Your health cover, explained.
An individual or family floater policy, a senior citizen's plan, a top-up or super top-up, before you buy or after: what the sum insured pays on a real hospital bill, room rent and the cut on other charges, co-pay and caps, every waiting period by date, exclusions against IRDAI's standard list, your rights and the tax saved, worked out by code from your own CIS and policy.
For policies you buy yourself. Employer group cover isn't covered yet.
Your cover, at a glance.
In rupees, from the documents.
On the samples: money you may be owed, could save, or have at risk. Each figure is a finding's own, with its calculation and source; options are never added together.
What to upload, step by step.
Pick what you have. Each one says where to get the document, how to save it, and what must be readable. Myra reads only what you upload; it never signs in to your insurer for you.
A policy you're thinking of buying
Before buying- 1.Ask the insurer, agent or bank for the quote for your family's ages and the sum insured, and for the Customer Information Sheet (CIS). Insurers must give the CIS with the policy; ask for it before you sign, it's a short summary in a standard format.
- 2.Buying online: download the quote or premium summary from the insurer's site, or use the browser's Print → Save as PDF. The CIS and the policy wording are usually on the product's page, under Downloads or Brochure & wording; match the plan name and UIN.
- 3.On a phone, take screenshots of every page of the quote instead.
- 4.Upload the quote and the CIS in the same check. Add the brochure or policy wording if you have them.
Myra will then ask: Who in the family is covered, if the quote doesn't show it, and the ages of anyone over 60, for the tax test.
Must be readable
- Plan name and type (individual, floater, top-up, super top-up)
- Sum insured and the premium for it
- Who's covered and their ages
- Room rent limit or room category
- Co-pay, deductible and caps on treatments
- Waiting periods
If something isn't found, Myra says exactly what's missing and asks for it.
How uploading works
PDF, JPG or PNG, up to 15 MB each; up to 5 files at once and 8 in one check. Sign in first, then drop the files on the upload card at the top of this page. Documents for one policy go in the same check; more can be added later.
Good photos and screenshots
Whole page, flat and in good light; the plan name visible in at least one of them; numbers sharp enough to read. Every page of the schedule, not just the first.
What's kept, and what isn't
Myra keeps the names, dates of birth and declared conditions of the people insured, encrypted, so it can answer about each person's cover; delete them any time from the report. Only the policy number's last 4 digits; never ID numbers, addresses or phone numbers. A protected PDF's password is used once and forgotten. Never send your insurer login or an OTP.
What the policy would pay.
Move the room rent, the days and each part of the bill. See every cut in order: items not paid, room rent, the proportionate cut, caps, co-pay. Free, no sign-in. The insurer decides what's admissible on a real claim.
| Step | Taken off | Left |
|---|---|---|
| The bill | — | ₹2,28,000 |
| Consumables not paid Gloves, masks, PPE kits and similar items aren't paid without a consumables cover. | −₹8,000 | ₹2,20,000 |
| Room rent above the limit The policy pays the room rent up to its limit a day; the rest of the room rent is yours. | −₹20,000 | ₹2,00,000 |
| Proportionate cut on room-linked charges Doctors', surgeons', OT and nursing charges are paid in the same proportion as the room rent. Medicines, implants, diagnostics and ICU charges aren't cut. | −₹60,000 | ₹1,40,000 |
Nine checks, one report.
Each one runs only when your documents support it, cites the line it used, and says what's still to confirm.
Top-up or super top-up.
Add a year's hospital stays and see what each kind would pay above the deductible. Numbers, not a recommendation.
| Stay | Admissible | Super top-up pays |
|---|---|---|
| Stay 1 | ₹3,00,000 | ₹0 |
| Stay 2 | ₹4,00,000 | ₹2,00,000 |
Rules, not search results.
IRDAI's health insurance rules and the income-tax rules, applied by the date your policy started. Myra never calls a term wrong without saying which rule and which line of your documents it used.
| Area | What Myra checks on your policy |
|---|---|
| Waiting periods | For policies from 1 Apr 2024: pre-existing diseases covered after at most 36 months of continuous cover, named illnesses and procedures after at most 36 months, never for accidents; no cover for illness in the first 30 days, except accidents. Older policies: up to 48 months. |
| Moratorium | After 60 continuous months of cover (years with an earlier insurer count when ported), a policy or claim can't be contested for non-disclosure, except proven fraud. |
| Room rent | Above the room limit, other charges linked to the room can be cut in proportion, but never medicines, implants, devices or diagnostics, never ICU charges, and not where the hospital charges the same for every room. |
| Exclusions | 18 standard wordings; some conditions can't be excluded, such as mental illness, internal congenital diseases and age-related macular degeneration. Listed modern treatments must be covered, possibly with a cap. |
| Your rights | A 30-day free look; a grace period of 15 days for monthly premiums, 30 otherwise; renewal not refused because you claimed; for a claim-free year, a higher sum insured, a lower premium or both, your choice; porting keeps your credits, with a decision in 5 days. |
| Claims | Cashless approval within 1 hour, final approval at discharge within 3 hours; reimbursement within 15 days of submitting the claim, with interest at the bank rate + 2% if late. A rejection needs the insurer's claims review committee. |
| Seniors | No upper age to buy. For individual policies of senior citizens, insurers must consult IRDAI before raising the premium more than 10% a year. |
| Tax and GST | Section 126 of the Income-tax Act, 2025 (formerly 80D), old regime only: up to ₹25,000 for your family (₹50,000 with a senior) and the same again for parents. No GST on individual and family policies from 22 Sep 2025. |
| Complaints | The insurer's grievance officer first, also through Bima Bharosa; then the Insurance Ombudsman (Bima Lokpal), free, for amounts up to ₹50 lakh. |
Questions policyholders actually ask.
Answered from your documents, with the line, the calculation and what's still unconfirmed. Drafts a request to the insurer when one would help; you send it.
Before buying
A policy I hold
Senior citizens
Top-ups
Know what your policy really pays.
Health policies from insurers in India, bought by you. The samples use invented insurers.