Best Health Insurance With Critical Illness Coverage in India
Serious health conditions like cancer, heart disease, and kidney failure are on the rise in India, putting immense financial pressure on families. Many treatments, from surgeries to long-term medication, cost anywhere between ₹5 lakh to ₹25 lakh, making quality healthcare unaffordable for a large section of the population.
Despite the growing need, many people, especially in rural areas, are unaware of insurance options that could help them manage these expenses. High premiums and late-stage diagnosis further add to the challenge, making it even harder for families to access timely treatment.
This is why having health insurance with critical illness cover is essential. It provides financial support when dealing with life-threatening diseases, ensuring patients get the care they need without draining their savings. In this article, we’ll explore some of the best critical illness insurance plans in India and what to look for when choosing one. Without waiting further, let's dive in.
Top 6 Critical Illness Health Insurance
Plans in India
| Features | HDFC ERGO Critical Illness Platinum | ICICI Lombard Critical Shield Plus | Aditya Birla Activ Secure Critical Illness | Bajaj Allianz Criti Care Plan | Niva Bupa CritiCare Plan | Care Health Care Critical Mediclaim |
|---|---|---|---|---|---|---|
| Incurred Claim Ratio | 79.94 | 77.33 | 64.68 | 74.27 | 54.05 | 55% |
| Number of Critical Illnesses Covered | 15 | 20 | Plan 1 - 20, Plan 2 - 50, Plan 3 - 64 | 43 | 20 | 32 |
| Cashless Facility/Network Hospitals | 13,000+ | 4000+ | 6,000+ | 6000+ | 10,000+ | 7400+ |
| Policy Type | Individual Policy is available | Individual & Multi-Individual | Individual & Multi-Individual | Individual policy is available | Family Floater & Individual options | Family Floater & Individual options |
| Critical Illness Initial Waiting Period | 90 Days | 90 Days | 90 Days | 180/120 days | 90 Days | 90 Days |
| Survival Period | 15-30 days | No survival period | 15 days | 7-15 days | 30 days | 30 days |
| Policy Tenure | 1 & 2 Years | 1, 2 & 3 Years | 1, 2 & 3 Years | 1, 2 & 3 Years | 1, 2 & 3 Years | 1, 2 & 3 Years |
| Sum Insured (in ₹) | 1 lac - 50 lacs | 15 - 50 lacs | 1 lac - 1 Crore |
Minimum SA for entry age 18-65 yrs is 1 lac. Maximum SA for entry age up to 60 yrs is 50 lac per section. Maximum SA for entry age between 61-65 is 10 lac per section. *Per member Sum Assured will be maximum 2Cr |
Up to ₹3 crore | ₹10 lakh to ₹2 crore |
| Min/Max Entry Age | 5 Years - 65 Years | 3 months - 65 years | Plan 1 and 2 - 5 years, Plan 3 - 18 years, Max. 65 years | 3 months - 65 years (Dependent: 30 Years) | 18-65 for adults only | 5 Years - 65 Years; Lifelong |
| Pre/Post Hospitalization | Yes. Pre-hospitalization: 60 days, Post-hospitalization: 90 days. | Yes. Pre-hospitalization: 30 days, Post-hospitalization: 60 days. | Yes. Pre-hospitalization: 30 days, Post-hospitalization: 60 days. | Yes. Pre-hospitalization: 30 days, Post-hospitalization: 60 days. | Yes. Pre-hospitalization: 30 days, Post-hospitalization: 60 days. | Yes. Pre-hospitalization: 30 days, Post-hospitalization: 60 days. |
| Premium Range | Not discolsed | Not discolsed |
Plan 1: Starting at ₹5,463* /annum Plan 2: Starting at ₹7,299*/annum Plan 3: Starting at ₹8,023*/annum |
Not discolsed |
Premium starts from ₹12,521*/annum |
Not discolsed |
| Coverage for OPD/Medication | Generally, no direct OPD coverage is provided. | Generally, no direct OPD coverage is provided. | Generally, no direct OPD coverage is provided. | Generally, no direct OPD coverage is provided. | Generally, no direct OPD coverage is provided. | Generally, no direct OPD coverage is provided. |
| Unique Benefits |
Offers Lump Sum Benefit on first diagnosis any of 15 critical Illnesses Lifetime renewal |
Free health check-up coupon to Insured for every Policy Year | Second medical opinion, health check-ups. | Wellness care, Dialysis Care & Cardiac Nursing |
Coverage for 20 major critical illnesses Tax benefits u/s 80d* of the Income Tax Act, 1961 |
Dialysis Cover Organ Donor Cover Psychiatric Counseling Lifetime renewal |
| Is Portability Available | Yes | Yes | Yes | Yes | Yes | Yes |
| Refill or Restoration Benefits | Yes, if the sum insured is exhausted. | Yes, if the sum insured is exhausted. | Yes, if the sum insured is exhausted. | Yes, if the sum insured is exhausted. | Yes, if the sum insured is exhausted. | Yes, if the sum insured is exhausted. |
* Please read the disclaimer at the end of this page before purchasing this policy.
