Health Insurance

Health Insurance

Mediclaim Policy covers expenses incurred as in patient towards medical treatment for an Illness or Accident when admitted to a hospital generally for more than 24 hrs, it also covers pre-hospitalization expenses & post-hospitalization expenses also.

Points to consider before buying insurance policy

  • Room rent capping like 1% of the sum insured or single private room
  • Hospital networth for cashless facility
  • Increase in future premium as per change in age band
  • Co-payment after certain age(60/65+)
  • Loading in premium on basis of claim history
  • No claim Bonus
  • Free health Checkup
  • Deductible option
  • TPA / No TPA
  • Organ donor benifit
  • Refill / restore benefit
  • Disease wise capping in claims
  • Number of day care procedure

 

 

Get to learn more about the various types of health insurance with us and choose the best policy for you and your family.

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  • What it cover
  • What it not cover
What does it cover:
  • Medical Practitioners’ fees
  • Diagnostics procedures
  • Medicines, drugs and consumables, Intravenous fluids, blood transfusion, injection
  • Operation theatre charges
  • The cost of prosthetics and other devices or equipment if implanted internally during a Surgical Procedure.
  • Intensive Care Unit charges
  • Hospital Accommodation
  • Organ Donor Expenses
  • Pre- hospitalization Medical Expenses up to 30 days
  • Post-Hospitalization Medical Expenses up to 60 days
What is excluded:
  • All treatments within the first 30 days of cover except any accidental injury.
  • Any pre-existing condition will be covered after a waiting period of 3 years.
  • 2 years waiting period for specific diseases like cataract, hernia, Sinusitis, joint replacement surgeries, etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Eyesight / Dental / Oral / OPD Treatment
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
  • Alternative treatment
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Stem cell implantation
  • Ageing and puberty; Artificial life maintenance
  • Pregnancy, Psychiatric and Psychosomatic Conditions.
  • Experimental, investigative and unproven treatment.

Key Features

  • Max Bupa Health Companion
  • Max Bupa Heart Beat
  • Apollo Optima Restore
  • Comprehensive coverage of sum insured up to 1 Crore
  • No Capping on Room Rent ( 1% of Sum Insured not applicable)
  • Pre and post hospitalization covered upto Sum insured, i.e. no capping on amount
  • All day care procedure covered up to sum insured, i.e. no specific list covered
  • Direct settlement of claims, No TPA, i.e. direct claims settlement
  • Cashless facility at quality hospitals anywhere in India.
  • No loading in premium on the basis of claim history
  • Assured renewal for life
  • No Internal capping for treatments like cataract, hernia, etc.
  • No age restriction for enrollment.
  • No Claim Bonus @ 20% on base sum insured, max upto 100%. (No Reduction even after claim)
  • Refill Benefit - If the base sum insured and No Claim Bonus is partially or completely exhausted (in case of Individual and Floater) policy will provide Refill Sum Insured upto 100% of Base Sum Insured, only once a year.
  • Option for deductibles (Top up)
  • Ayush (Ayurveda, Unani, Sidha and Homeopathy in) treatment covered upto Sum insured in Govt.recognised institutes
  • Free Health Check-up: A comprehensive health check-up involving a number of medical tests every year
  • Organ Donor - Treatment expenses for the organ donor at the time of organ transplant.
  • Comprehensive coverage of sum insured.
  • Pre and post hospitalization covered.
  • All day care procedure covered up to sum insured.
  • Direct settlement of claims, No third party.
  • Cashless facility at quality hospitals anywhere in India.
  • Maternity Cover after 2 years.
  • Assured renewal for life (No loading in premium on the basis of claim history)
  • Hospital Accommodation covered.
  • Proactive health management benefits.
  • Annual free health check up.
  • High quality service (24*7 Helpline).
  • Tax Savings under section 80 D.
  • 10% Loyalty Program.
  • 90 Days Waiting period for Planned Hospitalization.
  • Pre- Existing disease not covered for 2 Years.
Plan Benefits:
  • Entry Age: up to 65
  • No room rent capping.
  • Day-Care Procedures - The medical expenses for enlisted 140 day-care procedures, which do not require 24 hours hospitalization due to technological advancement, are covered.
  • Organ Donor - Treatment expenses for the organ donor at the time of organ transplant.
  • Restore Benefit - Automatic re-instatement of the basic sum insured, if the basic sum insured and multiplier benefit has been exhausted during the policy year. Basic sum insured will be re-instated only once in a policy year.
  • Multiplier Benefit (NCB) - You get a bonus of 50% of the basic sum insured for every claim free year accumulating up to 100%. (In the event of a claim, the bonus shall be reduced by 50% of the Basic Sum Insured at the time of renewal).
  • Free Health Check-up: A comprehensive health check-up involving a number of medical tests, upto 1% of Sum Insured per Policy, only once at the end of a block of two continuous years, for policies with Sum insured greater than Rs.15 lac. only.
  • Discounts: 7.5% discount on the full premium if you opt for a 2 year renewal & Upto 10% discount at Apollo pharmacies.

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***Exclusions may vary with different insurance products and insurers. You may or may not have full information to make an appropriate selection. In order to improve your selection get approval and essential advice on insurance, seek expert’s consultation from us, before you invest or buy insurance. Since, wealth comes from good health, so never compromise.*** (Read the offer documents carefully.)