Raheja QBE health qube Super Top Up plan

Raheja QBE health Super Top Up plan benefits

• Particulars	Premium
  Cover type	1 Adult	2 Adults	2 Adults +1 Child	2 Adults+2 Children
  Super Top Up Sum insured (INR)	20,00,000	20,00,000	20,00,000	20,00,000
  Deductible (INR)	10,00,000	10,00,000	10,00,000	10,00,000
  Age of insured (highest age)	30 years	35 years	40 years	45 years
  Age-Band	26-30 years	31-35 years	36-40 years	41-45 years
  Premium Rate Super Top up with restoration(INR)	383	743	1,211	2,327
  Per Day Premium (INR)	1.05	2.04	3.38	6.38

  Note: Above illustration are with Restore Benefit and Excluding GST of 18%
  
  

  Particulars	Premium
  Cover type	1 Adult	2 Adults	2 Adults + 1 Child	2 Adults + 2 Children
  Health QuBE Sum Insured (Comprehensive) (INR)	10,00,000	10,00,000	10,00,000	10,00,000
  Super Top Up Sum insured ( INR)	20,00,000	20,00,000	20,00,000	20,00,000
  Total Sum Insured Coverage	3,000,000	3,000,000	3,000,000	3,000,000
  Age of insured (highest age)	30 years	35 years	40 years	45years
  Age-Band	26-30 years	31-35 years	36-40 years	41-45 years
  Premium Rate (Combo) (INR)	5,053	10,598	14,207	22,205
  Per Day Premium (INR)(Combo)	13.84	29.04	38.92	60.84

  Note:Above illustration are with Restore Benefit and Excluding GST of 18%
  
  

  Understanding Deductible

  What is Deductible?
  Deductible is a fixed amount paid out-of-pocket by an insured for the medical expenses before an insurance company pays the balance cost.
  
  What is Aggregate Deductible?
  Sum of all the claims incurred by the insured during a policy period.
  
  How does Aggregate Deductible Work?
  Suppose you have bought a “Health QuBE Super Top-up” policy with Rs. 5 lakhs aggregate deductible and 10 lacs Sum Insured. In case during the policy period there is 1 or more claim more than Rs. 5 lakhs then Super Top-up will pay you the balance amount incurred upto maximum 10 lakhs.
  
  Let’s understand how claim in a “Health QuBE Super Top-up” works?
  

  Particular	No of claims in a Year	Amount (INR)
  A	Claim 1	3,00,000
  B	Claim 2	2,00,000
  C	Claim 3	2,00,000
  D	Total Claims in a Year (A+B+C)	7,00,000
  E	Aggregate Deductible as per policy	5,00,000
  F	Sum Insured Coverage as per policy	10,00,000
  G	Claim Payable (D-E)	2,00,000
  F	Balance Sum Insured (F-G)	8,00,000

• Eligibility Criteria of Raheja QBE Super Top Up plan

  • Age means age of the Insured person on last birthday as on date of commencement of the Policy
  • Any individual can buy “Health QuBE Super Top Up’ health insurance policy for themselves and for their family members
  • Entry age for children is 91 days to 25 years and for adults is 18 years to 65 years
  • Family floater covers entire family. You can cover yourself, your spouse, up to three dependent children and two dependent parents.
  • No medical check up required up to age of 55 years.

• Coverages of Raheja QBE Super Top Up plan

  • Pre and post hospitalisation coverage upto 60 and 90 days.
  • AYUSH Treatment is available
  • Option to choose restoration benefit.
  • No claim bonus of 10% every claim free year.
  • Offers life-long renewability.
  • Coverage for day care treatment facilities.

• Exclusions of Raheja QBE health qube plan

  • 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.