Health Insurance Guide for Returning NRIs - What You Need to Know Before Moving Back

You've just received comprehensive health coverage in Dubai for years. Emergency room visits, specialist consultations, annual check-ups – all seamlessly covered. Your employer's insurance plan handled everything. Now you're planning to return to India permanently, and you're expecting something similar.

Here's what most returning NRIs discover too late: Indian health insurance works differently. Very differently.

We have advised hundreds of NRIs through their return journey at Belong, and health insurance questions always come up. Not after they land in India – but unfortunately, sometimes only after they land. By then, they're facing waiting periods, coverage gaps, and surprises that could have been avoided.

Let us walk you through exactly what you need to know about health insurance when returning to India, so you can make this transition smoothly.

Why Your International Insurance Won't Work in India

Most NRIs assume their international health insurance will cover them once they become Indian residents. It won't.

International health insurance plans typically impose waiting periods for pre-existing conditions of 2-4 years, and many offer portability benefits only if you can prove continuous coverage abroad.

Here's the reality: International health policies typically don't cover planned or elective procedures done in India, and many treat India as a non-network region requiring advance approvals.

Even travel insurance – which some NRIs mistakenly rely on – covers only emergency medical expenses, not routine care or pre-existing conditions.

Your company insurance ends the day you resign. Your international plan has geographical restrictions. And Indian hospital bills have tripled since you left.

How Indian Health Insurance Is Different: What to Expect

Indian health insurance has improved dramatically over the past decade. India now has over 35,000 network hospitals across various insurers, with cities like Mumbai and Delhi offering cashless treatment at world-class facilities.

But there are key differences you need to understand:

Cashless Treatment System

Unlike the reimbursement models common abroad, most Indian insurers offer cashless hospitalisation at network hospitals where the company coordinates with the hospital for approval and settles the bill directly.

You won't pay upfront at network hospitals – the insurer settles directly. This works remarkably well in major cities where top-tier hospitals are part of multiple insurance networks.

Waiting Periods Are Standard

This is where most returning NRIs get caught off-guard. Most health insurance plans in India impose waiting periods of up to 3 years maximum for pre-existing diseases, per IRDAI's 2025 guidelines. (Source)

Here's what that means practically:

• 30-day initial waiting period for any claims
• 1-2 years for specific diseases (hernias, cataracts, joint replacements)
• Up to 3 years for pre-existing conditions like diabetes, hypertension, or heart disease, with some insurers offering 1-2 years via portability.

If you have diabetes and buy insurance after landing in India, you'll wait 2-4 years before any diabetes-related treatment is covered.

Lower Sum Insured Initially

Health insurance providers in India usually offer a limited sum insured to NRIs because they're considered risky applicants since they don't reside within India.

This improves once you become a resident, but initial coverage may be lower than what you're used to.

Significantly Lower Premiums

Here's the good news: A family floater plan covering ₹1 crore in India might cost less than what you paid monthly for basic coverage abroad.

Medical costs in India are dramatically lower than in the UAE, US, or UK, making comprehensive coverage affordable.

The Smart Strategy: Buy 3-4 Months Before Returning

The biggest mistake returning NRIs make is assuming they can buy health insurance after reaching India. Don't make this mistake.

Start your health insurance process at least 3-4 months before your return date.

Here's why this timing matters:

Complete Waiting Periods in Advance

If you're planning to return to India within 3-4 years, buying health insurance beforehand ensures the in-built waiting periods will be over by the time you shift back.

Think of it like this: You're currently healthy in Dubai. Buy your Indian health insurance now. By the time you return to India, those waiting periods are already served. You can raise claims immediately.

Avoid Coverage Gaps

Some insurers allow you to purchase Indian health insurance while still abroad, ensuring zero coverage gaps.

👉 Tip: Don't cancel your international insurance immediately upon return. Maintain overlap coverage for the first 2-3 months while you test your new Indian policy.

Better Documentation

While you're still abroad, you have easier access to:

• Your current insurance certificates
• Medical records from your international provider
• Employment documentation
• Tax residency certificates

All of these help with the portability process and can reduce or waive waiting periods.

Understanding Portability: Can You Transfer Your International Coverage?

This is the question we get most often: "Can I port my international health insurance to an Indian plan and avoid waiting periods?"

