Types of Health Insurance Plans

Individual Health Insurance

An Individual Health Insurance provides coverage for a single person under the policy. The insured receives a dedicated sum insured that can be used for covered medical expenses such as hospitalisation, surgeries, daycare procedures, and other eligible treatments.

For example, if you have an Individual health policy with a sum insured of ₹3 lakhs, you can claim up to ₹3 lakh anytime when needed. You can also buy individual plans for your spouse and kids. In this case, each person covered will have a seperate sum insured of ₹3 lakhs.

Best suited for: Young professionals, self-employed individuals, and people who want exclusive health coverage.

Features of Individual Health Insurance:

• It covers a single individual
• The sum insured amount is separate for each individual
• It provides coverage for costs related to hospital stays brought on by illnesses or injuries, surgeries, daycare, hotel rental, etc.
• Individuals within the age above 18 years old can purchase this plan.

Family Floater Health Insurance

A Family Floater Health Insurance covers multiple family members under a single policy. Instead of having separate policies for each member, the entire family shares one common sum insured in health insurance.

A family floater health insurance plan is beneficial because the premium is comparatively lower than the individual health insurance policy. This policy can cover you, your spouse, your children, and your parents.

For example, if you have a family floater health insurance of ₹5 lakhs for yourself, your wife and parents, your whole family will share this amount.

Best suited for: Young families with spouses, children, and dependent parents.

Features of Family Floater Health Insurance:

• One health insurance plan covers every member of the family.
• Every individual will split the insured amount.
• It provides financial protection against medical procedures, hospital stays, therapies, daycare, etc.

Group Health Insurance

A Group Health Insurance policy is designed for employers, organisations, or associations to provide health coverage to their employees or members. The policyholder is typically the organisation, while the members receive insurance benefits under the group policy.

These plans often provide immediate coverage without extensive medical examinations and can help employees manage medical expenses at a lower cost. However, the coverage usually remains linked to the organisation and may end when a person leaves the group.

Best suited for: Employees in companies, members of associations, or organisations.

Features of Group Health Insurance:

• It provides health insurance for the employees and, in certain situations, their family members as well
• Generally, the basic coverage is free for the employee
• Value-added services like yearly examinations, online medical consultations, diagnostic exams, etc., might be provided
• Pre-existing illnesses are also covered without a waiting period in health insurance.
• No pre-medical tests are required before this coverage

Senior Citizens Health Insurance

Senior citizen health insurance is a type of health insurance designed for individuals aged 60 years and above. It helps cover medical expenses that become more common with age, including hospitalisation, surgeries, treatments for age-related illnesses, and other covered healthcare costs.

A Senior Citizen Policy will offer coverage for cost of medicines, hospitalisation arising out of accident or illness, pre and post hospitalization and treatment. Along with these, some other benefits, like Domiciliary Hospitalisation and psychiatric benefits, are also covered.

As per the IRDAI circular, dated 30th January 2025, insurers cannot increase premiums for senior citizen health insurance plans by more than 10% in a financial year without prior approval from the regulator. Also, there is no age limit for senior citizen health insurance which means any seniors can now buy a senior health policy at any age.

Best suited for: Individuals aged 60 years and above looking for dedicated health coverage in their retirement years.

Features of Senior Citizen's Health Insurance:

• It is ideal for senior individuals above 60 years of age.
• Since the likelihood of medical treatment and hospitalisation increases with age, premiums for these plans are higher compared to plans for younger individuals.
• It is available in different sum insured options to suit varying healthcare requirements and budgets.

Maternity Health Insurance

A Maternity cover in health insurance can be bought as a separate health insurance or as an add-on that helps cover medical expenses related to pregnancy and childbirth.

Newly married couples or families who are planning a baby in the coming years should buy this policy. It covers child-delivery (including medically necessary terminations), infertility expenses and coverage for the newborn baby up to its first 90 days. The maternity cover has a minimum waiting period of 2-4 years.

Best suited for: Couples planning to start a family.

Features of Maternity Health Insurance:

• It pays for costs associated with the prenatal, postnatal, and delivery of the child.
• Some policies may cover the newborn for a predetermined amount of time.
• Maternity benefits are typically available only after completing the waiting period specified in the policy.

Disclaimer: Currently, at Digit, we are not offering any Maternity coverage with our Health Insurance.

Critical Illness Health Insurance

Critical illness insurance provides a lump-sum payout if the insured is diagnosed with a covered critical illness mentioned in the policy. Common covered conditions may include cancer, heart attack, stroke, major organ failure, paralysis, and other serious illnesses.

Unlike a regular health insurance policy that reimburses hospital expenses or settles bills directly, a critical illness plan pays a fixed benefit amount once the claim conditions are met. The amount can be used for treatment, recovery expenses, household costs, loan repayments, or income replacement.

It will be wise to buy this policy if you have had a family history of some diseases. Other than the lump sum amount, a critical illness policy reimburses you the cost of care and hospitalization expenses. You can also avail the benefits of complementary health check-ups.

Best suited for: Individuals with a medical history or those seeking extensive protection.

Features of Critical Illness Health Insurance:

• Many people purchase critical illness insurance as an additional layer of protection alongside
• Many critical illness policies include a survival period, which means the insured must survive for at least 30, or 60 days, depending on the policy
• Coverage is provided if you are experiencing this covered surgical operation or critical illness for the first time in your life

Super Top Up Health Insurance

Super top-up health insurance is a health insurance plan that provides additional coverage once a specified deductible amount is crossed during a policy year. It is designed to enhance your existing health insurance coverage and protect you from large medical expenses without significantly increasing your premium.

For example, if you have taken a cover for ₹15 lakhs and it has a deductible of ₹3 lakhs, then you will have to bear claim up to ₹3 lakhs out of your pocket. The amount over and above this will be paid by the insurer.

Best suited for: Individuals with limited employer health coverage.

Features of Super Top-Up Health Insurance:

• It provides an option for a higher sum covered amount beyond the basic plan
• It supplements your existing plan, ensuring you are covered when the hospital bills are high
• This policy only becomes active after you have paid a set deductible under this plan