How Does Health Insurance Work in India?

The popularity of health insurance has been rising consistently over the past few years for several reasons. People have realised the importance of having a security blanket, as a simple hospitalisation is often enough to wipe away most of your savings. With the easy availability of insurance services due to digitalization, their popularity is expected to increase even further in the future.

How Can You Buy Health Insurance in India?

One of the easiest ways of buying health insurance is through online insurance platforms like Upstox. You simply need to visit the Upstox app, provide your details (as prompted), and you will be provided with quotes from some of the top health insurance providers. You can compare plans, check premiums, review hospital networks, and purchase a policy.

You can also purchase a health insurance policy through traditional channels, such as working with an agent.

How Can You Renew Your Health Insurance?

Just like buying a health insurance policy online, renewing is quite straightforward by using a platform like Upstox. Simply log in to your account, select the policy nearing expiry, and choose to renew. You can review your coverage, opt for add-ons, or increase the sum insured if needed.

Most insurers offer a grace period of 15 to 30 days after expiry to renew without losing benefits. However, we strongly recommend renewing your health insurance on or before the specified deadline to maintain continuous coverage.

How Can You Make a Claim?

You have two options when making a claim: cashless (treatment at a network hospital) or reimbursement (treatment at a non-network hospital). For cashless claims, visit a network hospital, show your e-health card or policy details, and the insurer’s TPA (Third-Party Administrator) will handle the rest. Most of the expenses, depending on the policy terms and conditions, are borne by the insurance company without you having to pay anything upfront.

For reimbursement, you pay the bills first, then submit documents like hospital bills, prescriptions, and discharge summaries to your insurance company. The insurer reviews and transfers the approved amount to your account.

Situations When Health Insurance Helps

Health insurance proves invaluable in situations like emergency surgeries after accidents, dengue or fever-related hospitalizations, planned maternity care, or treatments for chronic illnesses like cancer and diabetes. It also covers ICU admissions during health crises like COVID-19. In each case, your financial troubles are taken care of by your insurance company, and you can simply focus on your health, recovery, and getting better.

Summing up

If you are serious about financial security, having health insurance should be on your priority list. It protects you from financial bankruptcy that can easily arise due to prolonged hospitalisation. Whether you're buying a new policy, renewing an existing one, or making a claim during a medical emergency, knowing how the process works helps you stay prepared. With platforms like Upstox making everything, from comparisons to claim tracking, completely digital, there’s no reason to delay. Choose wisely, renew on time, and stay insured.

FAQs

• Can I claim it immediately after buying health insurance?

No, most policies have a 30-day waiting period, except for accidents.

• What documents are needed to make a claim?

Hospital bills, discharge summary, prescriptions, policy details, and ID proof.

• What happens if I miss my renewal date?

You get a grace period (15–30 days). Post that, the policy lapses.

• Can I increase my sum insured later?

Yes, usually at the time of renewal, subject to underwriting.

• What is a TPA in health insurance?

A Third-Party Administrator processes your claims and assists during hospitalization.