Health Insurance - Buy Medical Insurance Plans with Easy Claims
Written by
Roocha Pradhan
Content Writer | AuthorReviewed by
Zeeshan Ali
Lead - Product Development | ReviewerWhat is health insurance?
Health insurance is a financial safety net that helps you cover the cost of medical treatment and healthcare services in exchange of premiums. By covering high medical costs of hospitalisation and emergencies, health insurance lets you seek the care you need without financial hesitation.
Health insurance is one of the simplest ways to take care of both your health and your finances. It helps cover a range of medical expenses, from hospitalisation and surgeries to diagnostic tests and specialised treatments, so you can access the treatment that you need without worrying about the cost. Health insurance is about being prepared and making informed choices for your future. It provides the confidence to prioritise your health, seek quality medical care when needed, and focus on living life with greater peace of mind. Why is buying health insurance an absolute necessity? Because emergencies cannot be predicted, they happen whether you are building your career, supporting loved ones, or enjoying a slower pace of life, buying health insurance protects what matters most, you and y...
Types of Health Insurance Plans
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Why choose us?
We combine decades of experience with a customer-first approach to offer reliable, adaptable, and innovative solutions. Our focus is on providing support that meets your needs at every stage of life.
Our total health approach
We strive to deliver seamless experience by alleviating customer anxieties and building journeys that truly empathize with the customer.
Our end-to-end assurance
We aim to build customised transformative solutions that address the ever-evolving health insurance needs of Indian customers powered by innovation and technology.
Our human touch
We plan to invest in developing capable, service-driven teams across our ecosystem - from employees to agents and partners, ensuring every customer interaction reflects respect, transparency, and simplicity.
Health insurance at a glance!
Medical insurance can be better understood by breaking it down into specific features that define coverage, cost, and overall value. The parameters below are commonly used by insurers and customers alike to compare, evaluate, and classify health insurance plans available in the market.
| Features | Description |
|---|---|
Sum Insured | Up to 2 Crores |
Network Hospitals | 12,000+ Across India |
Pre- Hospitalisation Expenses | Covered |
Post- Hospitalisation Expenses | Covered |
Cashless Claim settlement | Covered |
Reimbursement Claim Process | Available |
Pre-existing disease coverage | Available on completion of applicable waiting period |
Daycare procedure coverage | Covered |
Compare our top health plans
The plans have been designed for your growing family’s needs
| Plan Type | PRUHealth Edge | PRUHealth Signature |
|---|---|---|
Sum Insured | Cover options from ₹5 Lakh to ₹1 Cr | Cover options from ₹5 Lakh to ₹2 Crs |
Room Accommodation | Stay in any room type (except suite) | Stay in any room type (except suite) |
Day Care Treatment | Covered up to your sum insured | Covered up to your sum insured |
Pre-Hospitalisation Medical Expenses | 60 Days Cover Available | 90 Days Cover Available |
Post-Hospitalisation Medical Expenses | 180 Days Cover Available | 180 Days Cover Available |
Road Ambulance | Covered | Covered |
AYUSH Treatment | Covered up to your sum insured. | Covered up to your sum insured. |
Restoration Benefits | Your sum insured can restore 100% unlimited times from the 2nd claim | 2X protection from day 1 |
What health insurance covers, and what it doesn't.
A health insurance policy supports you through both planned and unexpected healthcare needs, covering hospital stays, recovery expenses, consultations, wellness benefits, and ongoing care. Understanding the base covers helps you know the support you can rely on when it matters most, while certain expenses such as self-harm related injuries, cosmetic procedures, and dental treatments (unless medically necessary) are excluded. Below is a detailed list of health insurance inclusions and exclusions.
Prudential Health Check-up
Get age and gender customised health check-ups that support preventive care, followed by a doctor consultation to help you understand your reports and take the right steps for your wellbeing.
In-Patient Care
Covers medical expenses when you need to be admitted to a hospital for treatment, surgery, illness, or an accident, so you can focus on recovery instead of worrying about hospital bills.
