Digit Health Care Plus

Digit Health Care Plus benefits

• Eligibility Criteria of Digit Health Care Plus

  • This policy covers entry age between 18 years
  • The policy period Options are 1 Year, 2 Years and 3 Years.
  • Based on the Proposal Form shared by You, we will advise if any medical tests are required. For all proposals accepted by US, We will bear the costs of pre-policy medical checkups
  • Sum Insured enhancement can be done only at the time of renewal. You need to submit fresh proposal for Sum Insured Enhancement.
  • Request for renewal along with requisite premium shall be received by the Company before the end of the policy period.

• Coverage	Option 1 - Maxima restore Super	Option 2 - Early cover	Option 3 - Super Care
  In-Patient Type	All Illness Hospitalization	All Illness Hospitalization	All Illness Hospitalization
  Zone	Zone A/B/C	Zone A/B/C	Zone A/B/C
  Territorial Limit	India	India	India
  Post Hospitalization lump sum Benefit (% of Approved Claim Benefit)	1%	1%	1%
  Initital Waiting Period	30 days	30 days	30 days
  Room Rent Restriction	Nil	Nil	Nil
  Ayush Benefit	Not Covered	Not Covered	Not Covered
  Home (Domiciliary) Hospitalization expenses	Not Covered	Not Covered	Not Covered
  Sum Insured ReInstatement	Once in a policy period - related illness	Once in a policy period - related illness	Once in a policy period - related illness
  Pre-Existing / Specific Illness Waiting Period Combinations	2/2	2/2	2/2
  CO-Payment	0	0	0
  Cumulative Bonus	CB - 10% each claim free year (max 50%)	CB - 10% each claim free year (max 50%)	CB - 10% each claim free year (max 50%)
  Organ Donor Expenses	Yes	No	No
  Bariatric Surgery	5%	5%	5%
  Pyschiatric Cover on IPD basis	5%	5%	5%
  Complimentary Health Check Up Annually (% of SI) max 5000	0.25%	0.25%	0.25%
  ROAD Ambulance	1% upto INR 5000	1% upto INR 5000	1% upto INR 5000
  Day Care	Covered	Covered	Covered
  2nd Medical Opinion	Covered	Covered	Covered
  Dental for Accident	Covered	Covered	Covered

• Coverages of Digit Health Care Plus

  • 1.Pre and post hospitalization Medical Expenses means medical expenses incurred during pre- defined number of days preceding the hospitalization of the Insured Person
  • AYUSH Treatment is available
  • Policy Period means the period between the commencement date and the expiry date specified in the Policy Schedule and includes both the commencement date as well as the expiry date.
  • Renewal means the terms on which the contract of insurance can be renewed on mutual consent with a provision of grace period for treating the renewal continuous for the purpose of gaining credit for pre-existing diseases, time-bound exclusions and for all waiting periods.
  • Expenses incurred on road Ambulance subject to a maximum of Rs.2000/- per hospitalisation..
  • Coverage for day care treatment is available

• Exclusions of Digit Health Care Plus

  • Investigation & Evaluation
    • Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded
    • Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.
  • Rest Cure, rehabilitation and respite care
    • Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes:
      • Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons.
    • Any services for people who are terminally ill to address physical, social, emotional and spiritual needs
  • Obesity/ Weight Control
    • Expenses related to the surgical treatment of obesity that does not fulfil the policy conditions
    • Obesity-related cardiomyopathy
    • Coronary heart disease
    • Severe Sleep Apnea
    • Uncontrolled Type2 Diabetes
  • Change-of-Gender treatments
    • Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.
  • Cosmetic or plastic Surgery
    • Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
  • Hazardous or Adventure sports
    • Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including but not limited to, parajumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
  • Breach of law
    • Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.
  • Excluded Providers
    • Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed in its website / notified to the policyholders are not admissible. However, in case of life threatening situations or following an accident, expenses up to the stage of stabilization are payable but not the complete claim.
  • Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
  • Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure.
  • Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 diopters.
  • Unproven Treatments
    • Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.
  • Sterility and Infertility
    • Expenses related to sterility and infertility which includes any type of contraception, sterilization, Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, Gestational Surrogacy, Reversal of sterilization
  • Maternity Expenses
    • Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy;
    • expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.

  Disclaimer: “For the detailed list of exclusions under the policy, kindly refer to the same provided in your policy kit”)