Health Insurance

Choosing the right health insurance is crucial, especially with medical costs going up every year. Government statistics reveal that a significant 83.7% of Indians use their own household income or savings to cover hospital bills, and more than 12% depend on loans or financial assistance from family and friends to manage these costs.

In India, these costs can jump by 12-14% annually. That's why it's important to think about health insurance policy as something you'll need for a long time, about 30-35 years, to make sure you're covered no matter what happens down the road. 

In this article, you will discover the importance of health insurance and how Digit Insurance can help you meet the rising healthcare costs for yourself and your family. Think of it like that one friend who you know will always be there for you whenever you’re sick or even just feeling low. 

A health insurance or a medical insurance is a  type of general insurance that safeguards you against financial losses by covering for you when you’re faced with a health condition or medical emergency such as due to a disease, illness or even an accident.

This includes expenses incurred during pre and post-hospitalization, annual  health check-ups, psychiatric support, critical illnesses and maternity-related expenses amongst others, as per your customized health insurance plan. 

Think of it like that one friend who you know will always be there for you whenever you’re sick or even just feeling low.

Here's why more and more people are opting for a health Insurance in India.

1. Because it helps cover for medical expenses!

The primary benefit of a health Insurance is that it covers for your pre and post hospitalization related expenses in case of an unfortunate accident or illness, which would otherwise eat your bank balance away!

As per the National Family Health Survey-3, 70% of urban and 63% of rural households depend upon private hospitals where the cost of healthcare services are usually much higher than government-owned medical facilities. Thus, middle and upper-class individuals are more likely to avail of services in a private hospital.

2. Because it can help maximize your tax savings!

Who doesn’t want additional tax savings, right? According to Section 80D of the Income Tax, anyone who buys a health Insurance for themselves, or their parents can claim tax benefits on the annual premium!  

3. Because it can safeguard you from critical illnesses

Contrary to popular belief, many critical illnesses like cancer and heart diseases are today diagnosed in young people <40. A health Insurance ensures you will be financially covered in the likelihood of the same.

4. Because it keeps you financially secure!

More than anything else, a health Insurance is a smart investment to make that not only helps safeguard your health by always being there you financially but, also helps you with benefits like no claim bonuses which are an ultimate win-win for the long run!

5. Because it ensures you get the right treatment at the right time!

Imagine that because of some reason, you or a family member need treatment but don’t have enough funds for it so you put it off for some time. This can often make matters worse.

A health Insurance is important as it prevents this from happening and ensures you get your required treatments done on time. Additionally, with annual health checkups included in health Insurance plans, you will always be aware of your health which can otherwise often go unnoticed.

6. Because it gives you some peace of mind!

How do you feel when you know that someone will always have your back during unfortunate situations? Relived, right? With regards to your health too- you can count on a health Insurance to have your back in times of need. 

• India has the highest medical inflation rate in Asia at 14%, surpassing China (12%), Indonesia (10%), Vietnam (10%), and the Philippines (9%). (1)
  
• In the Union Budget 2023-24, the Ministry of Health and Family Welfare received an allocation of INR 89,155 crore, marking a 3.43% increase from INR 86,200.65 crore in 2021-22. (2)
  
• In 2021, approximately 514 million people in India were covered under health insurance schemes, which represents only 37% of the population. (3)  
  
• Rajasthan has the highest proportion of households covered under health insurance or financing schemes (88%), followed by Andhra Pradesh (80%). The lowest coverage (less than 15%) is found in the Andaman & Nicobar Islands and Jammu & Kashmir. (4)
  
• As per the Consumer Pyramids Household Survey (CPHS) report by Centre for Monitoring Indian Economy (CMIE), Indian households spent over INR 120 billion on healthcare and medical related services in FY 2022. (5)

Our Wellness Program is an effort in helping you reach your goal of healthy life. It aims to help you achieve a healthy lifestyle through a range of discounts and benefits on health and fitness services.

Additionally, our program includes informative sessions and programs that can help you become more aware of your health and empower you to take better care of yourself. With our wellness program, we strive to provide you with the awareness and resources needed to stay in the pink of your health!

Some of our Wellness Benefits are:

• Teleconsultations with general physicians
• Offers and discounts on dental consultations
• Discounts on health checks and diagnostics
• Cashbacks on online medicine orders
• Access to Yoga sessions by professionals and many more offers.

