A basic health insurance policy with a threshold limit which needs to be met by the insured either by self or through any other health insurance policy.
Covers Ayush Treatment.
Premium paid under this policy is eligible for tax benefit under Section 80D.
Does not cover Domiciliary Hospitalisation.
| Sum Insured and Threshold Limits (R) | ||
| Coverage Type | Sum Insured | Threshold |
| A | 5,00,000 | 5,00,000 |
| B | 10,00,000 | 5,00,000 |
| C | 15,00,000 | 5,00,000 |
| D | 7,00,000 | 8,00,000 |
| E | 12,00,000 | 8,00,000 |
| F | 17,00,000 | 8,00,000 |
| G | 22,00,000 | 8,00,000 |
| Scope Of Cover | |
| Cashless Facility | Available at network hospitals |
| Reimbursement Facility | Available if treatment taken at any non empanelled hospital |
| Pre and post hospitalisation | Not covered |
| Inpatient Hospitalisation | Covered |
| Room rent/ ICU expenses | Room rent and boarding expenses capped at Rs 5,000 per day for Rs 5 lakh threshold and Rs 8,000 for Rs 8 lakh threshold. |
| ICU and ICCU expenses capped at capped at Rs 10,000 per day for Rs 5 lakh threshold and Rs 16,000 for Rs 8 lakh threshold. | |
| Surgeon, Anesthetist, Medical Practitioner, Consultant's Specialist fees | Covered |
| Anesthesia, blood, oxygen, OT charges, surgical appliances, medicines, etc. | Covered |
| Day Care Procedures | Covered |
| AYUSH Treatment | Covered |
| Emergency ambulance | Covered upto 1% of Threshold Limit |
| Expenses of donor for organ transplant | Covered |
| Exclusions and Waiting Period | |
| Pre-existing Diseases/ Illnesses | Covered after a period of 48 months |
| No claim period | 30 days commencing from inception of policy except for accidental injuries |
| Waiting Period | 24 months in the case of all internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps, Benign ear, nose, throat disorders, Benign prostate hypertrophy, Cataract and age related eye ailments, Gastric/ Duodenal Ulcer, Gout and Rheumatism, Hernia of all types, Hydrocele, Infective Arthritis, Piles, Fissures and Fistula in anus, Pilonidal sinus, Sinusitis and related disorders, Prolapse inter Vertebral Disc and Spinal Diseases unless arising from Accident, Skin Disorders, Stone in Gall Bladder and Bile duct, excluding malignancy, Stones in Urinary system, Treatment for Menorrhagia/Fibromyoma, Myoma and Prolapsed uterus, Varicose Veins and Varicose Ulcers, Renal Failure. |
| 48 months in case the above illnesses arise froma pre-existing condition or joint replacement due to degenerative condition, age-related osteoarthritis and osteoporosis. | |
| General Exclusions | Self inflicted bodily injury, Domiciliary Treatment, Dental treatment, Cost of spectacles, braces, contact lenses, Naturopathy treatment, engagement in any illegal or criminal activities. engagement in adventurous acts such as parachuting, bunjee jumping etc. Bodily injury arising as a result of terrorism. Bodily injury or disease caused as a result of HIV/ AIDS or any related condition, and others. |
| Annual Premium with a deductible of 5 Lakh (excluding taxes) | |||
| For Primary Member | |||
| Age (In years)/Sum Insured | 5,00,000 | 10,00,000 | 15,00,000 |
| 18-44 | 1800 | 2800 | 3500 |
| 45-54 | 2900 | 4500 | 5600 |
| 55-60 | 4020 | 6300 | 8040 |
| 61-65 | 6700 | 10500 | 13400 |
| For additional member | |||
| Age (In years)/Sum Insured | 5,00,000 | 10,00,000 | 15,00,000 |
| 0-17 | 700 | 1100 | 1400 |
| 18-44 | 900 | 1400 | 1750 |
| 45-54 | 1450 | 2250 | 2800 |
| 55-60 | 2010 | 3150 | 4020 |
| 61-65 | 3350 | 5250 | 6700 |
| Annual Premium with a deductible of 8 Lakh (excluding taxes) | ||||
| For Primary Member | ||||
| Age (In years)/Sum Insured | 7,00,000 | 12,00,000 | 17,00,000 | 22,00,000 |
| 18-44 | 1600 | 2300 | 3000 | 3600 |
| 45-54 | 2500 | 3700 | 4700 | 5600 |
| 55-60 | 3840 | 5760 | 7440 | 8940 |
| 61-65 | 6400 | 9600 | 12400 | 14900 |
| For additional member | ||||
| Age (In years)/Sum Insured | 7,00,000 | 12,00,000 | 17,00,000 | 22,00,000 |
| 0-17 | 600 | 900 | 1200 | 1400 |
| 18-44 | 800 | 1150 | 1500 | 1800 |
| 45-54 | 1250 | 1850 | 2350 | 2800 |
| 55-60 | 1920 | 2880 | 3720 | 4470 |
| 61-65 | 3200 | 4800 | 6200 | 7450 |
| Once the Insured Person crosses the age of 65 years, the applicable premium on renewal will be loaded by 2.5% per year. This loading is applicable on premium for the age band of 61-65 years. | ||||
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