Our Top 4 Recommended Health Insurance With Critical Illness Cover
Choosing the right health insurance plan with critical illness coverage can make a major difference in managing medical expenses during serious health conditions. Below are four plans that offer solid protection, each with its own benefits and limitations.
HDFC ERGO Critical Illness Platinum
HDFC ERGO’s Critical Illness Platinum plan provides a lump sum payout as soon as a covered critical illness is diagnosed. This means that instead of waiting for reimbursements, you get immediate financial support to begin treatment without delays. The plan covers a range of serious illnesses and offers cashless hospitalisation across a vast hospital network.
Why It Stands Out
Covers 15 critical illnesses, including major conditions like cancer, heart attacks, and organ failure, providing comprehensive protection.
Lifetime renewability means you can continue the coverage as you get older without worrying about losing it.
Short waiting period of just 90 days before you can make a claim, offering quick access to support when needed.
Cashless treatment at over 13,000 hospitals, making hospital visits much easier.
Potential Limitations
Covers 15 critical illnesses, which may be fewer than some other plans offering broader coverage.
Doesn’t include OPD or medication coverage, meaning some ongoing expenses will still need to be handled separately.
Limited policy tenures available (only 1- and 2-year options), which may not provide long-term peace of mind for some.
This plan is a good choice if you’re looking for a policy that offers quick financial support for critical illnesses with a strong hospital network. However, if you need coverage for regular doctor visits and medications, you may need an additional health plan.
ICICI Lombard Critical Shield Plus
ICICI Lombard’s Critical Shield Plus plan provides broad coverage for a variety of critical illnesses, and one of its biggest advantages is that there’s no survival period requirement. This means that as soon as a claim is made, you can receive the benefit without needing to survive a set number of days after diagnosis. This feature makes it particularly useful for those looking for quicker financial relief.
Why It Stands Out
Covers 20 critical illnesses, offering one of the more extensive protections in the market.
No survival period required, meaning you can access benefits right away—ideal for those who want faster coverage.
Family-friendly plan, covering multiple members under one policy for added convenience.
Free annual health check-ups, helping you keep track of your health and catch any potential issues early.
Potential Limitations
Network of covered hospitals is a bit smaller, with only 4,000+ hospitals compared to others with larger networks.
Pre- and post-hospitalisation benefits are more limited compared to some other plans, meaning some costs related to hospital visits may not be fully covered.
This plan is ideal if you want a broad range of critical illness coverage without worrying about survival period requirements. However, if a wider hospital network is important to you, you might want to compare other options before deciding.
Bajaj Allianz Criti Care Plan
Bajaj Allianz’s Criti Care Plan is designed to give you flexibility with its customisable coverage options. You can choose from multiple sum-insured amounts, allowing you to select a plan that fits your budget and needs. The plan covers a broad range of 43 critical illnesses, offering extensive protection. You also have the option to increase your coverage up to ₹2 crore, depending on what you feel is necessary.
Why It Stands Out
Covers 43 critical illnesses, which is one of the highest numbers compared to many other plans.
Flexible sum insured up to ₹2 crore, which can be adjusted based on your needs.
Additional benefits like wellness programs, dialysis care, and cardiac nursing, giving you added support beyond just hospitalisation.