For buying a health insurance plan with Digit, you will be required to provide the below documents for identity verification, proof of residence and age verification.

• Aadhaar Card
• PAN Card
• Voter’s ID
• Passport
• Driving License
• 10th or 12th grade mark sheets

Disclaimer: The documents listed above are the standard requirements for purchasing Digit Health Insurance. However, additional documents may be requested based on individual circumstances, policy terms, and underwriting guidelines. Please consult with the insurance provider for a comprehensive list of required documents. 

With us, you do not need to carry hard copies of your insurance policy. You can simply download it from our website or app.

Steps to Download Your Digit Health Insurance Policy through Website

Steps to Download Your Digit Health Insurance Policy through App

The policy document will be at your fingertips without any hassle.

Follow the below steps to download the e-card for Digit Health Insurance

• Step 1: Login to ‘Digit Insurance App’ using your number.
• Step 2: Click on My Policies on the bottom right of the screen.
• Step 3: Select the e-card and click on Download Policy option.

At Digit, our health insurance premiums vary based on healthcare costs across different cities, split into two zones for convenience.  

Zone 1 - Delhi NCR, Greater Hyderabad, and Greater Mumbai.  

Zone 2 - Rest of India.  

Let's look at a practical example to understand how the premium works for one of our most popular health insurance plan, the 'Infinity Wallet Plan.' 

Pritesh, a 26-year-old unmarried individual residing in Bangalore (Zone 2 city), has opted for the 'Infinity Wallet Plan' with a sum insured of ₹10 lakhs. 

But, Why We Recommend ₹10 Lakhs Coverage?

In the current climate of rising inflation and escalating healthcare costs, opting for ₹10 lakh sum insured is highly recommended as it provides substantial coverage to safeguard against significant medical expenses. This level of coverage ensures that you are well-protected against the high costs of treatments and hospitalization, which can quickly deplete lower coverage amounts.  

Additionally, having ₹10 lakhs sum insured offers peace of mind and financial security, reducing the risk of out-of-pocket expenses that could arise from unforeseen health issues.

Disclaimer - The premiums mentioned in this example are based on the specific scenario. Your premiums may vary depending on individual factors such as age, plan selection, and other conditions.

Below is a concise overview of the essential documents required to file your claim.

• Claim form (filled & signed) - if required
• Discharge summary
• Hospital bills (original, with breakdown)
• Prescriptions with pharmacy bills
• Consultations paper & investigation report
• KYC and bank details (with a cancelled cheque)

Note: The documents listed above are the standard requirements for filing an insurance claim. The company might ask for additional documents based on your requirement or policy terms. 

New to health insurance and confused how do health insurance claims work, especially with respect to Digit’s Health Insurance? We simplify it for you below.

What is a claim, even?

So you’ve seen this word everywhere but not sure what it means exactly. To simply put it, a claim is what you need to do when you want your health insurance company to pay for your hospitalization expenses in case of a treatment.

Claims are usually to be informed about in advance for planned treatments and hospitalizations whereas in case of medical emergencies the situation would be different, based on the type of claim you’re going for. At Digit, there are primarily two types of health insurance claims you can opt for.

Cashless Claims

As the name suggests, cashless claims refer to claims where you don’t need to pay from your pocket at the time of hospitalization. “But isn’t my health insurer supposed to pay anyway?” you wonder. The answer to that is yes, of course.

However, there is also an option to go for reimbursement claims wherein you pay for your treatment costs at the time of hospitalization, and later – within 20 to 30 days get the bills reimbursed by your insurer.

However, when you opt for cashless claims you don’t need to do that as the hospital will directly take care of the bills with your insurer.

Reimbursement Claims

As mentioned above, reimbursement claims are a type of health insurance claim wherein during hospitalization, you pay for your hospital bills and later, post discharge contact your health insurer to get your hospital bills reimbursed.

This process takes anytime between 2 weeks to 4 weeks depending on your insurer. At Digit, since all processes are digital (even for documentation purposes!) the time taken to settle claims is actually a lot faster!

