Health Guard
Gold
Platinum
Silver
|
Health Ensure
|
Health Care Supreme
Ultimo
Vital
Smart
|
Arogya Sanjeevani
|
Health Total
Vital
Superior
Premier
|
Arogya Sanjeevani
|
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In-patient Treatment | |||||
Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covered up to Sum Insured | Covered up to Sum Insured |
Room Rent | |||||
Silver plan: Up to 1% of Sum Insured per day (Excluding Cumulative Bonus) or actual, whichever is lower Gold: No sublimits |
1% of sum insured per day maximum Rs.5,000 per day | Actual | 2% of sum insured, maximum up to Rs.5,000 per day | NIL cap on room rent across all plans | Up to 2% of the sum insured subject to maximum of Rs.5,000/day. |
ICU Charges | |||||
Actual | 2% of sum insured per day maximum Rs.10,000 per day | Actual | 5% of sum insured, maximum up to Rs.10,000 per day | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000/day |
Pre-hospitalization | |||||
Up to 70 days | Up to 30 days | Up to 70 days | Up to 30 days | 60 days before the date of admission to the hospital | 30 days before the date of admission to the hospital |
Post-hospitalization | |||||
Up to 90 days | Up to 60 days | Up to 90 days | Up to 60 days | 90 days after discharge from the hospital | 60 days after discharge from the hospital |
Day care Procedures | |||||
All day care procedures are covered | All day care procedures are covered | All day care procedures are covered | Covered | Covered | Covered |
Domiciliary Treatment | |||||
Not Covered | Not Covered | Not Covered | Not Covered | Covered up to 10% sum insured | Not Covered |
Emergency Ambulance | |||||
Up to Rs.20,000 per policy year | Up to Rs.1,000 per hospitalisation | Up to sum insured | Up to Rs.2,000 per hospitalisation | Vital: Network Hospital - 1,500 per hospitalisation Non-network Hospital: Covered up to Rs.1,500 per hospitalisation Superior: Network Hospital - Actuals Non-network Hospital: Covered up to Rs.2,000 per hospitalisation Premier: Network Hospital - Actuals Non-network Hospital: Covered up to Rs.5,000 per hospitalisation |
Maximum of Rs.2,000 per hospitalization |
Dental Treatment | |||||
Not Covered | Not Covered | Covered out patient expenses procedures – Root Canal Treatment, Extractions | Dental treatment, necessitated due to disease or an injury | Vital: Not Covered; Superior: In case of dental consultations and diagnostics ,our liability will be restricted to 70% of admissible bills; Premier: In case of dental consultations and diagnostics ,our liability will be restricted to 70% of admissible bills |
Dental treatment, necessitated due to disease or injury |
Bariatric Surgery | |||||
50% of Sum insured max upto Rs.5 lakhs(waiting period: 3years) | Not Covered | Covered if medically indicated | Not Covered | Not Covered | Not Covered |
Ayush Benefit | |||||
Covered | Covered up to 20% of sum Insured | Covered | Covered | Covered | Covered |
Maternity Benefits | |||||
Silver plan: Up to 1% of Sum Insured per day (Excluding Cumulative Bonus) or actual, whichever is lower Gold: No sublimits |
Not Covered | Up to Rs.25,000 to Rs.1 lakh (waiting period: 2 years) |
Not Covered | Vital (3 to 10 Lakhs): Normal delivery - Rs.15,000 to 25,000; Caesarian - Rs.25,000 to 45,000; Superior (15 to 25 Lakhs): Normal delivery - Rs.30,000 to 40,000; Caesarian - Rs.50,000 to 60,000; Premier (50 Lakhs to 1 Crore): Normal delivery - Rs.50,000; Caesarian - Rs.1,00,000; (waiting period: 2 years) |
Not Covered |
New Born baby cover | |||||
50% of Sum insured maximum up to Rs.5 lakhs | Not Covered | Covered if medically indicated | Not Covered | Vital: Not Covered; Superior: Covered; Premier: Covered |
Not Covered |
Daily Cash for Accompanying an Insured Child | |||||
Up to Rs.500 per day maximum up to 10 days during each policy year | Not Covered | Not Covered | Not Covered | Covered up to Rs.500 per day to maximum of 30 days | Not Covered |