Room Rent
Covers the cost of any hospital room type, except suite. This gives you the flexibility to recover comfortably while keeping your hospital expenses clear.
ICU Care
Covers intensive care expenses if you need close medical monitoring or critical support during hospitalisation.
Unlimited Restoration
Refills your sum insured unlimited number of times, helping you stay protected for future claims in the same year.
Loyalty Addition
Rewards you for staying continuously insured by increasing your coverage on renewal, giving you added protection over time.
Domiciliary Hospitalisation
Covers hospital-level treatment taken at home in specific situations, such as when the patient cannot be moved or hospital beds are unavailable.
Pre-hospitalisation Medical Expenses
Covers medical expenses 60-90 days before hospital admission, such as consultations, diagnostic tests, and medicines linked to the same treatment.
Post-hospitalisation Medical Expenses
Covers follow-up expenses after discharge for 180 days, so your recovery can continue with the right medical support even after you leave the hospital.
AYUSH Cover
Covers inpatient treatment under recognised systems such as Ayurveda, Yoga, Unani, Siddha, and Homeopathy at approved facilities.
Road Ambulance Cover
Covers road ambulance expenses in an emergency, so you can reach the hospital safely and without delay.
Prudential Healthy Discount
Rewards healthy habits by offering a discount based on eligible healthy days, encouraging you to stay active while helping reduce renewal costs.
Mind Care Consultation
Gives you access to professional support for your mental wellbeing, because emotional health deserves care and attention too.
Upgrade Your Health Insurance with Smart Add-on Covers
Child Protect
Helps your child’s health cover continue if an unforeseen event affects the parent. In case of accidental death or critical illness of the parent, the child’s base premium is waived for up to 5 renewal years or until the child turns 18.
Pre-Post ExpressPay
Gives you quick support for expenses around hospitalisation without separate bills or extra paperwork. You get 10% of your approved inpatient claim amount, up to ₹25,000, to help cover pre and post-hospitalisation expenses.
Hospital Essentials Cover
Helps cover eligible non-medical expenses incurred during treatment, reducing out-of-pocket expenses.
Cashless OPD
Covers outpatient expenses such as doctor consultations, diagnostic tests, and prescribed medicines within the Prudential network.
Restoration Plus
2X Protection from Day 1. Refills your sum insured unlimited number of times from the 1st claim onwards.
Prudential Select Network
You can lower your premium by choosing treatment within the Prudential Select Network. This option gives you a 15% premium discount, while a 20% co-payment applies on every claim if treatment is taken outside Prudential Select Network hospitals.
Annual Aggregate Deductible
Choose an annual deductible between ₹25,000 and ₹5 lakh per policy year, based on what you are comfortable with, to help lower your premium.
Cancer Guard
Get an additional sum insured equal to your base sum insured for inpatient cancer treatment, giving you extra support for specialized care.
Co-payment
Offers flexibility to lower premiums by selecting suitable co-payment levels.
Chronic Care QuickStart
Shortens the waiting period for listed chronic conditions to just 30 days.
Chronic Management Program
Managing a chronic condition becomes easier when the right support is within reach. This cover gives you cashless access to doctor consultations, diagnostic tests, and ongoing support through a partner network for the chronic conditions selected by you.
Loyalty Addition Plus
On renewal, your cover increases by 100% of the base sum insured every year, up to 500%, so you continue to have higher coverage at the same cost.
Personal Accident Cover
Offers added financial support if an accident leads to accidental death or specified disability. The fixed benefit amount is paid as per the policy schedule, helping you and your family feel more financially prepared for unexpected situations.
Prudential Healthy Discount
Your daily effort to stay active can reward you at renewal. Insured members aged 18 and above can earn up to 35% discount on renewal premium based on the number of healthy days completed during the policy year.
Critical Illness Cover
Receive a lump sum payout upon diagnosis of a covered critical illness, with coverage options ranging from ₹10 lakh to ₹1 crore.
