Medi Classic Insurance Policy (Individual)
IRDAI UIN SHAHLIP25038V082425
HIGHLIGHTS
Plan Essentials
Sum Insured
Automatic Restoration
Instalment Options
Non Allopathic / AYUSH
New Born Cover
Zone Wise Premium Bifurcation
Day Care Procedures
Organ Donor Expenses
DETAILED LIST
Understand what’s included
IMPORTANT HIGHLIGHTS
Entry AgeAny person between 5 months and 65 years can avail this policy. |
In-Patient HospitalisationHospitalisation expenses incurred for a period of more than 24 hours on account of illness, injury or accidents are covered. |
Pre-HospitalisationIn addition to in-patient hospitalisation, the medical expenses incurred up to 30 days before the date of admission to the hospital are also covered. |
Post-HospitalisationPost-hospitalisation medical expenses up to 60 days from the date of discharge are covered as per the limits mentioned in the policy clause. |
Room RentRoom, boarding and nursing expenses incurred during in-patient hospitalisation are covered up to 2% of the basic Sum Insured of Rs. 5000/- per day. |
Road AmbulanceAmbulance charges up to Rs. 750/- per hospitalisation and over all limit of Rs. 1,500/- per policy period for transportation of the insured person by private ambulance service are covered. |
Day Care ProceduresMedical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered. |
Modern TreatmentExpenses incurred for modern treatments such as Oral Chemotherapy, Intra Vitreal injections, Robotic Surgeries, etc. are covered up to the limits mentioned in the policy clause. |
Non Allopathic Treatment / AYUSHExpenses incurred for the treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in AYUSH hospitals are covered up to 25% of the Sum Insured subject to the maximum of Rs. 25,000/- during the policy period. |
Cataract TreatmentExpenses incurred for Cataract treatment are covered up to the limits mentioned in the policy clause. |
Automatic Restoration of Basic Sum InsuredOn exhaustion of the limit of coverage during the policy period, 200% of the basic Sum Insured will be restored once during the policy year that can be utilised for illness or disease unrelated to illness or disease for which claims were made. |
Family Package PlanAvailable for persons from 5 months to 45 years. The sum insured is apportioned equally among insured family members. Health Checkup benefits will be calculated on the policy Sum Insured and equally divided among all the insured persons. |
Cumulative BonusThe insured person will be eligible for Cumulative bonus calculated at 5% of the basic Sum Insured for every claim free year subject to a maximum of 25% of the basic Sum Insured. |
Health Check-UpExpenses incurred towards the cost of health check-ups are covered up to 1% of the basic Sum Insured subject to the maximum of Rs. 5000/- for the basic Sum Insured of Rs. 2,00,000/- and above. The insured person is eligible for this benefit after every block of four claim free years subject to a continuous coverage. |
Co-paymentThis policy is subjected to a Co-payment of 10% of each and every admissible claim amount, for fresh as well as for the policies subsequently renewed for insured persons whose age at the time of entry into this policy is 61 years and above. |
IMPORTANT HIGHLIGHTS (FOR GOLD PLAN)
Entry AgeUnder Gold Plan, any person aged between 16 days and 65 years can avail this policy. |
In-Patient HospitalisationHospitalisation expenses incurred for a period of more than 24 hours on account of illness, injury or accidents are covered. |
Pre-HospitalisationIn addition to in-patient hospitalisation, the medical expenses incurred up to 30 days before the date of admission to the hospital are also covered. |
Post-HospitalisationPost-hospitalisation medical expenses up to 60 days from the date of discharge from the hospital are covered. |
Room RentRoom, boarding and nursing expenses incurred during in-patient hospitalisation are covered up to the limits mentioned in the policy clause. |
Road AmbulanceAmbulance charges up to Rs. 2,000/- per hospitalisation for transportation of the insured person by private ambulance service are covered. |
Day Care ProceduresMedical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered. |
Modern TreatmentExpenses incurred for modern treatments such as Oral Chemotherapy, Intra Vitreal injections, Robotic Surgeries, etc. are covered up to the limits mentioned in the policy clause. |
Cataract TreatmentExpenses incurred for Cataract treatment are covered up to the limits mentioned in the policy clause. |
Health Check-UpExpenses incurred towards the cost of health check-ups are covered up to 1% of the basic Sum Insured subject to the maximum of Rs. 5000/- for the basic Sum Insured of Rs. 2,00,000/- and above. |
