Senior Citizen Mediclaim Policy
Health Insurance Policy
Health Insurance Policy
1.0 COVERAGE:The Policy covers reimbursement of Hospitalisation Expenses for Illness/ Injury sustained.
2.0 SCOPE OF COVER: HOSPITALISATION EXPENSES
In the event of a claim becoming admissible, the Company will pay the expenses listed below that are Reasonable and Customary, and Medically Necessary incurred by or on behalf of such Insured Person but not exceeding, in aggregate, the Sum Insured mentioned in the Schedule.
|(i) Room, Boarding expenses charged by the Hospital/Nursing Home|
(ii) If admitted in ICU
|Up to 1% of Sum Insured per day|
Up to 2% of Sum Insured per day
Overall limit: 25% of the Sum Insured.
|Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees, Nursing Expenses||Overall limit 25% of Sum Insured|
|Anesthesia, Blood, Oxygen, OT charges, Surgical appliances, Medicines, Drugs, Diagnostic material and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of Stents and Implants||Overall limit 50% of Sum Insured|
2.1.1Claims in respect of the following Illness / Surgery, will be subject to the following limits:
|Name of Illness/Operation||Maximum Charges Inclusive of Room/ICU/OT Charges/ Surgeons, Anesthetist, doctor's fees, medicines, internal appliances and other charges incurred during hospitalization period|
|Cataract with imported foldable lens||10000/-|
2.2Actual Pre-Hospitalisation Medical Expenses of up to 30 days, subject to maximum 5% of hospital bill.
2.3Actual Post-Hospitalisation Medical Expenses of up to 60 days, subject to maximum of 10% of hospital bill.
2.4 AYUSH:Expenses incurred for Ayurvedic/Homeopathic/Unani Treatment are admissible up to 25% of the sum insured provided the treatment for Illness or Injury, is taken in a Government Hospital or in any institute recognized by Government and /or accredited by Quality Council Of India / National Accreditation Board on Health, excluding centers for spas, massage and health rejuvenation procedures.
2.5Ambulance charges, subject to a maximum of INR 1000/-
2.6Hospitalisation Expenses (excluding cost of organ) incurred on the donor during the course of organ transplant to the Insured. The Companys liability towards expenses incurred on the donor and the Insured recipient together shall not exceed the sum insured of the latter.
Senior Citizen Mediclaim Premium Chart(Excluding GST)
|Sum Insured (INR)||60-65||66-70||71-75||76-80||81-85||86 and above|