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Health Insurance Plans for Self-employed Individuals in India

If you are self-employed, a freelancer, a consultant, an entrepreneur, or a small business owner, you have no employer covering your medical bills. One hospitalisation without health insurance can wipe out months of savings. Medical inflation in India is running at an average annual rate of 12–14%, so it gets more expensive every year. This page helps you understand what to look for, what ACKO offers, and how to pick the right plan for your situation.

What is Health Insurance for Self-Employed?

Health insurance for the self-employed is a policy you buy on your own to cover medical expenses, since you don’t have an employer providing group health coverage. It helps cover hospitalisation, treatments, and sometimes OPD expenses, which can be especially important when your income isn’t fixed or backed by employer benefits. 

As a self-employed individual, you can either buy an individual health insurance plan or a family floater health plan. A family floater lets you cover your entire family under one policy, often at a lower cost than buying separate plans.

Benefits of Health Insurance for a self-employed individual

If you are self-employed, you handle your own medical expenses. Health insurance covers many expenses, including hospitalisation and preventive care. It also gives you access to tax savings. Here are some key benefits of a health insurance plan for self-employed individuals:

Medical Coverage: It covers hospitalisation, daycare treatments, and pre as well as post-hospital expenses. Most plans also include annual health check-ups.

Savings are Protected: A hospital stay can cost from thousands of rupees to lakhs, depending on the illness, hospital, and city. Having health insurance helps you handle these expenses without using your savings.

Coverage for the Entire Family: You can buy a family floater plan that covers your entire family. It includes your spouse, children, and parents, where you pay a single premium for everyone.

Protection from Medical Inflation: Healthcare costs in India are rising every year. A health insurance plan helps you stay financially prepared for these increasing costs.

Cashless Hospitalisation Benefit: You can get treated at network hospitals. This reduces the need to arrange funds during medical emergencies.

Income Tax Benefits: Under Section 80D of the Income Tax Act, you can claim:

  • Up to 25,000 per year for premiums paid for self, spouse, and children
  • An extra 25,000 for parents (50,000 if parents are senior citizens)

Types of Health Insurance Plans for Self-employed Individuals

When it comes to health insurance plans for self-employed individuals in India, several options are available. The most common types of health insurance plans for  Self-employed Individuals are:

Individual Health Insurance Plans

Individual health insurance plans are designed to provide coverage for a single person. These plans are customised to the individual’s health requirements. They cover various medical expenses, including hospitalisation, surgeries, and outpatient treatments. Premium charges are based on age, health condition, and the sum insured.

Family Floater Health Insurance Plans

Family health insurance plans provide coverage for the entire family under a single policy. Any family member can utilise the sum insured when they need treatment. It is an affordable option for self-employed individuals with families. 

Critical Illness Insurance Plans

Critical illness insurance plans provide coverage for critical illnesses listed in the policy. An overall sum (fixed lump sum amount) is paid out, if the insured individual is diagnosed with a covered illnesses. It could be cancer, heart attack, or stroke, etc. The amount can be used for treatment or recovery costs.

Super Top-Up Health Insurance Plans

A super top-up health insurance plan provides additional coverage once your medical expenses cross a fixed limit, called the deductible. Unlike regular top-up plans, which consider each hospitalisation separately, super top-up plans combine all medical expenses during a policy year. This makes them useful if you have multiple hospitalisations in a year. For self-employed individuals, a super top-up is a cost-effective way to increase total coverage without buying a second comprehensive plan.

Which health insurance plan is best for self-employed individuals in India?

For self-employed individuals in India, the best health insurance plan is one that offers high coverage, flexible options, and fewer restrictions. You can choose: 

  • Individual plan (if you are single), or
  • Family floater plan (if you have dependents)

    Experts generally recommend a minimum sum insured of ₹10 lakh, while ₹25 lakh or more is better in metro cities due to rising healthcare costs. So, when choosing a health plan, look for:

  • Low waiting periods
  • Flexible premium payment options
  • No room rent limits
  • Wide hospital network

Top Health Insurance Plans for Self-Employed from ACKO

ACKO’s health insurance plans offer zero deductions on claims, no room rent limits, 11,500+ cashless treatment across India, and fully digital as you can buy, manage, and claim online without agents. 

ACKO Standard Health Insurance Plan

Choose affordable coverage options with sums insured of Rs. 10 Lakhs, Rs. 25 Lakhs, Rs. 50 Lakhs, or Rs. 1 Crore.

ACKO Platinum Health Plan

Get full coverage with no deductions on claims and no waiting period, making it ideal for maximum protection.

ACKO Platinum Super Top-up Health Plan

Enhance your existing health plan with extra coverage. After a deductible, enjoy benefits like no waiting period and high coverage.

