Unlocking the Benefits: A Comprehensive Guide to Annual Health Checkups

As an aware customer, we have taken health insurance policy of any popular health insurance company, but we don’t know how to get benefits even if not claimed. Remember all the health insurance companies are offering annual health checkups free of cost to their policyholders, but it seems in my personal experience that they are not promoting this as an additional cost to health insurance companies. But as a policyholder, we have the right to get these benefits during the policy periods. All the companies have their terms and conditions for this.

In this article, explains the top 5 health insurance companies and how they offer health checkups for their top and popular health insurance plans.

HDFC Ergo Optima Secure – HDFC Ergo’s Optima Secure which is one of the most popular and best health insurance plans, also offers annual health checkups to its policyholders, which are as follows:-

Package– Not designed by the company policyholder can take the health checkups on their own and filed the reimbursement claim as per the policy sum insured. In the Individual plan 5 lakh SI up to Rs.1500, for 10 Lakh SI Rs.2000, for 15 Lakh SI Rs.4000, for 20, 25 and 50 Lakh SI Rs.5000 and for 1 Cr and 2 Cr SI Rs.8000 after 1st renewal of the policy.

for Family Floater policies limits will be for 5 Lakh SI Rs.2500, 10 Lakh SI Rs. 5000, 15 Lakh SI Rs. 8000, for 20,25 and 50 Lakh SI Rs. 10000 and 1 Cr & 2 Cr SI Rs. 15000 per policy year after 1st renewal of the policy.

Eligibility– for all insured members

How to avail – written request by the policyholder to the company through an Advisor/Agent or directly to the company.

Conditions– The policyholder should have done 1st renewal, which means these benefits can be availed after one year of the policy and it will not be carried forward. Costing of the health checkups will not reduce the Sum Insured, it is a complementary benefit by the insurance company to their policyholders and included in the plan.

Medical Reports – After Completion of the annual health checkups / preventive health checkups, the company will arrange medical reports from their respective service partner (e.g. medical aggregator / diagnostic centre) to policyholders as per the defined service days.

Niva Bupa ReAssure 2.0 – Ever since Niva Bupa launched this plan in February 2023, this plan has become their flagship plan, due to its unique features, which will be discussed in another article. For Preventive Health Checkups, details as below:-

Package – Complete blood count (CBC) Complete Physical Examination by Physician Serum Electrolytes Urine Routine & Microscopic Post prandial/lunch blood sugar (PPBS / PLBS) HbA1C Erythrocyte Sedimentation Rate (ESR) Uric Acid Thyroid function test Fasting Blood sugar (FBS) Lipid Profile Liver Function Test (LFT) Electrocardiogram (ECG) Kidney function test Treadmill test (TMT) OR 2 D ECHO X Ray chest Serum Vitamin D Ultrasound test (USG) Mammogram Colonoscopy (for >50 year olds) Serum calcium PAP smear.

Eligibility– All insured members per policy year, packages will vary as per the insured member’s age and the sum insured.

How to avail – written request by the policyholder to the company through an Advisor/Agent or directly to the company.

Conditions– It is only on Cashless at the Insurer’s network Hospital/Diagnostic Centre. Reimbursement is not allowed. Costing of the health checkups will not reduce the Sum Insured, it is a complementary benefit by the insurance company to their policyholders and is included in the plan, for every policy.

Medical Reports – After Completion of the annual health checkups / preventive health checkups, the company will arrange medical reports from their respective service partner (e.g. medical aggregator / diagnostic centre) to policyholders as per the defined service days.

Aditya Birla Health Activ One Max– It is recently launched by Aditya Birla Health Insurance and with unique features and benefits and offers preventive health checkups from day one of the policy, here are details below:-

Package:-

Sum Insured	up to 10 Lakh	15 Lakh to 25 Lakh	50 Lakh to 2 Cr
Test	MER, CBC with ESR, Urine routine, Blood Group, Blood Sugar, Lipid Profile, Kidney Function Test, ECG	MER, CBC with ESR, Urine routine, Blood Group, Blood Sugar, Lipid Profile, TMT, Kidney Function Test	MER, CBC with ESR, ABO Group & Rh type, Urine-routine, Stool-routine, S Bilirubin (total / direct), SGOT, SGPT, GGT, Alkaline phosphatase, Total Protein, Albumin: Globulin, Liver Function Test, TMT, ECG, Cholesterol, LDL, HDL, Triglycerides, VLDL, Creatinine, Blood Urea Nitrogen, Uric acid, Hba1C, Chest X ray, USG Abdomen

Eligibility– All insured members who completed 18 years of age.

How to avail – written request by the policyholder to the company through an Advisor/Agent or directly to the company.

