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| OPD Coverage Health Insurance Plans |
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| 3- Star Health Gian Insurance Policy |
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| Other pre - and post - hospitalisation benefits |
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- Expenses in a hospital for inpatient hospitalization (minimum 24-hour stay).
- Hospitalisation expenses under the following heads are payable.- Room rent or boarding upto 2% of the sum insured, subject to a maximum of Rs 4000 per day in Class A cities; 1% of the sum insured, subject to a maximum of Rs 3000 per day in Class B cities; 1% of the sum insured, subject to a maximum of Rs 1,000 per day in subject to a maximum of Rs 1000 per day in other locations.
- Nursing charges.
- Surgeons, consultants and anaesthetists fees
- Blood, oxygen, diagnostic expenses, cost of pacemakers and similar expenses
- Drugs and medicines
- Emergency ambulance charges for transporting the patient to the hospital upto a sum of Rs 750 per hospitalization and overall policy limit of Rs 1,500.
- Pre-hospitalization expenses upto 30 days prior to the date of admission in hospital/nursing home
- Post-hospitalization expenses calculated @7% of the hospitalization expenses (excluding room rent), subject to a maximum of Rs 5000 (benefit-based). |
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| What cannot be claimed? |
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-Treatment of illness/disease/sickness contracted by the insured person during the first 30 days from the commencement date of the policy
-First Two Years Exclusions: Cataract, Hysterectomy for Menorrhagia or Fibromyoma, Replacement surgery for knee and/or joint (other than caused by an accident), Prolapse of intervertebral disc(other than caused by accident),varicose veins and varicose ulcers
-First Year Exclusions: Benign Prostate Hypertrophy, Hernia, Hydrocele, Fistula in anus, Piles, Sinusitis and related disorders, congenital internal disease/defects, removal of gallstones and renal stone
-Naturopathy treatment
-Expenses which are purely diagnostic in nature with no positive existence of any disease
-Expenses incurred for non-allopathic treatment
-Treatment of external Congenital disease/defects/anomalies
-Expenses which are mainly cosmetic in nature |
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