my:health Medisure Classic Insurance
HDFC Ergo General Insurance Ltd. presents my:health Medisure Classic Insurance,
a meticulously designed. insurance solution that understands your family's unique
health needs and provides you with a step-by-step plan to ensure their complete
well-being. Especially designed through a scientific process, my:health plans enables
you to quickly bounce back from a medical emergency so that you can continue to
spend and cherish your time with your loved ones.
- Entry and renewals are available for a lifetime
- Option to buy a two year policy at a 5 % discount
- Replenishment of Sum Insured - Reinstatement of
Sum Insured in case of hospitalization due to an accident
- Maternity and new-born baby cover
- No age limit, however you have to undergo medical
tests if your age is >50 yrs or if you have declared any pre-existing diseases
- Cover for Ayurvedic treatment
- Additional recovery benefit of Rs 5000/- is provided
(no bills required) only when hospitalization exceeds 10 contiuous days
- Cover for day-care procedures with no static list
- Cover for pre as well as post hospitalisation expenses
- Additional cover for hospital cash and ambulance
* 50% of the standard medical tests charges would
be reimbursed, subject to acceptance of proposal and policy issuance.
- Hospitalisation Expenses –
- For treatment of any disease, illness or injury in a Hospital as an in-patient which
- Fees of Surgeon, Anesthetist, Nurses and Specialists.
- Cost of Operation Theatre, diagnostic tests, medicines, blood, oxygen and internal
appliances like pacemaker as long as these are medically necessary.
- Treatment should be for a continuous period and includes relapse within 45 days
from the date of last consultation at the Hospital/Nursing Home. Occurrence of same
illness after a lapse of 45 days will be considered as fresh illness.
- Hospitalisation as In-patient for a minimum period of 24 hours subject to the limits
set below Room Rent/Boarding & Nursing as per actuals limited to 1% of the Sum Insured
(excluding cumulative bonus) per day subject to a maximum of `4,000/- per day ICU
Rent/Boarding & Nursing as per actuals limited to 2% of the Sum Insured (excluding
cumulative bonus) per day subject to a maximum of 6,000/- per day.
- Expenses on account of Room Rent/ICU Boarding & Nursing if, incurred higher than
the limits above, shall be reduced in the same proportion as such actual costs bears
to the eligible limits above. Such limits shall not apply where Optional Cover for
Waiver of Room Rent Sub-limits has been opted.
- Pre-Hospitalization -Medical expenses 30
days immediately before hospitalization
- Post-Hospitalization - Medical expenses 60
days immediately after hospitalization
- Day care procedures - Medical expenses for
existing and upcoming day care procedures which do not require 24 hours hospitalization
due to technological advancement in medical science.
- Domiciliary Treatment - Coverage for medical
treatment requiring hospitalisation, taken at home on advice of the attending medical
practitioner, due to non-availability of a hospital bed, which continues for at
least 3 days
- Hospitalisation due to Accident - If, during
the term of your policy, the entire Sum Insured gets used up or is not enough to
cover your second hospitalisation due to accident, the Sum Insured of your policy
is ‘reinstated’ or ‘replenished’ to the extent of the claim amount (but not exceeding
the Sum Insured) to cover this hospitalisation. This additional amount will be available
only ONCE during the 12-month Policy Year.
- Expenses for Pre-existing diseasesYou can
rest assured that expenses incurred towards the treatment of pre-existing diseases
that you might have contracted before the inception of the policy will be covered
by us. Please note that such expenses will be covered only after 3 continuous renewals
- Maternity and New-born baby Cover - Coverage
towards maternity expenses and new-born baby cover up to the limit of Maternity
- Ayurvedic Treatment - Coverage for cost of
(non cosmetic) Ayurvedic treatment upto 25,000 per Policy Year, with prior approval
from the Company requiring 24 hours hospitalisation / residential in-patient with
government registered hospital for the specified treatments (For details refer the
- Sum Insured (Rs.) - 2, 3, 4 and 5 lacs
- Family Discount - TIf you opt for Individual
Sum Insured for each of your family members under a single policy instead of a Family
Floater option, we give you a Family Discount of 10% on the total premium payable
for covering more than 2 family members. This will include you, your lawful spouse,
dependent children and dependant parents only. The Family discount will be available
for a maximum of 6 persons only.
