Eligibility Criteria
| Minimum Entry Age |
60 years of age |
| Maximum Entry Age |
75 years |
Benefits
Coverage for all pre existing disease after 12 months from the date of commencement of policy.
No pre-acceptance and medical screening required in this policy.
Key Features
Sum Insured
Sum Insured is the amount of cover provided by the insurance company. |
The plan provides a cover of Rs. 1, 2, 3, 4, 5, 7.5 and 10 lakhs. |
In-patient hospitalisation
This covers hospitalisation expenses due to an illness or accident. |
The plan covers hospital accommodation up to Single private room, charges for stay in Intensive Care Unit, related hospitalization expenses such as surgeon’s fees, nursing, anesthesia, blood, oxygen, operation theater charges, surgical appliances, medicines, drugs and consumables up to the sum insured. |
Post-hospitalisation
It covers the medical expenses due to an illness after the insured is discharged from hospitalization. |
The plan covers post-hospitalization expenses of up to 7% of the hospitalization expenses; subject to maximum of Rs. 5000/-. |
Co-Payment
After a insured member turns a certain age, co-payment is applicable. Co-pay is that part of your claim amount, which you have to bear. |
50% of each and every claim relating to pre existing diseases. 30% of each and every claim for all other claims. |
Room Rent
Room rent specifies the sub-limit on room rent charges you can avail in case of hospitalization. |
In the event of hospitalization, the policyholder is entitled to get 1% of sum insured; subject to maximum of Rs. 6000/- per day. |
Day Care Treatments
These are treatments that don’t require a 24-hr hospitalisation and conducted in a hospital or day-care center. |
This plan covers the expenses of day care treatments up to Sum Insured. |
Ambulance Cover
In case of an emergency, the ambulance charges are covered by the insurance company. |
This plan covers ambulance expenses up to a sum of Rs. 600/- per hospitalization and overall limit of Rs. 1200/- per policy period. |
Out Patient Department expenses
These are the expenses which includes doctor’s consultation fees, health check ups, pharmacy bills, dental treatment, diagnostics tests, etc. |
Cover for an expenses incurred as an outpatient towards medical consultation in a network hospital up to limits mentioned in the below table with a limit of Rs. 200/- per consultation.
| Sum insured (Rs) |
Limit per policy period (Rs.) |
| 3,00,000 |
600 |
| 4,00,000 |
800 |
| 5,00,000 |
1000 |
| 7,50,000 |
1200 |
| 10,00,000 |
1400 |
|
Exclusions
- Genetic Disorder.
- Sexually transmitted disease or illness.
- Artificial Life Maintenance.
- Mental disorders (including treatments for mental health).
- Weight loss treatment.
- Alternative Practice.
- Recovery Benefit.
FAQs
Alterations like increase or decrease in Sum Insured, change in plan will be allowed at the time of Renewal of Policy. However, any such change request will be subject to underwriting decision or requirement of medical tests on a case to case basis.
When an insured is hospitalized and stays in hospital for more than 24 hours solely for receiving treatment it is termed as in-patient treatment.
Out-patient treatment is when insured visits a clinic/hospital or a consultation room for diagnosis and treatment based on the advice of medical practitioner. In out-patient hospitalization patient is not admitted under a day care or as an in-patient.
Your health insurance policy is in force across India. You can check whether there is any network hospital near to your residence as well the city of your current location. Network hospitals are the hospitals that have tie-up with the Third Party Administrator for cashless settlement of claims. If there is no network hospital, you can opt for reimbursement mode of settlement.
Apart from this we also provide coverage in case of Emergency situations anywhere in the world.
Pre-existing diseases/illness/injury/conditions will be covered post 12 months of continuous cover.
At the time of buying a health insurance you need to provide details of the illnesses you have suffered during your lifetime. The insurer refers such cases to their medical panel to differentiate between pre-existing and newly contracted illnesses.