Post-hospitalisation expenses
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Day-care procedures that modern me...
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ICU and intensive care charges
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Ambulance charges up to the policy...
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Domiciliary treatment where a hosp...
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AYUSH treatment at a recognised in...
Who Can Consider This Plan?
- Indian resident, typically aged 18 to 65 at entry
- Children can usually be covered from 91 days, subject to insurer rules
- Medical tests may be required above a threshold age or sum insured
- Full and accurate disclosure of existing conditions, medication and family history
- Tobacco and alcohol use must be declared — non-disclosure is the leading cause of rejected claims
What May Not Be Covered?
- Pre-existing conditions during the waiting period, commonly two to four years
- The initial waiting period, usually the first 30 days except for accidents
- Named ailments with their own waiting period — hernia, cataract, joint replacement and similar
- Maternity and childbirth unless a maternity benefit is specifically included
- Cosmetic, aesthetic and elective procedures with no medical necessity
Always check the policy wording before you commit.
Why Choose Wealth & Covers?
- Expert advice to choose the right plan
- Plans from leading insurance companies
- Hassle-free process and documentation
- End-to-end support, including claim assistance
- Dedicated relationship manager
Our Insurance Partners
- Star Health Insurance
- Care Health Insurance
- Niva Bupa Health Insurance
- HDFC ERGO
- ICICI Lombard
- Bajaj Allianz
We represent multiple providers to help you find the most suitable option at the best price.
- Expert Guidance Personalised advice from experienced insurance professionals.
- End-to-End Support From choosing the right plan to claim assistance, we are with you always.
- Claims Assistance Hassle-free claim support to ensure you get what you deserve.
- Transparent Process Clear information, easy documentation and a hassle-free experience.
Overview
An individual health insurance policy covers one person, in that person's own name, for hospitalisation and the treatment costs around it. It is the simplest form of health cover and, for anyone whose only protection today is an employer group policy, it is usually the most urgent thing to fix.
The reason is unglamorous: employer cover ends when the employment does. It ends on the day you resign, on the day you are let go, and on the day you retire — which is precisely the period of life when a fresh policy is most expensive to buy and most likely to be declined. A policy you own yourself is unaffected by any of that.
The second reason is pricing. Health premiums are set by the age at which you enter, and waiting periods for pre-existing conditions run from the date the policy starts. Every year you delay makes the same cover cost more and pushes the date on which your existing conditions become claimable further into the future.
Who should consider it
This is the right starting point if you are covered only by your employer, if you are self-employed or between jobs, or if you are young and healthy and want to lock in both a low entry premium and an early start to the waiting-period clock.
It is also the right structure where one person in a household has a materially different health profile from the rest. A family floater shares one sum insured across everyone in it, which works well when risk is broadly even and works badly when one member is likely to consume most of the cover. In that situation a separate individual policy for that person, with a floater over the rest of the family, usually produces better cover for a similar premium.
If you already hold cover, this is still worth reading. The most common problem we see is not the absence of a policy but a sum insured chosen years ago and never revisited against what treatment now costs.
Benefits
- The policy is yours — a job change, redundancy or retirement does not touch it
- Premium is fixed by your entry age, so buying earlier costs less for the same cover
- Waiting periods for pre-existing conditions start running from day one of the policy
- Cashless treatment at network hospitals, so you are not funding a deposit in a crisis
- Premium qualifies for deduction under Section 80D of the Income Tax Act
- Portable to another insurer at renewal without losing the waiting periods you have served
- No-claim bonus increases your sum insured for every year you do not claim
What is covered, and what is not
Read the right-hand column first. It is the one that decides whether a claim is paid.
Typically covered
- Hospitalisation for 24 hours or more — room, nursing, doctors, drugs and diagnostics
- Pre-hospitalisation expenses, typically the 30 to 60 days before admission
- Post-hospitalisation expenses, typically 60 to 90 days after discharge
- Day-care procedures that modern medicine completes in under 24 hours
- ICU and intensive care charges, subject to any stated limit
- Ambulance charges up to the policy limit
- Domiciliary treatment where a hospital bed was genuinely unavailable
- AYUSH treatment at a recognised institution, where the policy provides for it
- Organ donor expenses for a covered transplant
- Annual health check-up, generally after a stated number of continuous years
Typically not covered
- Pre-existing conditions during the waiting period, commonly two to four years
- The initial waiting period, usually the first 30 days except for accidents
- Named ailments with their own waiting period — hernia, cataract, joint replacement and similar
- Maternity and childbirth unless a maternity benefit is specifically included
- Cosmetic, aesthetic and elective procedures with no medical necessity
- Dental and optical treatment unless it follows an accident
- Treatment for self-inflicted injury, or arising from alcohol or substance abuse
- Non-medical consumables — gloves, administrative charges and similar line items
- Any condition not disclosed at proposal stage and later found to be material
- Treatment taken outside India, unless the policy explicitly extends abroad
Inclusions and exclusions vary between providers and between plans from the same provider. The wording in your own policy document is what governs — we will walk you through it before you buy.
