Top Features To Look For In A Modern Health Insurance Plan

Telemedicine and virtual care

A modern health insurance plan should have provisions for virtual care. The COVID-19 pandemic pushed telemedicine into the forefront in India, where traditionally in-person consultations were the norm. People have realised how convenient telemedicine is in terms of avoiding crowded healthcare spaces with long queues and even longer wait times. It can also be helpful for elderly parents who need routine consultations but aren’t up for the travel, and for those who live in remote locations.

Preventive care

"Prevention is better than cure" is a mantra that you must take seriously, especially when it comes to a health insurance plan. Most health insurance plans offer preventive health checkups and screenings free of cost to their policyholders. Ensure that the plan you chose has this feature, as preventing a disease from taking root is the easier route to take. It leads to better outcomes with less intervention. And it is also financially beneficial, as treating a disease in its later stages costs more, not to mention the emotional toll it takes.

Wellness incentives

Check if your health insurance provider has tangible wellness incentives when you meet certain health goals. This could be in the form of discounts on health insurance premiums or reimbursements for your gym membership and yoga classes. It can be a great way to save money and maintain your good health.

Cashless claims

Cashless claims can make your life very easy. It reduces the burden of out-of-pocket healthcare spending immensely, especially during an emergency. Your out-of-pocket expenses come down drastically with cashless claims, as most of the medical bill is settled directly between the insurer and the network hospital. This leaves you with a minimal amount as an out-of-pocket expense. Ensure that the insurance provider has a large number of network hospitals where the cashless claims feature can be availed with ease.

Mental health

There was a time when health insurers did not provide coverage for mental illness. However, this is no longer the case. Look for insurers that offer mental health coverage as part of their health insurance policy. Check what is covered through them and know the exclusions.

Flexibility and portability

A health insurance plan should be flexible and should allow you to customise it to your needs. For example, adding a new dependent to your family health insurance plan should be easy. Another way to customise your plan would be to upgrade your coverage as and when required. If you are unhappy with your policy, you should be able to port your plan to another insurer without having to lose the benefits you have accrued over the policy period.

International coverage

If you are someone who travels abroad often for work or leisure, a health insurance plan that extends coverage globally can be very beneficial. This feature can come in the form of an add-on. You can opt for this coverage if it seems worth it to you and you don’t plan on getting a travel insurance policy every time you need to travel.

Comprehensive coverage

This is an oldie but a goodie, even when it comes to a modern health insurance plan. This is because all the bells and whistles that your insurer offers would mean nothing if your health insurance plan does not offer comprehensive coverage. It should cover a wide range of medical services, including hospitalisation, pre- and post-hospitalisation expenses, pre-existing conditions, critical illnesses, emergency care, day care treatments, and medication. If these basics aren’t covered to your satisfaction, then the health insurance plan will not serve your needs.

Conclusion

A health insurance plan should step up and meet your health crisis head-on during your hour of need. Ensure that you don’t get swayed by features that look good on paper but won’t translate into any tangible benefits in real life. Use aggregators to compare benefits and pick a plan that offers you good benefits for the money you are paying. Beware of inclusions and exclusions, and don't forget to read the policy document carefully.

Frequently asked questions

Are the features that health insurers offer free of cost?

Some of the features that health insurers offer can be free of cost, while others may be chargeable. For example, an annual preventive health checkup will be free of cost. Add-ons and riders are chargeable and will increase your premium. Read the policy document carefully or talk to the insurance provider to ensure you get these details right.

Which is the best health insurance company in India?

There’s no single answer that fits everyone. The “best” health insurance company depends on what you prioritise: wide hospital networks, transparent pricing, strong customer support, or a simple digital experience. Established insurers like HDFC ERGO, ICICI Lombard, and Care Health offer comprehensive plans that many families trust. At the same time, ACKO Health Insurance has been gaining attention for its no-hidden-cost plans, hassle-free digital journey, and customer-friendly features like quick claims and app-based support, making it a strong choice for today’s digital-first buyers.

What to look for in a health insurance plan?

The most important aspects to look for in a health insurance plan are coverage, inclusions, exclusions, terms and conditions, waiting periods, sub-limits, benefits and features, claims process, and claims settlement ratio.

What is the claim settlement ratio (CSR) of top insurers?

Claim settlement ratios change every year, so it’s best to check the latest IRDAI report or the official insurer websites. Many leading insurers have reported strong performance recently. For example, HDFC ERGO has a CSR of about 98.6%, ICICI Lombard is around 98.5%, Star Health is roughly 99.2%, and both Niva Bupa and Care Health have reported a 100% CSR in the latest period. ACKO, which has been gaining attention for its digital-first health insurance plans, also reports a high CSR of around ~98%, reflecting its focus on quick and transparent claim processing.

Do features work the same way in an individual health insurance plan when compared to a family floater plan?

The main difference between these two policies would be how the sum insured is shared. With an individual health insurance plan, the sum insured can only be used by the policyholder, while with a family floater plan, the sum insured can be used by the policyholder and their dependents.

Do insurers offer cashless claims?

Yes, most health insurers offer cashless treatment at their network hospitals, allowing you to receive care without paying upfront. Well-known insurers such as HDFC ERGO, ICICI Lombard, Star Health, Care Health, and Niva Bupa provide extensive cashless networks across India. Digital-first insurers like ACKO further simplify the experience with 11,500+ network hospitals by enabling quick, app-based approvals, making the cashless process faster and more convenient for customers.

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