Before purchasing health insurance, thoroughly read the policy documents. Pay attention to inclusions, exclusions, waiting periods, and sum insured limits. Familiarize yourself with the policy’s terms and conditions. Knowing what’s covered and what’s not, will help you make informed decisions. 

Medical Information Disclosure

Be transparent about your medical history. Disclose any existing illnesses or conditions - even those you’ve recovered from. Non-disclosure can lead to claim rejection.

Choose Network Hospitals

Opt for cashless claims by using network hospitals or healthcare providers associated with your insurance company. This reduces the chances of claim rejection and streamlines the process.   

Know What’s Not Covered

Before finalizing your health insurance plan, look for the policy’s exclusions and limitations. Take the time to read your insurance policy documents thoroughly. Being aware helps prevent surprises during claim settlement. 

Verify Eligibility

Make sure you gather all the patient's details accurately to confirm their eligibility for insurance claim. 

Check for Excluded Hospitals

It’s also important to be aware of the list of hospitals excluded from your policy’s coverage.  

Given the importance of a health insurance, it is highly imperative that our healthcare policy is always active because we never know when we might need it.  Hence, paying the health insurance premium on time is of utmost importance. 

With an absolutely simple and digitally friendly process at Digit, you can renew your health insurance in just a few simple steps:

Step 1: Visit the Renewals tab on our website or My Policy section in Digit App and login with your registered mobile number or your policy details. 

Step 2: Click on the Renew Option for the Policy which is Pending for Renewal.

Step 3: Review the plan details, verify and click 'Pay Now.'

Step 4: Make the payment and it's done!

OR

You receive regular communication from Digit to renew your health insurance policy a few days prior to the renewal. These communications come with a renewal link that you can use to directly make the payment and renew your policy.

To add or remove members from your Digit Health Insurance policy, follow these steps: 

• Contact Customer Support: Reach out to our customer support via the helpline or email to inform about your intention to add or remove a member.
  
• Submit Required Details: Provide necessary documents such as identity proof, relationship proof, and medical history of the member to be added or details like policy number and other information for the member to be removed.
  
• Fill Out Form and Pay for Member Addition: Complete the member addition form if applicable and pay the additional premium for the new member. 

Once processed, you will receive a confirmation.

One of the benefits of buying a health Insurance plan online is, that you have the chance and endless possibility to do your research and compare health Insurance plans online.

To make your decision-making process easier, here are a list of factors you should compare before buying the best health Insurance plan:

• Coverage Details: The whole point of a health Insurance is to get maximum coverage on healthcare expenses. Therefore, always compare the kind of coverage you will receive and compare the sum insured for. After all, that would be up to how much your health Insurance plan will cover you for. 
• Service Benefits: While different health Insurance plan will offer basic coverages, some will also go out of their way to take better care of you through some extra benefits. Therefore, compare the service benefits offered by different health Insurance providers and see what works best for you.
  
• Network of Hospitals: Every health Insurance provider has a network of hospitals you can visit and avail cashless claims from during times of need. However, to avail this benefit – it's important that you compare the range of hospitals available with your Insurance provider and go for one that suits you the best.
• Type of Claims: There are generally two types of claims in a health Insurance plan; Cashless and Reimbursement. In times of need, Cashless Claims prove to be a lot easier and beneficial. Therefore, compare health Insurance plans to see if they provide you the benefit of cashless claims or not, and to what extent.
• Health Insurance Premium: This goes without saying, doesn’t it? This is something you’ll probably do. However, make sure your premium is relevant to the health Insurance plan you choose. Don’t blindly get lured into cheap premiums, but always compare the coverage details against the premium and make a sound decision accordingly.

Considering the below factors will help you assess and choose the best health insurance plan in India. 

Coverage Benefits

To choose the right insurance plan, start by assessing your coverage needs and looking for plans that meet those requirements. Consider unique features such as maternity coverage if planning to have a child. Evaluate additional benefits like sum insured restoration, high no-claim bonuses, value-added benefits, and annual health check-ups. Opt for a plan with comprehensive coverage to minimize out-of-pocket expenses and ensure better financial security.

Premium Amount

Premium amount is a crucial factor to consider before choosing a plan. The higher the premium, the better the coverage. You should evaluate your monthly premium, deductible, and out-of-pocket costs and balance affordability with coverage. 

