IFFCO Tokio Individual Medishield Policy

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Iffco Tokio Individual Medishield Policy Overview

Individual Medishield Policy helps you financially by reducing the expenses from your own pocket on the medical treatment in case of an accident or disease. Apart from medical coverage for illnesses with an option to extend the coverage for critical illnesses such as kidney failure, heart surgery, major organ transplantation, cancer, etc. as the cost of treatment for such illnesses is very high.

There is a provision of cashless hospitalization in more than 4500 hospitals across India. In the event of an unfortunate event like an illness or an accident resulting in hospitalization, the insurer will take care of the financial expenses.

Key Features of Iffco Tokio Individual Medishield Policy

  • The nationality of the proposer is not a bar, but to be the resident of India is a pre-requisite, as the medical reimbursements are valid PAN India only
  • Anyone between the age group of 3 months to 80 years can be insured. Dependent children between the age group of 3 months and 5 years can be included by their insured parents
  • Applicants below the age of 60 years do not need any pre-medical checkups. Anyone above the age of 60 years will need to undergo medical screening for diabetes, blood pressure, ECG, etc. Those who are above the age of 55 years shall undergo medical tests like Lipid profile or LP, Kidney functioning test or KFT
  • Discount on family cover

Inclusions of Iffco Tokio Individual Medishield Policy

  • Daily hospitalization allowance is provided at the rate of 0.1% of the sum assured, and a maximum of Rs. 250 per hospitalization
  • During pre and post hospitalization, nursing expenses shall be covered, if only prescribed by the medical practitioner during the treatment period
  • Hospitalization required for donating organs, at the time of organ transplantation of the proposer, subjected to limits of sum insured as specified under the Iffco Tokio health insurance policy
  • At the end of 4 consecutive claim-free years, amount to be reimbursed is kept at 1 % of the sum assured
  • Provision to cover the entire family including spouse, dependent children, and parents are there. Children can only be covered if they are below 23 years and are dependent on the insured parents.
  • In the case of non-allopathic treatments like Ayurveda and homeopathy, the cap of reimbursement is kept at 10% of the sum insured ( both pre and post hospitalization expenses)
  • By paying 30% of extra premium you can get 10 major critical illnesses covered
  • Avail 5% of discount on premium, on getting 2 members insured and 10% of discount on having more than 2 members insured under the same plan

Exclusions of Iffco Tokio Individual Medishield Policy

  • Any pre-existing disease diagnosed or treated during the first 3 years from the date of the commencement of the health insurance policy
  • Treatment during the first 30 days or waiting period of the policy ( unless it is an accidental case)
  • Some specified diseases as mentioned in the policy, will not to be treated in the first year of the policy
  • Cost of eyeglasses, lenses or any type of hearing instruments
  • Dental care until it requires hospitalization
  • Congenital diseases or regular health ailments
  • Pregnancy-related health claims except for ectopic pregnancy
  • Domiciliary hospitalization and out-patient treatment
  • Any expenses incurred on external medical equipment
  • Expenses incurred on obesity treatment, and any hormonal treatment
  • HIV/AIDS treatment
  • Expenses on naturopathy treatment, acupuncture, experimental or alternative medicine, acupressure, etc.
  • Involvement in life-threatening sports/activities.
  • Hospitalization required due to war conditions, terrorist activities and foreign attacks
  • Any type of non-medical expenses are not covered

Sum Assured (Rs.)

Minimum sum insured is Rs. 50,000 up to a maximum of Rs. 500,000. Which is extendible up to Rs. 2,000,000 if the need be.

Claim Process of Iffco Tokio Individual Medishield Policy

Their claim process is quite easy and simple claim process. You can file for both cashless and reimbursement claims. The procedure is listed below:

If you undergo treatment in a non-network hospital then you can file a claim on a reimbursement basis. Reimbursement claims will require a completed and signed claim form. You will need to submit the medical bills, prescriptions and cash memos of the chemist, receipt bills, pathological test reports, etc. the treatment can also be availed on a cashless basis in a network hospital.

Written By: PolicyBazaar - Updated: 01 April 2019