We live a sedentary lifestyle which makes health insurance a necessity. Even the rise of inflation in medical expenses makes it mandatory to buy health insurance in the future. Now, the foremost thing that strikes the mind is- which plan is the best and which should be bought that could fulfill all the health requirements of the self and the family?
After analysing several parameters such as Incurred Claims Ratio (as per the latest IRDA Annual Report 2018-19), Sum Insured, Pre & Post-hospitalisation expenses, etc. below is the list of best 10 health insurance plans in the Indian market that won’t disappoint.
Activ Assure Diamond Plan
Essential Privilege Plan
Care Health Insurance Plan (formerly known as Religare Health Insurance)
Star Family Health Optima Plan
Max Bupa Health Companion
HDFC Ergo Health Optima Restore Plan (formerly known as Apollo Munich Optima Restore)
ManipalCigna Prohealth Plus Plan
HDFC Ergo Health Suraksha Gold Regain
Royal Sundaram Lifeline Supreme Plan
Star Senior Citizen Red Carpet Plan
How To Choose Best Health Insurance Plan - Watch Video
Factual Representation In Tabular Form
The tabular representation has been given below for an easy and fast comparison between the health insurance plans. The comparison would help you decide in a better way and you can finalize which of the plan suits your requirements and budget the most:
Health Insurance Plans
Health Insurance Companies
Incurred Claims Ratio (2018-19)
Maximum Sum Insured Amount
Policy Renewal
Pre Hospitalization
Post Hospitalization
Ambulance Cover
AYUSH In-patient Treatment
Activ Assure Diamond
Aditya Birla
59%
Rs. 2 crores
Not Mentioned
30 Days
60 Days
Available
Available up to SI
Essential Privilege Plan
Universal Sompo
92%
Rs. 10 Lakhs
Lifetime Renewability
30 Days (60 Days in the case informed beforehand)
60 Days
Available
Available up to SI
Care Health Plan
Care Health Insurance company
55%
Rs. 6 Crores
Lifetime Renewability
30 Days
60 Days
Available
Covered
Health Companion Individual
Max Bupa
54%
Rs. 1 Crore
Lifelong Renewability
30 Days
60 Days
Available up to Rs. 3000
Covered
Family Health Optima
Star Health
63%
Rs. 25 Lakhs
Lifelong Rewal
60 Days
90 Days
Up to Rs. 1,500 per policy period
Maximum up to Rs. 20,000 as per SI
Optima Restore
HDFC Ergo Health (formerly known as Apollo Munich)
62%
Rs. 50 Lakhs
Lifelong Renewability
60 Days
180 Days
Up to Rs. 2,000
Not Mentioned
My: health Suraksha
HDFC Ergo
62%
Rs. 75 Lakhs
Lifelong Renewal
60 Days
180 Days
Available
Available
Lifeline Supreme
Royal Sundaram
61%
Rs. 50 Lakhs
Lifelong Renewability
60 Days
90 Days
Maximum cover up to Rs. 5,000
Maximum up to Rs. 30,000
Senior Citizen Red Carpet
Star Health
63%
Rs. 25 Lakhs
Lifelong Renewability
30 Days
The plan has specific parameters of calculation explained in detail in the plan brochure
Provided up to Rs. 3,000
Not Covered
Prohealth Plus
ManipalCigna
62%
Rs. 50 Lakhs
Lifelong Renewal
60 Days
180 Days
Provided up to Rs. 3,000
Not covered
**Last Updated on 16-09-2020
Brief Description Of The 10 Best Health Insurance Plans
A brief description of all the 10 best health insurance plans for the year 2020 have been presented below for your easy reference. The clarity of facts will help you make quick decisions to safeguard your savings at the time of medical emergencies.
The Activ Assure Diamond Plan is being offered by Aditya Birla Health Insurance Company. The plan provides comprehensive coverage to its policyholder. It is considered to be one of the best health insurance policies in the insurance market. The plan also has a higher sum insured option for its policy buyers. Several appreciable facilities and coverage are provided under the plan. Let us explore more about the plan.
