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Oriental HOPE Senior Citizen Health Insurance Plan

Oriental Insurance HOPE - Health of Privileged Elders, is a health insurance policy designed for senior citizens above the age of 60. The policy offers a wide range of cover including specified diseases. The policy also offers various benefits along with the health insurance policy. The unique feature of the policy is that it covers medical costs that usually are not covered such as ambulance charges, prescription drug charges and cost of prosthetic devices.

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Features and benefits of Oriental Insurance HOPE:

Listed below are the features and benefits of this plan:

Entry age Any individual of the age 60 years and above
Basis Individual policy
Policy period The minimum and maximum policy term for the policy is 1 year
Renewability The policy can be renewed after 1 year if needed
Medicals Not required
Sum Insured Ranges from Rs.1,00,000 to Rs.5,00,000
Discount The policy offers discount on premium depending on the co-pay opted For co-payment of 10%: 10% discount on premium For co-payment of 20%: 20% discount on premium For co-payment of 30%: 30% discount on the premium For co-payment of 40%: 40% discount on the premium For co-payment of 50% and above: 50% discount on the premium
Co-payments The plan comes with a compulsory co-payment of 20%
Coverage offered on the policy
  • The policy covers only the specified diseases / illness / injury and there is a maximum liability in respect of each disease -
    • Accidental injury
    • Knee replacement
    • Cancer
    • Stroke
    • Cardiovascular diseases
    • Orthopedic diseases
    • Benign prostate
    • Ophthalmic (Eye) diseases
    • Chronic obstructive lung disease
    • Hepatobiliary disorders
    • Chronic renal failure
  • Hospital room, boarding and nursing expenses and ICU charges
  • Emergency ambulance charges
  • Doctor, surgeon, anesthetist, consultant or specialists fees
  • Cost of anesthesia, blood, oxygen, operation theatre charges, surgical appliances
  • Cost of medicines, drugs and consumables
  • Cost of artificial limbs, prosthetic devices like pacemaker
  • Cost of diagnostic tests like X-ray
Benefits under the policy
  • Provides the benefit of domiciliary hospitalisation
  • Provides discount on premium on voluntary co-payment
  • Cashless service through TPA up to Rs.1 lakh
  • Offers benefit on the cost of health check-up after 4 consistent claim free years
  • Offers tax benefits on the premium under section 80D of the Income Tax Act.
Exclusions under the policy
  • Any disease / health condition / illness / ailment or any condition arising therefrom other than those specified in the policy as covered
  • 2 yr exclusion on arthritis, cataract, surgery of benign prostatic hypertrophy, age related osteoporosis and osteoarthritis, calculus disease etc
  • Pre-existing diseases and related conditions for first 2 yrs
  • Any disease covered under the policy contracted by the Insured person during the first 30 days from the commencement date of the policy except treatment for accidental injuries
  • Injury or conditions due to any act of foreign enemy, war, nuclear materials
  • Circumcision, vaccination, inoculation
  • Surgery for eye sight correction, cost of spectacles, contact lenses, hearing aids, crutches, braces, walker etc
  • Any conditions due to abuse of drugs, alcohol or intoxicating substances
  • General weakness or rest cure
  • Self-inflicted injuries, suicide
  • Psychiatric and psychosomatic disorders
  • AIDS / HIV / STD
  • Cost of vitamins, tonics etc unless part of treatment
  • Massages, Steam bath, Shirodhara and like treatment under Ayurvedic treatment.
  • Doctor’s home visit charges, Attendant / Nursing charges during pre and post hospitalisation period.
  • Naturopathy, accupressure and accupuncture

Also Read: How to File a Claim with National Insurance?

Other Health Insurance Plans from Oriental:

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GST rate of 18% applicable for all financial services effective July 1, 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

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