dociya

Health Insurance / Mediclaim (India)

IRDAI-regulated policy covering hospitalization, cashless at network hospitals or by reimbursement. Typically annual, renewable for life, with tapering waiting periods.

Do it on the official site

IRDAI-licensed health/general insurers (private + public) — irdai.gov.in, policyholder.gov.in

Fees

Premiums vary by age/city/sum insured/history/family size — always get a quote. Ayushman Bharat/PM-JAY gives free cover for eligible low-income families; private premiums qualify for Sec 80D deduction.

Processing time

Cashless pre-auth often within hours during the stay; reimbursement per IRDAI timelines; portability around renewal once filed ≥45 days prior

How long it lasts

Usually 1-year term, lifelong renewable

What to know first

  • Waiting periods: 30-day initial (accidents excluded); specific ailments up to 36 months; pre-existing disease (PED) up to 36 months (2024 Master Circular).
  • Moratorium: after 60 continuous months, the insurer can't contest a claim for non-disclosure (except proven fraud).
  • Portability preserves credits (waiting period, sum insured, NCB) — apply ≥45 days before renewal.
  • Keep renewals continuous; a break resets credits.

How to do it

  1. 1Buy: compare plans → disclose all pre-existing conditions honestly → pre-policy medical if required → pay → receive policy + network-hospital list.
  2. 2Renew: pay before the due date to keep continuity.
  3. 3Port: write to current insurer ≥45 days before renewal naming the new insurer → fill the new insurer's proposal + portability form → underwriting with waiting-period credit.
  4. 4Claim: cashless (pre-auth at network hospital) or reimbursement (pay then claim with bills + discharge summary).

What you need to bring

  • Proposal form + KYC (Aadhaar/PAN); age proof + photo; medical history + pre-policy reports if required. Portability: existing policy, renewal notice, claim history. Cashless: health/ID card + pre-auth. Reimbursement: original bills, discharge summary, prescriptions, claim form.

In person

Nearest cashless network (empanelled) hospital finder

Questions people ask

Cashless vs reimbursement?
Cashless — insurer settles directly with a network hospital; reimbursement — you pay then claim.
Waiting periods?
30 days initial; specific ailments & PED up to 36 months.
Lose benefits if I switch insurers?
No — portability transfers credits; apply ≥45 days before renewal.

Documents that travel with it

Sources

  • irdai.gov.in/health-dept; policyholder.gov.in/portability; IRDAI Master Circular 29-05-2024 (accessed 2026-06-26)