Janata Mediclaim Policy (Cashless Facility Available)
Health Insurance Policy
Health Insurance Policy
1.0 COVERAGE: The Policy covers reimbursement of Hospitalization Expenses for Illness/ Injury sustained.
2.0 Cost of treatment taken in General Ward of the Hospital/ Day-Care Centre per day maximum charges INR 450/-.
2.1 Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses.
2.2 Surgeon, Anaesthetist, Medical Practitioner, Consultants’ Specialist fees.
2.3 Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Dialysis, Chemotherapy, Radiotherapy, Artificial Limbs, Cost of Prosthetic devices implanted during surgical procedure like pacemaker, Relevant Laboratory/Diagnostic test, X-Ray etc.
2.4 Pre-Hospitalization medical Expenses up to 30 days.
2.5 Post-Hospitalization medical Expenses up to 60 days, subject to maximum of 10% of hospital bill.
2.6 AYUSH: Expense incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system of medicines are covered 100% of Sum insured.
2.7 Ambulances services – actual expenses for transportation of patient (insured) or INR 1,000/- whichever is less in case patient has to be shifted from residence to Hospital for admission in Emergency Ward or ICU or from one Hospital to another Hospital by fully equipped ambulance for better medical facilities.
2.8 Hospitalization expenses (excluding cost of organ) incurred on the donor during the course of organ transplant to the Insured person. The Company’s liability towards expenses incurred on the donor and the Insured recipient shall not exceed the sum insured of the Insured person receiving the organ.
2.9 The total amount payable under this policy during the period of insurance will in no case exceed the Sum Insured and will be subject to the limits shown in the following schedule or actual whichever is less.
2.10 SCHEDULE OF PAYMENT FOR SPECIFIED DISEAES
Name of Illness/Operation | Maximum Charges Inclusive of Room/ICU/ OT Charges / Surgeons, Anesthetist, doctors’ fees, medicines, internal appliances and other charges incurred during Hospitalization period |
---|---|
Cataract with imported foldable lens | 10800/- |
Hysterectomy | 22500/- |
Appendicectomy | 16200/- |
Cholecystectomy | 18000/- |
TURP | 18000/- |
Hemia-Inguinal | 16200/- |
Hernia- Ventral/Incisional | 19800/- |
Septoplasty | 9000/-- |
Haemorrhoidectomy | 8100/- |
Fissurectomy | 9000/- |
Fistulectomy | 10800/- |
Angiography | 12000/- |
Angioplasty (imported stent single) | Actual or Sum Insured whichever is less |
CABG | Actual or Sum Insured whichever is less |
Total Knee replacement | Actual or Sum Insured whichever is less |
Total hip replacement | Actual or Sum Insured whichever is less |
Tonsillectomy | 7200/- |
Tympanoplasty | 13500/- |
Kidney stone/lithotripsy | 13500/- |
Arthoscopy | 10800/- |
PID-Disectomy | 31500/- |
Mastectomy(Radical) | 36000/- |
Exploratory Laprotomy | 13500/- to 27000/- |
Actual expenses for Other Surgeries/Hospitalization or given hereunder whichever is less:
PER DAY CHARGES
Cataract with imported foldable lens | 450/- |
Minor Surgery (as defined) / Day care Room Rent per day | 450/- |
Operation Theatre Charges | 1260/- |
Anesthesia | 1630/- |
Anesthetist Fees | 945/- |
Surgeon fees | 3150/- |
INTERMEDIATE SURGERY
Room Rent | 450/- |
Operation Theatre Charges | 1764/- |
Anesthesia | 882/- |
Anesthetist Fees | 1323/- |
Surgeon fees | 4410/- |
MAJOR SURGERY
Room Rent | 450/- |
Operation Theatre Charges | 2520/- |
Anesthesia | 1260/- |
Anesthetist Fees | 1890/- |
Surgeon fees | 6300/- |
SUPRA MAJOR SURGERY
Room Rent | 450/- |
Operation Theatre Charges | 5040/- |
Anesthesia | 2520/- |
Anesthetist Fees | 3780/- |
Surgeon fees | 12600/- |
ICU Charges (per day with all intensive care infrastructure & facilities) | 1800/- |
Ventilator Charges (Per day) | 450/- |
Visit Charges (Per day irrespective of number of visits) | 360/- |
Sum Insured (INR) | 3 months to 5 yrs | 6 yrs to 35 yrs | 36 yrs to 40 yrs | 41 yrs to 45 yrs | 46yrs to 50 yrs | 51yrs to 55 yrs | 56 yrs to 60 yrs | 61 yrs to 65 yrs | 66 yrs to 70 yrs |
---|---|---|---|---|---|---|---|---|---|
50000 | 788 | 735 | 840 | 1155 | 1470 | 1628 | 1890 | 2153 | 2415 |
75000 | 1181 | 1103 | 1260 | 1733 | 2205 | 2468 | 2835 | 3203 | 3623 |