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What Medical Expenses Can You Claim in Health Insurance Plans?

Learn more about the list of expenses covered by health insurance plans. To know more about the policies, Visit now.

  • Jan 13, 2021

​A large section of the Indian population is outside the purview of health insurance. As per the latest report from Milliman, in a country like India, which is home to more than 1.35 billion people, more than 56% do not have health insurance. This implies that only 44% of the Indian population is financially secure against medical emergencies. With such low numbers, it is evident that the penetration of health insurance in India is significantly low. Moreover, with studies suggesting that the healthcare costs in India are set to rise at double the inflation rate, these figures become even more concerning. In these times, the importance of a health insurance plan is indisputable.

Importance of health insurance in recent times

Health insurance cover is a beneficial investment at all times. However, in recent times, it has become more of a necessity than a choice. Essentially, because:

  • The gruesome COVID-19 pandemic has affected more than 9.5 million in the country. In the absence of a good health insurance plan, the treatment cost can create a dent in the pocket, especially when one gets treated at private hospitals.
  • The healthcare cost in the country is expected to rise at 10% this year, which is double the rate of inflation (5%). Hence, health insurance is the only reliable medium which can support you in bearing medical treatment costs.
  • The rising incidence of health risk factors like stress, unhealthy eating, physical inactivity, environmental pollution, etc., have increased the chances of people falling sick. Today, even the young population is prone to multiple health diseases and ailments.

Hence, it is vital to invest in a comprehensive health insurance plan to ensure you are prepared for all types of medical emergencies in the future. However, you must understand the expenses covered by a health insurance plan, its terms and conditions, and then make an informed decision.

List of expenses covered by health insurance

Each insurance company offers plans that cover different expenses. Some of the standard health expenses covered are:

  • In-patient hospitalisation: In case you are hospitalised because of an injury or illness, and it is covered in your health insurance plan, the hospitalisation costs will be borne by the insurer. In-patient hospitalisation costs include:
    ○ Room rent or boarding expenses
    ○ Nursing expenses
    ○ ICU charges
    ○ Doctor consultation
    ○ Surgery
    ○ Other costs, like surgical tools, diagnostic material, etc.
  • Pre-hospitalisation expenses: All medical costs incurred before you are hospitalised, up to a pre-specified period, are covered in the insurance plan. These include doctor consultations, medical investigations, preliminary procedures, preventive surgeries, diagnostic tests, medicines, etc.
  • Post-hospitalisation expenses: All costs involved in your care and medicines, after you are discharged from the hospital, up to a pre-specified period, are included in your healthcare insurance. These include post-hospitalisation consultation, diagnostic tests, medicines, therapy, drugs, etc.
  • Ambulance charges: Your health insurance plan will also cover expenses involved in transporting you to a hospital by an ambulance.
  • Daycare treatment: The health plan will cover the costs of all procedures and treatments undertaken as an in-patient in a hospital or a daycare facility for less than 24 hours.
  • Daily hospital cash: Your health cover will provide you with a lump sum amount daily in case of hospitalisation.
  • Income benefit: Some advanced health insurance plans provide a lump sum to your family to replace the lost income for the family in case of your absence.


Overall, it is advisable to opt for a health cover with extensive benefits. Kotak Health Shield, with its fixed benefit health insurance plan, protects you against specific critical illnesses and also offers financial protection against accidental death or disability. Choose wisely for a secure future.

Kotak e-Term

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Ref. No. KLI/22-23/E-BB/2435


- A Consumer Education Initiative series by Kotak Life

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