Senior Citizen Mediclaim Policy

Senior Citizens Red Carpet Health Insurance Policy

Elderly Cover:  Designed for the age group of 60 – 75 years with lifelong renewals 

Outpatient Cover: Get cover for medical consultations as an outpatient at Network Hospitals 

Pre-insurance Screening: Pre-insurance screening is not required to avail this polic

Salient features of the Policy

1.0 COVERAGE:The Policy covers reimbursement of Hospitalisation Expenses for Illness/ Injury sustained.

2.0 SCOPE OF COVER: HOSPITALISATION EXPENSES
In the event of a claim becoming admissible, the Company will pay the expenses listed below that are Reasonable and Customary, and Medically Necessary incurred by or on behalf of such Insured Person but not exceeding, in aggregate, the Sum Insured mentioned in the Schedule.

2.1.0

Hospitalisation BenefitsLimits
(i) Room, Boarding expenses charged by the Hospital/Nursing Home
(ii) If admitted in ICU		Up to 1% of Sum Insured per day
Up to 2% of Sum Insured per day
Overall limit: 25% of the Sum Insured.
Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees, Nursing ExpensesOverall limit 25% of Sum Insured
Anesthesia, Blood, Oxygen, OT charges, Surgical appliances, Medicines, Drugs, Diagnostic material and X-Ray, Dialysis, Chemotherapy, Radiotherapy, Cost of Pacemaker, Artificial Limbs, Cost of Stents and ImplantsOverall limit 50% of Sum Insured

2.1.1Claims in respect of the following Illness / Surgery, will be subject to the following limits:

Name of Illness/OperationMaximum Charges Inclusive of Room/ICU/OT Charges/ Surgeons, Anesthetist, doctor’s fees, medicines, internal appliances and other charges incurred during hospitalization period
Cataract with imported foldable lens10000/-
Hysterectomy22000/-
Appendicectomy16000/-
Cholecystectomy18000/-
Prostate18000/-
Hemia-Inguinal16000/-
Hernia- Ventral/Incisional20000/-
Septoplasty9000/-
Haemorrhoidectomy8000/-
Fissurectomy9000/-
Fistulectomy10000/-
Angiography12000/-
Tonsillectomy7000/-
Tympanoplasty13000/-
Kidney stone/lithotripsy13000/-
Arthoscopy10000/-
PID-Disectomy31000/-
Mastectomy(Radical)36000/-
Exploratory Laprotomy18000/-

2.2Actual Pre-Hospitalisation Medical Expenses of up to 30 days, subject to maximum 5% of hospital bill.

2.3Actual Post-Hospitalisation Medical Expenses of up to 60 days, subject to maximum of 10% of hospital bill.

2.4 Expense incurred for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy system of medicines are covered 100% of Sum insured.

2.5Ambulance charges, subject to a maximum of INR 1000/-

2.6Hospitalisation Expenses (excluding cost of organ) incurred on the donor during the course of organ transplant to the Insured. The Companys liability towards expenses incurred on the donor and the Insured recipient together shall not exceed the sum insured of the latter.

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