Waiting Periods

Many health insurance policies have an initial waiting period (usually 30 days) during which you cannot claim benefits for illnesses or treatments. Some policies may have waiting periods for specific conditions (e.g., pre-existing diseases, maternity, or specific surgeries). Consider these when evaluating a plan.

Ease of Claim Settlement

Research the insurer’s reputation for timely claim settlements. Read reviews and consider the insurer’s responsiveness and support. Higher ratios imply better reliability.

Customization Options

Look for plans that allow customization. Can you choose your sum insured, add riders (additional coverage), or tailor the plan to your specific needs? Customization ensures flexibility. 

Available Discounts

Some insurers offer discounts for various reasons, such as family floater policies, long-term policies, or if you maintain a healthy lifestyle (e.g., non-smoker discount). Explore available discounts to optimize your premium. 

Pre and Post Hospitalization Cover

Check if the plan covers expenses incurred before hospitalization such as diagnostic tests or consultations and for post-hospitalization expenses such as follow-up visits, medications, etc. 

Health Insurance buying tips for Youngsters

• Get an insurance early in life.
  
• Go in for a higher sum insured as it increases the amount you have in case of an Accidental Hospitalization. 5-10 lakhs should be fine.
• Make sure you have a Critical Illness Cover included.
• If you plan to have a family in the future, choose a Maternity Benefit so that your waiting period is over in time.

Health Insurance buying tips for Families

• Insure all members of the family.
• Go in for a high sum-insured as it is distributed between all family members, you can keep 10 lakh per person and calculate the sum insured.
• If you have a floater plan, go in for a plan with Restoration Benefit
• Check the waiting periods for all benefits being offered.
• If you’re planning to insure your parents, check if it has common treatments like Knee Replacement, Cataract Surgery covered.

Health Insurance buying tips for Seniors

• With age the insurance premium goes up. So, if you already have a plan, you can increase its sum insured with a top-up plan.
• Make sure you check the kind of hospital tie-ups and service tie-ups your insurer is providing you.
• Check if the plan you’re getting has common treatments like Knee Replacement, cataract surgery covered.
• Check the sub-limits of the benefits being offered.
• Check the waiting period mentioned for different pre-existing diseases.

Wondering why health insurance premiums differ? Based on a combination of various factors, your health insurance premium is defined by the following: 

Age: While health conditions are on a rise for both people young and old, younger people are still a lot healthier due to stronger immune systems. Additionally, the younger you are, the more time you have to complete your waiting period for specific illnesses and covers. Therefore, the younger you are, the lesser is your premium! 

Lifestyle: More than 61% of deaths in India are due to issues stemming from lifestyle diseases, including pollution levels! Therefore, your lifestyle habits such as if you’re a smoker or not will have an influence on your health Insurance premium. 

Pre-existing diseases or conditions : If you’ve already been facing symptoms of some kind, or have a family history of a particular illness, then your health Insurance premium will probably be higher due to the higher risk involved. 

Location: Your premium will be affected by the city you live in because every city is different, in terms of risks and medical costs. For example, people living in North India are a lot more prone to lung diseases, due to the high percentage of pollution. 

Additional Covers: One can customize their health Insurance plan based on their personal requirements and health conditions. Therefore, when you opt for additional covers like a Maternity Benefit or AYUSH benefit, your premium too increases by a small margin.

Calculate your health insurance premium online in 2 mins. Here’s how!

• Step 1: Login to your Digit account by entering your pin code and mobile number.
• Step 2: Provide details of your family members, including the age of the eldest, then click "Continue" to customize your plan by choosing your Sum Insured and Plan.
• Step 3: Review and apply any available discounts, enter your health habits, choose additional benefits, and complete the contact and member details.

Based on the options you have chosen; you will be provided with your annual premium payment amount to avail the health insurance cover.

• Life Stage: When the life-stage changes, you may need a higher sum insured. Say if you’re about to get married or are planning a kid. 
• No. of Dependents: Insuring all the members of the family under a Health Insurance policy is a wiser way to protect your family against future financial risks related to high medical costs. 
• Health Conditions: If there is a hereditary disease in the family or a common health condition seen rising in the city the person is staying, you should consider a higher sum insured. 
• Lifestyle: If you live in polluted metro cities, toiling with traffic and bearing office stress every day, you may be at a higher risk of falling ill. Which in turn means, you need to cover yourself better. 

