PLAN DETAILS |
Arogya Sanjeevani |
Prime Senior Elite |
Premium Including GST | ||
Sum Assured | 3L, 4L & 5L | 5L, 7.5 L, 10L, 15L, 20L, 25L & 50L |
Product Type | Reimbursement Hospitalization and Cashless | Individual/Multi-individual and Family Floater |
Key Features (Key features of the plan) |
15 days Free-look period Lifelong Renewability Day Care Treatment covered 12 Advance processures covered upto 50% of SI AYUSH coverage Life-long renewability Tax Deduction: Under Sec 80D |
Modern and Advanced Treatments/HIV/ AIDS & STD / Mental Illness Cover are covered upto SI Unlimited Restoration of Sum Insured for unrelated/ related illnesses Unlimited Tele-consultation in a policy year including specialists Discount on Pharmacy - Diagnostics - Medical Devices - Health Supplements and other services offered by the network providers of MCHI Waives off next one year renewal Policy Premium upon occurrence of Accidental Death or diagnosis of any of the listed Critical Illnesses Reduction in PED Waiting period to 90 Days (Optional) |
OPD Details (In some policies, OPD (Out patient department) expenses are also covered.) |
Not covered | Not Available |
EMI Option | no | yes |
Pre-acceptance Medical Check Up (Whether a pre-acceptance check up is required or not to buy the policy) |
Not Required | Not required |
Room Rent (A limit of room rent cover during hospitalization if any) |
up to 2% of the Sum insured subject to maximum of Rs.5000/- per day | Single Private AC room |
Domicillary Hospitalization (It is the expenses incurred on treatment of the patient at home) |
Not covered | Up to Rs 10L |
Pre-hospitalization (Expenses before the insured is hospitalized) |
30 days | 60 Days |
Post-hospitalization (Expenses after discharge from the hospital) |
60 Days | 90 Days |
Non-allopathic (Expenses incurred on non-allopathic treatment) |
Covered | Upto Rs. 10L |
Day Care Treatment Covered (Day care treatments refers to the treatments that do not necessarily require 24hrs of hospitalization like MRI.) |
Covered | Upto Rs. 10L |
Hospital_network (Number of Hospital Network in city) |
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Organ Donor Expenses (Expenses incurred on organ donor in case of organ transplants) |
Not covered | Upto Rs. 10L |
Hospital Daily Allowance (Some plans offer daily allowance to take care of expenses like food, etc) |
Not covered | INR 800 per day up to maximum of INR 5600 per hospitalization (On Shared Accomodation) |
Pre-existing Coverage (If the insured is having some existing diseases, that would be covered after particular time period) |
After 4 year | Covers after 24 Months |
Cumulative Bonus (The amount by which your sum assured gets increased, if there is no claim.) |
Rs 0.25L per year upto Rs 2.5L | Guaranteed Bonus of Rs 1L Or max Upto Rs 10L |
Restoration Details (Increase of Sum Insured for non-related illness if the original sum insured is exhausted) |
Not Applicable | Unlimited Restoration of Sum Insured for unrelated/ related illnesses |
Ambulance Charges (Expenses incurred on ambulance charges) |
Rs.2000/- per hospitalisation | Upto Rs. 10L |
Worldwide Emergency (The emergency medical assistance and cover against medical expenses while the customer is abroad) |
Not Covered | Not Available |
Maternity Benefits (All Hospitalization cost covered at the time of pregnancy.) |
Not Covered | Not Available |
New Born Baby Covered (Newborn babies can be covered under the insurance plan after a certain period) |
NA | Not Available |
Health Checkup (An added benefit of one time full health checkup of policy holder.) |
Not covered | Annually from 1st year onwards. Limits basis opted Sum Insured |
Non-allopathic Details (Expenses incurred on non-allopathic treatment) |
yes | no |
Vaccination (Cover againts any medical expenses occurred in Vaccinations for certain diseases) |
Not covered | Not Available |
Animal Bite (Cover againts any medical expenses occurred due to any Animal Bite) |
Not covered | Not Available |
Sub Limit (Sub-limit is a monetary capping that applies on specific diseases like cataract) |
Applicable | Applicable |
Co-pay (Mentioned %, if any is to be borne by Insured and rest will be borne by insurer) |
5% on all admissible claim | You pay 20% of claim |
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Naval Goel is the CEO & founder of PolicyX.com. Naval has an expertise in the insurance sector and has professional experience of more than a decade in the Industry and has worked in companies like AIG, New York doing valuation of insurance subsidiaries. He is also an Associate Member of the Indian Institute of Insurance, Pune. He has been authorized by IRDAI to act as a Principal Officer of PolicyX.com Insurance Web Aggregator.