Room Rent Flexibility
Select a lower room category to reduce your premium costs.
Why Do You Need a Medical Insurance Plan at Every Stage of Life?
Health insurance provides financial protection against rising healthcare costs, helps preserve your savings, and ensures timely access to quality medical care when you need it most.
Kabeer is focused on building his future and staying independent. Being young and healthy helps him get a lower premium on health insurance early, without waiting period worries later in life. It also starts with his loyalty benefits, while financially protecting him from accidents or unexpected health issues.
Neha manages work, home, and the needs of her children. She has one family health insurance policy, and she knows everyone is covered under that one policy, which gives her peace of mind. No multiple premiums to deal with, and can trust her health plan for consistent, comprehensive coverage when it counts.
Meera is thinking ahead as her health needs begin to change. Comprehensive insurance keeps her on the front foot as lifestyle conditions become more common. Regular health check-ups and access to specialist care mean she can protect his savings and keep her long-term financial plans on track.
Ajay values comfort and reassurance in his golden years. Stress-free, frequent medical needs are handled by a specialised senior citizen health insurance plan. With coverage for chronic conditions and geriatric care, he can focus on living well, knowing that quality healthcare is always available.
Your Age v/s
Health Cover
If you’re 18 or 75, we’ve got you covered
Your Age
18 years
18
80
When you are in your Teens
Health insurance helps you start building financial protection early. It can cover unexpected medical expenses, provide access to quality healthcare, and help you lock in coverage before health needs and premiums increase over time.
Key Benefits of
Prudential Health Insurance Plans
Below are the key benefits of Prudential Health Insurance plans, designed to support your healthcare needs while offering strong financial protection at every stage of life.
Cashless Treatment at Network Hospitals
With cashless treatment, you can focus on recovery instead of finances. Your medical bills are settled directly at network hospitals, eliminating the need for upfront payments and ensuring stress-free access to quality healthcare during emergencies.
Covers Pre & Post Hospitalization Expenses
This benefit covers medical costs incurred before admission and after discharge from the hospital, such as diagnostic tests, medicines, and follow-up consultations, ensuring your treatment is fully supported beyond just the hospital stay.
How Health Insurance Helps You Save Tax with 0% GST
Health insurance premiums were subject to GST, which increased the overall amount payable.
Higher out-of-pocket expenses for the same level of coverage
Tax savings were limited only to deductions under Section 80D
Premium affordability was lower due to the added tax burden
Impact was more pronounced on family and senior citizen policies
No GST on eligible health insurance premiums, reducing the overall cost
Lower out-of-pocket expense for the same coverage
Tax savings through Section 80D (Section 126) continue, along with GST savings
Premium affordability improves due to the removal of GST
Greater savings for family and senior citizen policies
How Health Insurance Helps You Save Tax with 0% GST
Health insurance premiums were subject to GST, which increased the overall amount payable.
No GST on eligible health insurance premiums, reducing the overall cost
Higher out-of-pocket expenses for the same level of coverage
Lower out-of-pocket expense for the same coverage
Tax savings were limited only to deductions under Section 80D
Tax savings through Section 80D (Section 126) continue, along with GST savings
Premium affordability was lower due to the added tax burden
Premium affordability improves due to the removal of GST
Impact was more pronounced on family and senior citizen policies
Greater savings for family and senior citizen policies
Important Factors to Consider Before Buying Health Insurance
Decide the Right Sum Insured
Healthcare needs can change over time, so it is worth choosing a cover that feels comfortable for you today and tomorrow. A higher sum insured can give you added confidence if you ever need major treatment.
Check Network Hospitals Near You
It helps to know that quality care is close to home. Look for a plan that offers cashless treatment at trusted hospitals in your area, so support is easily accessible when you need it.
Understand Waiting Periods
Every policy comes with certain waiting periods, especially for pre-existing conditions. Taking a moment to understand these helps you plan better and know when your coverage becomes fully effective.