• Don’t choose a low sum insured just to save on your premium. Always choose the right sum insured based on your age, your healthcare needs and number of people you’re covering in your health insurance policy.
  
• Always check for what is covered and not covered in your health insurance policy, and read through the terms and conditions so you’re not in for any surprises! We understand that reading it all can seem boring, that’s why we at Digit have created short summaries and simpler policy documents to make this process simpler for you!
• If you have the option to customize your health insurance plan, always do that. For example: You can customize your health insurance policy with different add-ons for better coverage.
• Don’t wait too long to buy a health insurance. Buy a health insurance early in life, this way you will have more reasonable premiums and also ensure you’re through waiting periods faster!
  
• A health insurance is a vital financial decision so always evaluate all your options online before going for the first option you see!

In 2021, when India’s population stood at 1.39 billion, nearly  514 million people across India were covered under health Insurance schemes. Out of these, 342.91 million (24.67%) were covered under government sponsored schemes, 118.7 million (8.53%) under employee health Insurance (excluding the state owned) and just 53.14 million (3.82%) were covered under individual health Insurance. [1]

However, the situation has been improving in recent years due to various initiatives by the government and Insurance companies.

The COVID-19 pandemic led to a significant  increase in awareness and demand for health Insurance in India. Many people who were previously uninsured have realized the importance of having health Insurance during a health crisis, leading to an increase in the number of policyholders.

As of now, there are 32 health Insurance companies operating in India comprised of government sector insurers, private insurers, and standalone health insurers.

To increase the penetration of health Insurance in India, the government and the Insurance Regulatory and Development Authority of India (IRDAI) have taken several measures to make health Insurance more accessible and understandable to customers.

Read about IRDAI’s mission of  Insurance for all by 2047.

Health insurance is an important investment that provides financial security in case of medical emergencies. Consider the below scenarios where you may want to reconsider not having health insurance:

1. My Employer is Taking Care of my Health Insurance; I do Not Need One

While it is great that your employer provides health insurance, it may not be sufficient. Employee health insurance may have limitations such as lower sum insured or coverage that may not be adequate for your needs.

Also, an employer health insurance covers you only during your job tenure. Once you switch jobs and if there is a break between the next employer coverage, you are left without any insurance coverage in that period.

Some companies do not provide health cover during probation period. Owing to these reasons, it is important to review your employer's health insurance policy and consider investing in a separate individual health insurance policy to supplement it.

2. I Feel my 5 lac Sum Insured is Sufficient to Cover Even Serious Illnesses if Such Day Arrives.

You might have a health insurance but with low sum insured. A low sum insured may not be sufficient to cover the medical expenses in case of serious illnesses-related hospitalizations. It is important to review your health insurance policy and consider increasing the sum insured based on your needs.

3. I am a Government Employee, Have Coverage for the Entire Family Under Government Scheme, I Don't Need an Extra Personal Health Cover

As a government employee, you might have health coverage under some specified health schemes, however, please note that such facilities are available only at a few selected medical centres, generally concentrated in major metro cities. Hence, it is suggested to have an additional personal health cover to battle emergency situations when the government facility might not be accessible.

4. I Just Needed a Basic Health Insurance Policy, So I Purchased One with a Low Premium and Limited Coverage. I Feel it's Just Fine.

You might choose to opt for a lower premium health insurance policy with limited coverage. While this may save money in the short term, it may not provide adequate coverage when needed. It is important to strike a balance between premium and coverage and choose a policy that provides adequate coverage for your needs.

5. I Have Saved Enough Tax Under Different Sections of IT and Hence, I don't Need Health Insurance for Saving Tax.

While health insurance can save additional taxes under Section 80D of the Income Tax Act, it should not be viewed only as a tax-saving tool. The primary function of Health insurance is to provide financial security and peace of mind in case of medical emergencies.

6. I am Young, Fit, and Fine. I do Not Need a Health Insurance Plan

While you may be young and healthy now, medical emergencies can occur unexpectedly. Having health insurance can provide financial security and help you cover the cost of medical treatments and hospitalization. Also, investing in health insurance at a young age can help you secure a lower premium and accumulate cumulative bonuses over time.