Cumulative BonusFor every claim free year the insured person will be eligible for Cumulative bonus calculated at 25% of the basic Sum Insured in the second year and an additional 20% of the basic Sum Insured for each subsequent years subject to the maximum of 100% overall. |
Automatic Restoration of Basic Sum InsuredOn exhaustion of the limit of coverage during the policy period, 200% of the basic Sum Insured will be restored once during the policy year that can be utilised for illness or disease unrelated to illness or disease for which claims were made. |
Super RestorationOn exhaustion of the limit of coverage during the policy period, under the gold plan, 100% of the Sum Insured will be restored once for the remaining policy year that can be utilised for all claims. |
Domiciliary HospitalisationExpenses incurred for domiciliary hospitalisation, including AYUSH on the advice of a medical practitioner for a period exceeding three days are covered. |
Shared AccommodationIf the insured person opts for shared accommodation in a Networked Hospital, a cash benefit is provided for the opted Sum Insured as mentioned in the policy clause. |
Organ Donor ExpensesIf the insured person is the recipient, then the hospitalisation expenses incurred for organ transplantation are covered. |
Additional Basic Sum Insured for Road Traffic Accident (RTA)If the basic Sum Insured gets exhausted, then for hospitalisation due to Road Traffic Accidents, it will be increased by 50%. |
Hospitalisation Expenses for Treatment of New Born BabyThe coverage for the New Born Baby starts from the 16th day after its birth till the expiry date of the policy and is subject to a limit of 10% of the basic Sum Insured or Rupees Fifty thousand, whichever is less, subject to the availability of the basic Sum Insured, provided the mother has been insured under the policy for a continuous period of 12 months without break. |
Non Allopathic Treatment / AYUSHExpenses incurred for the treatment under Ayurveda, Unani, Siddha and Homeopathy systems of medicines in AYUSH hospitals are covered up to 25% of the Sum Insured subject to the maximum of Rs. 25,000/- during the policy period. |
Patient CareThe expenses incurred for one attendant at the residence of the insured person immediately after discharge from the hospital provided this is recommended by the attending physician are covered. Such expenses are payable up to Rs. 400/- for each completed day up to 5 days per occurrence and 14 day per policy period. |
Hospital Cash BenefitA cash benefit of Rs.1000/- for each completed day in the hospital is provided for a maximum of 7 days per hospitalisation and 14 days per policy period. |
Co-paymentThis policy is subjected to a Co-payment of 10% of each and every admissible claim amount, for fresh as well as for the policies subsequently renewed for insured persons whose age at the time of entry into this policy is 61 years and above. |
Family Discount5% discount on premium is available if 2 or more family members are covered under this policy. |
Major Organ Donor DiscountIf the insured person submits proof that he/she has donated a major organ, a discount of 25% of the premium is available at the time of renewal. This discount is available even for subsequent renewals as well. |
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Medi Classic Insurance Policy (Individual)
What is Medi Classic Health Insurance Policy?
Medi classic Insurance Policy is a kind of policy that offers coverage for hospitalization expenses incurred due to the Illness, disease, sickness and/or accidental injuries. This policy offers a feature of lifetime renewability.
Medi classic health insurance policy helps with hospital bills, medical treatments, and other healthcare costs. The Medi Classic Health Insurance Policy has several benefits compared to the other plans.
Mediclassic Insurance Policy (Individual) is a vital safeguard for personal well- being and financial stability. It offers multiple benefits that ensure comprehensive coverage, enabling policy owners to access required healthcare services without incurring excessive costs.
Benefits of Medi Classic Health Insurance Policy
Classic Health Insurance Policy has many benefits. Let's see some of the Benefits of Buying a Classic Health Insurance Policy:
- It covers the room rent expense of any room up to Rs 5,000 per day.
- It offers coverage of Rs 5 lakh two times a year for unrelated illnesses.
- It offers the feature of a Renewal Bonus of Rs 25,000 per year and up to a maximum of an additional Rs 1.25 lakh.