Organ Donor Expenses | |||||
Covered up to sum insured | Covered up to sum insured | Available up to Rs.500,000 | Not Covered | Covered | Not Covered |
Vaccination (In case of post bite treatment) | |||||
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
Health Check-up | |||||
Every 3 years, 1% of sum insured, maximum Rs.5,000, irrespective of claim | Every 3 years, 1% of sum insured, maximum Rs.1,500, irrespective of claim | Annual | Not Covered | Not Covered | Not Covered |
Hospital daily allowance | |||||
Not Covered | Not Covered | Up to Rs.1,000 per day | Not Covered | Not Covered | Not Covered |
Co-pay | |||||
Co-pay options of NIL / 20% based on Zonewise treatment availed |
Co-pay options of NIL / 20% based on Zonewise treatment availed | Co-pay options of NIL | 5% Co-pay applicable on all claims | 60 to 64 years: 20% Co-pay 65 to 69 years: 25% Co-pay 70 to 74 years: 30% Co-pay 75 and above years: 40% Co-pay |
5% co-pay on all claims |
Pre-existing diseases coverage | |||||
Covered after a waiting period of 3 years | Covered after a waiting period of 2 years | Covered after a waiting period of 2 years | Covered after a waiting period of 4 years | Pre-existing diseases covered after 2 years of continuous coverage | Pre-existing diseases covered after 4 years of continuous coverage |
Restore Benefit | |||||
Restoration benefit available up to 100% of Base sum insured | NIL restoration benefit | Restoration benefit available up to 100% of Base sum insured | NIL restoration benefit | 100% of base sum insured for all types of illnesses | Not Covered |
General waiting period | |||||
30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
Renewal Benefit / Cumulative Bonus | |||||
10% of base sum insured per annum up to 10 years (if without any break no claim in the preceding year) | 5% on base sum insured for every claim free year and up to 25% | 10% on base sum insured for every claim free year and up to 50% | 5% on base sum insured for every claim free year and up to 50% | 50% for every claims free year to a maximum of 100%. | 5% on base sum insured for every claim free year and up to 50% |
Emergency Air Ambulance | |||||
Not Covered | Not Covered | Rs.50,000 to Rs.5 Lakhs | Not Covered | Not Covered | Not Covered |
Available sum insured options | |||||
Silver Plan: Rs.1.5 Lakhs, 2 Lakhs Gold Plan: Rs.3 to 50 Lakhs |
Individual: Rs.50,000 to 10 Lakhs Floater: Rs.2 to 10 Lakhs |
Rs.5 to 50 Lakhs | Rs.1 to 5 Lakhs | Vital: Rs.3 to 10 Lakhs Superior: Rs.15 to 20 Lakhs Premier: Rs.50 to 1 Crore |
Rs.1 to 5 Lakhs |
Policy can be purchased for | |||||
1/2/3 years | 1/2/3 years | 1 year | 1 year | 1/2/3 years | 1 year |
Eligibility criteria | |||||
Adults from 17 to 65 years (dependents 3 months to less than 30 years) | Adults from 18 to 99 years (dependents 3 months to less than 30 years) | Adults from 18 to 99 years (dependents 3 months to less than 25 years) | Adults from 18 to 65 years (dependents 3 months to less than 25 years) | 1 day to lifelong,dependent children (Unmarried and up to the age of 25 years) | Adults from 18 to 65 years (dependents 91 days to 25 years).If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals |
Renewability | |||||
Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life |
Claims loading | |||||
No Loading | Loading | Loading | No Loading | No Loading | No Loading |
Portablity (At the time of renewal) | |||||
Yes | Yes | Yes | Yes | Yes | Yes |
Tax Benefits Limit | |||||
Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D |
Useful Links | |||||
Bajaj Allianz | Future Generali | |
---|---|---|
Claims Settlement Ratio ** | 94.55% | 94.55% |
Number of Lives covered * | 2,46,85,000 | 2,46,85,000 |
Network Hospitals | 6,500 + | 6,500 + |
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