The right age and time to buy a health insurance is Now! 

Basically, you should buy yourself a health insurance as soon as you start earning.  

Buying a health insurance policy at an early age is a smart financial move. Here are some reasons why you should consider investing in a health insurance policy at an early age:

1. Lower Premium

One of the primary benefits of buying a health insurance policy at an early age is that the premium is significantly lower. This is because younger individuals are considered less risky and have a lower probability of making claims. So, my premium for a 1 Crore health cover might seem high but it would still be much lower compared to the higher age groups.

By investing in a health insurance policy early, you can lock in a lower premium and save money in the long run. 

2. No Waiting Period

Most health insurance policies come with a waiting period, which is the time during which you cannot make any claims. By investing in a health insurance policy at an early age, you can serve out the waiting period during your hale and healthy days and be covered when you need it the most.

3. No Pre-Medical Tests

Another benefit of investing in a health insurance policy at an early age is that you are less likely to require pre-medical tests. Most health insurance policies require pre-medical tests for individuals above a certain age or with pre-existing medical conditions. By investing in a health insurance policy at an early age, you can skip the pre-medical tests and avoid any complications.

4. More Likelihood of Accumulating Cumulative Bonus

Health insurance policies come with a cumulative bonus, which is the amount added to your sum insured for every claim-free year. When you are younger, you have lesser probabilities of falling ill and in turn, filing claim. Hence, higher probabilities of accumulating the cumulative bonus.

Choosing the right medical insurance plan can be a daunting task. Here are some guidelines to help you choose the right plan in different scenarios:

You are a Young, Healthy Youth in the Late 20s or Early 30s, Earning, and Have a Few Financial Responsibilities

In this scenario, you should consider a basic health insurance plan with a lower premium. You may not need extensive coverage or high sum insured at this stage, but it is important to have a safety net in case of any unexpected medical emergencies. You can also opt for a plan with a high deductible, which will lower your premium further.

You Already Have a Corporate Health Cover & do Not Wish to Spend too Much on Health Insurance

If you already have a corporate health cover, you may not need an extensive individual health insurance plan. However, it is still important to have a backup plan in case you lose your job or change jobs. You can opt for a health insurance plan with the basic as well as other better benefits that might be missing in your corporate policy and hence provides you with coverage when you need it.

You Have a Family to Take Care of and Want to Cover Spouse + Kids

In this scenario, you should consider a family floater health insurance plan that covers your spouse and children. Family floater plans are cost-effective and provide comprehensive coverage for your entire family. You can also opt for a plan with maternity benefits if you are planning to have children in the future.

You are Looking to Secure Your Parents

If you are looking to secure your parents' health, you should consider a senior citizen health insurance plan. Senior citizen plans provide coverage for medical expenses that are specific to the elderly population, such as age-related illnesses and chronic conditions. Some senior citizen plans also provide benefits like domiciliary treatment, Ayush benefit etc.

My Family Has a Critical Illness History, do I Need to Buy Any Additional Health Cover?

If your family has a history of critical illnesses, you should consider a critical illness health insurance plan. Critical illness plans provide coverage for illnesses such as cancer, heart attack, and stroke.

Health Insurance Covers for Only Serious Illnesses

Many people are under the impression that health Insurance plans cover for only serious and critical illnesses. However, that’s not true! A health Insurance plan covers for regular illnesses, accidents, psychiatric support, child-delivery and also basic annual health checkups!

“I Don’t Need a Health Insurance, Cause I’m Too Young for Illnesses”

Contrary to popular belief, no matter how old you are- you can be prone to illnesses both big and small. Especially, in the times we live in today- more and more younger people are being diagnosed with health conditions like PCOS, cancer and lung diseases due to our climate change driven lifestyles and unhealthy eating habits. 

Health Insurance Processes are Time Consuming

This honestly just depends on the kind of health Insurance plan you have, and your Insurance provider! Thanks to technology, the best health Insurance plans are now a lot quicker and hassle free!

If You Have Savings, a Health Insurance Isn’t Important

We’re so optimistic sometimes, aren’t we? While our savings can help us in time of need, the limit of the same can never be foreseen. The best health Insurance on the other hand, is a dedicated investment you make solely towards your health so you don’t need to shell out your savings or face any financial pressure in the future!