What does Bajaj Allianz health insurance coverage include?

It covers hospitalisation, day-care procedures, pre- and post-hospitalisation expenses, organ donor costs, and advanced treatments depending on the plan variant.

Are pre-existing diseases covered?

Yes, after the waiting period (typically 24–48 months) depending on the plan, chronic and lifestyle diseases become eligible for coverage.

Does it cover maternity treatment?

Selected plans offer maternity and newborn benefits, subject to waiting periods and annual limits for both mother and child.

Are alternative treatments like Ayurveda covered?

Yes, in-patient treatments under AYUSH systems (Ayurveda, Yoga, Unani, Siddha, Homeopathy) are included in certain plans.

How does the cashless claim process work?

Cashless treatment is available at network hospitals by informing the insurer/TPA and presenting your health card for pre-authorization.

Are day-care procedures included?

Yes, treatments requiring less than 24-hour hospitalisation, such as dialysis, chemotherapy, or cataract surgery, are covered under Bajaj Allianz health insurance benefits.

What is the waiting period for pre-existing diseases?

Waiting periods vary from 24–48 months depending on the plan; claims for pre-existing conditions aren’t payable until this period ends.

Does it cover lifestyle diseases like diabetes and hypertension?

Yes, lifestyle diseases and their complications are covered once the waiting period for pre-existing conditions is completed.

Can I add critical illness cover?

Some variants allow optional critical illness riders, offering a lump sum payout on diagnosis of specified critical conditions.

Are hospital room rent and ICU charges included?

Yes, inpatient hospitalisation, ICU, nursing, doctor fees, and surgical expenses are part of the core Bajaj Allianz health insurance coverage.

Does it cover organ transplant expenses?

Selected plans cover the medical and surgical costs for organ donors and recipients during transplantation.

What is not covered under the policy?

Cosmetic surgery, infertility treatments, substance abuse, experimental therapies, rest cure, and non-network hospital treatments are excluded.

Can I customise my plan?

Yes, optional add-ons include maternity cover, critical illness benefit, personal accident cover, and higher sum insured options.

How does reimbursement work at non-network hospitals?

Pay the hospital upfront, submit bills and documents, and receive reimbursement as per the policy terms.

Does the policy include preventive care?

Certain plans offer annual health check-ups, wellness programs, and fitness rewards to encourage healthy living and early detection of diseases.

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97%

Claim Settlement Ratio (FY 24-25)

18,400 +

Network Hospitals

100 %

Claims Paid Within 3 Months

97%

Claim Settlement Ratio (FY 24-25)

18,400 +

Network Hospitals

100 %

Claims Paid Within 3 Months

Bajaj Allianz Health Insurance Coverage & Benefits

Customer Testimonials

Real experiences from our valued customers who have chosen our insurance coverage.

Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family……always been available to assist with any insurance/claim queries.

Nakul N

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family……always been available to assist with any insurance/claim queries.

Nakul N

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

My heartfelt thanks to the OneAssure team for making my insurance claim process effortless. Right from the very first interaction, they demonstrated professionalism, clear communication, and an impressive command of the procedures involved. Their swift updates, timely guidance, and persistent follow-through removed all the stress from what could have been a complicated experience.

Anju Renjith

I am truly grateful for the support and guidance I received in settling my insurance claim. The entire process was handled with great professionalism, clarity, and efficiency. Their prompt response, deep knowledge of the procedures, and consistent follow-ups ensured a smooth and hassle-free experience.Thank you once again for your invaluable help, highly recommended!

Yogesh Meena

I recently had the pleasure of purchasing health insurance for my parents through this company, and my experience has been exceptional...The team was incredibly patient and took the time to explain every detail to me. No matter how many times I asked questions, they were always calm and thorough in their explanations. Their professionalism and dedication made a significant difference in helping me make an informed decision.

Akash Kumar

OneAssure helped me understand my needs and choose a product that was right for me. There was no pressure tactics or mis-selling. This experience was respectful, informed, and completely stress-free.

Shreya Goyal

Had a great experience with OneAssure during my insurance claim process. A special shoutout to Sunad Raj for his exceptional support, he was professional, responsive, and guided me every step of the way. Thanks to his consistent follow-ups and clear guidance, the entire claim settlement was smooth and hassle-free. Highly recommend OneAssure for their service and transparency!

Sanjay Dakalia

The team is very professional and prompt. I would have all my health and life insurance needs met through them.