Compare Inclusions & Exclusions
Not all plans are the same, and that is okay. Exploring what is included helps you choose a plan that aligns with your preferences and needs.
Look at Room Rent Limits & Sub-limits
Comfort matters during recovery. Choosing a plan with flexible room options can help you focus on getting better without worrying about restrictions.
Check Claim Process & Support
A smooth, simple claims experience can make all the difference. Look for insurers known for easy processes and responsive support, so you feel guided every step of the way.
Balance Premium vs Coverage
It’s about finding what works best for you. The right plan offers a thoughtful balance between affordability and meaningful coverage, giving you peace of mind without stretching your budget.
Don’t Forget Add-on Covers
Life evolves, and your insurance can too. Add-ons like maternity or critical illness cover let you tailor your plan to your unique life stage and priorities.
Decide the Right Sum Insured
Healthcare needs can change over time, so it is worth choosing a cover that feels comfortable for you today and tomorrow. A higher sum insured can give you added confidence if you ever need major treatment.
Check Network Hospitals Near You
It helps to know that quality care is close to home. Look for a plan that offers cashless treatment at trusted hospitals in your area, so support is easily accessible when you need it.
Understand Waiting Periods
Every policy comes with certain waiting periods, especially for pre-existing conditions. Taking a moment to understand these helps you plan better and know when your coverage becomes fully effective.
Compare Inclusions & Exclusions
Not all plans are the same, and that is okay. Exploring what is included helps you choose a plan that aligns with your preferences and needs.
Look at Room Rent Limits & Sub-limits
Comfort matters during recovery. Choosing a plan with flexible room options can help you focus on getting better without worrying about restrictions.
Check Claim Process & Support
A smooth, simple claims experience can make all the difference. Look for insurers known for easy processes and responsive support, so you feel guided every step of the way.
Balance Premium vs Coverage
It’s about finding what works best for you. The right plan offers a thoughtful balance between affordability and meaningful coverage, giving you peace of mind without stretching your budget.
Don’t Forget Add-on Covers
Life evolves, and your insurance can too. Add-ons like maternity or critical illness cover let you tailor your plan to your unique life stage and priorities.
Eligibility Criteria for
Prudential Health Insurance Plans
Eligibility criteria for Prudential Health Insurance plans define who can purchase our policy and the applicable age or coverage conditions. This helps you make a confident, informed choice, so you can focus on what matters most: your health and peace of mind. It also ensures a smooth, trouble-free experience when filing a claim later.
Age Criteria
Adults can be covered from a minimum age of 18 years. Babies from 91 days (about 3 months) onward can be included under a family floater plan, allowing you to cover your entire family under a single policy from the start. Under a family floater, a dependent child can typically be covered up to the age of 25 years, after which they would need to move to an individual policy.
Medical History Disclosure
Being open about your health history helps ensure your policy truly works for you. It allows Prudential Health India to offer a plan that is suited to your needs and keeps things smooth and transparent whenever you need to make a claim.
Health Check-ups
In some cases, a simple health check-up may be required. Think of it as a helpful step to understand your current health better, so you can get a plan that is fair, balanced, and tailored to you.
Residency Status
Our health insurance plans are created for residents of India, making it easier for you to access healthcare services, manage your policy, and receive claims support whenever required. This helps ensure a smooth and hassle-free experience throughout your coverage journey.
How to File a health insurance claim ?
Health insurance claims are designed to ease your financial burden during medical emergencies. With digital processes and wider hospital networks, filing a claim today is quicker and more transparent than ever. Here’s a simple breakdown of the different types of health insurance claims and the step-by-step process for each.
Documents required for health insurance claim reimbursement
Documents required for health insurance claim reimbursement include the claim form, hospital bills, medical reports, discharge summary, and other supporting records to ensure smooth and timely claim processing.
Duly Filled Claim Form
This is the starting point of your claim process. Sharing accurate personal, policy, and treatment details helps us review your claim faster and keep everything on track.
