Future Generali Health Total Plan

Future Generali Health Total Review

Future Generali Health Total is a complete health insurance plan which provides a comprehensive coverage comprising of inbuilt basic coverage features, additional benefits and also optional riders. The plan comes in three variants offering different levels of Sum Assured.

Highlights of the Future Generali Health Total Plan

• The plan can be taken either on an individual basis or on floater basis.
• There are three plan variants of Vital, Superior and Premier with varying Sum Assured levels and the policyholder can choose any option as per his choice. 
• The plan promises lifelong renewability. 
• Even extended family members up to 15 can be covered under the Superior and Premier plan’s floater option.
• The plan has Sum Assured restoration feature which restores the Sum Assured if it is exhausted in any policy year. 
• No medical check-ups till 50 years of age in case of the first plan variant Vital.
• There is no limit on the entry age. 
• The Sum Assured is increased by 50% if a claim is not made in any year. The maximum increment allowed is limited to 100%. 
• In case of hospitalization due to an accident, the Sum Assured is increased by 25% to a maximum of Rs.10 lakhs. 
• The plan provides valued added benefits like restoration of Sum Assured, increment of Sum Assured in case of accidental injuries, E-Opinion, Wellness care, etc.

Working of the Future Generali Health Total Plan

• The policyholder chooses the plan option and the Sum Assured and decides whether he wants an individual plan or a floater one. 
• There are three plan types with different Sum Assured levels and different members covered which are as follows:

Plan Types	Sum Assured range	Members covered under the floater variant
Vital	Rs.3,5 and 10 lakhs	Self, spouse, dependent children up to 25 years of age and dependent parents.
Superior	Rs.15,20 and 25 lakhs	Self, spouse, dependent children up to 25 years of age, dependent or non-dependent parents, dependent siblings, daughter or son-in-law, parents-in-law, grandparents and grandchildren
Premier	Rs.50 lakhs and Rs.1 crore	Self, spouse, dependent children up to 25 years of age, dependent or non-dependent parents, dependent siblings, daughter or son-in-law, parents-in-law, grandparents and grandchildren

 

• A maximum of 15 members can be covered under the Superior and Premier options. 
• The premium is then determined based on the above parameters.
• On any contingency covered by the plan, compensation would be paid. However, there is a co-pay clause wherein a specified proportion of the claim would be borne by the policyholder if insured’s the age is 60 years and above. The co-pay ratios are as follows:

Age bracket	Co-pay ratio
60-64 years	20%
65-69 years	25%
70-74 years	30%
75 years and above	40%

Benefits and Features of Future Generali Health Total Plan

• Plan Benefits – Being a health insurance plan, a range of benefits are provided under the plan the value of which depend on the plan variant selected. the table lists all the benefits provided by all the plan variants:

Plan benefits	Variant – Basic	Variant – Essential	Variant – Privilege
Pre and post hospitalization	Covered for 60 and 90 days respectively	Covered for 60 and 120 days respectively	Covered for 60 and 180 days respectively
Inpatient hospitalization	Covered	Covered	Covered
Day care procedures	Covered	Covered	Covered
Domiciliary treatment	Covered up to 10% of the Sum Assured	Covered up to 10% of the Sum Assured	Covered up to 10% of the Sum Assured
Organ donor expenses	Covered	Covered	Covered
Medical treatments abroad	Not covered	Not covered	Covered after a waiting period of 4 years
Ambulance cost	Rs.1500	Actuals for treatment at network hospitals or Rs.2000	Actuals for treatment at network hospitals or Rs.5000
Emergency Medical Evaluation	Not covered	Covered up to 5% of the Sum Assured	Covered up to 5% of the Sum Assured
E-opinion	Covered	Covered	Covered
AYUSH benefits	Covered	Covered	Covered
Daily cash for accompanying person	Rs.500 per day	Rs.500 per day	Rs.500 per day
Child Vaccination	Not covered	Not covered	Up to Rs.5000 for children aged up to 12 years
Patient Care benefits for individuals aged above 60 years	Rs.350 per day for a maximum of 10 continuous days	Rs.500 per day for a maximum of 10 continuous days	Rs.1000 per day for a maximum of 10 continuous days
Outpatient benefits: A) For consultation and diagnostics   B) Prescribed medicines	Not covered	A) Rs.3000 for individual plan and Rs.10, 000 for floater plan. B) Not covered	Rs.10,000 for individual plan and Rs.20, 000 for floater plan.
Maternity expenses	Sum Assured 3 lakhs – Rs.15,000 for normal delivery and Rs.25,000 for Cesarean  Sum Assured 5 lakhs – Rs.20,000 for normal delivery and Rs.35,000 for Cesarean Sum Assured 10 lakhs – Rs.25,000 for normal delivery and Rs.45,000 for Cesarean	Sum Assured 15 lakhs – Rs.30,000 for normal delivery and Rs.50,000 for Cesarean Sum Assured 20 lakhs – Rs.40,000 for normal delivery and Rs.60,000 for Cesarean Sum Assured 25 lakhs – Rs.40,000 for normal delivery and Rs.60,000 for Cesarean	Sum Assured 50 lakhs – Rs.50,000 for normal delivery and Rs.1 lakh for Cesarean Sum Assured 1 crore – Rs.50,000 for normal delivery and Rs.1 lakh
Pre and post-natal hospitalization	Not covered	Covered for 90 and 45 days respectively	Covered for 90 and 45 days respectively
New born baby cover	Not covered	Up to the Sum Insured from first day till policy renewal	Up to the Sum Insured from first day till policy renewal
Restore benefit	Covered	Covered	Covered
Wellness benefits	Covered	Covered	Covered

