When considering budget health insurance plans, a ₹5 Lakh health insurance cover is the most basic one. It comes with affordable premiums and can cover a wide range of medical expenses. However, if you are planning to buy such a medical insurance plan, it is crucial that you know what a 5 Lakh health insurance plan covers and whether it will be applicable to your medical needs. 

Keep reading.  

What is a ₹5 Lakh Health Insurance Policy?

A ₹5 Lakh health insurance plan is a policy that offers coverage for medical expenses up to ₹5 Lakh within a year. It can be a good starting point for individuals who wish to gain coverage for unexpected medical expenses and opt for health insurance at a young age. However, for those seeking more comprehensive coverage, a health insurance 1 crore plan might be a more suitable option.

Now, the extent of coverage offered by such health plans will tend to vary based on the policy type and insurer. For instance, the Star Health Super Star plan offers comprehensive coverage, including in-patient hospitalization, pre-hospitalization, post-hospitalization, daycare treatment, dental checkups and more.

Benefits of the ₹5 Lakh Health Insurance Policy

A ₹5 Lakh health insurance plan offers several advantages:

• Provides coverage for unexpected illnesses or accidents, helping to manage emergency medical expenses.
• Many insurers offer cashless treatment at network hospitals, meaning you don’t need to pay out of pocket for medical care.
• Covers a variety of medical expenses, including in-patient hospital stays, outpatient procedures, and doctor visits.
• Premium payments qualify for tax deductions of up to ₹25,000 (₹50,000 for senior citizens) per financial year under Section 80D of the Income Tax Act.
• Additional tax deduction available of up to ₹5,000 for preventive health checkups.  
• Having health insurance gives you a sense of security, so you can focus on recovery without worrying about medical costs.

Additionally, the applicable ₹5 lakh health insurance premiums are usually on the lower side, serving as a cost-effective medical cover. However, the final premium amount will depend on factors like the holder’s age, health condition, and chosen add-ons (if any).  

Inclusion Under a ₹5 Lakh Health Insurance Plan

A health insurance 5 lakh cover provides financial compensation for the following:

• It covers medical costs for patients staying at least one night in the hospital.
• The plan generally includes medical expenses before and after hospital admission.
• It also covers medical procedures that don’t require an overnight stay.
• The insurer also pays for transportation from the accident site to the hospital or between hospitals.
• It even includes coverage for numerous medical tests, imaging and preventive health checkups.

Note – May tend to differ based on the policy type and insurance company. 

Exclusions in a ₹5 Lakh Health Insurance Plan

A ₹5 lakh health insurance plan does not cover the following treatments:

• Cosmetic surgery (e.g., recontouring or augmentation).
• Childbirth and pregnancy expenses (unless specified in the policy).
• Weight management or obesity treatments.
• Psychiatric care, including addiction treatment.
• Anti-HIV treatments.
• Infertility treatments.
• Self-inflicted injuries or attempted suicide.
• Claims from outside the insured geographic region.

Note – Exclusions can differ across policies and insurers. 

Steps to Buy a ₹5 Lakh Health Insurance Plan Online

Follow these simple steps to purchase a ₹5 lakh health insurance plan online:

• • Explore the various ₹5 Lakh health insurance policies from multiple providers. 

• Use an online ₹5 lakh health insurance premium calculator to get an idea of the premium and shortlist ones that align with your budget. 

• Select the policy that suits your requirements (individual or family floater) and choose ₹5 lakh coverage.
• Provide your full name, phone number, email, address, medical history and other required details.
• Check the plan’s details, premium cost, and terms and conditions.
• Complete payment via your preferred mode – debit card, credit card, or internet banking.
• After payment, you’ll receive a confirmation email with the policy document and details.
• Carefully read the policy’s coverage and exclusions before completing the payment.

Who Can Apply for a ₹5 Lakh Health Insurance Policy?

Here are the essential factors to consider when buying a ₹5 Lakh health insurance policy:

• Anyone over 18 years up to 75 years can buy coverage. The upper age limit tends to vary across providers. 
• The full disclosure of your medical history is necessary. You can inform the insurer about any pre-existing conditions, surgeries, or serious illnesses.
• After age 65, premiums are higher, and it becomes more difficult to get coverage. 

Documents Required to Buy a ₹5 Lakh Health Insurance

You’ll need the following documents to buy a ₹5 Lakh health insurance policy:

• Valid Passport
• Voter ID
• Permanent Driving License
• Aadhaar Card
• PAN Card
• Passport-sized Photos
• Income Proof (Bank Statements or ITR, if needed)

How to Make a Claim for Your ₹5 Lakh Health Insurance Policy Online?

Follow these simple steps to make an online claim:

1. Fill out the online claim form or contact customer support.
2. Upload necessary documents like medical bills and discharge summaries.
3. Then, the insurance team will assess your claim’s validity.
4. Once approved, the settlement process begins.
5. The claim amount will be transferred to your bank account or preferred method.

How to Choose the Best ₹5 Lakh Medical Insurance Policy?

Here are some tips for selecting the right ₹5 Lakh health insurance plan:

1. Ensure the insurer covers your preferred hospital in their network.
2. Read the policy to understand what is covered and what’s not.
3. Look for clauses on co-payment, room rent, or other limits.
4. Choose an insurer with an easy and fast claim settlement process.
5. If your budget allows, look for optional add-ons for extra coverage.
6. Select an insurer with a high claim-settlement ratio to improve your claim approval chances.
7. Check the waiting period for pre-existing diseases and see if it can be waived or reduced for an extra cost. 

A ₹5 Lakh health insurance policy provides solid coverage for common hospitalizations and treatments, helping you to manage medical emergencies without overwhelming your finances. 

In this regard, choosing the right insurer can let you avail of several benefits while keeping the premium amount within budget. For instance, apart from comprehensive coverage, the Super Star plan offers benefits like e-pharmacy services, wellness programs, telemedicine services, lab sample home pickups and more, starting at just ₹13/day. 

Check out our policies today and gain a safety net for your health and finances!