Benefit and Features:
In-patient hospitalization: In-patient hospitalization coverage is provided in case the hospitalization has been for more than 24 hours continuously. All the expenses relating to room rent, doctor consultancy fee, operation theatre, medicines, drugs, etc get coverage under the plan.
Pre-hospitalization: Any medical expenses incurred 30 days before the hospitalization gets covered under pre-hospitalization expenses.
post hospitalization: All the medical expenses incurred 60 days from the date of discharge from the hospital get covered under post-hospitalization expenses.
Daycare Procedures: There are certain treatments that take less than 24 hours due to technological advancements. Such 586 procedures are covered under the plan in case of hospitalization for less than 24 hours.
Domiciliary Hospitalization: Domiciliary hospitalization is provided in case the insured is not able to travel to the nearest network hospital/ health center or there is no availability of a bed in the hospital.
Sum Insured Reinstatement: In case the policyholder has exhausted all of his sum insured along with the bonus, the insured sum is reloaded from the health insurance company side.
Road Ambulance Cover: In case of emergency, the plan provides coverage for incurred ambulance expenses for traveling to the hospital.
Organ Donor Expenses: All the expenses incurred in the treatment of the organ donor is provided by the health insurance company under this plan.
AYUSH Treatment Cover: The plan provides coverage for alternative treatment like ayurvedic, homeopathic, Siddha, Unani treatment subjected to one condition- it should be done under hospitalization (more than 24 hours).
Daily Allowance: The policyholder gets daily cash of Rs. 500 subject to terms and conditions of the policy.
Health Coach Facility: The plan provides its policyholders with a health coach facility. The health coach can keep track of the nutrition and diet the insured intakes and can help him/her stay fit.
HealthReturns: The Activ Assure Diamond plan also rewards its policyholders for keeping fit in the form of HealthReturns. It can be used to pay bills of fever medicine or surgery in case the surgery is not covered due to the waiting period.
Second E-Opinion Option: The insured gets coverage for the second opinion in case of critical illness.
Room Upgrade: The insured can get admitted to the hospital and there is no restriction on the type of room. The room upgrade option is for policyholders who have opted for sum insured of Rs. 5 Lakhs and above.
Tax Benefit: The premiums paid under the plan are tax exempted according to section 80D of the Income Tax Act 1961.
Exclusions
Genetic diseases treatment expenses.
Mental disorder treatment.
Non-allopathic treatment expenses.
Treatment-related to obesity or any of the cosmetic surgeries.
Treatment relating to HIV AIDs disease
Any self-inflicted injury.
Suicidal cases.
Injury due to involvement in war activity.
Treatment for drug addiction, alcoholism or another intoxicant.
Any medical assistance outside the country.
Infertility related treatment.
2. Essential Privilege Plan
Universal Sompo provides an Essential Privilege Plan, which is a complete healthcare offer in itself. The company owns a tremendous Incurred Claims Ratio and offers both individuals and family floater plans. One can choose freely among the plans as per the requirement. It provides a wide range of coverage and also provides coverage to 91 days old babies. The family floater plan can include a maximum of six members. Here are mentioned a few details with respect to the plan:
Benefit and Features:
Daycare Procedures: The plan covers 141 daycare procedures in case of hospitalization for less than 24 hours.
Domiciliary Hospitalization: There are times when the insured is suffering from disease and s/he is not in a position to travel to the hospital. In such a worst scenario, he can be treated at home under the recommendation of a trained medical practitioner. The Essential Privilege Plan provides coverage for this.
Pre - Hospitalization Cover: The plan provides financial coverage for medical expenses incurred 30 days prior to the hospitalization date.
Post - Hospitalization Cover: After getting discharged from the hospital, the insured needs to bear the expenses of medicines and tests. Here the plan comes to help and provide coverage for medical expenses incurred within 60 days after discharge from the hospital.
