Cholamandalam Chola Tax Plus Healthline Plan

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Chola Tax Plus Healthline plan offers coverage for both hospitalizations as well as non-hospitalization i.e. OPD charges. This plan comes is available in both individuals as well as family floater option. And the premium options are fixed for this plan.

Key features and Benefits

  • Cashless hospitalization cover in more than 8000 network hospitals across India
  • Round-the-clock claims assistance through Chola MS HELP (their in-house TPA)
  • The sum insured options ranges from 1 lakh, 2 lakhs, 3 lakhs, 4 lakhs to 5 lakhs
  • The maximum age to buy this plan is 65 years
  • Pre-medical check-up is not required for an applicant below 55 years of age

Chola Tax Plus Healthline Plan Coverage

  • Entry age criterion is minimum 18 years and maximum of 65 years
  • Coverage is available to you, your parents, spouse, and dependent children. The age limit for dependent children is 3 months to 35 years. The age limit for a female dependent child is 35 years and for a dependent male child is 25 years.
  • A pre-policy medical check-up is required for applicants who are older than 55 years
  • Lifetime policy renewal

Section 1 - Hospitalization Cover

(In-patient hospitalization cover up to INR 5 lakh on individual & family floater basis)

Room Rent Charge

1 percent of Sum Insured ( on daily basis)

ICU Expense Cover

2 percent of Sum Insured ( on daily basis)

Pre-Hospitalization Expense cover

Maximum 5 percent of the claim and for a maximum of 30 days before the hospitalization

Post-Hospitalization Expense cover

Maximum 10 percent of the claim or Rs. 50,000 and for a maximum of 90 days of getting discharged

Ambulance Charges

Rs.3,000 for each hospitalization

Sub-limits

Cataract Surgery ( per eye): 7.5% of the SI/up to a maximum of 20,000 Rupees per eye

Hernia or Hydrocele: 10% of SI/ up to Rs.30,000

Anal Fissure, Fistula in Anus, & Piles : 10% of SI/ up to Rs.30,000

Sinusitis : 10% of SI/ up to Rs.30,000

Tonsillitis or Adenoids - 15% of SI/ up to Rs.40,000

Knee & Joint replacement Surgery - 50% of co-payment
*No co-payment in accidental cases

 

Section 2 - Non-Hospitalization Cover

Out-patient Medical Expenses Up to the Specified Limit

Treatment of injury/illness incurred without hospitalization

Pre & post natal Expenses

All pre-existing Illnesses

All dental treatments

Allopathic treatments and Indian medicine system (except for naturopathy)

Contact lenses, Spectacles, Hearing aids, Prosthetic appliances, etc. supported by a doctor’s prescriptions

Deductibles paid  during hospitalization due to the imposition of sub-limits


Medical Tests Required for Chola Tax Plus Healthline Plan

People up to 55 years of age don’t need to undergo any pre-medical screening. However, people above 55 years of age need to take the following medical tests to be eligible to buy the plan:

  • Fasting Blood Sugar
  • Medical Examination Report
  • Electrocardiogram
  • Complete Blood Count
  • Renal Function Test
  • Complete Urine Examination
  • Liver Function test

These medical tests can be done at any of our registered diagnostic centers. The insurer will pay off 50% of the cost once the policy is approved.

No-Claim-Bonus for Chola Tax Plus Healthline Plan

  • The No-claim-bonus that you can earn is 5% for every claim free year, and the maximum limit is 50 percent
  • No-claim-bonus is not applicable to non-hospitalization expenses

Exclusions of Chola Tax Plus Healthline Plan

  • Benefits are not applicable to pre-existing diseases until completion of 2 years of the policy term ( from the policy commencement date)
  • Expenses incurred during the initial 30 days of policy inception (apart from accidental cases). This is not valid for policy renewals
  • During the first year of the policy, the insurer shall not reimburse the expenses incurred on the surgeries and procedures relating to Benign Prostate Hypertrophy, Fistula in Anus, Hernia / Hydrocele, Piles, Anal Fissure, Tonsillitis, Congenital internal diseases.
  • During the first two years of the policy, the insurer shall not reimburse the expenses incurred on the surgeries and procedures relating to gall bladder stones, hysterectomy for non-malignant lesions, duodenal or gastric ulcer, knee replacement surgery ( except for accidental injuries), all benign tumors and lumps, joint replacement surgery, and Spondylosis. Moreover  the exclusions list includes Chronic renal failure/kidney disease, Degenerative Disc Disorders, Varicose veins, Prolapses of intervertebral disc (unless it is an accidental injury), Varicose ulcers, Fibroid in Uterus, Thyroiditis, Goitre, and Prolapsed Uterus Deviated Nasal Septum, Dilatation And Curettage, Gout And Rheumatism, Sinusitis, Cataract, Renal calculi, Mastoidectomy, Glaucoma, Arthritis, and Tympanoplasty.  

Claim Procedure of Chola Tax Plus Healthline Plan

Chola Tax Plus Healthline Cashless Claim Procedure

  • You can avail of cashless treatment in more than 8000 network hospitals across India
  • If you are undergoing treatment in a non-network hospital then you need to make the payment up-front and then compensation will be provided after submitting the relevant documents
  • In case of day care procedures or planned hospitalization, you need to inform Chola MS and get the pre-authorization form by calling at their 24 hrs toll-free assistance.
  • In the event of emergency hospitalization, intimation should be given within 24 hours of hospitalization

Chola Tax Plus Healthline Reimbursement Claim Procedure

  • Submit all the bills along with the diagnostic reports, prescriptions, etc.
  • The first claim needs to filed within 3 months of the policy commencement date
  • Family floater claims can be only be filed twice in a policy year