What does it do?
Optima Plus is a top-up health insurance policy also known as Deductible policy wherein, insurance company becomes active only once single hospitalisation medical bills breach the threshold limit. Expenses up to threshold limit have to be paid by insured person. Sample this, for a policy with deductible limit of Rs 3 lakh, if admissible medical expenses during a single hospitalisation stood at Rs 2 lakh, insurance company is not bound to pay anything. Here, policyholder has to bear the claim himself. In another case, if total medical bills pertaining to a single hospitalisation amount to Rs 4 lakh, insurance company will pay Rs 1 lakh (Rs 4 lakh-3 lakh).
Insurance company has tinkered this policy in order to set it apart from other top-up policies available in the market. It offers 'Waiver of Deductible' option which means it allows to convert this top-up policy into a full fledged health insurance policy without any deductible limit. Insured person can then enjoy a full health cover worth Rs 5 lakh. Conversion is allowed only when insured person reaches 58 years of age till 60 years provided the person entered the policy for the first time when he was 50 or younger.
This policy covers inpatient hospitalisation expenses including diagnostic procedures, accommodation, blood, anesthesia, oxygen, ICU and operation theatre expenses, medicines, nursing and cost of implant instruments used during surgeries. It covers pre and post hospitalisation expenses. Day care procedures which do not require a 24 hour stay in hospital due to technological upgradation and domiciliary treatment wherein, treatment is taken at home on advice of doctor which would have otherwise required hospitalisation also fall under its coverage. It also provides for emergency ambulance and hospitalisation expenses of organ donor during organ transplant.
Pros
There is no cover ceasing age. It offers lifelong insurance.
It provides a flat discount of 7.5 per cent on advance payment of 2-year premium.
Family discount of 10 per cent is applicable on including three or more family members under the same policy.
It covers pre and post hospitalisation expenses as well.
This policy can be purchased online.
Premium paid under this policy qualifies for deduction under section 80D of Income Tax Act.
Cons
Deductible limit is applicable to each hospitalisation except in case of any one illness.