High claim settlement ratio of 74.27%, meaning more claims are being successfully processed compared to many other plans.
Potential Limitations
A longer waiting period of 180/120 days for certain illnesses, meaning you’ll need to wait a bit longer before making a claim for some conditions.
A survival period of 7-15 days may delay the processing of claims, which can be inconvenient in urgent situations.
Limited network of hospitals (6,000+), which is fewer than some other plans that have a more extensive list of partnered hospitals.
This plan is a great option if you’re looking for comprehensive coverage for critical illnesses with flexibility in terms of sum insured. However, if you need a broader hospital network or more immediate claims processing, you might want to consider other options.
Aditya Birla Activ Secure Critical Illness Plan
Aditya Birla’s Activ Secure Critical Illness plan provides you with different plan variants to choose from. Whether you need coverage for 20, 50, or 64 critical illnesses, you can pick the plan that best suits your needs. The sum insured goes up to ₹1 crore, giving you decent coverage for most situations. Plus, you’ll benefit from additional services like second medical opinions and annual health check-ups, which can be valuable for managing your health over time.
Why It Stands Out
Offers three plan options, so you can select one based on how many critical illnesses you want covered (20, 50, or 64).
Sum insured up to ₹1 crore, providing good flexibility for most needs.
Multiple policy tenures (1, 2, and 3 years) that let you decide how long you want the coverage to last.
Includes valuable services like a second medical opinion and annual health check-ups, ensuring that you’re not just covered in case of illness, but also supported with regular health monitoring.
Potential Limitations
A survival period of 15 days before claims can be processed, which can be frustrating if you need immediate support.
Network of hospitals (6,000+) is smaller than some other providers, so you may have fewer choices in terms of where you can get treatment.
The plan selection can feel a bit complex due to the different variants, which might confuse you if you're trying to decide which one is the best for your situation.
This plan is ideal if you want flexibility in your coverage with options for extra services like second opinions and health check-ups. However, the smaller hospital network and longer waiting period may not be the best for everyone, so you might want to check whether your preferred hospitals are included.
What is a Critical Illness?
Critical illness refers to a serious health condition that can pose a significant risk to a person’s life or well-being. These illnesses often require immediate medical attention and may require long-term care. Examples of critical illnesses include heart attack, stroke, cancer, kidney failure, and severe injuries.
What makes an illness "critical" is not just its severity, but also how it impacts a person’s ability to live a normal, healthy life. These conditions can be life-threatening or leave lasting effects, and they often need specialised medical care and support. It’s important to recognise these conditions early so that proper treatment can be started right away, improving the chances of recovery.
What is a Critical Illness Policy?
A Critical Illness Policy is a type of insurance that provides financial support if you’re diagnosed with a serious illness covered by the policy, such as cancer, heart attack, or stroke. If you are diagnosed with one of these conditions, the insurance will pay you a lump sum of money. You can use this amount to cover medical expenses or other costs that come with your illness.
The specifics of what’s covered, how much you’ll receive, and the conditions included can vary between different policies, so it’s important to carefully check the details before you sign up. This will help you ensure the policy suits your needs and gives you the protection you’re looking for.
How Does Critical Illness Insurance Work?
Critical illness insurance is designed to give you financial support in case you’re diagnosed with a serious illness like cancer, heart attack, or head injury. It can help reduce the financial burden that comes with such health issues, giving you peace of mind during tough times.
To get started, you choose a health insurance plan that covers specific critical illnesses. Once you've selected the plan, there’s usually a waiting period (typically around 30 days) before you can make a claim. During this time, you’ll need to keep paying your premiums regularly to maintain the coverage. If, after the waiting period, you are diagnosed with one of the covered illnesses, you’re eligible to file a claim. Upon approval, the insurer will provide a lump sum payment to help cover medical costs and other expenses.
It’s important to be aware of the details of your critical illness insurance. Every policy has certain limits—this includes the illnesses covered and the conditions under which you can file a claim. Also, remember that critical illness insurance is different from life insurance. It pays out when you're diagnosed with a serious illness, not upon death.
A few factors affect the cost of your premiums, such as your age and health. If you're in good health when you purchase the policy, your premiums may be lower. But keep in mind, if you stop paying your premiums, the policy can lapse, and you might lose your coverage. Always ensure you’re able to keep up with the payments to maintain your protection.
