What are Loading Charges in Health Insurance Plans?

Health insurance has become a non-negotiable part of financial planning — especially after the pandemic of 2020 exposed the harsh truth of rising treatment costs. With insurers eager to boost health insurance premiums to shield themselves from financial risk, many policyholders face an unavoidable expense: loading charges added to the base premium. 

These extra costs account for higher health risks, like pre-existing conditions or lifestyle factors, and can quickly eat into your budget. Despite that, you needn’t worry — understanding how loading works (and comparing plans with and without it) can help you get your penny’s worth of coverage without overpaying. Let’s break it down:

Want to know more about loading charge-free health insurance plans? How about a 30-minute free consultation call? No spam - just a conversation with an IRDAI-certified health insurance expert!

What are Loading Charges in Health Insurance Plans?

Loading charges in health insurance plans refer to the additional charges applied to a policyholder’s base premium to shield the insurer from claims and ensure that the insured has some skin in the game as well. The insurance company assesses the insured person’s lifestyle and medical history to understand the level of risk associated with insuring them. If a person has any pre-existing diseases or habits like smoking, they are at increased risk of needing recurring medical care and, therefore, making frequent claims. The insurance company takes this added risk into account and tries to mitigate some of it by increasing their premium.

Disclaimer - The above list gives a few examples of plans with either category, they are subject to change based on the insurer’s underwriting and risk management.

How Does Loading Affect Your Premium?

Loading charges increase your premium and generally range from 10%-40% of the base premium. However, they can be even higher depending on the number and severity of conditions.

Types of Premium Loading

Loading charges in health insurance plans can come in different forms, and understanding these helps you know what to expect when insurers assess your risk profile:

1. Percentage of Premium Increase: The insurer adds a percentage to your base premium based on your risk factors. For example, a 20% loading on a ₹10,000 premium makes it ₹12,000.
2. Limited Sum Insured Offering: The insurer may grant you a sum insured amount that’s lesser than what you want to pick. For instance, if you apply for a ₹10 lakh sum insured but have a pre-existing condition (PED), the insurer might cap your coverage at ₹5 or ₹7 lakh instead of offering the full amount.
3. Permanent Exclusion (PE): For high-risk conditions, like cancer and severe cardiac conditions, insurers may permanently exclude coverage. Treatments related to them might never be covered under the policy.

These different types of loading help insurers manage risk, but they also highlight the importance of choosing the right policy — one that balances cost with the coverage you truly need.

Factors Affecting Loading Charges in Health Insurance Plans?

Several factors influence whether and how much loading gets added to your premium:

• Pre-existing Diseases (PEDs): Conditions like diabetes, hypertension, or thyroid disorders can lead to premium increases or limited coverage.
• Lifestyle Habits: Smoking and drinking habits can trigger loading charges — or even outright policy rejection in extreme cases.
• BMI (Body Mass Index): Being significantly underweight or overweight might increase your premium, as both conditions are linked to various health risks. For example, a person whose BMI is above 35 may be declined a policy.
• Age: Age is a significant factor in determining loading charges. While it may not impact loading charges directly, the likelihood of developing health issues increases as people age. This is why older policyholders often face higher premiums – they are more likely to be hospitalized, leading to increased claims for the insurer.
• Occupation: High-risk jobs, like construction or mining, may attract higher premiums due to the increased probability of accidents at the workplace.

Understanding these factors helps you make informed choices and possibly take steps to reduce your loading over time — like quitting smoking or managing chronic conditions proactively.

Best Health Insurance Plans With Loading Charges in 2025

Let’s explore some of the top health insurance plans with loading charges — so you can weigh the trade-offs between higher premiums and the benefits these policies offer:

1. HDFC Ergo Optima Secure: Optima Secure has loading charges but provides extensive coverage and benefits to its policyholders. It is a robust health insurance plan offering coverage from ₹5 lakh to ₹2 crore. This policy has comprehensive coverage with no room rent limits, disease-wise sub-limits, or mandatory copayment. It also includes extensive pre and post-hospitalization coverage, daycare procedures, and domiciliary treatments. With features like 100% restoration once during the policy period and a cumulative bonus of 50% per year up to 100% of the base sum insured, it provides significant financial protection. Unique benefits like the Secure Benefit, which doubles the base coverage from day one, and the Protect Benefit, which covers consumable expenses, make this plan an attractive choice. Additionally, home healthcare services are covered on a cashless basis. Notable add-ons include Unlimited Restoration and OPD coverage through Optima Well-being. 
2. Aditya Birla Activ One Max: Aditya Birla Activ One Max provides coverage from ₹5 lakh to ₹6 crore and includes wellness benefits like HealthReturns, which offers premium discounts for maintaining good health. It offers comprehensive coverage with loading charges based on your risk assessment. The plan has no restrictions on room rent and includes pre and post-hospitalization coverage of 90 and 180 days, respectively. It also covers daycare procedures, AYUSH treatments, and domiciliary care. 
   