 

Eligibility Criteria of Future Generali Health Total Plan

The plan can be bought only by permanent Resident Indians. Individuals can buy the policy for themselves and their family and the plan is renewable throughout the insured’s lifetime. The other eligibility criteria of the plan include:

	Minimum	Maximum
Entry age	1 day	NA
Plan tenure	1, 2 or 3 years
Premium payable	Depends on the age and Sum Assured chosen
Sum Assured	Rs.3 lakhs	Rs.1 crore
Premium payment mode	Annually. Half-yearly, quarterly or monthly

Additional Benefits of Future Generali Health Total Plan

• Premium rebates – The plan offers three types of rebates or discounts which are as follows:
  • Family Discount – If family members are included in the cover a premium discount of 10% is allowed. 
  • One-time discount – If the proposer dies and the plan is renewed, a one-time discount of 10% is allowed. 
  • Deductible discount – If the policyholder chooses a voluntary deductible, a premium discount ranging from 10% to 25% is allowed based on the level of deductible opted. 
  • Long Term Discount – If a two-year plan is taken, a discount of 7.5% is allowed. If a 3-year plan is taken the discount becomes 10%. 
• Cumulative Bonus – For each year where the proposer has not made any claim in the policy, the Sum Assured is increased by 50% subject to a maximum of 100% increment in the Sum Assured. 
• Portability – If the proposer wants to port his existing health insurance plan taken from another company to this plan, he can do so. Such portability should be requested at least 45 days before the expiry of the previous policy which is being ported. 
• Free Look Period – A cooling off period or a free look period of 15 days is granted to the policyholder after the policy issuance to review the policy terms and conditions. If found unsatisfactory, the plan can be cancelled within this period and the premium paid would be refunded after deducting the relevant mortality charge, service tax, cess and stamp duty paid.
• Grace Period – A grace period of 30 days is allowed for paying the premium after the due date during which the policy cover continues. 
• Plan cancellation –The Company can cancel the policy on grounds of fraud, misrepresentation or non-disclosure. In this case premiums paid are not refunded. The proposer can also cancel the policy if he wants and in this case premiums would be refunded after deducting the coverage cost for the period for which the policy was in force and other expenses. The proportion of premium refunded in a cancelled policy is as follows:

Risk period	Proportion of premium refunded
Up to 1 month	75%
Up to three months	50%
Up to six months	25%
Beyond 6 months	Nil

 

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Premium Illustration

The following chart shows the sample premium rates payable by the proposer for different combinations of cover options, Sum Assured (SA) and age:



The table below gives a quick tabular reference to the above chart:

Age	Vital		Superior		Premier
	Sum Assured Rs.5 lakhs	Sum Assured Rs.10 lakhs	Sum Assured Rs.15 lakhs	Sum Assured Rs.20 lakhs	Sum Assured Rs.50 lakhs	Sum Assured Rs.1 crore
36-40 years	6,752	8,639	10,731	13,942	48,853	63,237
41-45 years	7,227	9,394	12,793	16,858	56,230	74,117
46-50 years	10,033	13,726	17,094	22,453	69,237	85,353

Exclusions in Future Generali Health Total Plan

• Pre-existing illnesses are covered completely only after a continuous coverage period of 48months. However, in the 3rd year, 50% claim for any treatment related to pre-existing illnesses would be admissible. 
• Specific treatments like cataract, hernia, fistula, joint replacement, etc. are not covered in the first two years of the policy.
• Hospitalization within the first 30 days of the policy is excluded. 
• Joint replacement and organ transplant are covered after 4 years. 
• Maternity related coverage is available after 3 policy years. 
• Epidemic ailments and debilitating ailments are excluded. 
• Hospitalization due to suicide or self-inflicted injury, alcohol or drug abuse, participation in hazardous sports and activities, criminal act, war, commotion, consequential loss, pregnancy and related causes, defense related operations, curative treatments, aviation, radioactive contamination, circumcision, cosmetic treatments, STD or HIV, etc. would also be excluded.