Health Insurance 141 views July 6, 2021

Bajaj Allianz Tax Gain Plan

Bajaj Allianz Tax Gain Plan not only covers medical expenses during, before and after hospitalization but also lets you avail of tax benefits on premiums paid and medical bills. Available on both individual and family floater basis, the Bajaj Allianz Health Insurance Plan covers consumable expenses and provides several other value-added benefits to capture your imagination. Read this page further to know more about Bajaj Allianz Tax Gain Plan.

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Features and Benefits of Bajaj Allianz Tax Gain Plan

Firstly, Bajaj Allianz Tax Gain Plan comes in four variants with each offering hospitalization and OPD expenses under the same policy. The below pointers specify the importance of this health insurance plan. Take a look!

  1. Four plan variants are namely Plan A, Plan B, Plan C and Plan D (For Senior Citizens).
  2. Cover for pre and post-hospitalization under specified OPD expenses
  3. Cover for 130 day care procedures
  4. Free health checkup at the empanelled diagnostic centre of Bajaj Allianz
  5. Ambulance charges covered up to INR 1,000 in case of emergency hospitalization
  6. Tax benefits on the premiums paid under Section 80D of the Income Tax Act

Other Expenses Covered Under Bajaj Allianz Tax Gain Health Insurance Plan

The plan covers several other treatment expenses too that you can check below.

  1. Cataract is covered after a 2-year waiting period, up to 10% of the sum insured. The minimum and maximum cover amount regarding the same is INR 12,000 and INR 25,000, respectively.
  2. Cover for modern treatment methods and advanced technologies up to 50% of the sum insured or INR 5 lakh, whichever is lower. These methods and technologies include uterine Artery Embolization and HIFU, Balloon Sinuplasty, Oral Chemotherapy, Deep Brain Stimulation D., Immunotherapy – Monoclonal Antibody Injection, Intravitreal injection, Bronchial Thermoplasty, Vaporization of the Prostate, Robotic Surgeries, Stem Cell Therapy for Bone Marrow Transplant for Haematological Conditions, etc.

Sum Assured and Premium of Bajaj Allianz Tax Gain Plan

The sum assured and the premium amount of the Bajaj Allianz Tax Gain Plan differ based on the variant you choose. Premiums are also dependent on the age of the policyholder. There are age slabs based on which the premium varies. Let’s check out the same below.

Plan A – Hospitalization Sum Insured of INR 1 lakh 

The OPD sum insured for policyholders of different age groups is mentioned below.

Age Group (In YearsOPD Sum Insured (In INR)
18-253,100
26-402,900
41-452,500
46-551,600

The premium for Plan A – INR 4,670

Plan B  

The plan covers hospitalization as well as OPD expenses for you and your spouse. While the hospitalization sum insured remains INR 2 lakh, the OPD sum insured remains as shown in the table below.

Age Group (In YearsOPD Sum Insured for Self (In INR)OPD Sum Insured for Self + Spouse (In INR)
18-256,5005,200
26-406,0004,800
41-455,0003,500
46-553,0001,000

The Premium for Plan B – INR 9,345

Plan C 

It comes with two different hospitalization sum insured of INR 2 Lakh and INR 3 Lakh. The OPD sum insured varies based on the hospitalization sum insured you choose. Have a look at the table below to understand it better.

C1 Hospitalization Cover of INR 2 Lakh on a Floater Basis

Age Group (In YearsOPD Sum Insured for Self (In INR)OPD Sum Insured for Self + Spouse (In INR)
18-259,5009,000
26-409,0008,500
41-458,5007,000
46-557,5004,500

C2 Hospitalization Cover of INR 3 Lakh on a Floater Basis

Age Group (In YearsOPD Sum Insured for Self (In INR)OPD Sum Insured for Self + Spouse (In INR)
18-259,0008,000
26-408,5007,500
41-457,5005,500
46-556,0002,500

The Premium for Plan C – INR 14,015

Plan D 

This variant is exclusively for senior citizens and comes with a floater sum insured of INR 1 lakh. The OPD sum insured for the same is shown in the table below. Take a look!

Age Group (In YearsOPD Sum Insured for Self (In INR)OPD Sum Insured for Self + Spouse (In INR)
56-6013,00011,000
61-6512,50010,000
65-7012,0009,500
71-7511,0008,000

The Premium for Plan D – INR 18,690

Note – Premiums mentioned against different plan variants are exclusive of GST.