- Medi Classic Health Insurance Policy Free health checkup offers a free health checkup option once every 4 years.
- Co-pay is 90% paid by the insurer under this policy.
- It offers coverage for existing Illnesses for 3 years
- The initial Waiting Period for this plan is 30 days, except for claims arising because of an accident, provided the same are covered.
- Specific Illness coverage for 24 months is offered by this plan for slow-growing diseases like knee replacement, hernia, cataracts, etc.
- You can avail of the tax benefit by buying this plan.
Basic Plan
Any person aged between 5 Months and 65 years can take this insurance. Thereafter, only renewals will be accepted without capping the exit age.
Sum Insured Options: Rs.1,50,000/-, Rs.2,00,000/-, Rs. 3,00,000/-, Rs.4,00,000/-, Rs.5,00,000/-, Rs.10,00,000/-, Rs.15,00,000/-.
Cost of Health Checkup: Expenses incurred towards the Cost of Health checkup up to 1% of the average Basic Sum Insured after every block of four continuous claim years subject to a maximum of Rs.5,000/-
Automatic Restoration of Basic Sum Insured: There shall be automatic restoration of the Basic Sum Insured by 200%, once during the policy period, immediately upon exhaustion of the limit of coverage. It is made clear that such restored Basic Sum Insured can be utilized only for illness/disease unrelated to the illness/diseases for which the claim/s was/were made. The restored Basic Sum Insured cannot be carried forward. This benefit is not available for Modern Treatments.
For wider benefits, you can choose the Gold Plan.
Eligibility
Any person aged between 16 days and 65 years can take this insurance. Thereafter, only renewals will be accepted without capping the exit age.
Sum Insured Options: Rs. 3,00,000/-; Rs.4,00,000/-; Rs.5,00,000/-; Rs.10,00,000/-; Rs.15,00,000/- ; Rs. 20,00,000/- ; Rs. 25,00,000/-
Room Rent Eligibility
- For the Sum insured of Rs. 3 Lakhs and 4 lakhs, the Insured is eligible for 2% of the Sum insured maximum of Rs. 5000/-
- For the Sum insured of 5 lakhs and above, the Insured is eligible for a Single private AC room.
Ambulance charges up to Rs. 2,000/- per hospitalization for transportation of the insured person by private ambulance.
Pre-Hospitalisation: Medical expenses incurred for a period not exceeding 30 days prior to the date of hospitalization.
Post-hospitalisation: Medical expenses incurred for a period up to 60 days from the date of discharge from the hospital.
Coverage for Modern Treatments: Expenses are subject to the limits.
Non Allopathic Treatment / AYUSH: In patient hospitalizations expenses incurred for treatment of diseases / illness / accidental injuries by system of medicines other than allopathic is payable upto 25% of the Basic Sum Insured subject to a maximum of Rs 25000/- during entire policy period.
Organ Donor Expenses: In patient hospitalization expenses incurred for organ transplantation from the Donor to the recipient insured person are payable provided the claim for transplantation is payable. Donor screening expenses and post-donation complications of the donor are not payable.
Shared accommodation: If the Insured person occupies a shared accommodation in a networked hospital during in-patient hospitalization, then the amount as per the table given below will be payable for each continuous and completed period of 24 hours of stay, provided the hospitalization exceeds 48 hours in such shared accommodation.
Hospitalization expenses for treatment of New Born Baby: The coverage for New Born Baby starts from the 16th day after its birth till the expiry date of the policy and is subject to a limit of 10% of the Basic Sum Insured or Rupees Fifty thousand, whichever is less, subject to the availability of the Basic Sum Insured, provided the mother has been insured under the policy for a continuous period of 12 months without a break.
Automatic Restoration of Basic Sum Insured: There shall be automatic restoration of the Basic Sum Insured by 200%, once during the policy period, immediately upon exhaustion of the limit of coverage. It is made clear that such restored Basic Sum Insured can be utilized only for illness/disease unrelated to the illness/diseases for which the claim/s was/were made. The restored Basic Sum Insured cannot be carried forward. This benefit is not available for Modern Treatments.