   The Claim Protect feature ensures inbuilt coverage for consumables, while the Super Reload feature provides unlimited restoration benefits after the first claim. The Super Credit Bonus increases the sum insured by 100% annually up to 500%. Additional optional covers include Chronic Care, which provides day-one coverage for pre-existing conditions like diabetes and hypertension, a Cancer Booster for enhanced cancer-related expenses, and Durable Equipment Cover for medical devices like wheelchairs and ventilators.
3. Niva Bupa ReAssure 2.0: Niva Bupa is known for its robust coverage options and industry-first features. Keeping up with this trend, this policy offers unlimited restoration, booster benefits for the unutilized cover amount, and several useful add-ons. This plan also includes loading charges for higher-risk individuals. As an insurer, Niva Bupa has more than 10k+ hospitals under its network and a claim settlement ratio (CSR) of over 91%.

Best Health Insurance Plans Without Loading Charges in 2025

Now, let’s look at health insurance plans that skip loading charges altogether — offering broad coverage without penalizing you for existing health risks:

1. Care Supreme: Care Supreme offers comprehensive coverage without additional loading charges for pre-existing conditions. It provides extensive coverage ranging from ₹5 lakh to ₹1 crore, ensuring flexibility without disease-wise sub-limits or room rent capping. The plan includes 60 and 180 days of pre and post-hospitalization coverage, daycare procedures, AYUSH treatments, and domiciliary care. The restoration benefit is available an unlimited number of times during the policy period, and policyholders can benefit from a cumulative bonus of 50% per year up to 100% of the base sum insured. Notable add-ons include Instant Cover, which reduces waiting periods for pre-existing conditions like hypertension and diabetes to just 30 days.
2. Care Plus Complete: This plan offers all-encompassing coverage without loading charges, even for high-risk individuals. The policy stands out with unlimited restoration benefits, full coverage for alternative treatments like Ayurveda and Homeopathy, and a hefty no-claim bonus that can boost your sum insured by up to 200%. It even covers outpatient consultations and annual health checkups. However, the policy comes with a room rent cap, restricting you to a single private AC room — so if you want something fancier, you might need to pay out of pocket.
3. Star Assure: Star Assure is known for its extensive coverage and policy on no-loading charges. It is a feature-rich health insurance plan that balances coverage with flexibility, though benefits are tied to the sum insured. It covers hospitalization costs for assisted reproductive treatments (₹1–4 lakh) after a 2-year waiting period, with unlimited restoration of the sum insured for multiple claims in a year. The policy includes 60 days of pre-hospitalization and 180 days of post-hospitalization coverage, alongside daycare procedures, AYUSH treatments, and domiciliary care. While there are no disease-wise sub-limits, room rent is capped at 1% of the sum insured, and full coverage for pre-existing conditions kicks in after 3 years. A cumulative bonus increases coverage by 25% annually, up to 100% of the base sum insured, rewarding policyholders who stay claim-free.
4. Star Comprehensive: This policy offers extensive coverage with no loading charges or disease-wise sub-limits, making it a solid choice for families. The policy provides coverage up to ₹1 crore, including maternity benefits, outpatient consultations, and home hospitalization. It covers pre- and post-hospitalization for 60 and 90 days, respectively, and includes a restoration benefit if you exceed your insured sum. However, there’s a 10% co-payment if purchased after 61, and room eligibility is capped at a single private AC room.

Why Should You Approach Ditto for Your Health Insurance Plan?

At Ditto, we’ve assisted over 3,00,000 customers with choosing the right insurance policy. Why customers like Balaji below love us:

✅No-Spam & No Salesmen

✅Rated 4.9/5 on Google Reviews by 5,000+ happy customers

✅Backed by Zerodha

✅100% Free Consultation

You can book a FREE consultation. Slots are running out, so make sure you book a call now!

Conclusion

Understanding loading charges is essential for making an informed decision when buying health insurance. While loading can increase your premiums, it’s a tool insurers use to manage risk — and knowing how it works helps you plan better. Whether you choose a plan with loading for comprehensive coverage or opt for a no-loading policy to avoid extra costs, what matters most is finding a plan that fits your health needs and financial goals.