3. • It is insurance against the risk of incurring
medical expenses
• System of Assurance to make contingencies of
Health care Expenses
WHAT IS HEALTH INSURANCE
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6. • Covers in-patient hospitalization expenses
where hospital stay exceeds 24 hours
• Pre-Hospitalization (30 days prior to
hospitalization) and Post-Hospitalization (60
days after discharge)
Basic
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7. Coverage's
• Hospitalization expenses include
Room, Boarding charges, Doctor’s fees, Nursing
exp., Surgery expenses, O.T. Charges, Surgical
appliances , Dialysis, Chemotherapy, Radiotherapy,
Cost of pacemaker, Artificial limbs and cost of
organs and similar exp., lab charges and cost of
medicines.
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8. Day Care Treatments
Specific treatments where no In-Patient hospitalization is required
Cataract: Cataract is excluded during the first year of the Policy.
Covered from the second year of policy
Tonsillectomy
Eye Surgery
Lithotripsy (Kidney stone removal)
D & C
Any other disease specified from time to time.
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9. How to take Benefit
• Benefit Under Health Policy Claimable in Two Modes
• Reimbursement Mode
• Cashless
• Reimbursement Mode
If Admission at non network hospitals, claim settlement by Reimbursement
Through Insurance Company.
• Cashless Facility - Cashless through T.P.A. – Third Party Administrator
Treatment can be taken at any Network Hospitals with Pre- Admission
authorization from TPA, No Need to pay for any of the hospitalization
bills (except Inadmissible Items like Phone Bills, Diets etc.)
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11. Today there are over 200 Health Insurance Plans available to a
Consumer based on below mention category each having unique
USP’s.
• Individual Health Insurance
• Family Floater Plan
• Critical Health Insurance
• Senior Citizen Health Insurance
• Fixed Benefit Health Plan
• Group Health Insurance
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