Smart Health Pro – aasthainsurers

Smart Health Pro

ELIGIBILITY


Individual Entry Age Any person aged between 18 and 50 years can avail this policy.
Floater Entry Age Any person aged between 18 and 50 years can avail this policy. Dependent children are covered from the 91st day onwards up to 25 years.

IMPORTANT HIGHLIGHTS


Policy Type This policy can be availed either on an Individual or Floater basis.
Policy Term This policy can be availed for a term of one, two or three years.
Sum Insured The Sum Insured options under this policy are Rs.5,00,000/-, Rs.10,00,000/-, Rs.15,00,000/-, Rs.20,00,000/-, Rs.25,00,000/-, Rs.50,00,000/-, Rs75,00,000/-, and Rs.1,00,00,000/- .
Long-Term Discount A discount on premium is available if the policy term opted is more than one year.
Family Size Under floater Sum Insured you can add Self + Spouse/ Live-in Partner/ Same Sex Partner + Dependent Children. The policy covers maximum family size of 2 Adults + 3 Children under floater Sum Insured basis.

POLICY BENEFITS


In-Patient Hospitalisation Hospitalisation expenses incurred for a period of more than 24 hours on account of  illness, injury or accidents are covered.
Pre-Hospitalisation In addition to in-patient hospitalisation, the medical expenses incurred up to 60 days before the date of admission to the hospital are also covered.
Post-Hospitalisation Post-hospitalisation medical expenses incurred up to 180 days from the date of discharge from the hospital are covered.
Room Rent Room (Private Single A/c Room), boarding and nursing expenses as provided by the hospital are covered.
Road Ambulance This policy covers ambulance charges for admission to a hospital, for shifting from one hospital to another hospital and from the hospital to the insured’s residence (if it is in the same city).
Air Ambulance Air ambulance expenses are covered up to 10% of the Sum Insured per policy year, provided the situation requires an immediate hospitalisation of the insured person.
Day Care Procedures Medical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered.
Domiciliary Hospitalisation Expenses incurred for domiciliary hospitalisation, including AYUSH on the advice of a medical practitioner for a period exceeding three days are covered.
Home Care Treatment Insured person’s expenses incurred for home care treatment for specified conditions are covered up to 10% of the Sum Insured subject to the maximum of Rs. 5 Lakh in a policy year.
Mid-Term Inclusion The newly married spouse, newborn baby and/or legally adopted child can be included in the policy by paying a proportionate premium.
Hospitalisation expenses for treatment of New Born Baby Treatment expenses of newborn are payable from Day 1 of birth and subject to a limit of 10% of the Sum Insured and maximum of up to Rs. 2 lakhs. This will not apply for treatment related to congenital internal disease / defects.
AYUSH Treatment Expenses incurred for the treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in AYUSH hospitals are covered.
Modern Treatment Expenses incurred for modern treatments such as Deep Brain Stimulation, Intra Vitreal injections, Robotic Surgeries, etc. are covered up to the Sum Insured.
Automatic Restoration of Sum Insured On partial or full utilisation of the Sum Insured during the policy period, 100% of the Sum Insured will be restored once during the policy year and it can be utilised for all the claims.
Cumulative Bonus Cumulative bonus is provided at 50% of the Sum Insured for each claim-free year subject to a maximum of 100% of the Sum Insured.
Value Added Services This policy offers value added services including Star Tele-health Services, Medical Concierge Services, Digital Health Vault, Wellness Content, Post Operative Care, Discounts from Network Providers.

OPTIONAL COVERS (AVAILABLE ON PAYMENT OF ADDITIONAL PREMIUM)


Cumulative Bonus Booster This optional cover entitles the insured person to avail additional cumulative bonus calculated at 50% of the Sum Insured for each claim-free year subject to a maximum of 600% of the Sum Insured. This is applicable if the opted Sum Insured is Rs. 10 Lakh and above.
Modification of Room Category This cover entitles the insured person to enhance/reduce the room category from Private Single A/c Room to Any Room / Shared Accommodation.
Reduction of Pre-Existing Diseases Waiting Period Through this optional cover, the insured person can reduce the pre-existing diseases waiting period from 48 months to 36/24/12 months. This is applicable only for the first purchase of this policy.
Coverage for Non-Medical Items (Consumables) The coverage for non-medical items as specified in the List I of the policy schedule will be payable if the claim for in-patient / day care treatment is admissible under the policy.
Unlimited Automatic Restoration of Sum Insured On partial or full utilisation of the Sum Insured, 100% of the Sum Insured will be automatically restored for unlimited number of times which can be utilised for a subsequent hospitalisation.

Please refer to the Policy Documents to know the policy details and Terms & Conditions.