Future Generali Health Total Insurance Plan

Future Generali Health Total Insurance coverage details

All figures in ₹ INR	Vital Plan			Superior Plan			Premier Plan
Eligibility
Sum Insured	3,00,000	5,00,000	10,00,000	15,00,000	20,00,000	25,00,000	50,00,000	1,00,00,000
Minimum Age at Entry	1 day	1 day	1 day	1 day	1 day	1 day	1 day	1 day
Maximum Age at Entry	None	None	None	None	None	None	None	None
Maximum Renewal Age	Lifelong	Lifelong	Lifelong	Lifelong	Lifelong	Lifelong	Lifelong	Lifelong
Individual SI / Family Floater SI Options	Both	Both	Both	Both	Both	Both	Both	Both
Family Definition	Self+Spouse+2 Children+2 Parents (1+5)	Self+Spouse+2 Children+2 Parents (1+5)	Self+Spouse+2 Children+2 Parents (1+5)	Extended family upto 15 members	Extended family upto 15 members	Extended family upto 15 members	Extended family upto 15 members	Extended family upto 15 members
Hospitalisation Benefits
Hospitalisation	Upto Sum Insured (SI)	Upto Sum Insured (SI)	Upto Sum Insured (SI)	Upto Sum Insured (SI)	Upto Sum Insured (SI)	Upto Sum Insured (SI)	Upto Sum Insured (SI)	Upto Sum Insured (SI)
Day Care Treatment	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Pre Hospitalisation	60 days	60 days	60 days	60 days	60 days	60 days	60 days	60 days
Post Hospitalisation	90 days	90 days	90 days	120 days	120 days	120 days	180 days	180 days
Restoration of Sum Insured	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Cumulative Bonus- 50% for each claim free year (upto 100%)	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Maternity Benefit (Normal)	15,000	20,000	25,000	30,000	40,000	40,000	50,000	50,000
Maternity Benefit (Caesarean)	25,000	35,000	45,000	50,000	60,000	60,000	1,00,000	1,00,000
Pre Natal Hospitalisation (within Maternity Limit)	-	-	-	90 days	90 days	90 days	90 days	90 days
Post Natal Hospitalisation (within Maternity Limit)	-	-	-	45 days	45 days	45 days	45 days	45 days
Organ Donor Expenses	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
New Born Baby Benefits : Automatic Cover within Mother's SI up to expiry date	-	-	-	Covered	Covered	Covered	Covered	Covered
New Born Baby Benefits : Reasonable Vaccination benefits upto 1 year of age	-	-	-	Upto 3,500	Upto 3,500	Upto 3,500	Upto 5,000	Upto 5,000
Patient Care (above 60 years - per day benefit upto max)	350/day	350/day	350/day	500/day	500/day	500/day	1,000/day	1,000/day
Patient Care (above 60 years - Maximum)	10 days per Hospitalisation and 30 days per policy year
Accidental Hospitalisation - 25% increase subject to max of 10 lacs	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Accompanying Person (upto 12 years) 500/day upto max of 30 days	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Domiciliary Hospital Expenses - Max upto 10% of SI	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Alternative Treatments - Ayurvedha, Unani, Sidha, Homeopathy - Reimbursement	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Medical Treatment Abroad
Medical Treatment Abroad	-	-	-	-	-	-	Covered	Covered
Medical Treatment Abroad - Waiting Period	-	-	-	-	-	-	4 years	4 years
Road Ambulance
Road Ambulance Charges - Network Hospitals	1,500	1,500	1,500	Actuals	Actuals	Actuals	Actuals	Actuals
Road Ambulance Charges - Non Network Hospitals (Reimbursement)	1,500	1,500	1,500	2,000	2,000	2,000	5,000	5,000
Emergency Medical Evacuation
Emergency Medical Evacuation - upto 5% of SI	-	-	-	Covered	Covered	Covered	Covered	Covered
E-Opinion
E-Opinion for Illness / Injury (Maximum Twice per policy year)	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Outpatient (OPD) Expenses
Outpatient Consultation & Diagnostics (Reimbursement Upto)	-	-	-	3,000 for Individual and 10,000 for Floater Option	3,000 for Individual and 10,000 for Floater Option	3,000 for Individual and 10,000 for Floater Option	10,000 for Individual and 20,000 for Floater Option	10,000 for Individual and 20,000 for Floater Option
Prescribed Medicines (Reimbursement Upto)	-	-	-	-	-	-	10,000 for Individual and 20,000 for Floater Option	10,000 for Individual and 20,000 for Floater Option
Child Vaccination Benefits
Child Vaccination Benefits (Reimbursement Upto)	-	-	-	-	-	-	Upto 12 years of age - 5,000 per Annum	Upto 12 years of age - 5,000 per Annum
Wellness Benefit
Wellness including Medical Tests at Designated Centres	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
One Time Discount
One Time Renewal Discount - subsequent to death of proposer)	10%	10%	10%	10%	10%	10%	10%	10%
Family Discount
Family Discount (Individual SI Policies)	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Voluntary Deductible
Discount in lieu of Voluntary Deductible	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Waiting Periods
Pre Existing Diseases
Compulsory Waiting Period	2 years	2 years	2 years	2 years	2 years	2 years	2 years	2 years
Pre Existing Diseases - Max Liability 3rd Year onwards	50%	50%	50%	50%	50%	50%	50%	50%
Pre Existing Diseases - 4th Year onwards	100%	100%	100%	100%	100%	100%	100%	100%
General Waiting Periods
Fresh Proposals excluding Accidental Hospitalisation - 30 days	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Listed Conditions - 2 years	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Joint Replacement & Organ Transplant - 4 years	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
Compulsory Co Pay
20% co-payment where entry age is from 60 years to 64 years	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
25% co-payment where entry age is from 65 years to 69 years	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
30% co-payment where entry age is from 70 years to 74 years	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered
40% co-payment where entry age is 75 years and above	Covered	Covered	Covered	Covered	Covered	Covered	Covered	Covered

