Useful Information

United

TPA Information

Family Medicare

Synopsis:

The Policy provides cover on an Individual or Family Floater basis.

Highlight:

  • Sum Insured options of Rs 3 lacs, 4 lacs, 5 lacs, 6 lacs, 7 lacs, 8 lacs, 9 lacs, 10 lacs, 15 Lacs, 20 Lacs & 25 Lacs
  • One Yea Termr. Renewable annually.
  • Expenses in respect of the Cataract surgeries will be restricted to 10% of Sum Insured subject to maximum of Rs. 50,000/- per eye.
  • Mental illness covered upto 25% of Sum Insured subject to a maximum of Rs. 3,00,000 per policy year;

Benefit:

Title
Description
Room Rent Limit
For SI< 4 Lakh Room charges beyond 1% of Sum Insured per day. For SI>= 5 Lakh 1% of Sum Insured or Single Occupancy Standard AirConditioned Room Charges whichever is higher
ICU Daily Rent Limit
For SI< 4 Lakh Room charges beyond ICU/ICCU charges beyond 2% of Sum Insured per day. For SI>= 5 Lakh 1% of Sum Insured or Single Occupancy Standard AirConditioned Room Charges whichever is higher
Pre-Hospitalization Expenses
30 Days
Post Hospitalization Expenses
60 Days
Minimum Hospitalization Period
24 Hours
Day Care Procedure Coverage
Covered
Automatic Restoration of Sum Insured
For SI Rs.3 Lac & Above (Optional)
Pre-Existing Disease / Illness coverage
Pre-existing disease(s) covered after 48 months of continuous coverage.
Waiting Period for New Policy
30 days
Co-Payment
10% For persons with age of entry above 60 years
Medical Screening
Pre–acceptance medical check–up may be required at the Company’s discretion for all the members
Free Health Checkup
1% of Last 3 Years’ average SI Max Rs 5000/Person for Individual Policy and Rs 10000/Policy for Floater policy for block of every three claim free years.
Ambulance Expenses
0.5% of the Sum Insured subject to a maximum of Rs. 2500 per event and 1% of the Sum Insured subject to a maximum of Rs. 5000 per policy period
Non-Allopathic Treatments
0.5% of the Sum Insured subject to a maximum of Rs. 2500 per event and 1% of the Sum Insured subject to a maximum of Rs. 5000 per policy period
New Born Baby Cover
New born Baby shall be covered from day one upto the age of 90 days
Daily Hospitalization Allowance
Optional
Donor Expenses
Covered when insured person needs Donation and A lump sum payment of 10% of Sum Insured when Insured person is donor
No Claim Discount
5% on renewal premium and for every subsequent claim free year subject to a