Comprehensive Individual vs Senior Citizen Plan Health Insurance Plan
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| PLAN DETAILS |
 Comprehensive Individual |
Senior Citizen Plan |
| Premium Including GST | ||
| Sum Assured | 5L, 7.5L, 10L, 15L, 20L, 25L, 50L, 75L & 1Cr | 3L, 4L, 5L, 7.5L, 10L, 15L, 20L & 25L |
| Product Type | Reimbursement Hospitalization and Cashless | Reimbursement Hospitalization and Cashless |
| Key Features (Key features of the plan) |
Automatic Restoration – 100% Available No claim bonus Hospital cash benefit Cover against accidental death and permanent total disablement Health checkup for every claim-free year Wellness program – earn wellness reward Option available to buy back pre-existing disease |
No Pre medical test required Pre Existing disease coverd after 12 month Renewal gauranteed for lifetime |
| OPD Details (In some policies, OPD (Out patient department) expenses are also covered.) |
300 Per Consultation & overall limit 2100/- | Rs 200 per consultation upto Rs 1400 |
| EMI Option | no | no |
| Pre-acceptance Medical Check Up (Whether a pre-acceptance check up is required or not to buy the policy) |
Not Applicable | no |
|
Room Rent (A limit of room rent cover during hospitalization if any) |
Private Single Standard A/C | Upto Rs 6000 |
| Domicillary Hospitalization (It is the expenses incurred on treatment of the patient at home) |
Upto Rs. 10L | Not Applicable |
| Pre-hospitalization (Expenses before the insured is hospitalized) |
60 Days | Pre hospitalization medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalisation as per the policy |
| Post-hospitalization (Expenses after discharge from the hospital) |
90 Days | Post-Hosp. - 7% of the hospitalization expenses comprising of Nursing Charges, Surgeon / Consultant fees, Diagnostic charges,Medicines and drugs expenses, subject to a max of Rs.7000/- per occurrence |
| Non-allopathic (Expenses incurred on non-allopathic treatment) |
Rs.15k for Ayush Treatment | Not Covered |
| Day Care Treatment Covered (Day care treatments refers to the treatments that do not necessarily require 24hrs of hospitalization like MRI.) |
Upto 10L & All Day Care Treatment Covered | Upto 10L & All Day Care Treatment Covered |
| Hospital_network (Number of Hospital Network in city) |
||
| Organ Donor Expenses (Expenses incurred on organ donor in case of organ transplants) |
Applicable | Not Applicable |
|
Hospital Daily Allowance (Some plans offer daily allowance to take care of expenses like food, etc) |
750/- per day | Not Applicable |
| Pre-existing Coverage (If the insured is having some existing diseases, that would be covered after particular time period) |
After 3 years, Can get reduced to 1 year on additional premium payment | After 1 year |
| Cumulative Bonus (The amount by which your sum assured gets increased, if there is no claim.) |
Rs 10L per year upto Rs 10L | Not Applicable |
| Restoration Details (Increase of Sum Insured for non-related illness if the original sum insured is exhausted) |
Upto Rs 10L (on related and unrelated illness & on full exhaustion) | Not Applicable |
| Ambulance Charges (Expenses incurred on ambulance charges) |
Yes | Rs 1000/- per hospitalization up to max of 2000/- ppp |
| Worldwide Emergency (The emergency medical assistance and cover against medical expenses while the customer is abroad) |
NA | Not Applicable |
|
Maternity Benefits (All Hospitalization cost covered at the time of pregnancy.) |
Not Covered | Not Covered |
| New Born Baby Covered (Newborn babies can be covered under the insurance plan after a certain period) |
No | No |
| Health Checkup (An added benefit of one time full health checkup of policy holder.) |
Given after every claim free year (limit varies as per Sum Insured) | Rs 2000/- per person |
| Non-allopathic Details (Expenses incurred on non-allopathic treatment) |
yes | no |
| Vaccination (Cover againts any medical expenses occurred in Vaccinations for certain diseases) |
Yes | Not Applicable |
| Animal Bite (Cover againts any medical expenses occurred due to any Animal Bite) |
NA | Not Applicable |
|
Sub Limit (Sub-limit is a monetary capping that applies on specific diseases like cataract) |
Not Applicable | Applicable |
| Co-pay (Mentioned %, if any is to be borne by Insured and rest will be borne by insurer) |
You pay 10% of claim | 30% For any Claims |
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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.