Benefits of Future Genrali Health Total Insurance((All Amounts in ₹ INR)

Expenses covered
Hospitalization Medical Expenses, Day Care Treatment expenses, Pre-hospitalization Medical Expenses, Post-hospitalization Medical Expenses, Organ Donor Expenses, Domiciliary Hospitalisation Expenses.

Restoration of the Sum Insured
If the Sum Insured and Cumulative Bonus (if any) is exhausted due to claims payable, Restore Sum Insured (equal to 100% of the Sum Insured) will be automatically available for the particular Policy Year subject to T & C.

Maternity Expenses
Maternity benefit with only two years of waiting period when both husband and wife are covered together.

Miscellaneous Coverages
Patient Care, Accompanying Person, Road Ambulance Charges, Wellness Care, E-Opinion in respect of an Illness or Injury and Alternative Treatment.

Accidental Hospitalization
Increase in the Sum Insured by 25% of the available balance Sum Insured subject to maximum 10 lakhs in case of Accidental Hospitalisation.

Emergency Medical Evacuation (applicable for Superior Plan and Premiere Plan)
We will reimburse expenses under this Benefit incurred for medical evacuation from the place of local Hospitalisation /Accident to any other Hospital within India.

Out Patient Medical Expenses - (applicable for Superior Plan and Premiere Plan)

• Reimburse Expenses - We shall reimburse expenses towards consultation, diagnostic tests and medications prescribed as per plan opted.
• Child Vaccination Benefits (applicable for Premiere Plan) - We will cover charges for vaccinations for child less than 12 years of age.
• New Born Baby - (applicable for Superior Plan and Premiere Plan)
• Medical Treatment Abroad for listed conditions - (applicable for Premiere Plan)

Additional covers
Patient care, Accompanying Person, Road Ambulance Charges, E-Opinion in respect of an Illness or Injury, Alternative Treatment, Wellness Care

Cumulative Bonus
50% for every claims free year to a maximum of 100% * Product coverage’s applicable would be as per plan opted.