All you need to Know about Iffco Tokio Swasthya Kavach Policy for your Family

Iffco Tokio Swasthya Kavach policy provides health coverage for a range of hospital expenses. In this policy, you can get yourself and your family members covered. There are two types of plan namely – basic and wider plan, based on the coverage that is offered in the plan. If you are planning to buy this policy for your policy then you can check out the details given below to make an informed purchase:

What makes Iffco Tokio Swasthya Kavach Policy a Right Choice?

• People of any nationality can apply for the policy - if they are mainly a resident of India because the medical coverage is PAN India only
• Provides coverage to the proposer, spouse, and up to 3 dependent children, siblings, niece or nephew)
• For adults, the entry age is between 18 to 60 years
• And for children, it is between 3 months to 23 years of age at the time of inception of the policy
• The maximum age of renewability is up to 80 years
• If the age of the dependent children crosses 23 years then, he/she will be no longer be covered and will need a renewal in an individual plan
• No pre-medical check-up required up to the age of 60 years. If you are above 60 years, then you need to go through medical tests, blood sugar, ECG, Urine, etc.) before the policy purchase date. For some people, advanced tests like lipid profile, kidney functioning test, eco test are required
• Hospitalization will only be considered if the insured has been admitted for more than 24 hours unless the treatment is required for 121 specified day care procedures

What is the coverage amount?

The coverage amount ranges from Rs 2 lakh, Rs 3 lakh, Rs 4 lakh to Rs 5 lakh.

What are the Inclusions under Iffco Tokio Swasthya Kavach Base Plan?

• Hospitalization expenses including room rent charges at 1.0% of the sum insured and ICU expense up to 2% of the sum insured on a daily basis
• Hospital registration charges, service charges up to a limit of 0.5% of the basic sum insured
• Nursing expenses, if advised by the medical practitioner during the hospitalization period
• Fees charged by the medical practitioner, surgeons, doctors, specialists, consultants, anesthetists, etc.
• Cost of medicines, oxygen support, blood units, anesthesia, medical and diagnostic tests, operation theatre charges, are reimbursed
• Cost of chemotherapy, radiotherapy, pacemaker, dialysis, artificial limbs etc.
• Ambulance charges up to a limit of Rs 750
• Per day hospitalization cash allowance of Rs 150 per day
• Up to 20% of domiciliary hospitalization expenses are reimbursed, which may require 3 days of hospitalization otherwise, but is taken at home due to certain specified reasons
• 30 days of pre and post hospitalization expenses are covered. 7 percent of the sum insured or a maximum of Rs 7500 will be reimbursed for post-hospitalization expenses (exclusive of room rent)
• Organ donor expenses shall be covered as well
• You can choose from the prescribed hospital package charges for specific treatments, which can be reimbursed to a maximum of 80% of the sum insured or the actual expenses, whichever comes out to be less

What are the Inclusions under Iffco Tokio Swasthya Kavach Wider Plan?

• Hospitalization expenses, where the limit for room charges is kept at 1.5% of the basic sum assured and 2.5% for ICU charges
• Hospital registration fees, service charges, other fees etc. subject to a maximum of 0.5% of the basic sum insured
• Nursing expenses, incurred during both pre and post hospitalization period
• Fees charged by medical practitioners including surgeon fees, anesthetist, etc.
• Hospital charges levied on medicines, anesthesia, diagnostic and pathological tests, blood, oxygen, operation theatre, chemotherapy, dialysis, etc.
• Limit to reimburse ambulance charges is up to Rs 1,500 only
• Daily hospitalization allowance of Rs 250 per day
• 20% of basic sum insured will be compensated in case of domiciliary hospitalization expenses, for medical treatment required for more than 3 days, which would have been a normal hospitalization, but due to specific reasons, it is kept at home. Sub-limits are applicable to this clause.
• Pre-hospitalization expenses will be reimbursed for a maximum period of 30 days and post-hospitalization expenses shall be reimbursed for a maximum period of 60 days
• Hospitalization expenses during organ transplantation shall be recompensed up to the sum assured limit or as specified in the policy
• After completion of 4 claim-free years, the cost of health check-ups shall be reimbursed @ 1.0% of the average basic sum insured. Subjected to sub-limits as mentioned in the policy document.
• As mentioned in the above plan, hospitalization expenses for a specific disease to be reimbursed at the rate of 80% of the sum Insured or the actual expenses, either of them appears to be less

What are the exclusions under Iffco Tokio Swasthya Kawach Policy?

• Ay pre-existing disease before completion of 4 years of the policy term
• Any treatment taken in the initial 30 days from the date of policy inception, unless it is an accidental case
• Dental surgery or treatment, unless required for accidental injuries
• Cost of eyeglasses, contact lenses, or any type of hearing aids
• Dental treatment, unless requiring hospitalization
• Period of recovery, general weakness, congenital diseases are not considered
• Pregnancy-related complications unless it is an ectopic pregnancy
• Any expenses incurred on domiciliary hospitalization and out-patient treatment
• Purchase of external medical equipment’s
• Illness or injuries arising due to dangerous sports, profession or activities
• Medical expenses incurred on HIV/AIDS
• War conditions, terrorist activities, and nuclear attacks
• Obesity treatment and hormone replacement therapy
• Medical expenses incurred on naturopathy, experimental medications, acupressure, acupuncture, and similar treatments

This was a brief about the Iffco Tokio Swasthya Kavach health plan. It is a suitable plan for those who are looking for a health cover up to Rs 5 lakh. And in the same plan if you want to cover your spouse and children then it will be a right option. You can also buy this family health plan along with your employer’s health insurance policy to enhance the existing coverage amount.