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Health Premia is a health insurance plan that covers hospitalization expenses along with key medical needs like pre and post-treatment costs, daycare procedures, and emergency care. It also offers higher sum insured options and added benefits like restoration of coverage and global treatment support, making it suitable for both individual and family protection.
| PLAN DETAILS |
Health Premia Plan |
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Optima Restore Plan |
| Product Type | Individual and Family Health Insurance | Individual and Family Health Insurance |
| Key Features (Key features of the plan) |
|
|
| OPD Details (In some policies, OPD (Out patient department) expenses are also covered.) |
Covered | Not Covered |
|
Room Rent (A limit of room rent cover during hospitalization if any) |
Covered | Covered |
| Domicillary Hospitalization (It is the expenses incurred on treatment of the patient at home) |
Covered | Covered |
| Pre-hospitalization (Expenses before the insured is hospitalized) |
Covered | Covered |
| Post-hospitalization (Expenses after discharge from the hospital) |
Covered | Covered |
| Day Care Treatment Covered (Day care treatments refers to the treatments that do not necessarily require 24hrs of hospitalization like MRI.) |
Not Covered | Covered |
| Hospital_network (Number of Hospital Network in city) |
10000 | 15000 |
| Organ Donor Expenses (Expenses incurred on organ donor in case of organ transplants) |
Covered | Covered |
|
Hospital Daily Allowance (Some plans offer daily allowance to take care of expenses like food, etc) |
Covered | Covered |
| Ambulance Charges (Expenses incurred on ambulance charges) |
Covered | Covered |
|
Maternity Benefits (All Hospitalization cost covered at the time of pregnancy.) |
Covered | Not Covered |
| New Born Baby Covered (Newborn babies can be covered under the insurance plan after a certain period) |
Covered | Not Covered |
| Health Checkup (An added benefit of one time full health checkup of policy holder.) |
Covered | Not Covered |
|
Sub Limit (Sub-limit is a monetary capping that applies on specific diseases like cataract) |
Covered | Not Covered |
| Co-pay (Mentioned %, if any is to be borne by Insured and rest will be borne by insurer) |
Not Covered | Not Covered |
| Plan Entry Age | 18 - 65 Years | 5 to 65 years |
| Plan Premium Entry Age and S/A | 16436 | 8852 |
| Plan Waiting Period | 30 | 30 |
| Plan Coverage | Inpatient hospitalization expenses, pre and post-hospitalization cover, daycare treatments, ambulance charges, AYUSH treatment cover, organ donor expenses, maternity and newborn cover, and optional global emergency treatment coverage. | Individual & Family floater |
| Plan Sample Premium | 16436 | 8852 |
| Plan Brochure | Brochure URL | Brochure URL |
| Policy Term | 1 & 2 years | 1, 2 years |
| ICU Charges | Covered | Not Covered |
| Covid-19 Treatment | Covered | Covered |
| Cataract | Covered | Covered |
| Automatic Restoration | Covered | Covered |
| Ayush Treatment | Covered | Not Covered |
| Modern Treatment | Covered | Covered |
| E Consultation | Covered | Covered |
| Air Ambulance | Covered | Not Covered |
| Global Coverage | Not Covered | Not Covered |
| Claim Ratio | 94.4 | 95.30 |
| Solvency Ratio | 3.03 | 2.00 |
|
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