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Definition

Health insurance provides crucial financial coverage for a wide array of medical expenses. This includes hospitalization, surgeries, doctor consultations, and even alternative treatments. It encompasses both first-party and third-party liabilities, ensuring that individuals and families are safeguarded against high medical costs.

How does it work

Health insurance offers financial protection by covering medical expenses as per the policy terms. Policyholders pay a regular premium, and in return, the insurer covers costs like hospitalization, surgeries, and treatments. Understanding the policy's terms, including covered treatments, exclusions, and network hospitals, is key to maximizing its benefits.

What’s Covered

In-patient Hospitalization costs incurred for hospital stays due to illnesses or injuries.

Pre-existing Diseasesafter the completion of the waiting period, expenses for pre-existing conditions are covered.

Critical Illnessescoverage for life-threatening conditions like cancer, stroke, and heart diseases.

Emergency MedicalConditions immediate medical expenses during emergencies are covered.

Outpatient DepartmentExpenses overs costs of OPD consultations and treatments.

What’s Not Covered

Cosmetic Surgery elective cosmetic procedures are not covered unless medically necessary.

Self-Inflicted Injuries resulting from suicide attempts or harmful actions by the policyholder.

Pre-Existing Conditions excludes coverage for pre-existing conditions until the completion of the waiting period.

Alternative Medicine certain policies may exclude non-conventional treatments.

Substance Abuse medical expenses arising from substance abuse or addiction.

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SUB TYPES

Based on needs and to cover specific requirements of the public in general, there was a need to design varied types and sub types of cover, each of them serving different purposes.

BASE PLAN

Basic insurance plans, covering your domiciliary, pre, post and main hospital expenses in cashless and reimbursement mode.

Super Top-up

This is generally topping up on your base mediclaim, it comes with two variants Top-up & Super Top-up. This covers you over and above your mediclaim cover.

Critical Illness

Critical ailments need more attention and so they need more cover amount with specified coverage. Critical illness policies are designed to cover such ailments like Cancer, Stroke, Heart attack and more.

Hospital daily cash