In-Patient Hospitalization: All the expenses incurred in the treatment of the insured get covered under this if the hospitalization is for more than 24 continuous hours. The coverage includes bills like doctors’ consultancy fees, medicine charges, operation theatre charges, blood, etc.
Organ Donor Facility: In the case of organ donation, all the medical expenses incurred in the treatment of organ donor is covered by the health insurance company under the plan.
Ambulance Cover: In case of emergency, the safest way to reach the hospital in an ambulance and the plan covers the emergency ambulance expenses.
Child Coverage: If the child of the insured is less than 12 years in age and is hospitalized for more than 72 hours, the insurance company provides a daily allowance to the policyholder. This daily allowance is as per plan opted by the policyholder.
Vaccination: In the case of an animal bite, the post-bite treatment facility provides coverage for vaccination expenses.
Hospital Daily Cash: Under the plan, the insurance company provides an amount as daily cash to meet up the expenses in case the hospitalization is for more than 3 days.
Critical Illness Coverage: Critical Illness coverage is provided for a list of diseases. The list includes first heart attack, cancer of specified severity, open chest CABG, coma of specified severity, kidney failure dialysis, permanent paralysis of limbs, bone marrow transplant, permanent limb paralysis, and permanent motor neuron disease.
Sub-Limits: A list of sub-limits has been mentioned in the brochure with respect to different medical procedures. The policy buyer must go through it as this would be helpful in planning surgery.
Bonus: The policyholder gets the benefit of cumulative bonus in case s/he does not make any claim in a policy year. The sum insured is increased by 10% and it can be a maximum of up to 50%.
Grace Period: A 30 days grace period is provided to the insured.
Tax Benefit: The premiums paid under the plan are tax exempted under section 80D of the Income Tax Act.
Pre-Insurance Health Checkup: Medical screening is compulsory for all the policy buyers before buying the policy.
Care Health Insurance Plan offered by Care Health insurance company is one of the best health insurance plans competing in the health insurance market. It provides its policyholders with comprehensive coverage. It provides both- individual and family floater plans. It provides its insured with several medical facilities. Few of the benefits and features of the plan have been mentioned below:
Benefit and Features:
In-patient Care: The in-patient care is provided to the insured in case of hospitalization for at least 24 continuous hours. The in-patient care covers all the medical expenses incurred during hospitalization. It includes medical practitioner’s consultancy fees, nursing charges, ICU charges, anesthesia cost, operation theatre costs and many more things required in in-patient care.
Pre-Hospitalization Cover: Pre-hospitalization expense cover is provided for 30 days before the date of hospitalization.
Post-Hospitalization: Post-Hospitalization expense cover is provided for 60 days from the date the insured gets discharged from the hospital.
Daycare Treatment: Daycare procedures coverage is available under the plan.
No Claim Bonus: The insured gets a bonus for every claim-free year. The bonus is in the form of a 50% increase in the sum insured and it can be maximum up to 100% of the insured sum.
AYUSH Treatment Cover: The expenses incurred in an alternative mode of treatments like Ayurvedic, Homeopathic, Siddha, and Siddha also gets coverage under the plan.
Second Opinion Option: The plan provides coverage for the second opinion from a medical expert in case the policyholder is diagnosed with a critical illness.
Ambulance Cover: The ambulance expense cover is also included under the plan. The maximum ambulance expenses can be maximum up to Rs.3000.
Daily Cash Facility: The insured is provided with Daily cash to meet the conveyance expenses to the hospital, attendant’s cost and other daily expenses. A lump-sum amount is paid to the insured on a daily basis. It is provided for a maximum of 5 days.
Medical Screening: The medical health checkup is compulsory for all before purchasing the policy. The entire cost of medical tests is paid by the health insurance company if the policy has been bought for 2 years/3 years. In case the policy is bought for a tenure of 1 year then only 50% of the health checkup cost is paid by the insurance company. In case of cancellation of policy within the free look period, the expenses are to be borne by the policy buyer.
