Health Insurance
What is Health Insurance?
Health insurance is a vital financial safety net that covers medical and surgical expenses incurred by
the insured. It acts as a shield against the skyrocketing costs of quality healthcare, ensuring that you
and your loved ones can access the best medical treatment without worrying about the financial burden.
Whether it's a planned surgery or an unexpected medical emergency, a robust health plan provides the
necessary support for recovery.
At DigiAssure, we prioritize your wellness above all else. Our health insurance plans are meticulously
crafted to offer extensive coverage across a network of 10,000+ top-tier hospitals. From cashless
hospitalization and annual health checkups to maternity benefits and coverage for pre-existing diseases,
we provide holistic protection. With our simplified digital claim process and dedicated support, we
ensure that your focus remains entirely on getting well.
Types of Health Insurance
1. Individual Health Insurance
Covers a single person for a specific sum insured. It is ideal for young professionals or individuals who want dedicated coverage for their specific health needs without sharing the limit.
2. Family Floater Health Plan
A comprehensive policy that covers the entire family (spouse, children, and parents) under a single sum insured. It is highly cost-effective as the premium is shared among all covered members.
3. Senior Citizen Health Insurance
Specifically designed for individuals over 60 years of age. It covers age-related ailments, psychiatric benefits, and pre-existing conditions with shorter waiting periods and specialized support.
4. Critical Illness Cover
Provides a lump-sum payment upon diagnosis of life-threatening diseases like cancer, heart attack, or kidney failure. This helps manage high treatment costs and loss of income during recovery.
Key Features of Our Health Insurance
Cashless Treatment
Direct settlement of bills at over 10,000+ network hospitals across the country.
No Claim Bonus
Get up to 50% increase in your sum insured for every claim-free year you maintain.
Free Health Checkups
Complimentary annual medical screenings to help you monitor and maintain your health.
Tax Benefits
Save tax up to ₹75,000 on premiums paid under Section 80D of the Income Tax Act.
Restoration Benefit
Automatically refills your sum insured if it gets exhausted during a policy year.
Lifetime Renewability
Stay protected for life with guaranteed renewals regardless of your age or health status.
Individual vs Family Floater
Choose the right plan based on your family size and health requirements.
| Feature | Individual Plan | Family Floater Plan |
|---|---|---|
| Sum Insured Type | Dedicated per person | Shared among members |
| Premium Cost | Higher per individual | More economical for families |
| Age Limit | Flexible (all ages) | Based on oldest member |
| Claim Impact | Only affects individual | Reduces limit for everyone |
| Customization | High per person | Standard for the group |
| Tax Benefits | Yes | Yes |
| Restoration Benefit | Available | Available |
| NCB Rewards | Personal rewards | Collective rewards |
Health Insurance Coverage
Understand the essential inclusions and exclusions of your health policy.
What Health Insurance Covers
Comprehensive medical protections for you
- Hospitalization (24+ hours)
- Pre & Post Hospitalization
- Daycare Procedures
- Intensive Care Unit (ICU)
- Organ Donor Expenses
- Emergency Ambulance Charges
What Health Insurance Does NOT Cover
Standard exclusions in health policies
- Cosmetic or Plastic Surgery
- Obesity & Weight Control
- Alcohol or Drug related issues
- Self-inflicted injuries
- Unproven or Experimental treatments
- Congenital external diseases
Health Insurance Add-Ons
Enhance your base plan with specialized riders for extra care.
Maternity Cover
Covers expenses related to childbirth, including prenatal and postnatal care, along with first-year vaccinations for the newborn.
Critical Illness Rider
Provides an additional lump-sum payment if you are diagnosed with a major illness like cancer or stroke, helping with secondary expenses.
Daily Hospital Cash
Gives you a fixed daily allowance for each day of hospitalization to cover non-medical out-of-pocket expenses like food and travel.
OPD & Diagnostic Cover
Reimburses costs for doctor consultations, pharmacy bills, and diagnostic tests that do not require overnight hospitalization.
Air Ambulance Cover
Covers emergency medical evacuation by air if life-saving treatment is required in a different city or remote location.
Factors That Influence Health Premium
Understand how your health profile determines your policy cost.
1. Age of Insured
Age is the primary factor. Premiums are lower for younger individuals and increase as you age due to higher health risks.
2. Medical History
Pre-existing diseases or a history of chronic conditions can lead to higher premiums or specific waiting periods in the policy.
3. Lifestyle Habits
Habits like smoking or consumption of tobacco products significantly increase health risks and consequently the insurance premium.
4. Sum Insured Chosen
The total coverage limit you choose directly impacts the cost. A higher sum insured provides better protection but comes at a higher premium.
