Health Insurance April 23, 2021

Digit Health Care Plus Policy safeguards you and your family financially should a medical emergency arise. There are 16 sections under this policy covering different medical expenses. The list of sections under Digit Healthcare Plus Policy is as follows –

  1. Hospitalization Cover
  2. Infertility Treatment Cover
  3. Organ Donor
  4. Alternate Treatment (AYUSH) Cover
  5. Emergency Air Ambulance
  6. Long Hospitalization Cash Benefit
  7. Maternity & Newborn Baby Cover
  8. Out-patient (OPD) Benefit
  9. Domiciliary Hospitalization
  10. Sum Insured Refill Benefit
  11. Daily Hospital Cash
  12. Critical Illness Benefit Cover
  13. Critical Illness Hospitalization Cover
  14. Cancer Benefit Cover
  15. Cancer Hospitalization Cover
  16. Wellness Benefit Program

Keep reading this post and know more about the Digit Healthcare Plus Policy coverages.

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Digit Healthcare Plus Policy Coverage

You will get coverage under the following sections of Digit Healthcare Plus Policy –

Section 1. Hospitalization Cover

The hospitalization cover is divided into two covers –

Accidental Hospitalization Cover – You’ll get an in-patient cover for hospitalization due to accidental injuries. The claim can be made for the following –

  1. Accommodation/Room Rent
  2. ICU Charges
  3. Professional Fees
  4. Medication
  5. Diagnostic
  6. Operation Theatre Fees
  7. Day Care Procedures 
  8. Pre-Hospitalization Expenses
  9. Post-Hospitalization Expenses
  10. Dental Treatment
  11. Road Ambulance – up to 1% of the sum insured, with the maximum being INR 5,000
  12. Second Medical Opinion

And the sum insured option under this section ranges from INR 10,000-3 Crore.

Accidental & Illness Hospitalization Cover – The insurer provides you coverage for the following expenses –

  1. Accommodation/Room Rent
  2. ICU Charges
  3. Professional Fees
  4. Medication
  5. Diagnostic
  6. Operation Theatre Fees
  7. Day Care Procedures
  8. Pre-Hospitalization Expenses
  9. Post-Hospitalization Expenses
  10. Dental Treatment
  11. Road Ambulance up to 1% of the sum insured, subject to maximum INR 5,000
  12. Second Medical Opinion
  13. Bariatric Surgery
  14. Psychiatric illness
  15. Complimentary Health Check-Up

Accidental & Illness Hospitalization Coverage amount is a minimum of INR 10,000 and a maximum of INR 3 Crore.

Section 2. Infertility Treatment Cover – The insurance company will pay the medical expenses if you are hospitalized for infertility/subfertility treatments on the doctor’s advice. This cover includes – IVF, IUI, ZIFT, ICSI. The coverage amount under this section of Digit Healthcare Plus policy ranges from INR 10,000-3,00,00,000

Section 3. Organ Donor – The following are the medical expenses covered in respect of organ transplantation:

  1. Harvesting of the donated organ, up to the sum insured
  2. Organ transplantation should have taken place as per the Transplantation of Human Organs Act, 1994
  3. Pre & Post-hospitalization expenses
  4. A maximum of 5% of the claim amount in respect of harvesting expenses
  5. The insurer is not liable to pay for any other medical treatment in respect of organ harvesting.
  6. The coverage amount ranges from INR 10,000-3,00,00,000

Section 4. Alternate Treatment (AYUSH) Cover – Your In-patient treatment under Ayurveda, Unani, Siddha or Homeopathy shall be covered under this policy, up to the sum insured. This benefit is available to you, provided the treatment happens at an Ayush Hospital. Pre- and post-hospitalization expenses, daycare procedure and outpatient medical expenses, all preventive and rejuvenation treatments that are not medically necessary aren’t covered under this section. This cover is subject to a minimum of INR 10,000 and a maximum of INR 3,00,00,000.

Section 5. Emergency Air Ambulance – If you are in an emergency life-threatening health condition and require immediate ambulance transportation to the nearest hospital, the insurer will cover your transportation expenses for an airplane or helicopter. This transportation will be from the location where the illness/accident happened first. This cover is subject to a maximum of INR 3,00,00,000.

Note – You can opt for this cover only if the sum insured is more than INR 3 lakh.

Section 6. Long Hospitalization Cash Benefit – You will receive a lump sum of INR 5,000 or INR 10,000 on completion of every 24 hours of in-patient hospitalization. The cash benefit shall accrue from the time of admission.

Section 7. Maternity & Newborn Baby Cover – Under this section, the insurer covers the maternity expenses incurred during the delivery of a baby and treatment related to any complication of pregnancy or medically necessary termination. The maternity benefit is limited to two living children. However, there is no restriction on the number of medically necessary and lawful termination of pregnancies.

The following medical expenses are also covered under this section –

  1. Harvesting and storage of stem cells
  2. Ectopic Pregnancy
  3. Prenatal and Postnatal Medical Expenses

Whereas the New Born Baby’s hospitalization charges due to medical complications are covered up to 90 days from the date of delivery. Under the newborn baby cover, reasonable and customary charges for vaccinations are also covered under the policy. The insurer will provide the newborn baby cover until the baby turns 5 years old, provided the policy is renewed continuously without any break. The coverage amount for this section ranges from INR 10,000-5,00,000.