Types of Critical Illness Insurance Coverages
When it comes to critical illness insurance, you have two options to choose from. You can either get it as a standalone plan or as an add-on to your existing health insurance. Let’s break down what each option means:
1
Standalone Plan
Critical illness insurance can be purchased as a standalone plan, which is specifically designed to cover serious health conditions. This plan gives you more detailed coverage for a range of illnesses, such as cancer, heart attacks, or stroke. One of the benefits of this option is that you can personalise the plan to suit your needs, adjusting things like coverage limits, waiting periods, and the specific conditions you want to be covered for. Since it’s a separate policy, the premium for a standalone plan is typically lower than that of an add-on. If you’re looking for more focused coverage for critical illnesses, this option might be the right fit.
2
Add-On to Base Health Insurance
If you already have a base health insurance policy, you can choose to add critical illness coverage to it. This add-on offers an easy way to enhance your health insurance without having to buy a separate plan. Since you’re just adding it to your existing policy, the premium is generally lower than what you'd pay for a standalone plan. However, it's important to note that the coverage provided by the add-on is usually limited to a smaller list of serious illnesses. This may not be enough to cover all the conditions you might be concerned about in the future, so it’s worth considering whether the limited coverage will meet your needs in the long run.
Choosing between these two options depends on your personal needs and budget. Consider what kind of coverage you want and what you're comfortable with in terms of premiums before making your decision.
Which Illness is Covered by a Critical Insurance Plan?
When looking at Critical Illness Health Insurance, it’s important to understand the types of illnesses that are typically covered. These are severe health conditions that can have a major impact on your life. Here’s a list of some critical illnesses that are commonly covered under these policies:
Why is it Important to Have Critical Illness Insurance?
Critical Illness Insurance is designed to provide financial support during serious illnesses that can take a toll on both your health and your finances. Here's why it's worth considering:
Who Should Buy a Critical Illness Insurance Policy?
When it comes to buying a critical illness insurance policy, it’s important to think about your personal situation and whether this kind of coverage would be a good fit for you. Here’s who should consider getting a critical illness insurance policy:
Common Features of the Critical Illness Plans
Here's a closer look at some of the most common features that you get with Critical Illness Plans
Coverage for Critical Illnesses
Easy Claim Process
Tax Benefits
Affordable Premiums
Flexibility in Purchasing
Sum Insured Based on Your Needs
Exclusions of Critical Illness Insurance Plans
Critical illness insurance plans are designed to offer financial support if you’re diagnosed with a serious illness, but there are some conditions that are typically not covered under these plans. Here are a few common exclusions:
How to Select the Best Critical Insurance Plan?
When selecting the best critical illness insurance plan, it's important to make a well-informed choice to ensure that your loved ones are protected in case of a serious illness. Here are a few points to help you make the right decision:
1
Choose a Standalone Policy, Not an Add-on
You might be tempted to add critical illness coverage to your existing health insurance plan, but it’s often better to go for a separate, dedicated policy. While an add-on might seem like a cost-saving option, it may not offer the same level of coverage as a standalone critical illness insurance plan. A separate policy provides more comprehensive protection, even though it might cost a bit more. Think of it as investing in peace of mind.
2
Check the Range of Coverage
Critical illness insurance is designed to protect against serious illnesses, but the level of coverage can vary from one plan to another. Some policies cover over 20 critical illnesses, while others may focus on just a few. It's important to carefully review which diseases are included in the plan. Consider your family’s health history, lifestyle, and habits (like smoking) when assessing what diseases you might be more likely to face. This way, you can select a plan that best fits your needs and future health risks.
3
Understand the Waiting Period
Every critical illness insurance plan comes with a waiting period—this is the time before you can make a claim after purchasing the policy. It's important to know how long you’ll have to wait before the policy takes effect. Opt for a plan with a shorter waiting period so that if an emergency occurs, you can get the support you need quickly. The sooner you can access your benefits, the better, especially in times of medical urgency.
By taking these factors into account, you’ll be able to select the best critical illness insurance plan for you and your family.
Disclaimer