Harish Jindal

Very professional service from Ruchir & Aman. They were recommended by a friend who had a positive experience with them. I have taken both health and life policies through them and they have advised me well throughout the process and found the best options available in the market. I had a medical condition due to which it was difficult to find a suitable health policy in the market, however this team was able to find one for me. I would recommend their services to anyone looking to buy health or life insurance.

Siddhartha Saha

Wonderful experience with Prost. Right from suggesting the insurance products to claim process the entire experience hai been seamless. They do not mis-sell and are very transparent. Sundar Raj from the team has been wonderful and ensured prompt guidance. All the best Ruchir and keep up the good work!

Adarsh Ravindranathan

verdict

Our Verdict: Bajaj Allianz Health Insurance Coverage

Pros

Wellness benefits including annual check-ups and Health Prime Rider.

Fast claims with 97% settlement and most paid within 3 months.

High sum insured from ₹3 Lakh to ₹5 Crore.

Customisable plans with optional covers like OPD, maternity, and international emergencies.

Cons

Multiple plan options can be confusing.

Limited AYUSH coverage in some plans.

Long waiting periods for pre-existing conditions.

Higher premiums for top-tier plans.

Pros

Wellness benefits including annual check-ups and Health Prime Rider.

Fast claims with 97% settlement and most paid within 3 months.

High sum insured from ₹3 Lakh to ₹5 Crore.

Customisable plans with optional covers like OPD, maternity, and international emergencies.

Cons

Multiple plan options can be confusing.

Limited AYUSH coverage in some plans.

Long waiting periods for pre-existing conditions.

Higher premiums for top-tier plans.

Final Verdict

Bajaj Allianz Health Insurance provides comprehensive and flexible health coverage suitable for individuals and families seeking reliable protection. The plans stand out for their high sum insured options, ranging from ₹3 Lakh to ₹5 Crore, and customisable features like OPD, maternity, and international emergency coverage. The company maintains a strong...

Bajaj Allianz Health Insurance provides comprehensive and flexible health coverage suitable for individuals and families seeking reliable protection. The plans stand out for their high sum insured options, ranging from ₹3 Lakh to ₹5 Crore,...

Key Coverages & Benefits Offered Under Bajaj Allianz Health Insurance

Understand what Bajaj Allianz Health Insurance covers and what it excludes, so you can choose the right plan with confidence

Inclusions

Organ donor expenses including hospitalisation and surgery costs.

AYUSH in-patient treatments under Ayurveda, Unani, Siddha, and Homeopathy.

Maternity and newborn care (plan-specific, subject to waiting periods).

Domiciliary treatment at home when hospitalisation isn’t possible.

Day-care procedures like dialysis, chemotherapy, and minor surgeries.

Pre- and post-hospitalisation expenses for tests, consultations, and treatment.

Covers in-patient hospitalisation including room rent, ICU, doctors’ fees, medicines, and procedures.

Exclusions

Treatment at unregistered hospitals or admissions only for rest, rehabilitation, or observation.

Experimental or unapproved therapies.

Substance abuse or self-inflicted injuries.

Infertility and reproductive treatments like IVF.

Cosmetic or elective surgeries unless medically necessary.

Pre-existing diseases before the waiting period.

Illnesses during the first 30 days (except accidents).

Inclusions

Organ donor expenses including hospitalisation and surgery costs.

AYUSH in-patient treatments under Ayurveda, Unani, Siddha, and Homeopathy.

Maternity and newborn care (plan-specific, subject to waiting periods).

Domiciliary treatment at home when hospitalisation isn’t possible.

Day-care procedures like dialysis, chemotherapy, and minor surgeries.

Pre- and post-hospitalisation expenses for tests, consultations, and treatment.

Covers in-patient hospitalisation including room rent, ICU, doctors’ fees, medicines, and procedures.

Exclusions

Treatment at unregistered hospitals or admissions only for rest, rehabilitation, or observation.

Experimental or unapproved therapies.

Substance abuse or self-inflicted injuries.

Infertility and reproductive treatments like IVF.

Cosmetic or elective surgeries unless medically necessary.

Pre-existing diseases before the waiting period.

Illnesses during the first 30 days (except accidents).

Claims Process

How to file Bajaj claims?

Bajaj Allianz Health Insurance Coverage & Benefits

How Coverage and Benefits Vary in Bajaj Allianz Health Insurance

Treatment Coverage Differs Across Plans

All plans cover hospitalisation, day-care procedures, and pre- & post-hospitalisation expenses, but sub-limits and inclusions vary. Premium plans may offer higher coverage for maternity, AYUSH treatments, and advanced procedures.

