Insurance Plans October 29, 2020

New India Premier Mediclaim Policy

Health insurance plans are really important for many individuals because it covers various types of health risks. These plans cover various illnesses and their treatments so that the insured doesn’t have to face any kind of financial burden. One such plan is the New India Premier Mediclaim Policy that covers various treatments and diseases of an individual. You can also add your family members as well to this plan. All of them can be covered under the same plan. It covers hospitalization expenses, cataract treatment expenses, and many other medical expenses. So, you must have a thorough look at the features of this plan so that you can understand it better.

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Key Features of the Premier Mediclaim Plan

  1. Flexibility of choosing the Sum Assured of up to Rs.1 Crore.
  2. The insured is allowed to add their family members under the same plan.
  3. This plan covers hospitalization expenses as well.
  4. You will get hospital cash during hospitalization.
  5. The treatment for critical illness is covered in this plan.
  6. This plan covers AYUSH Treatment.
  7. OPD Treatments are covered in this health insurance plan.
  8. You will also get a cover for the infertility treatment.

Benefits of Premier Mediclaim Plan

Now, you must go through the benefits of this health insurance plan. You can see the various health risks covered in this insurance plan and the maximum amount of coverage allowed in them.

Hospitalization Expenses Cover

This plan will cover the following expenses incurred during hospitalization:-

  1. Room’s Rent including boarding and nursing expenses
  2. Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses
  3. Surgeon, Anesthetist, Medical Practitioner, and Consultants’ Specialist fees.
  4. Anesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Dialysis, Chemotherapy, and Radiotherapy
  5. Cost of Prosthetic devices implanted during surgical procedures like a pacemaker, Relevant Laboratory/Diagnostic test, X-Ray, and other medical expenses.
  6. All Hospitalisation Expenses (excluding the cost of an organ).

Hospital Cash Benefit

  1. You will get hospital cash of Rs.2000 per day during hospitalization if your Sum Assured is Rs.15 Lacs and Rs.25 Lacs.
  2. You will get hospital cash of Rs.4000 per day during hospitalization if your Sum Assured is Rs. 50 Lacs and Rs.1 Crore.

Critical Illness Benefit

You will get a reimbursement of Rs.2 Lacs if in case you are diagnosed with any critical illness mentioned below your Sum Assured is Rs.15 Lacs and Rs.25 Lacs. On the other hand, the critical illness benefit will increase to Rs.5 Lacs if your Sum Assured is Rs.50 Lacs and Rs.1 Crore. Critical illnesses that are covered in New India Premier Mediclaim Policy are as follows:-

  1. Cancer
  2. First Heart attack of specified 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 neuron disease with permanent symptoms
  11. Multiple sclerosis with persisting symptoms

AYUSH Treatment

The AYUSH Treatment includes Ayurveda, Unani, Siddha, and Homeopathy Treatments. So this insurance plan covers the expenses done for the AYUSH Treatment. The maximum coverage for the AYUSH Treatment will be 20% of the Sum Assured.

Ambulance Charges

  1. Air Ambulance charges are covered up to Rs.1 Lac.
  2. Road Ambulance Expenses are covered up to Rs.10000.

OPD Treatments

The company will reimburse Rs.5000 if in case you for the OPD treatment and your Sum Assured is Rs.15 Lacs and Rs.25 Lacs. On the other hand, the OPD benefit will increase to Rs.10000 if your Sum Assured is Rs.50 Lacs and Rs.1 Crore. OPD Treatments that are covered in New India Premier Mediclaim Policy are as follows:-

  1. Dental Treatment.
  2. Health Check-up.
  3. Consultation with a Medical Practitioner.
  4. Drugs and Medicines as prescribed by a Medical Practitioner.
  5. Investigations as prescribed by a Medical Practitioner.

Infertility Treatment Cover

  1. You will get an infertility cover of Rs.1 Lac if your Sum Assured is Rs.15 Lacs and Rs.25 Lacs.
  2. You will get an infertility cover of Rs.2 Lacs if your Sum Assured is Rs.50 Lacs and Rs.1 Crore.

Cataract Treatment Cover

  1. There will be a cataract treatment cover of up to Rs.75000 if your Sum Assured is Rs.15 Lacs and Rs.25 Lacs.
  2. There will be a cataract treatment cover of up to Rs.1 Lac if your Sum Assured is Rs.50 Lacs and Rs.1 Crore.

Other Health Risks Cover

  1. Maternity and Child Cover
  2. Baby Cover
  3. HIV/AIDS Cover
  4. Obesity Treatment Cover
  5. Dietician Counselling
  6. Second Opinion Cover

Eligibility Criteria for New India Premier Mediclaim Policy

ParticularsDetails
Minimum Age of Entry18 Years
Maximum Age of Entry65 Years
Minimum Age of Entry for Dependent Child3 Months
Maximum Age of Entry for Dependent Child18 Years
Minimum Amount of Sum AssuredRs.15 Lacs
Maximum Amount of Sum AssuredRs.1 Crore
Sum Assured OptionsRs.15 Lacs, Rs.25 Lacs, Rs.50 Lacs, and Rs.1 Crore
Family Members AllowedProposer, Spouse, Dependent Children, and Dependent Parents
Maximum Members Allowed under one Plan6 Members

Exclusions of this Plan

  1. Treatment of any Pre-existing Disease is not covered until thirty-six months of Continuous Coverage.
  2. Any Illness contracted by the Insured Person during the first 30 days
  3. The following illnesses will have a waiting period of 24 months:-
  4. All internal and external benign tumors, cysts, polyps of any kind, including benign breast lumps
  5. Benign ear, nose, throat disorders
  6. Benign prostate hypertrophy
  7. Cardiovascular and Circulatory Disorders
  8. Cataract and age-related eye ailments
  9. Diabetes Mellitus
  10. Gastric/ Duodenal Ulcer
  11. Gout and Rheumatism
  12. Hernia of all types
  13. Hydrocele
  14. Hypertension
  15. Non-Infective Arthritis
  16. Piles, Fissures and Fistula in anus
  17. Pilonidal sinus, Sinusitis, and related disorders
  18. Prolapse inter Vertebral Disc and Spinal Diseases unless arising from an accident
  19. Renal Disorders
  20. Skin Disorders
  21. Stone in Gall Bladder and Bile duct, excluding malignancy
  22. Stones in Urinary system
  23. Treatment for Menorrhagia/Fibromyoma, Myoma and Prolapsed uterus
  24. Varicose Veins and Varicose Ulcers

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