Main Highlight of the plan
- This plan is especially for senior citizens between age 46 years and 70 years.
- This plan has waiting period for pre-existing diseases is 1 year.
Scope of cover
|
Plan |
Entry Age |
Maximum Number of Members |
Sum Insured Range |
Premium Discount |
|
Individual Plan |
46 years to 70 years |
2 (Proposer and Spouse) |
INR 50,000 to INR 5,00,000 |
This policy has family
discount of 5% |
Coverage: Benefits & Features
Most Important
ROOM RENT/ ROOM CATEGORY
This plan does not have any limit on room expenses.
CO-PAYMENT
This plan has 20 % co-pay related to treatment in non-network hospital. However, this can be waivered off by paying 15 % extra premium.
NO-CLAIM BENEFITS
In this plan no-claim bonus equal to 10% of basic sum insured up to a maximum of 50% is available for each unclaimed year. However, the bonus amount is reduced by 10 % of sum insured once a claim is made.
- Note: After any claim, only the bonus amount would be reduced at the time of renewal. However, the basic sum insured will not be affected.
SUB-LIMITS
This plan covers pre-existing diseases up to 50% of sum insured.
- Cataract treatments would be paid up to 10% of sum insured for a minimum of INR 12,000 and a maximum of INR 25,000.
Good to have
PRE/POST HOSPITALIZATION
This plan covers pre and post hospitalization expenses up to 3% of total claimable expenses.
RESTORE BENEFITS
This plan does not offer restore benefit.
HEALTH CHECK-UP
This plan offers health check-up benefit once every 4 continuous claim free years at empanelled diagnostic centers.
Value Adds
AMBULANCE CHARGES
This plan provides coverage for ambulance expenses up to INR 1000 per claim.
EYE COVER
This plan does not provide coverage for eye treatment expenses.
DOMICILIARY HOSPITALIZATION
This plan does not have domiciliary hospitalization coverage.
OUTPATIENT BENEFITS
This plan does not have any outpatient benefits.
CRITICAL ILLNESS COVERAGE
This plan does not have additional coverage for critical illnesses.
ALTERNATIVE PRACTICE
This plan does not cover medical expenses for alternative practices like Ayurveda, Unani, etc.
DENTAL COVER
This plan does not covers dental expenses.
DAILY CASH
Daily cash allowance is not available in this plan.
ORGAN DONOR COVER
This plan does not cover expenses related to organ donor in case of organ transplant.
CONVALESCENCE BENEFIT
This plan does not provide convalescence benefit.
MATERNITY COVER
This plan does not cover maternity expenses.
Exclusions
A cooling off period of 30 days is applicable on buying health insurance policy for the first year. No claims (other than claims related to an accident) can be made in this cooling off period. There is no cooling off period applicable on renewal of this policy.
Waiting period of 1 year is applicable for some specific ailment. Refer to the policy wordings for the list of these specified ailments.
Waiting period of 1 year is applicable for pre-existing diseases.
Waiting period of 4 years is applicable for joint replacement.
PERMANENT EXCLUSIONS
Cosmetic surgery, Lasik eye treatments, drugs or alcohol abuse, genetic disorders, self-inflicted injuries, war related injuries, etc. are some of the exclusions. For the detailed list of please refer the Bajaj Allianz Health Insurance policy document.