Value-Added Benefits Vary by Plan

Higher-tier plans include features like sum insured restoration, cumulative bonuses for claim-free years, annual health check-ups, and wellness rewards. Lower-tier plans may offer limited additional benefits.

Optional Add-Ons and Riders

Critical illness cover, personal accident riders, or top-up plans can be added to enhance coverage, depending on the variant. These add-ons make your policy more comprehensive and tailored to your needs.

Treatment Coverage Differs Across Plans

All plans cover hospitalisation, day-care procedures, and pre- & post-hospitalisation expenses, but sub-limits and inclusions vary. Premium plans may offer higher coverage for maternity, AYUSH treatments, and advanced procedures.

Value-Added Benefits Vary by Plan

Higher-tier plans include features like sum insured restoration, cumulative bonuses for claim-free years, annual health check-ups, and wellness rewards. Lower-tier plans may offer limited additional benefits.

Optional Add-Ons and Riders

Critical illness cover, personal accident riders, or top-up plans can be added to enhance coverage, depending on the variant. These add-ons make your policy more comprehensive and tailored to your needs.

How to Choose

How to Choose the Right Health Insurance Coverage

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What is the Waiting Period in Bajaj Allianz Health Insurance?

A waiting period is the minimum time you must complete after buying your Bajaj Allianz health policy before you can claim for certain illnesses, procedures, or pre‑existing conditions. Any medical expense related to a condition still under this waiting period will be denied.

Initial Waiting Period – 30 Days

For most illnesses, there is a 30-day waiting period from the policy start date. Accidental hospitalisation is covered immediately and does not fall under this waiting period.

Pre‑Existing Disease (PED) Waiting Period

The PED waiting period under Bajaj Allianz is 36 months (3 years) of continuous coverage for plans like Health Guard Gold or Platinum. Only conditions disclosed at the time of policy purchase are considered.

Specified Diseases / Procedures Waiting Period – 24 Months

Certain listed diseases and surgical procedures—such as cataract, hernia, kidney stones, mental illness, and selected internal surgeries—are covered only after 24 months of continuous coverage.

Maternity Waiting Period

For Gold and Platinum variants of Health Guard, the waiting period for maternity benefits (including pregnancy, delivery, and newborn care) is 72 months (6 years) of continuous coverage.

Other Waiting Periods (Plan-Specific)

Bariatric surgery has a waiting period of 36 months in some plans.
Waiting periods may apply again if you enhance the sum insured for PED or specified diseases unless continuous prior coverage is maintained.

Initial Waiting Period – 30 Days

For most illnesses, there is a 30-day waiting period from the policy start date. Accidental hospitalisation is covered immediately and does not fall under this waiting period.

Pre‑Existing Disease (PED) Waiting Period

The PED waiting period under Bajaj Allianz is 36 months (3 years) of continuous coverage for plans like Health Guard Gold or Platinum. Only conditions disclosed at the time of policy purchase are considered.

Specified Diseases / Procedures Waiting Period – 24 Months

Certain listed diseases and surgical procedures—such as cataract, hernia, kidney stones, mental illness, and selected internal surgeries—are covered only after 24 months of continuous coverage.

Maternity Waiting Period

For Gold and Platinum variants of Health Guard, the waiting period for maternity benefits (including pregnancy, delivery, and newborn care) is 72 months (6 years) of continuous coverage.

Other Waiting Periods (Plan-Specific)

Bariatric surgery has a waiting period of 36 months in some plans.
Waiting periods may apply again if you enhance the sum insured for PED or specified diseases unless continuous prior coverage is maintained.