The answer is: Sometimes, yes.

Some insurers offer portability benefits if you can prove continuous coverage abroad.

Here's what you need:

Required Documentation for Portability:

1. Detailed medical reports from your current provider
2. Insurance certificates showing continuous coverage
3. Claims history (or no-claims certificate)
4. Medical records for any pre-existing conditions
5. Letter from international insurer confirming coverage dates

Be completely transparent about pre-existing conditions during the application process. Hidden conditions discovered later can result in claim rejections.

Not all insurers offer this portability benefit, and approval isn't guaranteed. But it's worth pursuing because approved portability can significantly reduce or eliminate waiting periods.

Types of Health Insurance Plans in India

Unlike the employer-sponsored plans common abroad, India offers multiple types of health insurance. Here's what's available:

Individual Health Insurance

Coverage for one person. Premium and coverage tailored to that individual's age, health status, and needs.

Best for: Singles, or families where members have significantly different health profiles.

Family Floater Plans

Under a floater plan, the entire sum insured is available to any family member.

If your policy has ₹50 lakh coverage, any family member can use up to that amount. You're not dividing it among members.

Best for: Young families with children, or families where members have similar health profiles.

Cost advantage: Usually cheaper than individual policies for each family member.

Senior Citizen Plans

Specialized plans for people over 60. Higher premiums, but designed for age-related conditions.

Features:

• Pre-existing disease coverage after waiting period
• No medical tests required (some policies)
• Lifetime renewal options

Top-Up and Super Top-Up Plans

These plans kick in after your base policy limit is exhausted and are remarkably affordable.

Example:

• Base policy: ₹10 lakh
• Super top-up: ₹50 lakh (triggers after ₹3 lakh deductible)
• Total effective coverage: ₹57 lakh

For returning NRIs used to higher coverage amounts, this combination approach provides comprehensive protection without breaking the bank.

What to Look for in a Health Insurance Policy

When comparing health insurance policies, focus on these factors:

1. Network Hospitals in Your City

Check if your preferred hospitals are in the network. Download the insurer's app and verify hospital locations before buying.

2. Claim Settlement Ratio

This shows what percentage of claims the insurer actually pays. Reliance General Insurance has the highest claim settlement ratio of 99.57% as of March 2025.

Look for insurers with 95%+ settlement ratios.

3. Room Rent Limits

Some policies cap room rent at 1% of sum insured per day. A ₹10 lakh policy would cover only ₹10,000/day for rooms. Premium rooms in metro hospitals can cost ₹15,000-25,000/day.

Look for policies with no room rent capping or at least 2% of sum insured.

4. Pre and Post-Hospitalization Coverage

Standard coverage is 60 days pre-hospitalization and 180 days post-hospitalization for treatments in India. Some policies offer less. Verify this.

5. Day Care Procedures

Modern treatments like chemotherapy, dialysis, and cataract surgery don't require 24-hour hospitalization. Ensure these are covered.

6. Co-payment Clauses

Some policies require you to pay 10-20% of every claim. This significantly increases your out-of-pocket expenses.

7. Waiting Period for Pre-existing Diseases

This varies from 2-4 years. According to IRDAI, a condition diagnosed 48 months prior to the policy purchase date is considered a pre-existing condition.

Choose policies with shorter waiting periods.

8. Restoration Benefit

If your sum insured gets exhausted, restoration benefit replenishes it for another claim in the same policy year. Extremely valuable for families.

Comparison: Top Health Insurance Plans for Returning NRIs (2025)

Source: Star Health Official | HDFC ERGO Official | Care Insurance Official | ICICI Lombard Official | Niva Bupa Official

👉 Tip: Don't just compare premiums. A policy that's ₹3,000 cheaper annually but has a 20% co-payment clause will cost you much more during a ₹5 lakh claim.

Pre-existing Conditions: What You Must Know

This is critical. If you have diabetes, hypertension, thyroid conditions, or any ongoing treatment, here's what happens:

Disclosure Is Mandatory

You must disclose pre-existing conditions to the insurer, or there's a very high chance your claim will be rejected.

Hidden conditions discovered during claim processing lead to:

• Complete claim rejection
• Policy cancellation
• Difficulty getting insurance elsewhere

Waiting Periods Apply

Most health insurance policies cover all pre-existing conditions after a waiting period of up to 36 months from the policy date (source).

