IndiaFirst Mediclaim Plan
IndiaFirst Mediclaim Plan is a Non-Participating Health Insurance Plan. It is a Traditional Plan without any Bonus Facility.
How it works – In this plan, premium needs to be paid for the entire Policy Tenure of 5 years. There is a Premium Guarantee for 3 years in this plan even if there is a claim and will be reviewed thereafter at the end of every three years.
There are 2 Plan Types:
- Easy Health and
- Premier Health
Where the Sum Assured Varies for an:
- Individual- Self Coverage
- Family Floater- Spouse, Dependent Children, Parents as well as Parents-in-Law
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Benefits
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Plan
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Easy Health
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Premier Health
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Individual
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Family Floater
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Individual
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Family Floater
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In Patient Hospitalization
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Covered
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Covered
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Covered
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Covered
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Day Care Treatment
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Covered
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Covered
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Covered
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Covered
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Lifetime Renewability
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Covered
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Covered
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Covered
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Covered
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Term Rider
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Covered
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Covered
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Covered
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Covered
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Maternity Benefit
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Not Covered
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Not Covered
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Not Covered
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Covered
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Domiciliary Benefit
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Not Covered
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Not Covered
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Covered
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Covered
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Organ Donor Coverage
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Covered
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Covered
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Covered
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Covered
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Ectopic Pregnancy
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Covered till Rs 30,000
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Covered till Rs 50,000
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Pre and Post Hospitalization
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Covered
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Covered
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Cost of Artificial Limbs
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Covered
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Covered
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This Plan covers for all options:
- Basic Hospitalization In –Patient Expenses,
- Pre and Post Hospitalization expenses
- Day Care Benefits
- Emergency Ambulance Benefit
- Donor Expense Benefit
- Cost of Artificial Limbs- Payable as per actual expenses, subject to a maximum of 10% of the annual SA or INR 25,000, whichever is lower
Maternity Benefit is provided under Premier Health Option of Family Floater Plans after a waiting period of 2 years.
There is an additional Benefit of Best Doctor Facility, whereby:
- Inter Consultation Service- Expert medical consultation provides a comprehensive medical review by the experienced medical team
- Ask an Expert, where questions pertaining to health condition and treatment options can be asked to the Best Doctor Experts
- Find Best Care Service: A service whereby Best Doctors, on the Insured’s behalf, makes appointments, organises all details regarding medical treatment, including arranging for hospital, admission, physician Appointments, accommodations, transportation, and customer service
Key Features of IndiaFirst Mediclaim Policy
- This is a Health Insurance Plan
- In this plan, the premium remains constant for a period of 3 years even if there has been a claim
- Self, Spouse, Children, Parents as well as Parents-in-Law can be covered in this option
- This Plan can be opted for a maximum Sum Assured of Rs 25 Lacs
- This plan can be opted for an Individual or for the family under Family Floater Option
- There are 2 Plan Types- Easy Health and Premier Health
- This plan offers Guaranteed Lifetime Renewability
- There is Best Doctor Facility in this Plan
- There is an additional Term Rider available in this plan
Benefits you get from IndiaFirst Mediclaim Insurance Plan
Hospitalization Benefit – The Regular Benefits covered under both Options of this plan are:
- In Patient Hospitalization:
- Room Rent
- Nursing charges, Surgeons, Anaesthetists, Dieticians and other doctor's fees
- Diagnostic and Laboratory Charges
- Anaesthesia, blood, oxygen, medicines and drugs etc.
- 200 Day Care Benefits as mentioned
- 30 days of Pre-Hospitalization Benefit and 60 days of Post-Hospitalization Benefit
- Emergency Ambulance Benefit
- Donor Expense Benefit
- Cost of Artificial Limbs subject to 10% of Sum Assured or Rs 25,000 whichever is lower
Additional Benefit – There are some benefits provided in some of the options
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Plan Type
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Benefit
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Easy Health
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Premier Health
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Ectopic Pregnancy
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Actual expenses upto
Rs 30,000
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Actual expenses upto
Rs 50,000
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Maternity Benefit
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Not Covered
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Covered
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Domiciliary Benefit
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Not Covered
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Covered
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Maternity Benefit -- is provided under Family Floater Option under Premier Plan which covers:
- Actual Medical expenses incurred by the Life Insured towards hospitalization
- Medical Complications
- Delivery
- Medical Termination of Pregnancy
Subject to:
- Waiting Period of 2 years
- Maximum of Rs 1 lac
- For the first 2 pregnancies only
- Expenses of the New Born Baby and the Vaccinations are not covered
- Pre-Hospitalization and Post-Hospitalization expenses are not covered
Domiciliary Benefit – is provided under Premier Plan upto a maximum of 5% of the Basic Sum Assured
Income Tax Benefit – Premium paid towards Critical Illness Benefit and Cancer Care Benefit is up to Rs. 15,000 are allowed as a deduction from the taxable income each year under section 80D and the remaining premium is eligible for a deduction from the taxable income each year under section 80C.
Eligibility in IndiaFirst Mediclaim Insurance Policy
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Minimum
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Maximum
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Sum Assured (in Rs.) for Easy Health in Lacs
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2, 3, 4, 5, 7
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10
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Sum Assured (in Rs.) for Premier Health in Lacs
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10, 15, 20
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25
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Policy Term (in years)
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5
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Premium Payment Term (in years)
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5
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Entry Age of Life Insured (in years)
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18,
3 months for dependent children
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65,
20 for dependent children
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Age at Maturity (in years)
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-
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Lifelong
25 for dependent children
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Premium (in Rs.)
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2000 yearly
200 monthly
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No Limit
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Payment modes
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Yearly or Monthly
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Additional Features and Benefits of IndiaFirst Mediclaim Plan
Riders- There is 1 additional rider available with this plan:
Disclaimers in IndiaFirst Mediclaim Plan
- Maternity Benefit is available after a waiting period of 2 years and payable up to a maximum of Rs 1 lac only
- There is a Waiting Period of 30 days in this plan and hospitalization due to symptoms that occurred during the first 30 days of this plan is beyond the scope of this policy
- The expense of the artificial limb would be payable only once during the entire term of the plan and payable for a single limb only
- There is a 36 Months Waiting Period for Pre-existing diseases
- There is a 24 Months Waiting Period for Specified Surgeries
- Domiciliary hospitalization benefit may be reimbursed under the Premier Health option subject to a maximum of 5% of base sum assured. Domiciliary Benefit will only be reimbursed if the life assured has been under medical treatment for more than 3 days for such illness/ disease/ injury which in the normal course would require care and treatment at a hospital/ nursing home
- Domiciliary Treatment covers:
- Asthma
- Bronchitis
- Chronic Nephritis and Nephritic Syndrome
- Diarrhoea and all type of Dysenteries including Gastroenteritis
- Diabetes Mellitus and Insipidus
- Epilepsy
- Hypertension
- Influenza, Cough and Cold
- All Psychiatric or Psychosomatic Disorders
- Pyrexia of unknown Origin for less than 10 days
- Tonsillitis and Upper Respiratory Tract infection including Laryngitis and pharangitis
- Arthritis, Gout and Rheumatism
- Physiotherapy
- Maternity and its related complications
- Rest cure and palliative care for terminally ill persons
- Cost of any appliances or equipment
What happens if?
You stop paying the premium - If the policy holder stops paying the premium, the insurance cover will cease and the policy will lapse. Revival is not allowed in this plan
You want to surrender the policy – There are no Surrender Benefit in this plan.
You want a loan against your policy - There is no loan available under this plan.