Co-payment Clause Related to Hospitalization Claims

In case the treatment takes place at a non-network hospital, a co-payment clause of 10% will apply to the claims arising out of the same. It means you will need to pay 10% of the claim amount first before Bajaj Allianz will honour the remaining amount up to the sum insured.

Policy Period and Premium Paying Term for Bajaj Allianz Tax Gain Plan

The plan can be issued for 1, 2 and 3 years with the premium payable at any of monthly, quarterly, half-yearly or yearly installments.

Waiting Periods Applicable Under Bajaj Allianz Tax Gain Plan

The waiting period, as the name suggests, is the time up to which the policyholders won’t get covered for any illnesses/ailments. An initial 30-day waiting period will apply, except for accidental claims, provided they are covered under the policy. In case you have a disease before accepting this plan, a waiting period of 48 continuous months from the date of inception will be in force. Bajaj Allianz has fixed waiting periods for a few OPD expenses. The cost of spectacles will be covered from the second year onward, which means no coverage for the first year. Besides, the policy does not cover the cost of dentures in the first two years. The coverage will begin from the third year, but up to 25% of the OPD limit.

Exclusions to Keep in Mind

Besides the waiting period, one should know other exclusions too for a hassle-free health insurance journey with the insurer. Let’s see such exclusions below.

  1. Dental treatment comprising of dentures, cosmetic surgery, dental implants, orthodontics, surgery of all kinds, except for accidental bodily injury to natural teeth that requires hospitalization
  2. Medical expenses where there is no need for in-patient care and supervision of qualified nursing staff and medical practitioners. However, this exclusion won’t apply to day care procedures.
  3. War, acts of foreign enemies, invasion, civil war, hostilities (irrespective of the declaration of war), commotion, unrest or any such activities
  4. Circumcision unless necessary to treat an illness or an accidental bodily injury
  5. Investigation and evaluation
  6. Expenses incurred primarily for diagnostic and evaluation purposes
  7. Diagnostic expenses that do not correspond to the ongoing diagnosis and treatment
  8. Rest cure, rehabilitation and respite care
  9. Participation in hazardous sports
  10. Congenital External Diseases or Anomaly
  11. Other exclusions as specified in the policy

Entry Age for Different Bajaj Allianz Tax Gain Plan Variants

The minimum age required at the time of entering into plan variants from A to C is 18 years, whereas the maximum age permitted till maturity is 75 years.

Cancellation of Bajaj Allianz Tax Gain Plan

You can cancel the plan by giving a written notice of 15 days to Bajaj Allianz, which will then refund the paid premium for the unexpired policy period. The extent of refund varies based on the receipt of premiums. Take a look at the below table to know the refund you could get upon policy cancellation.

The Extent of Refund for Annual or One-time Lump Sum Premium

Period in RiskPolicy Period of 1 YearPolicy Period of 2 YearsPolicy Period of 3 Years
Within 15 daysAs Per the Free Look Period ConditionAs Per the Free Look Period ConditionAs Per the Free Look Period Condition
More than 15 days but less than or equal to 1 month75%75%80%
More than 1 month but less than or equal to 3 months50%75%80%
More than 3 months but less than or equal to 6 months25%65%75%
More than 6 months but less than or equal to 12 months0%45%60%
More than 12 months but less than or equal to 15 months0%30%50%
More than 15 months but less than or equal to 18 months0%20%45%
More than 18 months but less than or equal to 24 months0%0%30%
More than 24 months but less than or equal to 27 months0%0%20%
More than 27 months but less than or equal to 30 months0%0%15%
More than 30 months but less than or equal to 36 months0%0%0%

The Extent of Refund Based on Premium Installment Intervals

Period in Risk (From the Date of Latest Installment)% of Half-Yearly Premium% of Quarterly Premium% of Monthly Premium
Up to 15 days from the first installment dateAs Per the Free Look Period ConditionAs Per the Free Look Period ConditionAs Per the Free Look Period Condition
More than 15 days but less than or equal to 3 months30%No RefundNo Refund
More than 3 months but less than or equal to 6 months0%No RefundNo Refund

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