Hospital Bills and Receipts
Clear, itemised hospital bills and payment receipts are important for understanding your expenses. These should include details like room charges, procedures, medicines, and diagnostics so we can ensure a transparent and accurate assessment.
Medical Reports and Prescriptions
Prescriptions and medical reports explain the treatment you received and why it was needed. Issued on the doctor’s or hospital’s letterhead, they help us connect your diagnosis and treatment with your policy coverage.
Discharge Summary
Your discharge summary gives a complete overview of your hospital stay from admission details and diagnosis to treatment provided and recovery status. It helps us review your claim with clarity and context.
Diagnostic Test Results
Test reports such as blood work, radiology scans, and imaging support your diagnosis and treatment details. When submitted along with prescriptions, they make the evaluation process smoother and quicker.
Identity and Policy Details
A valid government-issued ID, your health insurance card, and correct bank details help us verify your information and ensure the approved claim amount is credited securely to your account.
Why buy health insurance online
Buying health insurance online lets you easily compare multiple plans, explore options at your own pace, and choose what truly fits your needs, often at better value. Here are the details.
Easy Comparison
Online platforms make it easy to review multiple plans in one place. You can compare coverage, hospital networks, and claim support across insurers, helping you make a confident decision without any pressure.
Transparency
Everything you need to know is clearly available upfront. From coverage details to waiting periods and exclusions, you can go through the policy at your own pace and feel assured about what you are choosing.
Instant & Hassle-Free Process
No paperwork or visits are required. Just fill in your details, make a secure payment, and receive your policy documents instantly in your inbox, quick, simple, and convenient.
Instant Quote & Flexibility
With online calculators, you can see your premium instantly. Adjust coverage, add benefits, and understand the impact on cost in real time, so you can choose a plan that feels just right for you.
Easy Comparison
Online platforms make it easy to review multiple plans in one place. You can compare coverage, hospital networks, and claim support across insurers, helping you make a confident decision without any pressure.
Transparency
Everything you need to know is clearly available upfront. From coverage details to waiting periods and exclusions, you can go through the policy at your own pace and feel assured about what you are choosing.
Instant & Hassle-Free Process
No paperwork or visits are required. Just fill in your details, make a secure payment, and receive your policy documents instantly in your inbox, quick, simple, and convenient.
Instant Quote & Flexibility
With online calculators, you can see your premium instantly. Adjust coverage, add benefits, and understand the impact on cost in real time, so you can choose a plan that feels just right for you.
What is the waiting period in health insurance?
Waiting periods in Health Insurance is the time when you cannot make a claim against certain conditions. It helps you know when different parts of your coverage become available, so you can plan with clarity and feel confident about your policy. Most health insurance plans in India follow a few standard timelines to keep coverage fair and premiums affordable for everyone.
PHI: Your ally in achieving better health
Lifestyle and Habits
Your everyday choices matter to insurers. Smoking or frequent drinking increases health risks and insurance costs. Sameer, a non-smoker, and Karan, a smoker, applied for the same plan. Because of tobacco-related risks, Karan ended up paying about 15% more.
Choose the Right Sum Insured
It helps to pick a cover that fits your needs based on your family size and city. The goal is to find a balance where you feel adequately covered without paying for more than you actually need.
Buy Health Insurance at a Younger Age
Starting early can make a big difference. Premiums are usually lower when you are younger, helping you secure good coverage at a more comfortable cost for the long term.
Avoid Unnecessary Add-on Covers
Add-ons are useful, but it is best to choose only what truly fits your current needs. Selecting relevant covers like maternity or critical illness helps you keep your premium efficient and purposeful.
Maintain a Healthy Lifestyle
Many insurers reward healthy habits. Staying active can earn you wellness benefits or renewal discounts, helping lower your premium while supporting your overall well-being.
Choose the Right Sum Insured
It helps to pick a cover that fits your needs based on your family size and city. The goal is to find a balance where you feel adequately covered without paying for more than you actually need.