How it works with us
- 1 Tell us who is being covered Age, city, existing conditions and any cover you already hold. Two minutes, and it decides everything downstream.
- 2 We shortlist on structure, not price Room rent, co-payment, sub-limits and pre-existing waiting periods — the four things that decide what you actually get paid.
- 3 You see two or three options, with the trade-offs named Including what each one gives up. If your existing policy is already the right answer, we will tell you that.
- 4 Proposal and medicals We help you complete disclosure properly. A medical test, where required, is usually arranged at home.
- 5 Policy issued, and we stay on the file At claim time you call us, not a helpline. We prepare the file, submit it and chase the insurer until it settles.
Important considerations
The things a brochure tends to leave out. Read these before you decide.
- Room rent limits do more damage than most buyers expect. If your policy caps the room at 1% of sum insured and you take a costlier room, many insurers reduce every associated charge in the same proportion — not just the room bill.
- Sum insured is worth stress-testing against your city, not the national average. A single cardiac or oncology admission in a metro can exceed a ₹5 lakh cover.
- A base policy plus a super top-up above a deductible almost always buys more total cover than a single large policy at the same premium. It is the most useful structural decision on this page.
- Disclose everything at proposal stage. A policy issued on incomplete information is a policy your family may not be able to enforce when it matters.
- Porting to another insurer preserves your served waiting periods — but only if you initiate it within the window before renewal, typically 45 to 60 days.
- Premiums rise with age and with medical inflation. Budget for that rather than being surprised by it at the fifth renewal.
Documents required
- Completed proposal form with full medical disclosure
- Identity proof — Aadhaar, passport, voter ID or driving licence
- Address proof
- PAN card
- Recent passport-size photograph
- Medical reports, where the insurer requires them at your age or sum insured
- Existing policy copy, if you are porting
Frequently Asked Questions
Is an individual policy better than a family floater?
Neither is universally better. A floater shares one sum insured across the family and is efficient when everyone's risk is broadly similar. An individual policy is better where one person's health profile differs sharply from the rest, because in a floater that person can consume the cover the whole family depends on. Many households end up with a sensible hybrid: a floater over the family plus a separate individual policy on the member with the higher risk.
I already have health cover through my employer. Do I need this?
Almost certainly yes. Employer cover ends with the employment, and it ends at exactly the moment a new policy is hardest to buy — after a diagnosis, at an older age, or during a job search. Holding a policy in your own name alongside the group cover means you never have to buy protection under pressure.
What is a waiting period and why does it matter so much?
A waiting period is a window at the start of the policy during which certain claims are not payable. There is usually a 30-day initial period, a longer one for named ailments, and a longer one still for pre-existing conditions. They matter because they run from the date the policy begins — so the cost of delaying a purchase is not just a higher premium, it is a later date on which your existing conditions become claimable.
How much sum insured is enough?
It depends on your city and your family history far more than on any rule of thumb. In a metro, a single serious hospitalisation can run past ₹8 to ₹10 lakh. Rather than buying one very large policy, most people are better served by a base policy topped by a super top-up above a deductible, which buys substantially more total cover for a similar premium.
What is cashless treatment, and is it guaranteed?
At a network hospital the insurer settles the bill directly, so you are not funding a large deposit during an emergency. It is not a guarantee: the hospital raises a pre-authorisation request and the insurer approves an amount, which can be partial and can be revised. Outside the network you pay and claim reimbursement afterwards. Either way, intimate the claim early.
Can I move to a different insurer without losing my waiting periods?
Yes. Portability lets you carry your served waiting periods to a new insurer at renewal, which is what makes switching viable at all. You have to initiate it within the window before your renewal date — commonly 45 to 60 days — and acceptance remains subject to the new insurer's underwriting.
Does the premium qualify for a tax deduction?
Premium paid for a health policy qualifies for deduction under Section 80D, with a higher limit where the insured is a senior citizen. The deduction is only available under the old tax regime. Our income tax calculator will show you which regime works out cheaper on your numbers.
What most often causes a health claim to be reduced or rejected?
In our experience, three things. Non-disclosure at proposal stage, by a distance. A room rent limit that proportionately reduces the entire bill. And incomplete documentation at submission. The first is avoidable when the policy is bought, the second when it is chosen, and the third is the part we handle for you.
Want a shortlist instead of a catalogue?
Tell us the situation and an advisor comes back with two or three options that actually fit — and names what each one gives up.