Super Restoration: If the limit of coverage under this policy is exhausted during the policy period, an additional Basic Sum Insured of 100% would be provided once for the remaining policy period for the subsequent hospitalization. This additional basic sum insured can be utilized even for illness/disease for which the claim/s was/were made. The unutilized additional Basic Sum Insured cannot be carried forward. This benefit is not available for Modern Treatments.
Inclusions of Medi Classic Health Insurance Policy
There are many inclusions in the Medi Classic Health Insurance Policy. Here are some of the inclusions of Medi Classic Health Insurance Policy.
- Expenses for the Anesthesia, Blood, Oxygen, Operation Theatre charges, ICU charges, Cost of Pacemaker etc., are included in this plan.
- It covers the Ambulance charges for transporting the covered Patient to the Hospital up to a sum of Rs. 750/- per hospitalization, but overall limit of Rs. 1500/ is per policy period.
- This plan covers the Pre-Hospitalization medical expenses for up to 30 days before the date of admission.
- The plan post hospitalization offers coverage for the medical expenses up to a period of 60 days after discharge from the Hospital.
- This plan offers coverage for modern treatments, but these treatments are subject to limits.
- The health checkup expenses incurred are covered under this medi classic health insurance policy.
Medi Classic Health Insurance Policy Exclusions
Though there are many things included in the medi classic insurance policy individual plan, there are still some exclusions. The exclusions of Med Classic Health Insurance Policy are :
1. Pre-Existing Diseases expenses associated with the treatment of a pre-existing Disease (PED) are not included till the expiry of 36 months of coverage prior to the date of inception of the first policy with insurer.
2. Some specified disease/ procedure waiting period expenses associated with the treatment of the some listed conditions, surgeries/treatments will not be included until the expiry of 24 months of continuous policy coverage after the date of inception of the first policy with the insurance company.
3. Expenses associated with the treatment of any illness within 30 days from the first policy commencement date shall be excluded.
4. Costs associated with any admission, basically for diagnostics and evaluation purposes only, are not included.
5. Expenses for the rest cure, rehabilitation and respite care are excluded.
6. Obesity or Weight Control costs associated with the surgical treatment are not included.
7. Change-of-gender treatments and Cosmetic or plastic Surgery Costs are not included.
8. Medical Expenses related to Hazardous or Adventure sports are strictly excluded.
9. Expenses for the treatment of alcoholism, drug intake or, substance abuse or any addictive condition and consequences are not included.
10. The Unproven Treatments expenses connected to any unproven treatment, supplies and services for or in connection with any treatment are excluded.
11. Medical costs related to the Sterility and Infertility are not included.
12. Expenses for the Medical treatment associated with the Maternity are excluded.
Medi classic insurance policy reviewal will help you understand which medical needs of you is matching the policy. It helps understand why you should buy the medi classic health insurance policy.
Analysing the inclusions and exclusions of very health insurance plan will help you find the best one that matches your health needs.
Coverage Claims Procedure of Medi Classic Health Insurance Policy
There are some steps that have to be followed to claim coverage under the health insurance plan. Here are the steps to claim the coverage :
- Initially, for assistance, call the official number of the Insurance company.
- For quick reference, inform the ID number.
- When the policyholder is admitted to the Hospital, the policyholder's ID Card issued by the Insurance Company must be shown at the Hospital.
- Get the Pre-authorisation Form from the Hospital Help Desk. Finish filling the Patient.
- Information and resubmit to the Hospital Help Desk.
- During emergency hospitalization, inform the Patient within 24 hours prior to the hospitalization.
- See for the Cashless facility wherever possible in network hospital. If you have selected the cashless facility in the network hospital, then the insurance company will settle the bill in the Hospital, but only as per rules and regulations.
- In non-network hospitals, payment must be made up-front and then reimbursement will be effected after the submission of documents. The following documents has to be submitted for the reimbursement.
1. KYC (Identity proof with Address) of the proposer, according to the AML Guidelines.
2. NEFT documents with Customer name, Bank name, etc.
- Then, you will have a waiting period of specific time period, after which you could get the coverage.
Starhealth Insurance has a brochure stating all the details about the classic insurance policy of Starhealth Insurance, which can be downloaded from the official website. You can save that as medi classic insurance policy pdf on your electronic device and see all the valuable features of this policy. You can buy the medi classic individual insurance policy after understanding its benefits and features.
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