Bajaj My Health Care Plan is a customizable health insurance policy designed for individuals and families. It covers inpatient hospitalization, outpatient care, maternity, and modern treatments, as well as unique options such as home nursing and international emergency coverage. The plan also offers higher sum insured (SI) options, going up to ₹5 crore, making it suitable for both basic and high coverage needs.
It is backed by Bajaj General's 96.78% claim settlement ratio (average for FY 2022-25) and 12,000+ network hospitals. A 25-year-old in Bengaluru pays ₹13,842 per year for a ₹15 lakh individual cover.
This guide is for individuals and families aged 18 to 65 who are comparing health insurance options and want a flexible, feature-rich plan that goes beyond basic hospitalization coverage.
Most health insurance plans exclude outpatient expenses, maternity costs, and newborn care. And that’s where families often end up paying out of pocket for some of their most predictable medical expenses.
Very few plans in the market offer all these benefits together, even though many families actively look for them. The Bajaj My Health Care Plan is one such option that brings these benefits under a single policy. In this review, we take a closer look at its features, coverage, eligibility, and whether it is worth buying.
Bajaj My Health Care is a customizable health insurance plan from Bajaj General Insurance (formerly Bajaj Allianz General Insurance). It allows policyholders to build their coverage by selecting a base plan and enhancing it with features that suit their specific healthcare needs.
Bajaj My Health Care plan offers a wide range of sum insured options ranging from ₹3 lakh to ₹5 crore. Its primary appeal lies in benefits like covering hospitalizations as short as 2 hours, inbuilt maternity and newborn care, and a renewal premium waiver for dependents if the proposer passes away during the policy term.
Also, from Bajaj General: My Health Care Super Top-Up Plan
The My Health Care Super Top-Up (Plan 8) is a separate policy that activates once total medical expenses in a policy year exceed a predefined aggregate deductible. It covers costs beyond this threshold across multiple claims.
It is a cost-efficient way to increase coverage to a high sum insured at a lower premium than upgrading the base plan. You can choose a sum insured from ₹5 lakh to ₹5 crore with deductible options from ₹1 lakh to ₹1 crore. It can be paired with any existing policy or bought as a standalone, but the deductible must be met each year before coverage begins.
It covers hospitalization, daycare, pre- and post-hospitalization, AYUSH, domiciliary care, modern treatments, maternity, newborn care, and consumables. It suits individuals with a base policy and families whose total annual expenses are likely to exceed the deductible.
Key Features – OPD, Hospitalization, and Add-Ons
Outpatient Department (OPD) Benefits
Consultations: Includes instant teleconsultations and in-clinic doctor visits.
In-Clinic Limit: Doctor consultation expenses are covered up to 50% of the OPD coverage amount.
Diagnostics and Tests: Covers doctor-prescribed investigations, pathology, and radiology expenses.
Preventive Health Check-ups: Includes annual health check-up vouchers, 1 for individual policies and 2 for floater policies.
High Value Benefit: Total OPD coverage can go up to 2x of the premium amount.
Hospitalization Benefits
Room Rent Flexibility: Allows a single private room for sum insured between ₹3 lakh and ₹10 lakh, and any room category for sum insured above ₹10 lakh.
Pre- and Post-Hospitalization: Covers expenses for 60 days before and 90 days after hospitalization.
Day Care Treatments: Covers daycare procedures that do not require 24-hour hospitalization, with expenses payable up to the full sum insured.
Domiciliary Treatment: Home treatment expenses are covered when hospitalization is not possible.
Restoration Benefit: Allows one reinstatement per year for sum insured below ₹5 lakh, and unlimited reinstatement for sum insured of ₹5 lakh and above.
AYUSH Treatment: Covers alternative treatments such as Ayurveda, Yoga, Unani, Siddha, and Homeopathy, with expenses payable up to the sum insured.
No Co-payment: No mandatory cost-sharing by the insured.
Consumables Cover: In-built coverage for items like gloves, PPE kits, etc.
Home Nursing: Covered up to 10 weeks if prescribed by a doctor.
