Raheja QBE health qube plan

Raheja QBE health qube plan benefits

• Eligibility Criteria of Raheja QBE health qube plan

  • The Policy would cover all the persons from the age group of 90 days to 65 years. The maximum entry age is restricted to 65 years. The minimum adult entry age for dependents is 18 years and the maximum entry age is 65 years.
  • Children upto 90 days till 5 years can only be covered provided either of his/her parent or legal guardian is insured with under the same policy (family floater).
  • Children up to 25 Years of age can be insured under the policy
  • Maximum cover ceasing age for children is 25Years. In case of Family floater policies, The young adult would have an option on renewal to continue as an adult with the suitable change in premium slab. If the Plan cannot accommodate the young adult . We would offer him an Individual policy with equivalent SI and NCB vested at corresponding premium slab.
  • The policy provides for lifelong renewals.
  • The Policy can be issued for 1 or 2 years. The benefits are on policy year basis.
  • The policy can be issued on an Individual or Floater cover basis.
  • We cover maximum 6 members in a family floater and individual type of cover.
  • In a family floater policy age of eldest member is taken into consideration while computing the premium.

• Benefits for Raheja QBE Corona Kavach health insurance

  Coverage of Non-Medical expenses – As per Sum insured opted*

  Sum Insured Band (Rs)	Maximum Amount Per Day (Rs)
  3L to 6 Lakhs	1000
  7L to 9 Lakhs	2000
  10L to 15 Lakhs	3000
  16L to 50 Lakhs	5000

  
  
  

  Sum Insured Band (Rs)	Maximum Amount Per Hospitalisation (Rs)
  3L to 9 Lakh	1500
  10 L to 50 Lakh	2500

  
  
  

  Sum Insured Band (Rs)	Max Amount (Rs)
  3L to 9 Lakh	25,000
  10L to 20 Lakh	50,000
  21L to 50 Lakh	1,50,000

  
  
  

  Product Features	Basic	Comprehensive	Super Saver
  In Patient Hospitalization	Yes	Yes	Yes
  Room Rent	1 % Sum Insured	No Limit	1 % Sum Insured
  ICU charges	2 % Sum Insured	No Limit	2 % Sum Insured
  Doctor Fees	25% of Sum Insured	No Limit	25% of Sum Insured
  Pre-Hospitalization	60 Days	60 Days	60 Days
  Post Hospitalization	90 Days	90 Days	90 Days
  Ambulance Charges	Yes	Yes	Yes
  Recharge Benefit	Yes	Yes	Yes
  Complimentary Medical check Up	Yes	Yes	Yes
  Sum Insured Increase	Yes	Yes	Yes
  No Claim Bonus	Yes	Yes	Yes
  Domiciliary Hospitalization	Yes	Yes	Yes
  Organ Donor Benefit	Yes	Yes	Yes

• Coverages of Raheja QBE health qube plan

  • Individual/Family health cover
  • Enjoy cashless hospitalization at network hospitals
  • Add-on covers to enhance policy benefits
  • Grab 10% premium discount on buying policy directly through website
  • Portability option is available
  • Avail Lifelong renewability
  • Tax benefits applicable
  • In-patient hospitalization expenses such as hospital room rent, ICU, diagnostic procedures, anaesthesia, operation theater charges, surgical appliances, medicines, drugs, etc. are covered, when the insured is hospitalized for at least 24 hours.
  • Pre hospitalization expenses are covered for 30/60 days (depending on the sum insured chosen) before hospitalization.
  • Post hospitalization expenses are covered for 60/90 days (depending on the sum insured chosen) after hospitalization.
  • Hospital daily allowance is payable, in case of in-patient hospitalization for a maximum of 6 consecutive days of hospitalization per claim.
  • Organ donor expenses incurred for harvesting the organ are covered.
  • Medical expenses incurred for domiciliary hospitalization are covered.
  • Ambulance charges are covered up to a limit specified.
  • Annual health check-up can be availed by the insured person aged 18 years & above, provided it is conducted at network providers.
  • Get sum insured increase by 10% on cashless hospitalization

  Coverages under all plan variants

  Schedule of benefits	Basic	Comprehensive	Super Saver	Ala carte
  Sum insured limits	- 1 to 2 Lacs - 3 to 50 Lacs	- 3 to 50 Lacs	- 1 to 2 Lacs - 3 to 50 Lacs	- 1 to 2 Lacs - 3 to 50 Lacs
  In-patient hospitalisation	Covered	Covered	Covered	Covered
  Room rent (per day)	1% of sum insured	No limit	1% of sum insured	1% per claim* (can be waived with add-on)
  ICU charges (per day)	2% of sum insured	No limit	2% of sum insured	2% per claim* (can be waived with add-on)
  Doctor fees (per day)	25% of sum insured*	No limit	25% of sum insured*	25% per claim* (can be waived with add-on)
  Pre hospitalisation	- 30 Days - 60 Days	- 60 Days	- 30 Days - 60 Days	- 30 Days - 60 Days
  Post hospitalisation	- 60 Days - 90 Days	- 90 Days	- 60 Days - 90 Days	- 60 Days - 90 Days
  Ambulance charges	Covered	Covered	Covered	Covered
  Daily allowance	Upto Rs. 500 per day		Upto Rs. 500 per day	Upto Rs. 500 per day
  Organ donor benefit	Upto 20% of sum insured	20% of sum insured	Upto 20% of sum insured	Upto 20% of sum insured
  Recharge/replenish benefit	Covered	Covered	Covered	Covered
  Medical checkup	Covered	Covered	Covered	Covered
  Non Medical expenses(-)(on cashless facility)	Covered based on SI	Covered	Covered based on SI	Covered based on SI
  Sum insured increase	10% on cashless	10% on cashless	10% on cashless	10% on cashless
  Domiciliary hospitalisation (@)	Covered	Covered	Covered	Covered
  No claim bonus	Covered	Covered	Covered	Covered
  Sub limit waiver	Not Covered	Built-in	Not Covered	Optional
  Co-pay - 20%	Not Covered	Not Covered	Built-in	Optional
  2 Year Policy availability	Covered	Covered	Covered	Covered

• Exclusions of Raheja QBE health qube plan

  • Investigation & Evaluation
    • Expenses related to any admission primarily for diagnostics and evaluation purposes.
    • Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment
  • 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.
  • War (whether declared or not) or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints and detainment of all kinds.
  • Nuclear, chemical or biological attack or weapons, contributed to, caused by, resulting from or from any other cause or event contributing concurrently or in any other sequence to the loss, claim or expense.
  • Circumcision unless necessary for treatment of an Illness or as may be necessitated due to an Accident.

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