Buy Health Insurance at a Younger Age
Starting early can make a big difference. Premiums are usually lower when you are younger, helping you secure good coverage at a more comfortable cost for the long term.
Avoid Unnecessary Add-on Covers
Add-ons are useful, but it is best to choose only what truly fits your current needs. Selecting relevant covers like maternity or critical illness helps you keep your premium efficient and purposeful.
Maintain a Healthy Lifestyle
Many insurers reward healthy habits. Staying active can earn you wellness benefits or renewal discounts, helping lower your premium while supporting your overall well-being.
Choose Family Floater Instead of Separate Policies
A family floater plan can be a practical option, allowing all members to share a single sum insured. This often works out more cost-effective than maintaining multiple individual policies.
Compare Plans Before Buying or Renewing
Taking a few minutes to compare plans online helps you find the right mix of prices and benefits. It ensures you choose a plan that truly aligns with your expectations.
Use No Claim Bonus to Increase Cover
Renewals come with rewards. Your insurer may increase your sum insured at no extra cost, helping you build stronger coverage over time without raising your premium.
How to Reduce Your Health Insurance Premium
Reducing your health insurance premium is possible with the right choices that help you optimise costs without compromising coverage.
Common Reasons Why
You Should Not Delay Buying Health Insurance
Reducing your health insurance premium is possible with the right choices that help you optimise costs without compromising coverage.
“I’m Young and Healthy, I Don’t Need Insurance”
When you are feeling fit and active, health insurance may not seem urgent. However, starting early can actually work in your favour as premiums are lower, and you also get more time to complete waiting periods while you are healthy, so your coverage is fully ready whenever you need it.
“Health Insurance Is Too Expensive”
It is easy to look at premiums as an added expense, but many plans today are designed to be more affordable. With 0% GST on individual health insurance, costs have become more accessible, and you can choose plans that fit your budget while still offering meaningful coverage over time.
“My Company Insurance Is Enough”
Corporate insurance provided by your Employer is a great benefit, but having your own plan adds an extra layer of comfort. A personal policy stays with you through job changes and different life stages, helping you maintain continuity in your coverage.
“I’m Young and Healthy, I Don’t Need Insurance”
When you are feeling fit and active, health insurance may not seem urgent. However, starting early can actually work in your favour as premiums are lower, and you also get more time to complete waiting periods while you are healthy, so your coverage is fully ready whenever you need it.
“Health Insurance Is Too Expensive”
It is easy to look at premiums as an added expense, but many plans today are designed to be more affordable. With 0% GST on individual health insurance, costs have become more accessible, and you can choose plans that fit your budget while still offering meaningful coverage over time.
“My Company Insurance Is Enough”
Corporate insurance provided by your Employer is a great benefit, but having your own plan adds an extra layer of comfort. A personal policy stays with you through job changes and different life stages, helping you maintain continuity in your coverage.
“I Will Rely on My Savings for Emergencies”
Savings are important, and health insurance helps you protect them. Instead of using your savings for medical expenses, insurance can support those costs, allowing you to keep your financial plans on track.
“The Process Is Too Complicated”
It used to feel that way but today buying health insurance is much simpler. You can explore, compare, and purchase plans online in just a few minutes, with clear, easy-to-understand information to guide your decision.
Key Health Insurance Terms You Should Know
Health insurance comes with several commonly used terms that can feel confusing at first. This glossary simplifies those terms so you can clearly understand your policy and make informed decisions.
Our Network
Access to the right care, close to home, can make all the difference. Whether it is planned care or an unexpected visit, Prudential Health India’s wide network of hospitals helps make the experience smoother with cashless treatment options, so you can focus on getting better while we take care of the process.
12,000+
Hospitals
Common Myths About
Health Insurance
Mediclaim only covers hospitalisation.
My employer’s group insurance is enough.
I’m fit and healthy, so I don’t need insurance.
Common Myths About
Health Insurance
Mediclaim vs Health Insurance: What’s the Difference?
Frequently Asked
Questions
