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As an insurtech startup in India, Plum understands that navigating the world of health insurance can be daunting. In this blog post, we will break down the basics of how health insurance works in India.

Types of Health Insurance Plans

Health insurance plans in India can be broadly categorized into two types: individual plans and family floater plans. Individual plans cover a single individual, while family floater plans provide coverage for the entire family under a single policy.

Within these two categories, there are a variety of plans to choose from. Some plans offer basic coverage for hospitalization expenses, while others offer additional benefits such as maternity coverage, critical illness coverage, and more.

Coverage and Benefits

To funny understand how health insurance works, we need to understand the coverage and benefits.

Health insurance plans in India typically cover hospitalization expenses such as room rent, doctor's fees, surgical expenses, and more. However, the extent of coverage may vary depending on the plan and the insurance provider.

In addition to hospitalization expenses, many health insurance plans also provide coverage for pre- and post-hospitalization expenses, ambulance charges, and day care procedures. Some plans also offer add-on benefits such as wellness benefits, second medical opinion, and more.

Costs of Health Insurance

The cost of health insurance in India varies depending on a number of factors, including age, health condition, type of plan, and coverage amount. Generally, family floater plans tend to be more expensive than individual plans due to the higher coverage amount.

It is important to note that health insurance premiums may increase over time, especially as you age or if you develop pre-existing conditions. However, many insurance providers offer no-claim bonuses and other benefits that can help reduce the cost of insurance.

Making a Claim

The most important part of understanding how health insurance works is the claims process.

In the event that you require medical treatment, you can make a claim on your health insurance policy. To do so, you will typically need to submit a claim form along with any relevant documents such as hospital bills, doctor's prescriptions, and more.

Once your claim is approved, the insurance provider will typically reimburse you for the amount of expenses covered under your policy. It is important to carefully review the terms and conditions of your policy to understand the claims process and any restrictions or limitations.


In conclusion, health insurance can provide much-needed financial support in the event of a medical emergency. By understanding the basics of how health insurance works in India, you can make an informed decision when choosing a plan that meets your needs and budget.