Common waiting periods:

• Diabetes: 24-48 months
• Hypertension: 24-36 months
• Thyroid: 24-36 months
• Heart conditions: 24-36 months
• Asthma: 24-36 months

(insurer-dependent, max 3 years per IRDAI) (source)

Higher Premiums Expected

Insurance companies charge higher premiums for people with pre-existing conditions because they're perceived as high risk.

The premium increase depends on:

• Severity of the condition
• Your age
• Number of conditions
• How well-controlled the condition is

Some Conditions May Be Excluded Permanently

High-risk conditions might be permanently excluded from coverage, even after waiting periods. This is rare but happens for:

• Advanced kidney disease
• Some types of cancer
• Severe heart conditions with multiple complications

Tax Benefits Under Section 80D

Here's a benefit many returning NRIs don't know about: tax deductions on health insurance premiums.

Under Section 80D of the Income Tax Act, NRIs below 60 years of age can claim a tax deduction of up to ₹50,000 in a financial year for premiums paid towards health insurance for themselves, their family, and dependent parents.

Deduction breakdown:

• ₹25,000 for insurance for self, spouse, and children (under 60 years)
• ₹50,000 for insurance for self, spouse, and children (60+ years)
• ₹25,000 for insurance for parents (under 60 years)
• ₹50,000 for insurance for parents (60+ years)

Maximum total deduction: ₹1,00,000 per financial year

GST Refund for NRIs

NRIs can also benefit from an 18% GST refund on health insurance premiums if they pay from an NRE account and their stay abroad exceeds 182 days.

Requirements for GST refund:

1. Pay premiums annually using an NRE account only
2. Stay abroad exceeds 182 days (qualify as NRI under Income Tax Act)
3. Provide bank statements of NRE account for last 6 months
4. Submit KYC documents, international address proof
5. Provide Tax Residency Certificate (TRC)

This makes Indian health insurance even more affordable.

Common Mistakes Returning NRIs Make (And How to Avoid Them)

Mistake #1: Waiting Until After Landing

Starting the health insurance process at least 3-4 months before your return date is crucial. By the time you land, find a home, settle your kids in school, and then think about insurance – you've lost months of waiting period credit.

Solution: Start researching policies 6 months before your return date. Apply 3-4 months before.

Mistake #2: Not Disclosing Pre-existing Conditions

Thinking "they won't find out" about your diabetes or hypertension is the worst decision you can make.

Something as basic as a missing timestamp or not having evidence of an online payment can become grounds for rejection. Insurers are very thorough with documentation.

Solution: Complete transparency. List every condition, every medication. Get it in writing that these conditions are noted and will be covered after the waiting period.

Mistake #3: Choosing Based Only on Premium

The cheapest policy often has sub-limits, co-payments, and exclusions that make it expensive when you actually need to claim.

Solution: Compare total coverage, not just premium. Use our NRI Fixed Deposit rates comparison tool to understand how comparing apples-to-apples works in financial products – the same principle applies to insurance.

Mistake #4: Ignoring Network Hospitals

You buy a policy, then discover your preferred hospital isn't in the network. Now you have to pay upfront and wait for reimbursement.

Solution: Check network hospitals BEFORE buying. Download insurer apps and verify.

Mistake #5: Canceling International Insurance Too Soon

Maintaining overlap coverage for the first few months while you test your new Indian policy helps you understand claim processes and ensures you're never without coverage.

Solution: Keep both policies active for 2-3 months during transition.

Mistake #6: Not Keeping Proper Documentation

Required documents include a valid passport, overseas and Indian address proofs, treatment plans, diagnostic reports, admission and discharge summaries, hospital bills with GST details, pre-authorization letters, and a complete digital payment trail.

Solution: Create a dedicated folder (physical and digital) for all health insurance documents from day one.

Mistake #7: Buying During a Short Visit

Many policies require the insured to spend at least 182 days in India during a policy year; otherwise, future claims may be denied due to non-residency.

Solution: Only buy Indian health insurance when you're genuinely relocating, not just visiting.

