The “Health Advantage Plus Health Insurance Policy” is a unique health insurance policy that covers unexpected medical emergencies like hospitalisation costs as well as Outpatient Treatment Expenses (OPD) in the form of reimbursement of cost of medicines, drugs, ambulance charges and dental expenses. You avail optimum tax-saving benefit, this policy enables you to save up to Rs. 5099* under Section 80 D of the Income Tax Act.

Moreover, the 45 year age limit for ‘no health check-up’ for policy issuance is now extended to 55 years of age.

This Plan is available for all ages between 5-65 years and senior citizens aged 66 and above (renewable up to 70 years). So, you save more, benefit better.

Policy Coverage

This is a comprehensive Tax-Saving health plan and provides 2 covers:

1. Basic Hospitalisation Cover
2. Outpatient Department (OPD)

1. Basic Hospitalisation Cover

This covers inpatient hospitalisation expenses up to sum insured of Rs. 2 or Rs. 3 Lakhs (depending on the plan chosen). You can avail the cashless claim facility in any of the 4500+ network hospitals across India.

Basic Hospitalisation cover includes:
Medical expenses incurred as an inpatient during hospitalisation for more than 24 hours, including room charges, doctor’s / surgeon’s fee, medicines, diagnostic tests, etc.

• 30 days prior to hospitalisation
• 60 days post hospitalisation
• Pre-existing disease can be covered after the 2nd year provided the policy is renewed with us for three consecutive years.
• Technologically advanced treatment that do not need 24-hour hospitalisation but are covered under this policy are:-

- Cataract
- Lithotripsy (Kidney Stone Removal)
- Tonsillectomy
- Eye Surgery
- Dialysis
- Dilatation & Curettage
- Chemotherapy
- Radiotherapy
- Coronary Angiography
- Cardiac Catheterization

Coverage limit for specific ailments / conditions:
Certain specific ailment(s) / surgery(s)/ procedure(s) are covered up to pre-defined limits under this policy (subject to the total sum insured).

All others ailment(s) / surgery(s)/ procedure(s) are covered up to the sum insured under the policy.

*- Pre-hospitalisation period, the period of Hospitalisation and the Post-hospitalisation period, should fall within the Period of Insurance

2. Outpatient Department (OPD)

This covers outpatient treatment expenses in the form of reimbursement of medical bills, dental expenses, etc. In case of an OPD treatment (Outpatient Department), the claims will be settled later after furnishing the medical prescription documents/bills.

Outpatient Department Covers:

• Room, Boarding Expenses as charged by the Hospital
• Nursing Expenses
• Expenses related to Dental Treatment
• Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees
• Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Consumables, Medicines and Drugs, Diagnostic Materials and X-ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Cost of Artificial Limbs External Medical Aids, Dental treatment charges, Ambulance charges
• OPD claims can be lodged only once during the Period of Insurance, within a period of 90 days from start of cover and 30 days of end of cover.

Sum Insured for Plans covering 2 individuals comes under the Floater benefit.

Key Benefits

• Floater benefit – The floater benefit would mean that one policy covers 2 family members with one sum insured and one premium. This takes care of hospitalisation expenses as well as Outpatient Treatment expenses in case of a sudden illness, accident or planned surgery of either of the family members.
• Optimum income tax benefit under section 80 D*. Save up to Rs. 5099/- on your Policy premium Click here to know more about Tax Benefit
• Fixed premium of Rs 15,000 for all plans excluding Senior Citizens aged 65 & above. Click here to know more
• Reimbursement of OPD expenses upto Rs. 10,000/- This includes diagnostics tests, dental treatment, etc. (OPD Benefit depends on age of senior most insured member and the plan chosen)
• Declared pre-existing illness covered after 2 years, i.e. from the 3rd year.
  Cashless claim facility available at over 4,500 network hospitals across India.
• No health check up required upto the age of 55 years (as on last birthday).
• Free health check-up coupon for any one insured family member.
• Medical check-up mandatory for insured of age 56 years and above.

*Optimum Tax Benefit of Rs 5099/- subject to the provisions of Section 80D of the Income Tax Act, 1961 and amendments made thereafter. (assuming highest tax bracket and premium of Rs. 15,000)

Eligibility

• The enrolment age (of the senior most family member) should be between 5 years to 65 years.
• The policy cover is renewable till the age of 70 years.
• The customer can buy the policy only for his two family members - defined as self, spouse or dependent children or dependent parents for the purpose of income tax exemption u/s Sec. 80D.

Need for Policy

• Save Tax up to Rs. 5099/- under section 80 D of the Income Tax Act
• Supplements employer-based health plans with higher sum insured and medical benefits
• Individuals require to have an insurance that caters solely to their health needs, apart from life insurance and investments, that provides cover against expenses incurred during hospitalisation, as well as before and after
• Avail cashless hospitalisation through ICICI Lombard’s network of 4500+ hospitals across India

If you want a Life Insurance/ ULIP, Health Insurance or any kind of General Insurance and Mutual Funds, Please CALL/SMS us @ 9830329228 or Contact us. Thanks for visiting!

1. D. Prakash Says:
   March, 2008

   Thanks for creating this blog. I thought it was a very interesting read. It is so interesting reading other peoples personal take on a subject....