Edelweiss Health Platinum Plan

A health insurance plan is a policy in which the person insured gets coverage against hospitalization costs, thereby ensuring financial stability to the policyholder's family. These health insurance plans either reimburse medical expenses or provide cashless treatment. Edelweiss Health Platinum Plan comes with multiple insurance benefits like free health check-ups, pre-hospitalization, and post-hospitalization covers, maternity benefit, recovery benefit, critical illness cover etc.

Edelweiss Health Platinum Policy: Key Highlights

Type

Individual/Floater plan

Sum Insured

Up to 1 cr

Maternity Benefit

Up to 2 lakh

AYUSH Benefit

Covered

Restoration of SI

Available

Voluntary Co-payment

10%-20%


Scope of Coverage Offered

Edelweiss Health Platinum Policy provides the following coverage as mentioned below:

  • Room Rent Limit: This policy covers the cost of a standard private single room daily of the policyholder. Under the platinum variant, there is no limit on the room rent.
  • Hospitalization Expenses: The cost of hospitalization maximum up to the sum insured amount gets covered in the policy.
  • ICU Charges: Admitting the person insured on a medical practitioner's advice to the ICU is covered in the Edelweiss Health Platinum Policy.
  • Pre-hospitalization: This policy covers the cost of pre-hospitalization, i.e., expenses incurred before the policyholder gets admitted to the hospital up to sum insured for 90 days.
  • Post-hospitalization: This policy covers the cost of post-hospitalization, i.e., expenses incurred after the policyholder gets admitted to the hospital up to sum insured for 180 days.

Inclusion of the Edelweiss Health Platinum Plan

 Inclusions for the online Edelweiss Health Platinum Plan are:

  • Ambulance Cover: The policy covers the cost of an ambulance up to Rs 10,000 per hospitalization.
  • Day Care Procedures: The Edelweiss Health Platinum Plan covers various da care procedures, i.e., those treatments for which the person insured is required to be hospitalized less than 24 hours up to the sum insured amount.
  • Organ Donor Cover: Expenses up to Rs 2 lakhs are covered in the health insurance plan for organ donor expenses.
  • Domiciliary Hospitalization: The policy provides coverage against domiciliary hospitalization maximum up to sum insured amount.
  • AYUSH cover: The policy provides coverage against non-allopathic treatment expenses like Homeopathy, Unani, Siddha, Ayurveda, and other therapies up to the sum insured amount.
  • Critical Illness Cover: For the first time the policyholder is diagnosed with an illness as per the defined SI limit.
  • Top-up: Available for 100%, where the sum insured doubles.

Exclusions of the Edelweiss Health Platinum Plan

The exclusions of the Edelweiss Health Platinum Insurance Policy are:

The following conditions or treatments will not be covered under the plan:

  • Childbirth
  • Cosmetic Surgery
  • Out-patient department
  • Hospitalization due to substance abuse
  • Participation in dangerous activities
  • Suicide

This list is only indicative. Please refer to the policy document or the product brochure for a detailed list of exclusions.

Features and Benefits of This Plan

 The features and benefits of the Edelweiss Health Platinum Health Insurance plan are:

  • Cumulative Bonus: On a policy year where no claims are made, the policyholder gets a cumulative bonus —the sum insured amount increases by 50%, which can be up to a maximum of 100%. But one must note that if claims are made, then the sum insured amount decreases by that percentage, i.e., 50% or maximum up to 100%.
  • Health Check-Up: There is also a provision health check-up under which Edelweiss Health Insurance will bear a health check-up cost if no claims are made in a policy year.
  • Maternity Benefit: The female policyholder gets a maternity benefit of up to a maximum of Rs 2 lakhs after 4 policy years.
  • Recovery Benefit: The person insured gets Rs 1,500 daily from the 11th to 20th day of hospitalization as a recovery benefit.
  • Shared Accommodation: If the person insured uses shared accommodation, the insurer will pay Rs 1,000 per maximum up to Rs 6,000 in total.
  • Critical Illness Coverage: The person assured on detection of critical illness gets their sum insured increased by 100% in the plan's platinum variant.
  • Restoration Benefit: Edelweiss Health Insurance on the sum insured's exhaustion restores the sum insured by 100%.

Eligibility Criteria

One has to consider the following eligibility criteria while buying the Edelweiss Platinum health insurance policy:

Minimum Entry Age

For adults - 18 years

For children

3 months

Maximum Entry Age

No limit

Number of people covered

 

The policy provides coverage to 8 family members

 

Residential Status                    

The policyholder must be a resident of India either as a citizen or a pass holder, or a permanent resident of India


Cancellation Terms of the Policy

If the person insured is not satisfied with the policy's conditions and terms, he/she can return the policy within 15 days from the commencement date of the policy. The insurer will reimburse the policyholder's premiums after deducting some nominal charges like stamp charges and taxes. The policy will not be returned if any claim is made.

FAQs

Written By: PolicyBazaar - Updated: 28 December 2020

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