Tax Benefit: The insured gets tax benefits as he can save tax on the premiums paid under the health insurance plan.
Exclusions
Injury due to attempt to suicide or any other self-inflicted wound.
Congenital illness.
Treatment of HIV/AIDs.
Major wound due to participation in war, riot or any unlawful activity.
Star Health Insurance company is offering Family Health Optima Plan. It is a super saver plan. It provides coverage to the entire family under a single sum insured. It is loaded with extra benefits. Here are a few of the details relating the plan:
Benefit and Features:
Room Rent Facility: The plan provides room rent facility with a sub-limit of maximum up to Rs.5,000. There is an option of a single standard AC room for policyholders having sum insured Rs. 5 Lakhs and above.
Organ Donor Expenses: All the organ donor treatment expenses are covered under this plan. The plan provides coverage up to 10% of the sum insured or a maximum of Rs. 1 Lakhs.
Sub-limits: The plan has sub-limits applicable to certain illness treatment. For example, in the case of cataract the sub-limits are as follows:
Sublimit of Rs. 35,000 per policy year for sum insured of Rs. 3 Lakhs.
Sublimit of Rs. 45,000 per policy year for sum insured of Rs. 4 Lakhs.
Sublimit of Rs. 75,000 per policy year for sum insured of Rs. 10 Lakhs to Rs. 25 Lakhs.
Air Ambulance Cover: Air ambulance cover is a special benefit under the plan. It is provided to policyholders with a sum insured of Rs 5 Lakhs and above. Air ambulance cover is provided up to 10% of the sum insured.
Ambulance Cover: In case of emergency, the ambulance expense is covered under the plan.
New Born Baby Cover: For the newly born baby cover, the most important thing is that the mother should be covered under the plan for a continuous 12 months duration. The newborn baby gets cover from the 16th day till the time the policy expires. It is subject to a limit of 10% of the sum insured or Rs.50,000, whichever is less.
Bonus: In the case of the claim-free year, the policyholder gets a bonus of up to 25% of the sum insured for the first claim-free year. An additional 10% bonus is provided for subsequent years coming forth.
Alternative Treatment: AYUSH treatment is considered under alternative treatment. The maximum coverage under this can go up to Rs. 20,000.
Second Medical opinion: As a special feature of the plan, the second medical opinion expenses are covered by the health insurance company in case the insured is diagnosed with a critical illness.
Exclusions
Frenuloplasty, circumcision & preputial dilation.
STD and venereal diseases.
Psychiatric treatment.
Mental disorder.
Congenital anomalies.
Treatment with respect to abortion, miscarriage, or other complications.
Injury caused by self.
Treatment relating to HIV/AIDs.
Refractive error correction and lasik laser expenses.
Treatment of endocrine diseases.
Treatment-related to sleep apnea.
Treatment of injury due to war, invasion, enemy attack, etc.
Max Bupa Health Insurance Company is offering a health companion plan. It has a wide range of Sum Insured options for its policyholders. There are 3 variants available under the plan based on sum insured options and facilities. Below are some of the benefits and coverage of the plan:
Benefit and Features:
Domiciliary Hospitalization: Domiciliary hospitalization facility is provided under the plan and it continues for three consecutive days. All the expenses incurred during the domiciliary hospitalization is paid by the insurance company.
Emergency Ambulance: The plan provides coverage for the expenses of the emergency ambulance.
Animal Bite Vaccination: In case the insured has got an animal bite, he can take the benefits treatment coverage under the plan. Moreover, the insured can take vaccination with respect to the same.
Refill of SI: The insured sum is reinstated in case the insured has completely exhausted all of his/her accumulated bonus in the policy term. The plan provides a refill of insured sum only once in a policy year. Moreover, in the case of a family floater plan, the refill is on the basis of the family floater and all the insured persons in a particular policy year.
