Overview
Reliance Health Gain Plus is a customizable health insurance plan offering coverage options ranging from ₹3 lakhs to ₹5 lakhs. It covers essential benefits like inpatient hospitalization, pre- and post-hospitalization expenses (60 days each), domiciliary care, and modern treatments (up to 50% of base cover amount). The plan provides flexibility with add-ons such as reduced waiting periods for pre-existing diseases, loyalty bonuses on sum insured during renewals, and room rent preferences.
Experts Review
Written by Nikhil Nair
Senior Writer
The Reliance Health Gain Plus plan is a well-rounded health insurance offering that caters to individuals and families seeking basic yet customizable coverage. One of its key strengths is the ability to personalize features, such as room rent preferences and reduced waiting periods for pre-existing conditions through add-ons.
Additionally, the plan includes a loyalty bonus that increases by 33% by to 100% of the base sum insured upon renewal, incentivizing long-term policy retention. Coverage for essential healthcare needs like inpatient hospitalization, pre- and post-hospitalization expenses (up to 60 days), and modern treatments ensures financial security during medical emergencies.
The plan also offers reinstatement of the base sum insured up to 100% for unrelated illnesses, and 20% when you claim for the same illness. This provides added protection during multiple claims within a policy year. However, other policies have it much better.
However, the plan’s coverage range is limited to ₹3–₹5 lakhs, which may not suffice for major medical expenses or advanced treatments. Sub-limits on modern treatments like robotic surgeries, oral Chemotherapy etc., could lead to out-of-pocket costs.
Pros
Feature set is satisfactory.
Great pick if you're looking for something affordable.
Insurer has a solid track record with great claim and service metrics.
Offers Loyalty cover, which makes this policy stand out.
Cons
Your insurer doesn’t provide free health check-ups, which is a notable gap.
Maternity benefits not offered, which could be a drawback for some.
Doctor consultations are not covered, which is a key feature.
Reliance
Key Insights
Founded
2000
Reliance was established 25 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
87% claims settled in 30 Days
Reliance settles 87% of all claims it receives. This is reasonable performance, though there is room for improvement compared to top insurers.
Network Hospitals
10,000+
Reliance maintains a moderate network of 10,000 hospitals, offering reasonable coverage across key locations.
Complaints
4 complaints per 10,000 claims registered
Reliance maintains a low volume of complaints, reflecting strong customer satisfaction and effective service.
Features
All
Great
Good
Bad
Loyalty cover
STANDOUT
The insurance company shall provide a loyalty cover to the insured members up to a specified limit based on the renewal timeline for Accidental Death and Permanent Total Disability, Critical Illness, Hospital Cash, etc.
Co-payment
If you bought this policy after you turned 61, you have to pay 20% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Customisable
Change Single Private room to Shared Accommodation.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for modern treatments Meaning the insurance company has a cap of 50% of the sum insured if you are treated for the same.
Customisable
Increase your coverage for modern treatment methods from 50% to 100% of sum insured. Indemnifies you for the medical expenses incurred towards the correction of eyesight due to refractive error of +-6.0 Dioptres or above and also covers you for the cost incurred towards availing a second opinion from a medical practitioner.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Customisable
For any illness: Pre existing disease waiting period is modified/reduced from 3 years to 2 or 1 year.
Add-ons
Reduction in PED
Recommended
For any illness: Pre existing disease waiting period is modified/reduced from 3 years to 2 or 1 year.
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 3 days, with a maximum payout of ₹1000, 1500, 2000 or 2500 per day for up to 30 days.
Annual Health Checkup
Annual health check-up for specified tests, with a maximum limit of ₹3,000 or as per the sum insured on a cashless or reimbursement basis.
Room Rent Modifier
Change Single Private room to Shared Accommodation.
Aggregate Deductible
Choose deductible between ₹10,000 and ₹1,00,000 and get a discount on premiums.
Convenience Cover
Increases your pre & post hospitalisation limit to 90 and 180 days respectively. Provides coverage for air ambulance and Radio Taxi. The insurer will also pay an additional lump sum amount, on hospitalisation for a minimum period of 7 continuous and consecutive days.
Smart Cover
Increase your coverage for modern treatment methods from 50% to 100% of sum insured. Indemnifies you for the medical expenses incurred towards the correction of eyesight due to refractive error of +-6.0 Dioptres or above and also covers you for the cost incurred towards availing a second opinion from a medical practitioner.
Family Cover
Covers the cost of medical expenses related to listed home treatments like Dialysis, Chemotherapy, etc. along with a fixed daily amount payout to the one who accompanies the insured member while getting treated in a hospital. This benefit also covers for children’s expenses in case you are hospitalised and can’t take care of them at home.
Enhanced Cover
Keeps the unutilised bonus intact even if a claim has been made, offers unlimited restoration that will restore your cover in full every time a claim is settled for any illness along with extended coverage for generally excluded items like syringes, gloves, PPE kits etc
Double Cover
Gives an additional 100% of the sum insured for the same claim.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Hormonal therapies
Peritoneal dialysis
Treatment by a family member
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Sinusitis
Rhinitis
Tonsillitis
Adenoidectomy
Mastoidectomy
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting periodCustomisable
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. This policy also further allows to reduce the PED waiting period to 2 or 1 year for all diseases.
What's missing in the policy
Your insurer doesn’t provide free health check-ups.
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
A
Alok Verma
Good basic coverage for common health issues. Simple and straightforward plan.
P
Priya Singh
The policy is easy to understand, no complicated terms.
M
Manoj Kumar
Premiums are affordable, good option for individuals or small families on a budget.
A
Anand Kumar
The coverage for pre-existing diseases has a long waiting period.
D
Deepak Patel
The sum insured options are limited, might not be sufficient for major illnesses.
S
Shweta Jain
Covers hospitalization expenses adequately for routine illnesses.
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Frequently Asked Questions
Does Health Gain Plus have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does Health Gain Plus have room rent restrictions?
Does Health Gain Plus offer a restoration benefit?
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