My Health Care Plan in one table
| Insurer | Bajaj General Insurance Company Limited |
|---|---|
| Sum insured | ₹3 lakh to ₹5 crore, in tiers of 3 / 4 / 5 / 7.5 / 10 / 15 / 20 / 25 / 30 / 35 / 40 / 45 / 50 / 75 lakh and 1 / 2 / 3 / 4 / 5 crore |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What My Health Care Plan covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from Bajaj General's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| Co-payment | None as standard · 5% to 20% only if you choose the voluntary co-payment discount · 10% inside the international cover | No Co-payment |
| Room Rent Limit | Single private AC room from ₹3 lakh to ₹10 lakh cover · at actuals above ₹10 lakh | No room rent capping |
| Disease sub-limit | Cataract 20% of sum insured per eye, max ₹1 lakh, up to ₹10 lakh cover · at actuals above it | No sub-limit |
| No Claim Bonus | 25% a year at ₹3 and ₹4 lakh cover · 50% a year from ₹5 lakh · both capped at 100% | 50% each year (Minimum upto 100%) |
| Restoration Benefit | Unlimited from ₹5 lakh cover, once below it · works for the same illness, 15 days after discharge | 100% restoration once in a year |
| Pre-Hospitalization | 60 days | At least 60 days |
| Post-Hospitalization | 90 days | At least 120 days |
| Consumables | Built in, up to the in-patient sum insured, whenever the hospitalisation claim itself is admitted | Consumables covered |
| Maternity | ₹50,000 to ₹1 lakh by sum insured, 36-month wait · not covered at ₹3 and ₹4 lakh | Included |
| OPD wallet | Teleconsultation, in-clinic consults, prescribed pathology and radiology, and one annual health check-up | Included |
| Baby Care | ₹1 lakh to ₹15 lakh by sum insured, 36-month wait | Included |
| Entry age | Adults 18 to 65 · dependent children 3 months to 30 years · lifetime renewal | No maximum entry age |
My Health Care Plan add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
My Health Care Plan discounts you can ask for
Published discounts on this plan. Most are applied at quote stage rather than offered, so it is worth naming the ones you qualify for. Every figure is a ceiling, not a promise - what you actually get depends on the case.
| Discount | Worth | When it applies |
|---|---|---|
| Zone discount | Up to 15% or 25% | 15% on Zone B and 25% on Zone C, based on the proposer's residential address. Unlike Health Guard, there is no zone co-payment attached. |
| Wellness discount | Up to 5% to 12.5% | 5% for meeting 4 of 8 health parameters, 7.5% for 6 and 10% for all 8, plus 2.5% more for 10,000 steps on 20 days a month. Members aged 25 and above only. |
| Family discount | Up to 10% or 15% | 10% for two family members on one policy, 15% for more than two. Not available on floater policies. |
| Long-term discount | Up to 4% or 8% | 4% on a two-year policy, 8% on three years. Not available if you pay in instalments. |
| Early entry discount | Up to 5% | For a long-term policy bought before the proposer turns 35, and it keeps applying at renewal until each covered member reaches 45. |
| Loyalty and fitness discounts | Up to 5% each | 5% if you already hold a Bajaj motor, health, home, cyber or pet policy above ₹2,500 premium, and 5% for two 5 km marathon finishes in the preceding year. |
| Voluntary co-payment | Matched to the co-pay chosen | Agree to bear 5%, 10%, 15% or 20% of every admitted claim and the premium falls in proportion. |
From the plan brochure. Applied to the base premium; the insurer's stacking rules apply.
My Health Care Plan waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days |
|---|---|
| Specific Illness | 24 months |
| Pre-Existing Disease | 36 months |
| Maternity and Baby Care | 36 months, cut by a year if a long-term policy is paid up front |
The named illnesses that wait 24 months
Payable once the policy has run 24 months without a break; the wait does not apply to an accident. This list is indicative – the wording carries the full set of named conditions.
My Health Care Plan exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where My Health Care Plan falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
My Health Care Plan questions, answered
Is the no-claim bonus really 50% a year?
Only from ₹5 lakh cover upwards. At ₹3 lakh and ₹4 lakh the cumulative bonus accrues at 25% of the sum insured a year, and both tiers stop at 100%. A claim reduces the accrued bonus at the same rate it built up, though the base sum insured itself is never cut. Check which tier you are quoted at before you count on the higher figure.
How does reinstatement work on My Health Care Plan?
From ₹5 lakh cover it is unlimited within the policy year, and crucially it works for the same illness, which most competitors refuse. The condition is a 15-day gap between discharge and the next admission for the same person; there is no gap requirement if the next claim is for a different family member. Below ₹5 lakh you get one reinstatement only.
Is there a room rent limit?
Yes, and it applies further up the range than most buyers expect. From ₹3 lakh to ₹10 lakh cover you are limited to a single private air-conditioned room. Only above ₹10 lakh is room rent paid at actuals. If your local hospital's entry-level private room is a deluxe category, that limit will trigger a proportionate deduction across the whole bill.
Are consumables covered?
Yes, in the base plan, up to the in-patient sum insured, provided the hospitalisation claim itself is admitted. Gloves, syringes, PPE and the other non-medical items hospitals bill separately are paid rather than deducted. That is a real advantage – the sister plan Health Guard excludes them entirely.
What does the international cover actually pay for?
Emergencies only, and only if the illness or injury begins while you are already outside India – it does not fund planned treatment abroad. A mandatory 10% co-payment applies on top of any other co-payment in your policy, cover lasts 45 continuous days per trip and 180 days across the year, and your bonus, reinstatement and recharge amounts cannot be used against it.
What are the waiting periods?
Thirty days for any illness, 24 months for the named list of specific conditions, and 36 months for declared pre-existing disease. Maternity and Baby Care also wait 36 months, reduced by a year if you buy a long-term policy and pay the whole premium up front. Several of these are configurable at purchase, so read your policy schedule rather than assuming the defaults.
Read it from the insurer
We summarise. The policy wording is the contract, and it is the only document that settles a dispute. These links go to the insurer's own pages.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.
Other Bajaj General plans we have read
Bajaj General files these separately, and the terms differ between them. If you are choosing within the range, compare the waiting periods and the exclusions rather than the sum insured.