5. Type of Plan
Whether you choose an individual, family floater, or a plan with multiple add-ons will determine the final payable amount.
Tips to Save on Health Insurance
Smart strategies to get the best health coverage at the lowest price.
1. Buy Early in Life
Buying health insurance when you are young and healthy locks in lower premiums and completes waiting periods sooner.
2. Choose Family Floaters
For families, a floater plan is much cheaper than buying individual policies for every member of the household.
3. Opt for Voluntary Co-pay
If you are willing to pay a small percentage of claims yourself, insurers offer significant discounts on the annual premium.
4. Maintain a Healthy Lifestyle
Regular exercise and healthy habits can help you avoid claims, leading to substantial No Claim Bonus discounts on renewal.
5. Go for Multi-Year Plans
Paying for 2 or 3 years upfront often attracts discounts of 5-15% and protects you from annual premium hikes.
Documents Required for Health Insurance
Keep these documents ready for a smooth buying or claim process.
KYC Documents
- Aadhaar Card or Voter ID
- PAN Card (Mandatory)
- Passport (if available)
Medical Records
- Pre-policy checkup reports (if required)
- History of previous surgeries
- Current medication lists
Claim Documentation
- Discharge Summary from hospital
- Original bills and payment receipts
- Diagnostic reports and prescriptions
Age Proof
- Birth Certificate
- School Leaving Certificate
- Driving License
Bank & Payment Details
- Canceled Cheque (with name printed)
- Bank account statement copy
- IFSC code details for NEFT
Health Insurance Claim – Step by Step
How to get your medical bills settled through cashless or reimbursement modes.
Hospital Intimation
Notify us within 24 hours of emergency admission or 48 hours before planned hospitalization.
Show Your Health Card
Present your DigiAssure Health Card and a valid photo ID at the hospital's insurance desk.
Pre-auth Request
The hospital sends the pre-authorization form to our team for initial review and verification.
Claim Evaluation
Our medical experts review the treatment plan and approve the cashless request within 2-4 hours.
Cashless Treatment
Receive quality medical care without paying the bills. We coordinate directly with the hospital.
Final Verification
At discharge, the hospital sends the final bill and summary for our definitive approval.
Bill Settlement
We settle the approved amount with the hospital directly. You only pay for non-medical expenses.
Post-Hosp Claims
Submit your follow-up pharmacy bills and diagnostic reports for reimbursement within 30 days.
Benefits of Health Insurance
Why millions of families trust DigiAssure for their healthcare needs.
Financial Security
Protects your life savings from being drained due to sudden high-cost medical treatments.
Quality Healthcare
Access the best doctors and private hospitals without worrying about the cost of care.
Tax Savings
Reduce your taxable income significantly through premiums paid under Section 80D.
Mental Peace
Focus entirely on recovery and wellness while we handle the financial complexities.
Annual Wellness
Avail complimentary annual health screenings to stay ahead of potential health issues.
Comprehensive Cover
From pre-hospitalization to post-discharge care, we cover the entire treatment journey.
Frequently Asked Questions
Everything you need to know about our health insurance policies.
What is a waiting period in health insurance?
A waiting period is the specific duration after buying the policy during which certain diseases or treatments are not covered. This usually includes an initial 30-day period, a 2-year period for specific ailments, and a 3-4 year period for pre-existing diseases.
What does cashless hospitalization mean?
It is a facility where the insurance company settles medical bills directly with the network hospital. The policyholder doesn't need to pay upfront from their pocket, except for non-medical expenses like registration or service fees.
What is a Co-payment clause?
Co-payment is a fixed percentage of the claim amount that the policyholder agrees to pay out of their pocket. The insurance company pays the remaining balance. Choosing a higher co-pay can reduce your annual insurance premium.
Can I port my existing policy to DigiAssure?
Yes, you can port your current health insurance policy to DigiAssure. You will retain all your accrued benefits, including No Claim Bonus and waiting period credits, as per IRDAI portability guidelines.
Does the policy cover COVID-19 treatment?
Yes, all our standard health insurance plans cover hospitalization expenses related to COVID-19 and its complications, subject to the terms and conditions of your specific policy.
What is Restoration of Sum Insured?
It is a benefit where the sum insured is automatically refilled if it gets exhausted due to a claim during the policy year. This ensures you have coverage available for subsequent hospitalizations for different or same illnesses.
What are daycare procedures?
Daycare procedures are medical treatments or surgeries that require less than 24 hours of hospitalization due to advancements in medical technology, such as cataract surgery, dialysis, or chemotherapy.
Are AYUSH treatments covered?
Yes, we provide coverage for alternative treatments like Ayurveda, Yoga, Unani, Siddha, and Homeopathy, provided they are taken in a government-recognized hospital or accredited institute.