In-patient Care: Inpatient care is provided to the insured under the plan in case of hospitalization for 24 continuous hours. All the expenses incurred in the process of in-patient care are covered under this.
Pre-hospitalization and Post-Hospitalization: Pre-hospitalization and post-hospitalization expense coverage is provided to the insured for 30 days and 60 days respectively.
ICU Cost Cover: All the expenses incurred in intensive care unit treatment get coverage under the plan.
Living Organ Donor Transplant: Organ donor treatment cost is borne by the health insurance company if the person is insured under the plan.
Waiting Period: Under the plan, a waiting period of 4 years is applied in the case of pre-existing disease. Other than this, an initial waiting period of 30 days and a specific waiting period for a list of diseases is also applied. All the details are mentioned in the plan brochure.
Optima Restore Plan is being offered by HDFC Ergo Health Insurance Company (formerly known as Apollo Munich Health Insurance Company). The plan cares for its policyholders & rewards them for staying fit. There is also an option of auto restoration of the sum insured in case it is completely utilized during the policy year. There is also a free health checkup facility once in a 2-year policy period on sum insured of Rs. 5 lakhs and once every policy year on sum insured of Rs.10 Lakhs and above.
Let us explore more about the plan:
Benefit and Features:
Day Care Procedures: All daycare procedures are covered under this health insurance policy.
Pre-hospitalization and Post-hospitalization: The insured can get the benefit under pre-hospitalization and post-hospitalization expense coverage for 60 days and 180 days respectively.
Organ Donor Cover: The expenses incurred in the treatment of organ donor at the time of organ transplant is covered up to the sum insured limit.
Ambulance cover: The insured is provided with an amount of Rs.2,000 per hospitalization as an ambulance expense cover.
E-Opinion: In case the person covered under the policy is diagnosed with a critical illness, the insurance company provides coverage for the second opinion from a medical expert.
Daily Cash For Opting shared Accommodation: A maximum of Rs.6,000 is provided as daily cash in case the insured has opted for shared accommodation.
Domiciliary Treatment: Coverage for domiciliary treatment expenses is provided under the plan up to the sum insured.
In-Patient Hospitalization: Under the in-patient hospitalization cover, the expenses are met up to the insured sum.
Critical Advantage Rider: This coverage option is especially for those who have the basic insured sum of Rs.10 lakhs and above.
Discounts: The policyholder gets daily cash of Rs. 500 subject to terms and conditions of the policy.
Pre-Existing Disease Waiting Period: A waiting period of 3 years has been set for coverage of pre-existing disease treatment.
Exclusions
Any claim except accidental case within the initial waiting period of 30 days
There is an exclusion for 2 years for specific diseases like hernia, cataract, joint replacement, hysterectomy, etc.
HIV/AIDs treatment.
Intoxicant abuse like drugs and alcohol.
Injury due to participation in war or any defense activity.
Injury due to chemical, nuclear or biological weapons.
Mental disorder.
Congenital diseases.
Non-Allopathic treatment.
Cosmetic surgery and weight control treatments
7. Prohealth Plus Plan
Prohealth Plus Plan is a health plan launched by the ManipalCigna Health Insurance Company. It is a self-sufficient health insurance plan which provides comprehensive coverage. It covers both types of policyholders- who are residing within the country and outside the country in case of an emergency. The benefits of the plan that attract the policy buyers have been mentioned below:
Benefit and Features:
Worldwide Emergency Cover: Any disease sustained or contracted outside India gets coverage under the plan depending upon the severity of illness. In case the insured needs emergency treatment, the insurance company provides coverage for expenses incurred for in-patient hospitalization.
Restoration Of Sum Insured: At times it happens that the policyholder has completely exhausted his sum insured along with accumulated bonus. So, in such cases, the plans provide the policyholder with 100% restoration of the insured sum once a policy year.
Maternity Expenses: Maternity expenses cover is provided if the mother is insured under the plan. The coverage is provided for a maximum of two deliveries and between the age limit of 18 years to 65 years.
