Your health insurance policy almost certainly includes benefits you have never used, and often did not know existed. Five of the most commonly overlooked benefits are free preventive health check-ups, restoration (or refill) of your sum insured after it gets exhausted, cover for day-care procedures that do not need a 24-hour hospital stay, cover for AYUSH treatments such as Ayurveda and Homoeopathy, and the right to port your policy to another insurer while keeping the benefits you have built up.
Preventive Health Check-ups are Included
Many health insurance plans include a free preventive health check-up, but it's a benefit that often goes unused. It's a routine health check-up offered at no extra cost and can help identify potential health issues before they become serious.
How frequently you can utilise this service depends on the health insurance policy that you hold, such as:
There are health insurance policies that offer a free preventive health check-up to policyholders each year.
There are health insurance policies that allow policyholders to avail of this facility only after a certain period without filing claims under their health insurance coverage.
The tests may include checks for blood pressure, blood sugar, cholesterol, a complete blood count (CBC), and other routine health screenings. It's one of the few health insurance benefits you can use even when you're feeling completely healthy.
You Can Restore Your Sum Insured
Depending on your policy and insurer, if your sum insured is exhausted during the policy year, a restoration (or refill) benefit can restore it so you are not left without cover. This feature automatically reinstates all or part of your base sum insured after a claim has used it up, within the same policy year.
Suppose your sum insured is Rs 5 lakh and your policy includes 100% restoration.
| EVENT | AMOUNT | COVER REMAINING |
|---|---|---|
| Sum insured at start of year | Rs 5,00,000 | Rs 5,00,000 |
| First hospitalisation claim | Rs 5,00,000 | Rs 0 |
| Restoration triggers, refills the cover | + Rs 5,00,000 | Rs 5,00,000 |
| Second, unrelated hospitalisation later that year | Rs 3,00,000 | Rs 2,00,000 |
Without the restoration benefit, the second claim in this example would have had no sum insured left to cover it. It is important to read the policy wording carefully because some health plans restore the sum insured only for a different or unrelated illness, and some allow restoration only once in a policy year. In many plans, the restored amount cannot be used to continue paying for the same hospitalisation or claim that exhausted the original sum insured.
Read more about restoration and recharge benefits in health insurance.
Health Insurance Coverage for Day-Care Treatments are Included
Day-care treatments, which are medical procedures that once required a long hospital stay but are now completed in under 24 hours thanks to modern technology, are covered by most health insurance policies. Common day-care procedures that are typically covered include:
Cataract surgery
Dialysis
Chemotherapy
Certain endoscopic and laser procedures
Tonsillectomy and similar minor surgeries
It's important not to confuse day-care treatment with an OPD consultation. A day-care treatment is a medical procedure carried out under a doctor's supervision that is completed within the same day. It may involve anaesthesia or specialised equipment, whereas an OPD consultation is simply a visit to the doctor without being admitted to the hospital.
Read your policy schedule and wording
Every health insurance policy is different. The benefits, waiting periods, limits, and exclusions can vary not just between insurers but even between different plans from the same insurer. Before you use any benefit or make a claim, take a few minutes to read your policy schedule and policy wording. They'll tell you exactly what's covered, what's not, and any conditions you need to know.
AYUSH Treatments are Included
Many health policies cover AYUSH treatments, which are treatments under Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy. However, this benefit is usually available only if certain policy conditions are met. For example:
The treatment generally needs to be taken as an inpatient in a government hospital or a recognised, registered AYUSH hospital or facility.
Some health plans cap the AYUSH benefit at a percentage of the sum insured rather than the full amount.
Outpatient AYUSH consultations may not be covered unless your plan specifically includes OPD.
You Can Switch Health Insurers Without Losing Your Benefits
Not happy with your current health insurer? You don't always have to buy a new policy and start from scratch. With health insurance portability, you can switch to another insurer while carrying forward the waiting periods you've already completed, including the waiting period for pre-existing diseases.
Here's how the process usually works:
Apply before renewal
Request portability from the new insurer at least 45 days before your existing policy's renewal date.
Submit the proposal and history
Fill out the portability and proposal forms; the new insurer collects your medical and claim history from the old insurer.
Underwriting review
The new insurer assesses your application and decides whether to accept, with or without changed terms.
Continuity of credit
Once accepted, the waiting periods you have already completed are carried over to the new policy.
Key Takeaways
Many health plans include a free preventive health check-up, sometimes yearly and sometimes after one or two claim-free years.
Restoration (or refill) of the sum insured can bring back your coverage after it has been exhausted during a policy year. However, the benefit comes with conditions, such as being available only once a year or only for an unrelated illness.
Most health insurance plans cover day-care procedures like cataract surgery, dialysis, and chemotherapy. You don't always need to be admitted to the hospital for 24 hours to make a claim.
Many health insurance plans also cover AYUSH treatments such as Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy. Make sure the treatment is taken at an eligible hospital or centre and meets your policy's conditions.
Frequently asked questions
No. A free preventive health check-up is a policy benefit and it does not affect your sum insured. However, it is important to know that many insurance companies reimburse the expenses only up to a specified limit, so it's a good idea to check your policy details.
Usually, no. In most cases, a health insurance plan restores the sum insured only for another disease. The restored sum insured cannot be used for the illness that led to exhaustion of your cover.
No. A day-care treatment is a medical procedure performed under clinical supervision that is completed in less than 24 hours, such as cataract surgery or dialysis. An OPD consultation is simply a visit to a doctor and is covered only if your policy includes OPD benefits.
Yes. In case you choose to port your health insurance policy, all the waiting periods which you have already completed, including those for the pre-existing illnesses, are transferred to the new company as per the guidelines laid down by the IRDAI.
Usually, no. Most health insurance policies cover inpatient AYUSH treatment at recognised or government-approved AYUSH hospitals or centres. Routine out-patient AYUSH consultations are covered only if your policy specifically includes OPD benefits.
About the authors
Neviya Laishram
Written by · Senior Editor – Health, Life and Group Health Insurance Content at ACKOWith a journalism background, she brings 9 years of experience in strategising and editing health, life, and group health insurance content. Having written for magazines and digital publications, she combines research and editorial expertise to create credible, useful content for readers.
Dr Nitin Kumar Gupta
Reviewed by · SVP – Health Underwriting & Claims at ACKO General InsuranceWith 20+ years of experience in digital transformation and growth, he is a leader specialising in health, life, accident, and disability insurance. Backed by an MBBS degree and insurance designations (FLMI, FALU, FLHC, ACS, ARA), he combines expertise with leadership.
