Bajaj Allianz Tax Gain Health Insurance Plan

Eligibility

1. 56 years -75 years for Senior citizens plan Tax Gain 19999 Renewable up to 75 years.
2. 18 years - 55 years for Tax Gain 4999, Tax Gain 9999 & Tax Gain 14999 Renewable up to 55 years.
3. No medical test required for those under 45 years of age.

Coverage

1. Both hospitalization expenses and outpatient (OPD) expenses covered under one policy.
2. Cashless facility can be availed at over 5000 hospitals across the country.
3. Ambulance charges up to Rs. 1000/- will be covered in this scheme.
4. Day care procedures for 130 days will be covered (subject to terms and conditions).
5. The same policy can be continued until the individual becomes 75 years old.
6. If you decide to take treatment in non-network hospital, 10% co-payment of the admissible claim amount applicable. Co-payment will be waived on payment of additional premium.
7. No restrictions of waiting periods to claim under Out-Patient expenses
8. At the end of each four (Hospitalization) claim free policy periods, you can avail free Health check-up. The tests done in this benefit will be as specified in the schedule. Only one insured member can benefit from this.
9. The premium slabs stays the same from 18 years - 55 years and 56 - 75 years.
10. This scheme covers treatment under OPD section and dental procedures.
11. OPD Section covers cost of dentures, Spectacles and crutches.
12. No hassles of going through a TPA to make claims as it will be in house claims.

Exclusions

For outpatient claims:

1. If diagnostic tests are conducted without the treating doctor's referral, the expense for it will not be covered in this policy.
2. Health check-up cost.
3. Cost of spectacles will not be covered until the policy has finished one complete year and has been renewed. Also, only up to 25% of the cost will be covered.
4. Cost of dentures and hearing aids will not be covered until the policy has finished two complete years and has been renewed. Also, only up to 25% of the cost will be covered.

For hospitalization claims:

1. If a disease is contracted within the first 30 days of the policy inception, the treatment will not be covered in the policy.
2. If a disease/ illness is pre-existing for a period of 4 years, the treatment will not be covered.

Common for both Outpatient & Inpatient claims:

1. AIDS-related expenses.
2. Aesthetic and Cosmetic treatments.
3. Pregnancy & childbirth related expenses
4. Use of intoxicating alcohol and drugs.
5. Non allopathic treatment

Additional Benefits

After every four claim free policy periods, policyholder can avail Free Health Check-up at designated Bajaj Allianz Empanelled Health Insurance Diagnostic centres.

Tax Benefit

Avail Tax benefits under section 80 D of Income Tax Act.

Flat premium 4999

18-25 yrs

26-40 yrs

41-45 yrs

46-55 yrs.

Hospitalization cover - Floater Sum Insured 1 lac

OPD Benefits Self

3100

2900

2500

1600

PLAN-B Tax Gain9999

Flat premium 9999

18-25 yrs

26-40 yrs

41-45 yrs

46-55 yrs.

Hospitalization cover - Floater Sum Insured 2lacs

OPD Benefits Self

6500

6000

5000

3000

OPD benefits Self + spouse

5200

4800

3500

1000

PLAN-C Tax Gain 14999 1 ) C- 1

Flat premium 14999

18-25 yrs

26-40 yrs

41-45 yrs

46-55 yrs.

Hospitalization cover - Floater Sum Insured 2 lacs

OPD Benefits Self

9500

9000

8500

7500

OPD benefits Self + spouse

9000

8500

7000

4500

2 ) C-2

Flat premium 14999

18-25 yrs

26-40 yrs

41-45 yrs

46-55 yrs.

Hospitalization cover - Floater Sum Insured 3 lacs

OPD Benefits Self

9000

8500

7500

6000

OPD benefits Self + spouse

8000

7500

5500

2500

PLAN- D-FOR SENIOR CITIZENS - Tax Gain 19999

Flat premium 19999

56-60 yrs

61-65 yrs

65-70 yrs

71-75 yrs

Hospitalization cover-Floater Sum Insured 1 lac

OPD Benefits Self

13000

12500

12000

11000

OPD benefits Self + spouse

11000

10000

9500

8000