How to Buy Health Insurance Before Returning to India

Here's the step-by-step process:

Step 1: Research Insurers (3-6 Months Before Return)

Compare at least 4-5 insurers. Focus on:

• Policies designed for NRIs/returning residents
• Insurers with strong claim settlement ratios
• Network hospitals in your target city in India

Step 2: Check Portability Options (3 Months Before Return)

Contact shortlisted insurers and ask:

• "Do you accept portability from international policies?"
• "What documentation do I need?"
• "Will waiting periods be waived or reduced?"

Step 3: Gather Documentation (3 Months Before Return)

Collect from your current insurer:

• Insurance certificate with coverage dates
• Medical records
• Claims history or no-claims certificate
• Letter confirming continuous coverage

Get from your employer/records:

• Employment proof
• Tax residency certificate
• Medical test reports

Step 4: Apply Online or Through Agent (2-3 Months Before Return)

Most insurers allow online applications. Some may require:

• Video KYC
• Medical tests at approved centers (some have tie-ups in UAE/US/UK)
• In-person documentation (rare, but possible)

Step 5: Medical Underwriting

A medical test may be mandatory especially for applicants with pre-existing conditions or older individuals.

Tests typically include:

• Blood sugar (fasting and post-prandial)
• Lipid profile
• Kidney function
• Liver function
• Blood pressure
• ECG (for 45+ age group)

Step 6: Policy Issuance

Once approved, you'll receive:

• Policy document
• Insurance card
• Login credentials for insurer portal/app
• List of network hospitals

Step 7: Maintain Both Policies During Transition

Keep your international insurance active for 2-3 months after landing in India. This gives you time to:

• Test the Indian insurance claim process
• Identify network hospitals
• Understand policy nuances
• Ensure no coverage gaps

How to File Claims in India

The claims process in India is straightforward once you understand it:

For Planned Hospitalizations (Cashless)

1. Inform insurer 48-72 hours before admission
2. Get pre-authorization approved (insurer reviews and approves coverage)
3. Show insurance card at network hospital during admission
4. Hospital bills insurer directly for covered expenses
5. You pay only for excluded items/co-payment (if applicable)

For Emergency Hospitalizations (Cashless)

1. Show insurance card immediately upon admission
2. Hospital contacts insurer for emergency pre-authorization
3. Inform insurer within 24 hours (or as per policy terms)
4. Hospital and insurer coordinate for bill settlement

For Reimbursement Claims (Non-network Hospital)

1. Inform insurer within 24-48 hours of hospitalization

2. Keep ALL bills, prescriptions, reports

3. Submit completed claim form within 15-30 days of discharge

4. Include:

• Claim form (signed by doctor)
• Original bills and receipts
• Discharge summary
• All test reports
• Prescriptions
• Payment receipts (must be digital/documented)

1. Insurer reviews and processes (usually 15-30 days)

2. Amount credited to your bank account

👉 Tip: Always inform your insurer within 24-48 hours of any planned treatment and get pre-authorization. This single step prevents 80% of claim rejections.

Special Considerations for Retired NRIs

If you're returning to India after retirement, health insurance becomes even more critical.

Ayushman Bharat Scheme

Over 1.06 lakh Ayushman Vay Vandana cards have been issued as of mid-2025, with over 1.06 lakh claims processed worth approximately ₹200 crore (scheme covers ~4.7 crore eligible seniors aged 70+) (source)

This government scheme provides:

• ₹5 lakh annual coverage
• For Indian citizens aged 70+
• Completely free
• No income criteria
• Covers government and empanelled private hospitals

How to enroll:

• Aadhaar-based e-KYC
• Fully digital process
• Through empanelled hospitals or online portals

This acts as a free backup plan alongside your private insurance.

Cost Realities for Retirees

At 60-plus, even a routine procedure can cost ₹2-3 lakh, a cardiac stent procedure costs ₹70,000-3.6 lakh, and hip replacement costs ₹2-4 lakh. . (source)

These costs have grown significantly with medical inflation. Without insurance, a single hospitalization can deplete years of savings.

Entry Age Limits

Most policies have entry age limits of 65 years. After that, options become limited and premiums increase substantially.

If you're planning to retire in India within the next 5 years, buy health insurance NOW while you're still under 60. Premiums are lower, and you'll have more policy options.

For more guidance on planning your return, check out our article on NRI account management.

Understanding FEMA Regulations for NRI Health Insurance

The Foreign Exchange Management Act (FEMA) governs health insurance for NRIs.