Newborn baby cover: The newborn baby cover is provided under the inpatient hospitalization of the mother during delivery. After the mother is discharged, the baby can get coverage under the family floater plan once s/he is 91 days old.
First Year Vaccination Cover: The newly born baby gets coverage for vaccination expenses. It is provided for 1 year from the date of birth of the baby. A list of vaccinations is mentioned in the brochure of the plan.
Free Health Checkup: Every member insured under the plan can take the benefit of free health checkup once every policy year, subject to a condition that s/he is 18 years and above in age.
Expert Opinion: An expense cover for expert opinion is provided to the insured in case the insured is diagnosed with a critical illness.
Cumulative Bonus: There is a provision for a cumulative bonus for claim-free years. A maximum of 50% of the cumulative bonus can be provided to the insured.
Family Floater Limit: The family floater plan can cover up to 2 adults and 3 children under it.
Mandatory Co-payment: Co-payments are mandatory on each claim if the insured is 65 years and above in age.
Pre And Post-Hospitalization Cover: The insured is provided with pre and post-hospitalization cover for a fixed number of days.
Portability Option: The plan provides the insured with a portability facility in case the policyholder is not satisfied with any of the facilities provided under the plan. All the cumulative bonus remains intact in case of port and there is no loss of benefits.
Free-look Period: A free look period of 15 days is provided under the plan for cancellation of the policy.
Income Tax Exemption: Under section 80D of Income Tax Act 1961, the premiums paid under the plan is tax exempted.
Waiting period: A waiting period of 4 years is applied to the treatment of pre-existing diseases. There is a waiting period of 2 years for a list of diseases like varicose veins, varicose ulcers, gastric ulcer, duodenal ulcer, cataract, hysterectomy, etc.
Exclusions
Expenses relating artificial life support including a life support machine used in the procedure.
Dyslexia
Behavioral problems including attention deficit hyperactive disorder (ADHD).
Routine medical checkup of eye and ear.
Birth control treatments and contraceptive supplies expenses.
Circumcision unless the disease requires surgery.
Laser surgery of the eye.
Cosmetic surgery.
Weight loss treatment.
Syphilis, genital warts, gonorrhea, genital herpes, chlamydia, etc.
8. my: Health Suraksha
HDFC Ergo Health Insurance Company has always brought to you the best of the health plans and one of those is my: Health Suraksha . The plan covers you in all possible ways and can easily fit your budget. It covers you, your family as well as your newly born baby. Here are few of the details of the plan which can help you take better decisions:
Benefit and Features:
Pre-Hospitalization: Pre-hospitalization expense cover is provided for 60 days prior to the hospitalization.
Post-Hospitalization: A post-hospitalization expense cover for 180 days after discharge from the is provided to the insured.
Regain Benefit: There is an automatic restoration of the sum insured in case of complete exhaustion of sum insured including NCB once in the policy year.
Enhanced Cumulative bonus: Under the enhanced cumulative bonus, there is an increase of 10% in the insured sum and maximum up to 100% of the base sum insured.
Newborn Baby Cover: The plan provides coverage to the newly born baby since the birth subjected to a condition that the parents are insured under the plan.
Organ donor: All the expenses incurred in the treatment of the organ donor during organ transplant is borne by the health insurance company under the plan.
Daycare Procedures: The plan covers 586 daycare procedures.
Emergency ambulance: An emergency ambulance cover is provided under the plan.
Second E-Opinion: The insured diagnosed with a critical illness can go for expert advice under the second opinion cover of the plan.
Renewal Benefits: Under renewal benefits, a cumulative bonus of 5% for every claim-free year and a maximum of up to 50% is provided to the insured.
Exclusions
Any injury due to involvement in war activity.
Injury due to unlawful activity.
Self-inflicted injury and suicidal cases.
Cases related to intoxicating substance abuse like drugs and alcoholism.
HIV/AIDs related treatment.
Any type of cosmetic surgery.
Any treatment relating to weight control.
