Health insurance Ready Reckoner for the Self-employed

Gone are the days when people aspired to work in a cushy nine-to-five job till retirement. Today, there is a definite shift from being employed with an organization to being “your own boss”. The luxury and freedom to do what you love, and are good at, on your own terms, is what drives many to opt for self-employment or solo-entrepreneurship. The digital environment promoting work-from-home opportunities further boosted this transition. The government of India has also encouraged the “follow-your passion” theme with initiatives such as Startup India, Skill India, and Standup India, to name a few.

With self-employment generated income, financial planning for the future cannot be far behind. More so since the self-employed are vulnerable to erratic income flow and chronic medical conditions, due to the stress of being a “one-man show”. While building a cozy nest egg is the ultimate objective, securing your savings from a debilitating medical contingency ought to be on your horizon too.

Health Insurance Ready Reckoner for Self-Employed Individuals:

A suitable Health Insurance plan will ease the financial burden of recurring healthcare expenses or of an unforeseen and exorbitant medical treatment.

When you explore the vibrant health insurance market, you must be confident of what you want from the policy. Here is a health insurance Ready-Reckoner to help you make an informed choice.

(A) Types of Health Insurance Plans available in India:

Health insurance is classified into two types:

  1. Indemnity: The insurer bears the permitted treatment costs up to a specified amount or on the basis of actual cost incurred.
  2. Fixed Benefit: The sum insured is paid in a lump sum upon the event’s occurrence, like the diagnosis of critical illnesses or accidental death.
  3. Individual Health Insurance: Your health insurance coverage is separate for you and your family members.
  4. Family Floater Health Insurance: You can insure your dependents along with yourself in the same policy, either on an individual or a shared coverage basis.
  5. Super Top-Up Health Insurance: The insurer offers health insurance at a fractional cost of the standard policy, but it comes with a deductible amount. When combined with another policy, the top-up coverage kicks in only after the base coverage is exhausted.
  6. Senior Citizens Health Insurance: Such policies cater to covering medical requirements of the elderly and the various age-related ailments that tend to affect their health.
  7. Critical Illness Health Insurance: Plans that cover life-threatening ailments and their long-term treatment.

(B) Key Features of Health Insurance Plans:

  1. Pre-policy Medical Evaluation: Many insurers mandate pre-policy medical check-up to assess the applicant’s insurability and the premium quote (in case of higher age and / or health concerns).
  2. Waiting Period: The insurer defines the compulsory waiting periods before the coverage kicks in and claims are accepted. A waiting period is generally applied from the policy inception date for the initial claim, pre-existing diseases, and other specific diseases.
  3. Cashless Hospitalization: The insurer pays the hospital directly for the treatment cost arising out of illness, accident, or injury. This form of claim settlement is available only in the insurer’s network hospital involving an overnight stay.
  4. Daycare Expenses: The cost of treatment procedures is covered where the hospital visit lasts for a few hours due to advanced medical techniques.
  5. Domiciliary Hospitalisation Treatment: The treatment cost if undertaken at home (due to lack of hospital facilities or immobility of the patient under doctor’s advice) for an ailment that would require hospitalization in the usual course.
  6. No-Claim Bonus: It is a benefit applicable at renewal for every claim-free year. It is a usually expressed as the percentage by which the sum insured increases up to the defined limit in the Health Insurance for self-employed.
  7. Add-on Riders: You can choose suitable optional riders to augment your coverage against an additional premium.
  8. Sub-limit: The insurer defines the upper limit (usually a percentage of sum insured or a fixed amount, depending on the plan and the insurer) till which a particular facility is covered.
  9. Deductible: It is particularly applicable to Super Top-up Health Insurance for Self-Employed for the coverage to kick in. For a Super Top-up Health Insurance policy supplementing another policy, the base policy coverage is usually the deductible amount.
  10. Exclusions: It is crucial from the claim settlement aspect as claims are liable to be repudiated for specific conditions. General exclusions are uniform across insurers.

Your search for Health Insurance as a self-employed individual ends here! We at SANA.Insure offer a wide range of health insurance solutions and services suited to your healthcare and insurance needs. Our Health Insurance Experts assure impartial advice and our dedicated Relationship Managers coordinate with your insurer to expedite claims settlement for you.

We invite you to visit our health insurance portal for more information. You can also connect with a Health Insurance Expert at SANA.Insure via WhatsApp chat on 8278271818, or via our toll-free number 1800 202 8118.

Wish you a healthy and happy life!


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