Aditya Birla Health Insurance For Senior Citizens Plan
Overview
Aditya Birla Capital Limited (ABCL) is the holding company for all the financial service businesses of the Aditya Birla Group. With a strong presence across the life insurance, asset management, private equity, corporate lending, structured finance, general insurance broking, wealth management, equity, currency and commodity broking, online personal finance management, housing finance, pension fund management and health insurance business, ABCL is committed to serve the end-to-end financial services needs of its retail and corporate customers. Aditya Birla Capital Limited is a part of the Aditya Birla Group, a USD 40 billion Indian multinational in the league of Fortune 500. Anchored by an extraordinary force of over 120,000 employees, belonging to 42 nationalities, the Aditya Birla Group operates in 36 countries across the globe. About 50 per cent of its revenues flow from its overseas operations.
Highlights for ABHI Activ Care Premiere
Health Assessment
HealthReturns
No Claim Bonus
Second E-Opinion
Home Treatment
Worldwide Emergency Assistance
586 Day Care Procedures
Nursing At Home
Post Hospitalisation Medical Expenses
Lifestyle Support & Portable Medical Equipment
Features
Sub-limits
Ambulance
Transportation of the patient to the hospital and back home
Pre-Hospitalisation : 30 days
The amount of expenses incurred during this period prior to hospitalisation such as diagnostic tests, doctor fees, medicines, etc. for investigiation purpose are also payable by the insurer
Post Hospitalisation : 60 days
The amount of expenses incurred during this period after discharge from hospitalisation for the purpose of recovery such as follow-up tests, doctor fees, medicines, etc. are also payable by the insurer
Pre existing Disease cover : Treatments for Pre-existing diseases are covered after 24 months of continuous renewal.
Coverage for all Pre-Existing Diseases covered after a certain specified waiting period with continuous renewal.
Waiting Period- Initial : 30 days
No claims are accepted within this period except due to accidents/ injury.
Waiting Period- Specific : 24 months for specific illness
Listed specific illness
Waiting Period- PED : 24 months
No pre-existing ailment related claims are accepted within this period.
Room Rent : Single private AC room
Room rent for in-patient hospitalisation
ICU Charges : Covered up to Sum Insured
Charges for ICU hospitalisation
Co pay : 20% co pay for all Inpatient Hospitalisation, Domicilia_x001f_, Ayush, Home Treatment and Day care claims.
% of the claim that the policyholder needs to pay out-of-pocket
Restore Benefit/ Recharge/ Refill : 100% of Sum Insured once per year
If the sum insured is exhausted due to hospitalisation expenses of one or more members, there is an automatic restoration of the sum insured for related or unrelated ailments.
Health Check up : Once a policy year
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
No Claim Bonus : 10% of S.I. per annum, max up to 50% of S.I.
% of the sum insured that rises every claim free year.
Video/telephone consultation : Available
E-consultation with expert doctors empanelled with the insurer for a second opinion.
Domiciliary hospitalization : Covered upto Sum Insured
Home care treatment where there are no beds in the hospital or paitient is not in a condition to be moved to the hospital, This treatment is provided under the supervision of a registered medical practitioner.
Ambulance : Network Providers - Covered up to Actual expenses , Non- network Providers- Up to 5000 per hospitalisation
Transportation of the patient to the hospital and back home
Convalescence benefit : Not Available
A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.
Organ Donor : Up to Sum Insured
The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.
Bariatric cover : Not Available
Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.
Daycare : 586 Day Care procedures covered
Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments
AYUSH : Not Available
Alternative treatment coverage such as ayurvedic, unani, sidha and homeopathy which leads to hospitalisation.
Congenital Coverage : Not Available
Covers medical expenses related to diagnosis and treatment of heriditary and internal congenital ailments/ conditions/ traits that exist from birth.
Modern Treatments : Not Available
All advanced treatment with upgrade in technology.
Health Management/ Wellness : Available
Benefits provided for staying fit and managing health
Maternity Benefit : Not Available
All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.