Health Insurance 592 views May 27, 2021

Magma HDI OneHealth Plan

Magma HDI OneHealth Plan shall cover the reasonable and customary charges for your medical expenses incurred during in-patient hospitalization, as well as before and after it. This policy is available to persons aged between 18-65 years and you can purchase it on an individual (single individual) or family floater basis (up to 4 adults and 3 children). Continue reading this page further and learn more about the coverage of the Magma HDI OneHealth Plan.

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Magma HDI OneHealth Plan Base Cover

The insurer shall provide you coverage against the following medical expenses –

In-patient Care: In case you are hospitalized due to an illness or injury during the policy period, the insurer shall cover the following medical expenses –

  1. Medical practitioners’ fees
  2. Room rent, boarding and nursing charges
  3. ICU Charges
  4. Operation theatre charges
  5. Diagnostic procedures’ charges
  6. Medicines, drugs and other consumables prescribed by the doctor
  7. Intravenous fluids, blood transfusion, injection administration charges
  8. Cost of anesthesia, blood, oxygen, surgical appliances and other devices or equipment if implanted internally during a Surgical Procedure

The insurer shall apply the following sub-limits to room rent as per your chosen variant

  1. Support Variant: Up to 1% of the sum insured per day. In case of admission to ICCU, the coverage under this benefit shall be limited to 2% of the sum insured per day
  2. Secure Variant: Coverage to single private room and ICCU expenses are covered as actual
  3. Support Plus, Shield and Premium Variant: No room rent limit

Pre-hospitalization Expenses: The insurer shall reimburse pre-hospitalization medical expenses incurred before your date of hospitalization.

Post-Hospitalization Expenses: The insurer shall reimburse post-hospitalization medical expenses incurred after your discharge from the hospital.

Day Care Treatment: You will get coverage for the medical expenses incurred on your daycare treatment that gets performed within 24 hours.

Note: Any OPD treatment undertaken in a Hospital/Day Care Centre shall not be covered under this benefit.

Ambulance Cover: Your transportation by road ambulance to the nearest hospital will be covered under this policy.

Organ Donor Expenses: The insurer will cover the medical expenses of the organ donor.

Domiciliary Hospitalisation: Your domiciliary hospitalization expenses shall be reimbursed if it continues for a minimum of 3 days without any interruption. The claim under this benefit shall be subject to the following conditions –

  1. Attending Medical Practitioner confirms in writing that you cannot be transferred to a hospital due to your condition
  2. There is no bed available in the hospital

If a claim has been admitted under this benefit, pre and post-hospitalization expenses shall also be covered.

AYUSH Treatment: If you undergo an AYUSH Treatment in a government hospital or any institute recognized by the government, the insurer shall cover the medical expenses incurred during your stay.

IVF Treatment Cover: You will get coverage against IVF (in-vitro fertilization) treatment if it is advised by a specialist medical practitioner. Conditions applicable to this benefit are as follows –

  1. Patient age should be less than 40 years
  2. Claims shall be admissible under this benefit after a waiting period of 3 years
  3. Third-party surrogate, gestational carrier in pregnancy or any expenses for consultation, diagnostic tests or procedure of infertility shall not be covered under this benefit.

Bariatric Surgery Cover: The insurer shall cover the medical expenses for Bariatric Surgery if you have undergone the same as per the advice of a specialist. Conditions applicable to this benefit are as follows –

  1. Patient age must be 18 years or above
  2. Body Mass Index (BMI) >= 40 or >= 35 in conjunction with any of the following severe comorbidities – Obesity-related cardiomyopathy, Coronary heart disease, Severe Sleep Apnea, Uncontrolled Type2 Diabetes
  3. A claim under this benefit shall be admissible after a waiting period of 3 years

Psychiatric Treatment Cover: Under this, you’ll get coverage for the following conditions/disorders –

  1. Severe Depression
  2. Schizophrenia and Psychosis
  3. Bipolar disorder
  4. Post-traumatic Stress Disorder
  5. Obsessive-compulsive disorders
  6. Panic disorders including anxiety
  7. Personality and related disorders

The benefit under this cover shall be available to you after a waiting period of 36 months.

Lasik Surgery Cover: You will get coverage for medical expenses while undergoing LASIK Surgery for correction of refractive error, provided you have a refractive index of plus/minus 7.5 or more. A waiting period of 3 years shall apply to this benefit.

HIV/AIDS Cover: The insurer will cover in-patient hospitalization, daycare treatment and pre and post-hospitalization expenses for HIV / AIDS up to INR 50,000. This benefit is subject to a waiting period of 4 years from the date of the policy inception.

Modern treatment Procedures: The following procedures are covered under this policy –

  1. Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
  2. Balloon Sinuplasty
  3. Deep Brain stimulation
  4. Oral chemotherapy
  5. Immunotherapy- Monoclonal Antibody to be given as an injection
  6. Intra vitreal injections
  7. Robotic surgeries
  8. Stereotactic radio surgeries
  9. Bronchial Thermoplasty
  10. Vaporization of the prostate (Green laser treatment or holmium laser treatment)
  11. IONM – (Intra Operative Neuro Monitoring)
  12. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions

Magma HDI OneHealth Plan Optional Covers

You can opt for any of the following optional covers under this plan by paying an additional premium for it –

Critical Illness Cover – Under this cover, the insurer shall cover the following critical illnesses

  1. Cancer of Specified Severity
  2. Myocardial Infarction (First Heart Attack of specific severity)
  3. Open Chest CABG
  4. Open Heart Replacement or Repair of Heart Valves
  5. Coma of Specified Severity
  6. Kidney Failure requiring Regular Dialysis
  7. Stroke resulting in Permanent Symptoms
  8. Major Organ/Bone Marrow Transplant
  9. Permanent paralysis of Limbs
  10. Motor Neurone Disease with Permanent Symptoms
  11. Multiple Sclerosis with Persisting Symptoms

Personal Accident Cover – Here, the insurer will cover –

  1. Accidental Death
  2. Permanent Total Disablement due to an accident

Aggregate Deductible – If you opt for this optional cover, this policy becomes a top-up policy wherein claims are admissible only after a deductible limit chosen by you.

Voluntary Co-Payment – Under this optional cover, a co-payment applies to your Policy schedule irrespective of your age.

Free Look Period

You’ll have a free look provision of fifteen days from the date of receipt of this policy to review the terms and conditions and return the same if not acceptable. In case you return the policy, you’ll be entitled to a refund of the paid premium less medical examination and stamp duty charges.

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