External Medical Aids: Covers prescribed aids like crutches, walkers, braces, wheelchairs.
Maternity and Newborn Cover: Maternity and baby care benefits are available after a 36-month waiting period. The plan covers childbirth, surrogacy, and complications related to assisted reproductive techniques (ART). Coverage limits vary by sum insured. Newborns are covered from day one, with limits ranging from ₹1 lakh to ₹15 lakh depending on the sum insured.
Bonus Structure: A no-claim bonus of 25% per year (up to 100%) is offered for ₹3–4 lakh SI, while 50% per year (up to 100%) is offered for ₹5 lakh and above.
Disease-wise Sublimits: Cataract is covered up to 20% of SI (max ₹1 lakh per eye) for SI up to ₹10 lakh; actual expenses are covered for sum insured above ₹10 lakh.
Annual Health Check-up: Free once every policy year.
Add-On Covers
Loss of Income Cover: Provides a weekly payout if hospitalized for at least 72 hours due to a non-infectious illness or accidental injury.
Major Illness and Accident Multiplier: Doubles the sum insured for specified critical conditions.
Renewal Premium Waiver: Future premiums waived for dependents if the proposer dies due to illness/accident.
CTA
Premium, Sum Insured and Eligibility
Category
Details
Premium
Premium varies based on chosen sum insured, location, age, family size, and add-ons.
Discount Advantage
The waiting period for maternity is reduced if the 3-year premium is paid upfront.
Sum Insured Options
Starts from ₹3 lakh and goes up to ₹5 crore.
Entry Age
Adults can enroll between 18 and 65 years, while dependent children and grandchildren are covered from 3 months up to 30 years.
Waiting Periods
30 days initially (accidents covered from day 1), 2 years for specific diseases, and 3 years for pre-existing conditions.
Policy Types
Available as individual and family floater plans.
Bajaj General My Health Care Plan Premium
Profile
Annual Premium
1 Individual (Age: 25 years)
₹13,842
2 Adults (Ages: 32 & 31 years)
₹23,296
2 Adults + 1 Child (Ages: 39, 37 & 3 years)
₹29,580
2 Senior Citizens (Ages: 61 & 62 years)
₹83,996
Note: The premiums shown are indicative for a ₹15 lakh sum insured, based on a Delhi (110010) profile with no pre-existing diseases. The premium varies depending on underwriting, selected add-ons, and applicable discounts.
Before purchasing, it’s advisable to review the Bajaj My Health Care plan brochure to understand premiums based on your family’s specific profile and healthcare needs.
Is Bajaj My Health Care a Good Plan to Buy?
Buy This Plan If You:
Want a customizable plan where you can build coverage based on your needs.
Prefer a comprehensive policy that goes beyond basic hospitalization (OPD, maternity, and modern treatments).
Are looking for a high sum insured option for long-term protection.
Value a plan backed by strong claim metrics and a large hospital network.
Skip This Plan If You:
Want a simple, ready-made plan without needing to choose multiple features.
Are on a tight budget, as premiums can increase significantly with add-ons.
Prefer plans with fewer conditions, sub-limits, or waiting periods.
Don’t want to actively review and optimize your coverage over time.
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Bajaj My Health Care plan stands out as a strong and well-rounded health insurance option. However, the plan needs careful understanding before you buy it. Several features come with limits that vary based on the sum insured, so it’s important to check what is covered and how much you can claim. Premiums can also increase significantly as you add more features, and in some cases, the total cost may be higher than similar plans, such as HDFC Ergo Optima Secure.
Overall, it is a flexible and feature-rich plan suited for informed buyers who want long-term coverage. If you’re exploring alternatives, our best health insurance plans guide might be a good place to start.
Frequently Asked Questions
What tax benefits do I get on Bajaj My Health Care premium?
Premiums paid for Bajaj My Health Care are eligible for tax deduction under Section 80D of the Income Tax Act (old regime). You can claim up to ₹25,000 per year for coverage on yourself, your spouse, and your children. If you're also covering parents below 60, you get an additional ₹25,000 deduction and up to ₹50,000 if your parents are senior citizens. This applies to both the base plan and the Super Top-Up premium, making it worth factoring into your annual tax planning. Note that these benefits are available only under the old tax regime.