Note – If you are unmarried women or a single parent, the above-mentioned benefits shall not apply

Section 8. Out-patient (OPD) Benefit – This section covers expenses incurred during an allopathic out-patient treatment. Under this, the following medical expenses shall be covered:

  1. Professional Fees
  2. Diagnostic Charge
  3. Surgical Treatment
  4. Medication
  5. Out-Patient
  6. Dental Treatment
  7. Hearing Aids
  8. Psychiatric illness

This cover excludes expenses incurred towards – spectacles, contact Lenses, physiotherapy, cosmetic procedures, and ambulatory devices like – walkers, BP monitors, glucometers, thermometers, dietician fees, vitamins and supplements. The coverage amount ranges from INR 2,500-50,000 under this section.

Section 9. Home (Domiciliary) Hospitalization – Any injury or illness requiring medical treatment at home, which would otherwise require hospitalization, due to the following conditions –

  1. The patient is not in a condition to be moved to the hospital
  2. The patient takes treatment at home on account of non-availability of room in the hospital,

No payment shall be made under this section for the following illnesses – Asthma, Bronchitis, Tonsillitis, Upper Respiratory Tract Infection including Laryngitis and Pharyngitis, Cough and Cold, Influenza, Arthritis, Gout and Rheumatism, Chronic Nephritis and Nephritic Syndrome, Diarrhoea and all types of Dysenteries including Gastroenteritis, Diabetes Mellitus and Insipidus, Epilepsy, Hypertension, Psychiatric or Psychosomatic Disorders of all kinds, Pyrexia of Unknown Origin.

Section 10. Sum Insured Refill Benefit – The refill benefit shall be available to you if the cause of the hospitalization is not related to or arising out of earlier hospitalization. After the refill, the maximum amount payable for any single claim should not exceed INR 3,00,00,000. if the first claim exceeds the sum insured, the refilled sum insured will not be applicable for the same hospitalization.

Section 11. Daily Hospital Cash – A daily cash allowance for each continuous and completed period of 24 hours of hospitalization shall be offered to you. The minimum daily cash amount is INR 100 per day and the maximum remains INR 5,000 per day. And if you are hospitalized in ICU, the daily cash allowance amount shall be 2X the regular benefit.

Section 12. Critical Illness Benefit Cover – If you diagnosed with any of the following illnesses, the insurer will pay up to the sum insured –

  1. Cancer of Specified Severity
  2. Cardiovascular system Myocardial Infarction
  3. Open Heart Replacement or Repair of Heart Valves
  4. Surgery to Aorta
  5. Primary (Idiopathic) Pulmonary Hypertension
  6. Open Chest CABG
  7. Major Organ Transplant End-Stage Lung Failure
  8. End-Stage Liver Failure
  9. Kidney Failure Requiring Regular Dialysis
  10. Major Organ/ Bone Marrow Transplant
  11. Nervous System Apallic Syndrome
  12. Benign Brain Tumour
  13. Coma of Specified Severity
  14. Major Head Trauma
  15. Permanent Paralysis of Limbs
  16. Stroke Resulting in Permanent Symptoms
  17. Motor Neurone Disease with Permanent Symptoms
  18. Multiple Sclerosis with Persisting Symptoms
  19. Aplastic Anaemia

Section 13. Critical Illness Hospitalization Cover – The insurer will pay all the reasonable and customary charges for the diagnosed critical illness or surgical procedure mentioned in section 12.

Note – No claim shall be admissible under this section if the Critical Illness or the Surgical Procedure is a consequence of the pre-existing condition/disease.

Section 14. Cancer Benefit Cover – If you are diagnosed with or suffering from Cancer for Specified Severity for the first time, the insurer will cover its treatment cost up to the sum insured.

Section 15. Cancer Hospitalization Cover – Under this section, the reasonable and customary charges incurred in respect of Cancer for Specified Severity treatment will be covered up to the Sum Insured.

Note – No claim shall be admissible under this section if the Critical Illness or the Surgical Procedure is a consequence of the pre-existing condition/disease.

Section 16. Wellness Benefits Program – Go Digit offers a Wellness Benefits Program through which you can take care of your health/fitness and maintain a healthy lifestyle. You can opt for any of the 12 services under the Wellness Benefits Program –

  1. Doctor on Call Upon Your request – The insurer will facilitate an appointment with the empanelled medical practitioner. The appointed medical practitioner will provide you round-the-clock medical helpline services through chat or voice call service.
  2. Wellness Coach – If you opt for this service, you can communicate with wellness coaches through emails, blogs and other online platforms. This includes – Weight Management, Activity and Fitness, Nutrition, Tobacco Cessation, Alcohol Abuse de-addiction Program, Information on various diseases, Dietary Plans
  3. Lab Services – The insurance company facilitates lab services for the collection of test samples such as blood, urine, stool, etc.
  4. Vital/Physical activity monitoring services such as blood-pressure monitors, glucometers, wireless pedometers, smartwatches, etc. to assess your vitals as reported by the device
  5. Reminder notifications for a daily dosage of your medicine
  6. Medical Wallet to provide easy access to medical history and reports
  7. Report aggregation for regular analysis of your health status as per the medical records/reports
  8. Home Care – Nursing, Patient Assistant, Physiotherapy, Yoga Trainer, Psychologist, Palliative Care, Renting Medical equipment.
  9. Ambulance Arrangement
  10. Pick-up and Drop – Your transportation to the Healthcare Facility
  11. Prioritizing Appointments – Prioritize necessary treatment or diagnostics based upon the urgency

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