Reliance Health Gain Insurance Plan is an health plan that provides coverage for daycare treatments, pre and post-hospitalization, expenses related to COVID-19, and other related hospitalization expenses under this plan.
Health Gain Policy is available in individual and family floater options, cashless facilities, restoration benefits, and other add-on features. This plan comes in 2 variants i.e., Plan A and Plan B. Both are ideal plans and offer similar benefits, but Plan B provides wide coverage in terms of extra cover, sub-limit, and sum insured options.
|Entry Age (Minimum)||Dependent children - 91 days to 25 years under Floater plan |
Children above 5 years can be covered as an individual (with at least 1 member aged 18 years or above)
|Entry Age (Maximum)||65 years|
|Exit Age||No Exit Age. Lifelong Renewability option is available|
|Individual Policy||A maximum of 6 members can be covered|
|Floater Policy||A maximum of 6 members can be covered under the same floater plan|
**Last Updated on July, 2021
Before buying any health plan, it is important to understand the plan and its features thoroughly. Let's have a look at some of the listed features below:
The major benefits of Reliance Health Gain Insurance Plan are:
In this, a patient is provided with a 24-hour care facility. This plan provides coverage for hospitalization expenses for in-patient treatment of covered illnesses, where the policyholder is hospitalized for more than 24 hours consecutively.
The plan provides coverage for the daycare procedures where the policyholder needs less than 24 hours of hospitalization. Refer to the policy wording for the complete list of daycare treatments.
The plan offers coverage to the insured up to 60 days before the hospitalization as well as 60 days after the discharge from the hospital.
This plan covers the expenses incurred on organ donor treatment. A 50% of the sum insured is covered under the plan for a maximum of up to Rs. 5 lakhs.
Expenses are covered for transporting the patient from one hospital to the other in case of medical emergencies.
In some cases when it is not possible to move a patient to the hospital then the treatment is conducted at home which can also be covered under this plan.
When you have exhausted all your sum insured and cumulative bonus, and still you want additional hospitalization expenses for any illness, then the company refills the sum insured free of cost.
When you do not make a claim in any policy time, then 33.33% of the cumulative bonus on your sum insured is provided to you at the end of each claim-free year.
|Benefits||Plan A||Plan B|
|Sum Insured||Rs. 3 lakhs, Rs. 6 lakhs, Rs. 9 lakhs||Rs. 12 lakhs, Rs. 15 lakhs, Rs. 18 lakhs|
|Domestic Road Ambulance||Up to Rs. 1,500||Up to Rs. 3,000|
|Guarantee for policy service||Rs. 10,000 Sum insured for the delay in the issuance of policy||Rs. 20,000 Sum insured for the delay in the issuance of policy|
|No Claim Renewal in Accidental Death Cover||NA||Death cover of Rs 1 lakh of Personal accident|
|Pre and post hospitalization expenses||Up to 60 days|
|Inpatient hospitalization expenses||Covered up to the sum insured|
|Day Care treatments||Covered up to the sum insured|
|Expenses on organ donor treatment||50% of base sum insured subject to a limit of Rs. 5 lakhs|
|AYUSH Treatment||Covered up to 100% of sum insured|
|Modern and advanced treatments||Covered up to 50% of sum insured|
|Eligibility for Room Rent||A single private room is available|
**Last Updated on July, 2021
Family discount depends on the family's size when you have more than insured members in your family individually in the existing policy instead of having a family floater plan. At that time, the policyholder is eligible for a 5% or 10 % discount.
You are eligible for a 5% discount if you have insured a little girl or a single woman in your family.
7.5% of discount for 2 years policy period
This table illustrates the Premium payable by an individual at different ages for a sum insured Rs. 3 lakhs. Let's understand this with the help of a graph.
Premium Payable by an individual at different ages under Health Gain Plan
Here, you can see, with the increase in age, the premium amount is also increasing. For example, at 30 years of age, the premium is Rs. 5546 whereas, at 40 years of age, it increased to Rs. 6844. The premium increases with age because of the changes in lifestyle, pre-existed illnesses/diseases, smoking habits. The premium of a smoker is greater in comparison to the premium of a non-smoker because the smoker is at a higher risk of getting illnesses.
Take a look at some of the major exclusions of this policy.
The buying process of the Reliance Health Gain Insurance Plan is quite easy and smooth. Follow the below-listed steps,
There are two options available for processing claims: Cashless claims and Reimbursement claims. Cashless claims do not require you to pay single money from your pocket when you are admitted to a network hospital at the time of a medical emergency. After submitting your pre-authorization form and other related documents, you are eligible for a cashless claim.
When you are hospitalized in a non-network hospital that is not enlisted with your insurer, then the patient is required to pay all the medical bills, but after informing the insurer and submitting all the required documents, the insurer refunds all the money in your respective bank account.
For processing the claim:
What is Domiciliary Hospitalization
Introduction About Ayushman Bharat Yojana or PMJAY
Common Exclusions In A Health Insurance Policy
Medical Indemnity Insurance
Health Insurance Claim Settlement Ratio
Health Insurance FAQs
Benefits Of Renewing Health Insurance On Time
Preventive Health Checkup
In some cases, you are required to have a medical check-up,
In Plan A - if you are above or equal to 45 years
In Plan B - If you are above or equal to 18 years
In any health insurance plan- if you are < 45 years of age, but suffering from a pre-existing illness.
The proposed insured pays the PPC i.e., Pre-Policy Check-up directly to the diagnostic centre or to the medical practitioner. The appointment will be coordinated with our doctor via R-CARE.
Yes, you can do that by only informing and submitting details of the nominee to the insurance company.
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Last updated on July, 2021
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