Who should consider buying the Bajaj My Health Care Plan?
This plan works best for individuals and families who want one policy covering both hospitalization and day-to-day expenses like OPD consultations, diagnostics, and maternity under one policy. It's a strong fit if you're comfortable actively choosing your coverage components, since the plan is flexible and requires deliberate selection. With sum insured options from ₹3 lakh to ₹5 crore, it suits a wide range of budgets and life stages. However, it may be less ideal for buyers seeking a simple, low-cost plan that requires minimal decision-making at the time of purchase.
How do I file a cashless claim under Bajaj My Health Care?
For planned hospitalization, inform Bajaj General at least 48 hours in advance. For emergencies, notify within 24 hours of admission. Visit a network hospital from Bajaj General's empaneled hospitals, show your health card and a valid photo ID, and the hospital will send a pre-authorization request to Bajaj General's Health Administration Team (HAT). The insurer typically conveys its decision within 60 minutes. If you're treated at a non-network hospital, you can file a reimbursement claim by submitting all original bills and documents within the stipulated timeframe after discharge.
What modern treatments does the Bajaj My Health Care Plan cover?
Bajaj My Health Care covers a range of advanced medical procedures under its modern treatment category. This includes robotic surgeries, stem cell therapy for bone marrow transplants, immunotherapy via monoclonal antibody injections, balloon sinuplasty, and deep brain stimulation. It also includes oral chemotherapy, intravitreal injections, stereotactic radio surgeries, and bronchial thermoplasty, among others. The plan also covers 500+ daycare procedures that don't require a 24-hour hospital stay. Coverage for these treatments matters because newer procedures are typically more expensive than conventional ones and are often excluded under older or basic health plans.
Does Bajaj My Health Care cover consumables, and is there any limit?
Yes, the consumables cover is an inbuilt benefit under the base plan; you don't need to pay extra for it. It covers non-medical items such as syringes, needles, gloves, masks, catheters, and other disposables used during hospitalization, as listed in Annexure IV of the policy wording. The cover is available up to the inpatient hospitalization sum insured, with no separate sub-limit specified. However, it only applies when a valid inpatient hospitalization claim is accepted. Consumables expenses cannot be claimed independently without an underlying admissible hospitalization claim.
What are the sub-limits in Bajaj My Health Care that could affect my claim?
Room rent is capped at a single private AC room for a sum insured up to ₹10 lakh; above that, actuals apply. OPD doctor consultations are limited to ₹500 for a general physician and ₹1,200 for specialists. External medical aids are capped between ₹10,000 and ₹50,000, depending on your sum insured slab. Maternity cover is limited to 2 lifetime events, and home nursing is capped at 10 weeks per policy year. Baby care, family visit, and maternity package amounts vary by sum insured and are specified in the policy schedule.
What are the key exclusions under the Bajaj My Health Care Plan?
The plan excludes cosmetic dental treatments, routine care not requiring hospitalization, and external aids like spectacles, hearing devices, and dentures. Congenital external defects, self-inflicted injuries, substance abuse-related conditions, and treatments during war or civil unrest are not covered. Non-medical consumable items listed in Annexure II, vaccinations, and medical treatment outside India (unless the optional international cover is purchased) are also excluded. Non-allopathic treatments other than AYUSH, and certain home-use medical equipment like CPAP machines and oxygen concentrators, are excluded as well.
Does Bajaj My Health Care premium vary by location?
Yes, Bajaj General follows a zone-based pricing system that directly affects your premium. Policyholders in Zone A cities, typically metros like Mumbai, Delhi, and Bengaluru, pay the highest premiums. Those in Zone B, which covers most of India, pay around 15% less. Zone C, which includes states like Goa, Punjab, Chandigarh, and Bihar, can attract discounts of up to 25% compared to Zone A pricing. This means two people with identical age and sum insured can pay meaningfully different premiums simply based on where they live at the time of purchase.
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