L&T Medisure Plus Health Insurance Policy

Entry Age

Adults between the ages of 18 years and 65 years can take this policy. If children are covered then they must be between the ages of 91 days and 23 years.

Basis

Individual or family floater health insurance

Policy Period

1 year or 2 years

Renewability

Lifelong

Sum Insured

The sum insured can range from Rs. 2 lakhs to Rs. 25 lakhs

Medicals

Up to the age of 50 years medical tests will be carried out only if medical adversities exist. After the age of 50 years they may be mandatory.

Discount

10% discount on premiums if more than 2 member are covered

Co-Payments

Beyond the age of 80 years a co-pay of 10% will be applicable to every claim

Coverage

1. In-patient expenses like nursing charges, surgeon fee, blood, oxygen medicines, etc. will be covered.
2. Room rent up to a maximum of Rs. 4,000 a day will be covered.
3. ICU charges up to a maximum of Rs. 6,000 per day will be covered.
4. Pre-hospitalisation expense for 30 days will be covered
5. Post-hospitalisation expenses for up to 60 days will be covered.
6. Certain day care procedures that don't require hospitalisation for more than 24 hours will be covered.
7. Domiciliary treatment will be covered if you can't be shifted to a hospital because of your condition or unavailability of beds at the hospital.
8. Ambulance charges of up to Rs. 1,500 for each trip will be covered.

Benefits

1. You can cover family members under the same policy.
2. The people who can be covered are you, your spouse, children, grandparents, grandchildren, brother, sister, son/daughter in law and nieces and nephews.
3. The policy offers a grace period of 30 days from the due date of the premium.
4. The policy also comes with a free-look period of 15 days.
5. The premiums paid towards this policy are eligible for tax benefits under section 80D.
6. Every two years the policy will provide coupons for up to Rs. 1,000 for medical check-ups.

Exclusions

1. Ailments like arthritis, hysterectomy, hypertension, diabetes, etc. will not be covered.
2. Treatments for illnesses resulting from a pregnancy won't be covered.
3. Congenital diseases won't be covered.
4. Stem cell treatments will not be covered.
5. Dental treatments won't be covered unless they are needed as a result of injuries that need 24 hour or more of hospitalisation.
6. Routine medical exams and diagnostic procedures won't be covered.
7. Use of life support machines when treatment cannot revive you won't be covered.
8. Injuries resulting from indulging in illegal activities or attempting suicide won't be covered.