Diseases Covered/not Covered

Diseases Covered/Not Covered Under Bajaj Allianz Health Insurance

Diseases Covered

Congenital & Genetic Conditions

Experimental or Unproven Treatments

Substance Abuse & Self-Inflicted Injuries

Cosmetic & Elective Procedures

Pregnancy & Maternity

Critical Illnesses (Optional Add-On)

Specified Illnesses & Procedures

Pre-Existing Diseases

Diseases / Conditions Not Covered

Initial Waiting Period Exclusions

Congenital & Genetic Conditions

Experimental or Unproven Treatments

Weight Management & Obesity Treatments

Sexually Transmitted Diseases (STDs)

Substance Abuse & Self-Inflicted Injuries

Cosmetic & Elective Surgeries

Pregnancy, Maternity & Childbirth

Diseases Covered

Congenital & Genetic Conditions

Experimental or Unproven Treatments

Substance Abuse & Self-Inflicted Injuries

Cosmetic & Elective Procedures

Pregnancy & Maternity

Critical Illnesses (Optional Add-On)

Specified Illnesses & Procedures

Diseases / Conditions Not Covered

Initial Waiting Period Exclusions

Congenital & Genetic Conditions

Experimental or Unproven Treatments

Weight Management & Obesity Treatments

Sexually Transmitted Diseases (STDs)

Substance Abuse & Self-Inflicted Injuries

Cosmetic & Elective Surgeries

Pre-existing Diseases

Pre-Existing Diseases Covered Under Bajaj Allianz Health Insurance

Chronic Lifestyle Conditions

Pre-existing conditions like diabetes, hypertension, and related complications are covered once you complete the mandatory waiting period specified in your plan.

Heart & Cardiac Disorders

Heart-related illnesses such as coronary artery disease, previous cardiac surgeries, and other cardiac complications become eligible for coverage after the PED waiting period.

Respiratory Diseases

Chronic respiratory conditions like asthma, COPD, and bronchitis are covered once the waiting period ends, ensuring long-term protection.

Thyroid & Hormonal Disorders

Conditions like hypothyroidism, hyperthyroidism, and other endocrine-related disorders are included after completing the PED waiting period.

Joint & Musculoskeletal Issues

Arthritis, osteoarthritis, spondylosis, and similar chronic joint problems are covered post waiting period, allowing for treatments like joint replacement if needed.

Digestive & Gastrointestinal Conditions

GERD, chronic acidity, ulcers, and other persistent digestive issues are covered after the applicable waiting duration.

Kidney & Liver Disorders

Chronic kidney disease, kidney stones, hepatitis, and other liver-related complications are included once the PED waiting period is completed.

Mental Health Conditions

In-patient psychiatric treatments for pre-existing mental health conditions are covered after serving the waiting period.

Chronic Lifestyle Conditions

Pre-existing conditions like diabetes, hypertension, and related complications are covered once you complete the mandatory waiting period specified in your plan.

Heart & Cardiac Disorders

Heart-related illnesses such as coronary artery disease, previous cardiac surgeries, and other cardiac complications become eligible for coverage after the PED waiting period.

Respiratory Diseases

Chronic respiratory conditions like asthma, COPD, and bronchitis are covered once the waiting period ends, ensuring long-term protection.

Thyroid & Hormonal Disorders

Conditions like hypothyroidism, hyperthyroidism, and other endocrine-related disorders are included after completing the PED waiting period.

Joint & Musculoskeletal Issues

Arthritis, osteoarthritis, spondylosis, and similar chronic joint problems are covered post waiting period, allowing for treatments like joint replacement if needed.

Digestive & Gastrointestinal Conditions

GERD, chronic acidity, ulcers, and other persistent digestive issues are covered after the applicable waiting duration.

Kidney & Liver Disorders

Chronic kidney disease, kidney stones, hepatitis, and other liver-related complications are included once the PED waiting period is completed.

Mental Health Conditions

In-patient psychiatric treatments for pre-existing mental health conditions are covered after serving the waiting period.

Customize Plan Options

How to Customize Bajaj Allianz Health Insurance for Maximum Coverage

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Bajaj Allianz Health Insurance Coverage & Benefits

Related Health Insurance Plans

Senior Citizen Health Plan

Secure against age-related medical costs
Tailored for seniors healthcare needs

Family Health Plan

One policy covers the entire family
High sum insured with cashless care
Multiple coverage options based on your family needs

Maternity Health Plan

Covers delivery, newborn care, and maternity expenses
Reduces financial stress of childbirth costs

Senior Citizen Health Plan

Secure against age-related medical costs
Tailored for seniors healthcare needs

Family Health Plan

One policy covers the entire family
High sum insured with cashless care
Multiple coverage options based on your family needs

Maternity Health Plan

Covers delivery, newborn care, and maternity expenses
Reduces financial stress of childbirth costs

Coverage & Benefits

Still Confused? Get Expert Guidance

Our insurance experts are here to help you make the right choice. Get personalized recommendations based on your specific needs and budget.

Claim Settlement

FAQs Frequently Asked Questions

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