Any claim within the initial 30 days of buying the policy except accidental cases.
9. Lifeline Supreme Plan
Lifeline Supreme is one of the health plans being offered by the Royal Sundaram health insurance company. When we talk of coverage, the plan is counted to be one of the best coverage providers. It provides comprehensive coverage to both individuals and families. Several add on facilities are provided under the plan. Few of the benefits and features have been detailed below:
Benefit and Features:
Daycare Treatment: The plans provide daycare procedures for medical conditions like chemotherapy, hemodialysis, etc.
Ambulance cover: The insured gets an ambulance cover up to Rs. 5,000.
NCB: No claim bonus is provided to the insured in case of the claim-free year. A bonus of 20% of the base sum insured and maximum up to 100% of the base sum insured is provided.
Re-load Of Sum: If the policyholder completely exhausts the sum insured along with accumulated bonus, the base sum insured is reloaded automatically from the side of the health insurance company.
Vaccination in Case Of Animal Bite: Coverage for vaccination in case of animal bite is provided to the insured under the plan.
Free Health Checkup: All the members insured under the plan can avail the facility of free health checkup once every policy year.
Second Opinion: The plan provides the facility of second opinion expense coverage for 11 critical illnesses mentioned in the brochure of the plan.
Worldwide Emergency: The plan also provides coverage for a worldwide emergency.
Maternity benefit: Maternity benefits are available under the plan subject to the condition that the pregnant mother is covered under the plan and she has served a waiting period of 3 years.
Newborn Baby Cover: A newly born baby gets coverage since birth.
Vaccination Cover for New Born baby: A newly born baby gets vaccination coverage for the first year after birth and the maximum sub-limit is Rs.10,000.
Pre-Existing Disease Waiting Period: All the pre-existing diseases should be mentioned to the health insurance company at the time of buying the policy and there is a waiting period of 3 years to get coverage with respect to the same.
Star Health Insurance Company is offering one of the best plans for senior citizens named Senior Citizen Red Carpet Plan. Medical issues are common with the growing age. It is necessary to have a plan that can provide you medical coverage and cut down on the medical expenses in old age. The plan has proved to be of great help to elderly people with the choice of good Sum Insured options. The benefits and features of the plan have been explained below:
Benefit and Features:
Pre-Hospitalization Cover: Pre-hospitalization expense cover is provided for 30 days before the date of hospitalization.
In-Patient hospitalization: All the expenses incurred under in-patient hospitalization are covered by the insurance company subjected to co-payments applied to it as per the details mentioned in the brochure.
Pre-insurance Medical Screening: Health checkup is mandatory before buying the policy.
Hospitalization Cover: Hospitalization cover includes expenses of room, boarding, and nursing, etc.
ICU Charges: In the case of intensive care unit hospitalization, the insured is provided with coverage of :
Up to 2% of the SI - For sum insured between Rs.1 lakhs and Rs. 10 lakhs.
Actual ICU expenses are covered - For sum insured between Rs.15 lakhs to Rs. 25 lakhs.
Health checkup: Under this plan, the annual health checkup expense cover has got sub-limits based on the sum insured opted by the policyholder.
Co-payment: Copayments are applied in the case of treatment.
For pre-existing disease treatment: 50% of each and every admissible claim.
For non-pre-existing disease treatment: 30% of each and every admissible claim.
Sub-limits: A list of diseases is mentioned in the brochure which has a particular sub-limit for every claim. The list includes cataract, medical renal disease, cancer, vascular cardiac diseases, cerebrovascular accident, treatment of breakage of long bones, etc.
Exclusions
Venereal diseases.
Sexually transmitted diseases.
Intentional self-injury.
Congenital external condition.
Inoculation or vaccination.
Convalescence.
Run-down condition or rest cure.
Nutritional deficiency state.
All types of cosmetic surgery.
Plastic surgery.
Dental treatment.
Treatment of subfertility assisted conception and other related complications of the same.
