Basics of Mediclaim
Mediclaim Policy
The Mediclaim policy provides for reimbursement of hospitalisation/ domiciliary hospitalisation expenses for illness/diseases suffered or accidental injuries sustained during the policy period.
The insurance is available to persons between age of 5 and 80 years. Children between the age of 3 months and 5 years can be covered provided one or both parents are covered concurrently.
The policy is available only for allopathy, ayurvedic and unani systems of medicine. Other alternative systems of medicine are not eligible for claims.
The Mediclaim protection is available for illness/disease contracted anywhere in the world provided the treatment is availed in India.
For those who require dialysis: When treatment such as Dialysis, Chemotherapy, Radiotherapy etc is taken in the Hospital/Nursing Home and the insured person-patient is discharged on the same day, the treatment will be considered to be taken under Hospitalisation Benefit Scheme.
Criteria
First analyse carefully your needs.
If you need a wide cover and income tax benefits also, choose a family package cover.
You may also decide on the major ailments policy with annual, five and ten year cover options offering you a reasonable amount of premium savings.
Those going for a wide coverage as also long term cover about five or ten years can opt for the term hospitalisation policy. This gives benefits that are not available under the normal mediclaim policy. Another convenience this policy offers is the non-requirement of annual renewal of the policy.
For those closer to retirement age the long-term retirement benefit plan would be the ideal cover.
Disease pre-existing?
Disclosures about injuries, ailments suffered by you are important.
At the time of insurance, you should be aware whether you have any disease and whether you are undergoing any treatment.
The insurers refer such health issues to their medical panel to differentiate between pre-existing and newly contracted illnesses.
What are the different benefits that can be claimed under the Mediclaim insurance policy in the event of hospitalisation?
Different heads of benefits under hospitalisation:
Room boarding expenses by the hospital nursing home
Nursing expenses
Surgeon, anaesthetist, medical practitioner, consultants, specialist’s fees
Anaesthesia, blood, oxygen, operation charge, surgical appliances, medicines and drugs, diagnostic material and x-rays, dialysis and chemotherapy, radiotherapy, pacemaker, artificial limbs and cost of organs and similar expenses
All the above benefits are limited to the maximum sum insured .
Hospitalisation must
The minimum period of hospitalisation should be for 24 hours. However, for certain treatments this limit is not applicable when package charges are levied for treatment by the hospital.
The Insurers
National Insurance Corporation
Oriental Insurance Corporation
United India Insurance Corporation
National India Assurance Corporation
Bajaj Allianz
Royal Sundaram
ICICI Lombard
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