Bajaj Allianz Health Guard Individual Health Plan

Entry Age

18 years to 65 years. Children of the ages of 3 months to 25 years can also be covered under this policy

Basis

Individual / Family floater

Policy Period

1 year with a grace period of 30 days

Renewability

Lifelong

Medicals

Mandatory for policyholders above the age of 46 years

Sum Insured

Ranges from Rs. 1.5 lakhs to Rs. 10 lakhs

Discount

1. 10% discount if families are also covered by the policy
2. 10% cumulative bonus for claim-free years

Co-Payments

1. 10% of expenses if treatment was done in a non-network hospital
2. 20% co-payment will be applicable if the insured is above the age of 56 years.

Coverage

1. Pre-hospitalisation expense of up to 60 days prior to hospitalisation will be covered
2. Post-hospitalisation expenses of up to 90 days following hospitalisation will be covered
3. Expenses for hospitalisation in a non-network hospital will be eligible for reimbursements
4. Ambulance charges are also covered up to Rs. 1,000
5. Up to 130 day care procedures will be covered by the policy
6. Pre-existing conditions will be covered after a period of 48 months
7. For certain diseases like ulcers, hernia, endometriosis etc. the waiting period will be 2 years
8. Only accidental injuries will be covered in the first 30 days of the policy

Benefits

1. 100% cost of medicals prior to taking the policy will be paid for by the company
2. At the end of 4 claim-free years, policyholders can avail a free health check-up specified diagnostic centres
3. Free look period of 15 days
4. Premiums paid are eligible for tax benefits under section 80D of the IT Act
5. Premiums are not increased in the years following a claim
6. The sum insured can be increased at the time of renewing the policy
7. The portability options offer the benefits of transferring health insurance to Bajaj Allianz without loss of accrued benefits
8. The health insurance policy also offers a voluntary deductible option for which you get a corresponding discount in the premiums

Exclusions

1. Treatment for self-inflicted injuries will be excluded
2. Hospitalisation for the purpose of diagnostics
3. Donor treatment for the purpose of organ transplants
4. Hospitalisation due to acts of war or exposure to nuclear, biological or radiation hazards
5. Medical expense when hospitalisation is not required
6. Experimental treatments or treatments that are not allopathic
7. Treatment for mental disorders