 

Disclaimer: Benefits may vary based on the plan selected and policy terms. Please read the policy wording for detailed coverage, exclusions, and conditions.

Exclusions of Health Insurance for Self-employed Individuals

Health insurance policies come with specific terms and conditions regarding coverage. While these terms may vary across different insurance providers, there are certain general exclusions in health insurance policies for self-employed individuals in India. Common exclusions include:

  • Treatment for intentional self-injury
  • Treatment for injuries/illness resulting from intoxicants (alcohol and drugs)
  • Cosmetic or plastic surgery
  • Infertility treatment

Who Can Buy Health Insurance for Self-employed Individuals?

Any individual in India aged 18 years and above can buy health insurance. As long as you can pay the premium and meet basic eligibility, you can get covered. This includes:

  • Business owners
  • Freelancers
  • Consultants
  • Farmers
  • Small business owners
  • Gig workers (delivery partners, drivers, etc.)
  • Traders and shop owners
  • Independent professionals (doctors, designers, lawyers, etc.)

    For self-employed individuals, there are no special restrictions. The eligibility is the same as for any individual buying a personal health insurance plan.

How to Choose a Health Insurance Plan for Self-employed Individuals?

Choosing the right health insurance plan is important when you are self-employed. So, here are some key factors you should keep in mind:

  1. 1. Check Coverage Options:

    • Individual Plan: Suitable if you are single, with coverage designed for your needs.
    • Family Floater: A cost-effective option if you want to cover your spouse and children under one plan.
    • Super Top-Up Plans: Helps increase your coverage (for example, ₹20-50 lakh extra) at a lower cost, which triggers after your base plan is exhausted.

    2. Coverage Amount

    • Choose a sum insured based on your age, health needs, and family size. If you have dependents, a higher cover (like ₹10-25 lakh or more) is usually recommended.

    3. Premium Cost

    • Compare premiums across different health plans, also check what is covered and what is not. A lower premium may come with limited benefits.

    4. Network Hospitals

    • Check if the insurer has a wide network of hospitals near you. This ensures you can access cashless treatment when needed.

    5. Pre-existing Disease Waiting Period

    • Most health plans have a waiting period for existing health conditions. So, always check how long you need to wait before illnesses are covered.

    6. Co-payment Clause

    • Some health plans require you to pay a part of the claim amount. Make sure the co-payment is affordable during a medical emergency.
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Steps to Buy Health Insurance for Self-Employed from ACKO

    • Step 1: Enter Your Details
      Share basic details like your age, dependents, and personal information to get a quote.
    • Step 2: Choose a Plan
      Select from available plans such as ACKO Standard or ACKO Platinum based on your needs.
    • Step 3: Customise Your Coverage
      Add or adjust coverage options to suit your requirements.
    • Step 4: Read the Terms and Conditions and Make Payment
      Read your policy document very carefully. Make sure that you understand the inclusions and exclusions. Then, complete the payment to buy the plan.
    • Step 5: Policy Issuance
      Your policy is issued after processing. Coverage starts from the date of purchase.

Frequently Asked Questions (FAQs)

Self-employed individuals in India can choose from the same health insurance plans available to everyone. The most common options are individual health insurance and family floater plans. 

No, critical illness coverage is typically not included in health insurance plans for self-employed individuals. You may need to buy this plan separately.

Yes, these health plans often come with a waiting period, which is an initial period during which certain specified illnesses or treatments are not covered by the insurance plan.

Yes, the insurance company may request a complete medical check-up, however this depends upon their terms and conditions.

The cost of health insurance for self-employed individuals in India can vary widely depending on factors such as age, coverage requirements, pre-existing conditions, and the insurance provider. It is recommended to obtain quotes from different insurance companies to get a better understanding of the potential costs.

The right time to buy health insurance for self-employed individuals is as early as possible. It is advisable to secure coverage when you are young and healthy, as this can help in getting better premiums and ensuring coverage for any future medical needs.

The best plan for self-employed individuals is a comprehensive individual or family floater plan with a sum insured of at least ₹10 lakh, zero deductions at claim, no room rent sub-limits, and a wide cashless hospital network. 

Self-employed individuals can claim a deduction of up to ₹25,000 on health insurance premiums under Section 80D of the Income Tax Act.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet and is subject to changes. Please consult an expert before making any related decisions.

Best Family Health Insurance Plans

Roocha Kanade profile avatar

Written by

Roocha Kanade

Content Architect

Dr Nitin Kumar Gupta profile avatar

Reviewed by

Dr Nitin Kumar Gupta

SVP – Health Underwriting & Claims at Acko General Insurance