According to FEMA regulations, the claim amount payable under health insurance for NRIs can be paid in Indian rupees if premiums were paid in Indian rupees, while claims outside India can be settled in foreign currency in case of global coverage.

Key FEMA points:

• Claims can be paid to your foreign bank account or RFC account in India
• Premium payments must align with claim currency
• If you pay in foreign currency, claims can be in foreign currency (up to premium amount)
• Full documentation required for foreign currency transactions

Also Read -FEMA Guidelines Every NRI Should Know

How Belong Can Help You Plan Your Financial Transition

At Belong, we've built tools specifically to help NRIs like you make smarter financial decisions during your return to India.

Your Residential Status Matters

Use our Residential Status Calculator to determine whether you're classified as NRI, RNOR, or Resident. This affects:

• Your tax liability in India
• Eligible investments
• Tax benefits on insurance premiums

Stay Compliant

Our Compliance Compass helps you check whether you're following all necessary rules across banking, investments, and taxation. One quick tool shows you where you stand.

Compare Investment Options

While planning your return, compare safe investment options using our NRI FD Comparison Tool. See rates across NRE, NRO, FCNR, and GIFT City fixed deposits at a glance.

Hedge Against Currency Risk

Track the rupee's performance against the dollar with our Rupee vs Dollar Tracker. Understand why more global Indians are choosing USD-denominated assets through GIFT City investments.

Your Action Plan: Next Steps

Here's what you should do this week:

If you're returning in the next 3-6 months:

1. List all your current health conditions and medications
2. Request insurance certificates and medical records from your current insurer
3. Research 4-5 Indian insurers using comparison websites
4. Check network hospitals in your target city
5. Calculate your required sum insured (factor in family size and age)

If you're returning in 6-12 months:

1. Start tracking Indian health insurance options
2. Use our Residential Status Calculator
3. Join our WhatsApp Community (link below) to ask questions
4. Begin gathering documentation from your current provider

If you're returning in 1-2 years:

1. Consider buying Indian health insurance now to start serving waiting periods
2. Check if your employer's insurance has post-employment coverage
3. Keep detailed medical records from now – you'll need them
4. Research insurers' portability policies

Final Thoughts: Plan Early, Stay Covered, Stay Healthy

Returning to India is exciting. You're reconnecting with family, friends, and home. But health insurance shouldn't be an afterthought that leaves you vulnerable during the transition.

The NRIs who navigate this smoothly are the ones who plan 3-6 months ahead. They:

• Understand waiting periods and buy early
• Gather documentation while still abroad
• Maintain overlap coverage during transition
• Choose policies based on coverage, not just premium
• Are completely transparent about pre-existing conditions

You've worked hard abroad for years. You've built savings. You've planned your return carefully.

Don't let an avoidable insurance gap jeopardize your health security or drain your savings on unexpected medical expenses.

Start your health insurance research today. Your future self in India will thank you.

Ready to Plan Your Financial Return to India?

Join over 12,000 NRIs in our Belong WhatsApp Community where we discuss:

• Health insurance recommendations
• Best practices for returning NRIs
• Tax planning strategies
• Investment options in GIFT City
• Real experiences from NRIs who've made the move

Download the Belong app to access:

• USD Fixed Deposits with tax-free returns
• Tools for NRI financial planning
• Expert guidance on investment decisions
• Compare FD rates instantly

Making smarter financial decisions for your return doesn't have to be complicated. Let us help you navigate this journey.

Sources:

Policybazaar – Health Insurance for NRIs

HDFC Life – Health Insurance Plans for NRIs in India

ACKO – Health Insurance for NRIs in India

Bajaj Allianz – Complete Guide to Health Insurance for NRIs

Outlook Money – Why Global Health Insurance Often Fails Returning NRIs

ICICI Bank – Can NRIs Buy Health Insurance in India?

NRI Return to India – How to Manage Health Insurance When Moving Back

Disclaimer: This article is for informational purposes only and does not constitute financial, legal, or medical advice. Health insurance policies, terms, and benefits vary by insurer and are subject to change. Always read policy documents carefully and consult with insurance advisors before making decisions. Waiting periods, premium amounts, and coverage details mentioned are indicative and may vary. Check with insurers directly for current rates and terms.