3- Coverage & Exclusion Under Individual Health Insurance Policies in India |
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What health insurance policy covers in India |
Health Insurance Covers hospitalization when a patient is in hospital for more than 24 hours due to: |
- Illness
- Accident
- Surgery requirement
- Symptoms, when diagnosis is been done According to the Document of Cholamandalam MS General Insurance the costs covered are
- Room, Boarding Expenses in Hospital/Nursing Home
- Nursing Expenses, intensive care unit expenses,
- Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist fees
- Anesthesia
- Blood Oxygen,
- Operation Theater Charges,
- Surgical Appliances, Medicines,
- Drugs,
- Diagnostic Materials,
- X-ray,
- Dialysis,
- Chemotherapy,
- Radiotherapy,
- Pacemaker cost,
- Artificial Limbs,
- Cost of Organs.
- Pre-Hospitalization Expenses
- Post-Hospitalization Expenses
- General Health and Eye Examination (Optional with extra premium)
- Local Ambulance Services (Optional with extra premium)
- Hospital Daily Allowance (Optional with extra premium)
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Admissible Limits : |
- Minimum 24 hrs. Hospitalization except Dialysis, Chemotherapy, Radiotherapy, Eye Surgery, Dental Surgery, Lithotripsy, D&C,
Tonsillectomy (insured discharged on same day)
- Pre-Hospitalization Expense: Laboratory, X-ray or any other medically necessary diagnostic procedures ordered by a physician (60 days prior to Hospitalization in case of all type of covers)
- Post-Hospitalization Expenses: The medically necessary treatment ordered by a physician and readered (within a time period of the Insured person's discharge from Hospital or Day Treatment) (90 days after hospitalization in case of all type of covers).
- General Health and Eye Examination: Radiology, Blood Diabetes, Liver, Renal/Kidney, Cardiac Lipid, Phospholids, Lung, Abdomen, Cancer, Optometry, Slit Lamp Examination, Direct Fungus Examination, Indirect Fungus Examination, Color Vision Testing, Prescription of Glasses if necessary.
- Local Ambulance Services; Emergency ambulance road transportation by a licensed ambulance service to the nearest Hospital.
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