Conditions – It is only on Cashless at the Insurer’s network Hospital/Diagnostic Centre. Reimbursement is not allowed. Costing of the health checkups will not reduce the Sum Insured, it is a complementary benefit by the insurance company to their policyholders and is included in the plan, for every policy.

Medical Reports – After Completion of the annual health checkups / preventive health checkups, the company will arrange medical reports from their respective service partner (e.g. medical aggregator / diagnostic centre) to policyholders as per the defined service days.

Tata AIG Medicare Premier– As we know among health insurance TATA is one of the largest market players and offers each policy year Preventive Health Checkups to their policyholders, details as below:-

Package– Tata AIG General Insurance will provide the Preventive Health Checkups upon the reimbursement basis as per the Sum Insured, The customer can avail of this per policy year, per policy and filled the reimbursement claim to the insurance company

Sum Insured	Upto 50 Lakh	75 Lakh	1 Cr	2 Cr	3 Cr
Health Checkups	Upto 1% of Sum Insured; maximum Rs.10,000 per policy	Upto 1% of Sum Insured; maximum Rs.15,000 per policy	Upto 1% of Sum Insured; maximum Rs. 20,000 per policy	Upto 1% of Sum Insured; maximum Rs.25,000 per policy	Upto 1% of Sum Insured; maximum Rs. 50,000 per policy

Eligibility– All the insured persons within the above-mentioned chart.

How to avail – written request by the policyholder to the company through an Advisor/Agent or directly to the company.

Conditions – Preventive Health Checkups will be on the reimbursement mode as per the above-mentioned chart.

Medical Reports – After Completion of the annual health checkups / preventive health checkups, the company will arrange medical reports from their respective service partner (e.g. medical aggregator / diagnostic centre) to policyholders as per the defined service days

Care Supreme – Care Health Insurance is a famous name in Indian Health Insurance and it has been operating for more than a decade it also provides preventive health checkups once every year to its policyholders, details as follows:-

Package– For insured persons below 18 years of age, irrespective of the Sum Insured test will be arranged “Physical Examination(BMI) Eye Examination, Dental Examination and Scoring, Growth Charting, Doctor Consultation, RUA. But for the above 18 years of age, the package will depend upon the Sum Insured as well, as below

Sum Insured	Packages
5 Lakhs to 10 Lakhs	Complete Blood Count(CBC), Urine Routine, ESR, ABO Group & Rh Type, Blood Sugar Fasting, Cholesterol, Cholesterol Direct LDL, CholesterolHDL, Triglycerides, Total Cholesterol/HDL Ratio, Creatinine, Blood Urea Nitrogen, Bun/ Creatinine Ratio, Uric Acid
Above 10 Lakhs	Complete Blood Count(CBC), Urine Routine, ESR, ABO Group & Rh Type, Blood Sugar Fasting, Cholesterol, Cholesterol Direct LDL, CholesterolHDL, Triglycerides, Total Cholesterol/HDL Ratio, Creatinine, Blood Urea Nitrogen, Bun/ Creatinine Ratio, Uric Acid, Treadmill Test

Eligibility – For all insured members each per policy year.

How to avail – written request by the policyholder to the company through an Advisor/Agent or directly to the company.

Conditions – It will be arranged through the Network Hospital/Diagnostic Center of the insurance company on and cashless basis with a pre-defined preventive health checkup package mentioned above. For all insured members per policy year, it will not reduce the sum insured from the policyholder’s policy.

Medical Reports – After Completion of the annual health checkups / preventive health checkups, the company will arrange medical reports from their respective service partner (e.g. medical aggregator / diagnostic centre) to policyholders as per the defined service days.

All these Preventive Health checkups for top and popular health insurance companies. Behind these features company wants to know how probable the claim will impact in future based on the current medical conditions of their policyholders. A soft copy of medical reports will be provided to the policyholders and another to the insurance company.

In this activity, multiple stakeholders involvement is there, 1st the Policyholder, 2nd the Insurance Company, 3rd Medical Aggregator (if Any like TPA) & the 4th and most importantly Hospital/Diagnostic Centre where the preventive health checkups will be conducted.

Conclusion– Each Health insurance company will offer preventive health checkups for their customer but it’s on a request basis by them only, so avail of these benefits every year to get your health status, as prevention is better than cure is always a universal truth. All the above-mentioned information is based on real experience and policy wording of the respective plans, which might be changed as per the respective companies’ internal policy from time to time.

About the writer – Kumar has more than 2 decades of personal finance Sales, Operations, Health Insurance Underwriting, and Health Insurance Claims, and has been associated with multiple training teams for Learning and Development.