Mediclaim
Health Insurance
Health insurance can simply be defined as contract between the insurer and the insured wherein insurer agrees to pay hospitalization expenses to the extent of an agreed sum assured in the event of any medical treatment arising out of an illness or an injury.
COVER – Cover is available for reimbursement of Hospitalisation expenses in India in respect of both individuals and Groups. This insurance provides cashless Hospitalisation, for the treatment of any covered illness or disease or accidental injury contracted during the Policy period. For administering this arrangement and to provide hassle free admission and discharge from the Network hospitals, Third Party Administrators (TPAs) are empanelled by Insurance Companies. There are various options for the extent of coverage sought to be insured – i.e. the Sum Insured. It differs from Insurer to Insurer.
The expenses covered usually include
- Cost of room bed
- Boarding expenses
- Nursing expenses
- Doctor’s fees
- Diagnostic fees Medicines and Drugs
- Operation theatre charges and
- Expenses related to surgical appliances and the like Diagnostic Materials and x-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs and Cost of Organs and similar expenses
What is not covered
Health insurance policies in India normally provide a comprehensive health cover, covering nearly all illnesses and etc.
Group Mediclaim Policy
The health insurance covers employees of organisation / member of a firm or Association or Club. The number of persons and the sum insured in each Group should be specified when the cover is taken.
Cover
Cover is available for reimbursement of Hospitalization expenses in India in respect of both. This insurance provides cashless Hospitalization, for the treatment of any covered illness or disease or accidental injury contracted during the Policy period. For administering this arrangement and to provide hassle free admission and discharge from the Network hospitals, Third Party Administrators (TPAs) are empanelled by Insurance Companies. There are various options for the extent of coverage sought to be insured – e.g. Pre Existing Disease & Waiting Period Waivers, Mental Illness & congenital Cover, Modern Treatment Methods & Advancement in Technology and Maternity coverage, Ayurveda & Homeopathic treatment, domiciliary hospitalisation etc
Expenses reimbursed or provided cashless
The expenses covered usually include:
- Cost of room / bed
- Nursing expenses
- Doctor’s fees
- Diagnostic fees Medicines and Drugs
- Operation theatre charges and
- Expenses related to surgical appliances and the like Diagnostic Materials and x-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs and Cost of Organs and similar expenses
NB: Various other health insurance policies e.g critical illness insurance & insurance for OPD expenses are also available