- Free-Look Period - : It is possible that
you might decide to opt out of the policy after buying it. We give you the option
of cancelling the policy within 15 days from the date of receipt of policy documents,
if you are not satisfied with the coverage and terms of the policy. We will refund
the premium paid after adjusting the amounts spent on stamp duty charges, Medical
examination (wherever applicable) and proportionate premium (if policy has already
commenced). Refund will not be applicable if you have made a claim against the policy
during that period.
- Entry Age - From 91 days till No limit.
- Policy Period -The policy will be issued
for 1 year /2 years period.
- Pre-Policy Check up - Required > 50 Yrs of
age (Except if PED declared).
- Double Sum Insured for Critical Illness:
- Provides for an additional cover equivalent to the
Sum Insured excluding the cumulative bonus for treatment of - Cancer, Kidney Failure,
Multiple Sclerosis, Primary Pulmonary Hypertension, Major Organ Transplant, Aorta
Graft Surgery, Coronary Artery Bypass Graft, First Heart Attack and Stroke.
- Expenses arising from HIV or AIDS and related diseases
are permanently excluded
- Additional Sum Insured (excluding cumulative bonus)
is exclusively available only for the treatment of the first occurrence of the above
Critical Illnesses. - Coverage will not be extended for the same Critical Illness
for any subsequent Policy Year, however, the remaining critical illnesses will continue
to be covered.
- This coverage is in addition to the Hospitalisation
cover and the cumulative Sum Insured under both could be used for hospitalisation
against covered Critical Illness. And both could be used for any Critical Illness
- The option can be availed only up to the age of
65 years (age last birthday) and for Sum Insured of `2 Lacs and above. For customers
who avail of such option at or before that age, the cover shall continue to be available
in the case of continuous renewals.
- Waiver of Room Rent Sub-limits:
- If this coverage is opted, the sub limits of Room Rent and ICU under the Basic Cover
of Hospitalisation Expenses will be waived however, subject to the overall limit
of the Sum Insured.
- All pre-existing diseases / illness / injury / conditions
as defined in the policy, until 36 months of continuous covers have elapsed since
inception of the first policy with us.
- Waiting Periods
- 30 days waiting period will apply to all claims,
except if any insured person suffers an accident
- 2 years exclusions for specific diseases
- Permanent exclusions in the policy
- Non-allopathic treatment except Ayurvedic
- Expenses arising from HIV or AIDS and related diseases
are permanently excluded
- Mental disorder or insanity, cosmetic surgery, weight
- Abuse of intoxicant or hallucinogenic substance
like drugs and alcohol
- Hospitalization due to war / acts of war, nuclear,
chemical / biological weapon & radiation of any kind
- Pregnancy, dental and external aids and appliances
unless covered under specific plans
- Experimental, investigational or unproven treatment,
devices and pharmacological regimens
My:health Medisure Classic is a filed and approved product of HDFC General (formerly
known as L&T Insurance), a wholly owned subsidiary of the Company and hence the
Company is also offering the said product
Read more ...
What is a Pre-Existing Disease?
A Pre-Existing Disease means any condition, ailment or injury or related condition(s)
for which signs or symptoms, and/or was diagnosed, and/or received treatment medical
advice/treatment, within 48 months prior to the first Policy with us.
How does the Family Floater option in Medisure Classic operate?
The Family Floater option in Health Insurance covers the family & the coverage is
shared among the members of the family.
I am a Foreign Citizen? Can I take a health policy for my child who is continuing
further studies in India?
Yes. The scope of cover age shall be restricted to treatment taken in hospitals
in India during the policy period.
Are naturopathy and homeopathy treatments covered under a health policy?
My:health Medisure Classic covers only Allopathic and Ayurvedic treatment as per
the coverage, terms, conditions and exclusions of the Policy.
Does my:health Medisure Classic Insurance cover diagnostic charges like X-ray, MRI
my:Health Medisure Classic Insurance covers all diagnostic test like X- ray, MRI,
blood tests etc as long they are associated with the patients stay in the hospital
for at least 24 hours. Any diagnostic tests which do not lead to hospitalization
or which have been prescribed as Out-patient are not covered.