Who is Eligible to Buy the Policy?
The following are the eligibility conditions of the plan-
- The enrollment age of the senior most member should be between 5-65 years
- In a single policy, maximum two adults can be covered
- The proposer should be above 18 years
- The policy can be renewed till the age of 70 years
- An individual proposer over 56 years of age has to undergo medical tests at the insurer’s diagnostic centers.
Key Benefits of Health Care Plus
The policyholder becomes eligible to enjoy the following benefits-
- Individual cover for each member of the family
- Flexible sum insured
- Long term cover of 1 or 2 years
- Flexible deductibles
- No Co Payment
- Free health checkup for any one insured member at the time of policy renewal
- Income tax benefit under Section 80D
What is Covered Under the Policy?
The insurer will indemnify the insured against-
- Hospitalization expenses covering
- Hospital room rent/bed charges
- Medicine and surgical expenses
- Diagnostic test
- Doctor’s/surgeon fees
- Pre-existing ailments are covered after 4 years of continuous coverage with the insurer
What is Not Covered Under the Policy?
The exclusions of the policy can be divided under two heads-
Exclusions which are valid for only 30 days:
- Any illness or disease arises 4 years before the commencement of the policy coverage.
- Any medical expenses which are incurred during first 30 days of the inception of the policy coverage
- Expenses incurred on the treatment of the below diseases which happen within first 2 years from the inception of the policy-
- Joint Replacement unless it is due to an accident
- All kinds of hernia
- Arthritis, rheumatism and spinal disorders
- Stones in the urinary system
- Gastric and Duodenal ulcers
- Dialysis required for chronic renal failure
- Surgery on tonsils, adenoids and sinuses
- Any physical or medical condition which is specifically excluded in the policy
- Routine medical, eye and ear examinations, cost of spectacles, laser surgery
- Suicide or self-inflicted injury
- Treatment of birth defects
- Dental treatment
- Hormone replacement therapy
- Cost of cochlear implant(s) unless required by an accident
- Personal comfort and convenience items
- Cosmetic surgery
Note - There could be more exclusion under the policy. Please check the policy wordings for more details.