Medical Insurance for the year 2023 - 2024 : Policy Period : 20th June 2023 to 19th June 2024 - Insurance Co : Liberty General Insurance Ltd.

SNO COVERAGE COVERAGE NEW TERMS ADDITIONAL BENEFITS
1 Family Definition A family floater policy is a health insurance plan which covers the entire family on the payment of a single annual premium. The sum assured covers the entire family and can be used in case of multiple hospitalizations in the family
  • Children OR Parents or Parents in-law (cross selection allowed) & Siblings upto 30 years (size of the family should not be more than 1+5)
  • Only dependent and unmarried children & Siblings upto 30 years covered. Rest - 99 years.
  • Siblings & Children upto 30 yrs
  • Permanent disabled child, covered without any age limit
2 Sum Insured family floater basis The sum insured is the maximum value for a particular year that the insurance company can pay if hospitalized. Any amount exceeding the sum insured will have to be borne by the employee. Agreed amount on the sum insured will be the maximum amount received in case of medical treatment or hospitalization. SUM INSURED     03 Lakhs / 05 Lakhs 10 Lakhs /25 Lakhs & 30 Lakhs You can select the coverage as per your family's requirement
3 Room Rent Restrictions Sub-limit on room rent would mean that the insurer defines the maximum amount it will pay towards the room rent. ICU No limit. Normal Room Rent For 3 Lakhs - 3k    5 Lakhs - 6k /  10 Lakhs - 8k /   25 Lakhs -12.5k & 30 Lakhs  - 15k      All other charges in accordance with the Room Rent restriction
4 30 days , 1st, 2nd 3rd & 4th Year waiting 1.Coverage of Pre-existing Conditions without any waiting period. 2. Waiver of the exclusions relating to the first 30 days of the Policy period. Waived
5 Maternity Day 1 No waiting period for Maternity   Normal & C-section Rs. 1.5 lacs
6 Pre & Post Natal expenses Pre- and post-natal expenses would mean costs pertaining to ultrasound, regular checkups, doctor's consultation fee, medicines and so on. These are similar to pre- and post-hospitalization expenses that are admissible under a standard health insurance policy. Pre - Within Maternity limits , Post within full Sum insured
7 New born Baby Cover Cover Medical Expenses towards the medical treatment of the Insured Person's New Born Baby while the Insured Person is Hospitalized for Inpatient Care for delivery. Covered within Family Floater SI from Day 1 No additional premium required for new born baby
8 Pre-existing Disease Covered - day 1 Any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice / treatment within 48 months prior to the first policy issued by the insurer. Covered for all Members
9 Pre & Post Hospitalization period The Policy pays the Medical Expenses incurred as
defined for an ailment / disease / Injury not different from the one for which hospitalization was
necessary during the Pre and Post Hospitalization period.		 60 & 90 days 
10 Domiciliary hospitalization Domiciliary hospitalization means medical treatment for a period exceeding three days for such an illness/disease/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances:
- the condition of the patient is such that he/she is not in a condition to be removed to a hospital, or
- the patient takes treatment at home on account of non-availability of room in a hospital. 		10% of SI
11 Emergency Ambulance charges / Air fare Expenses for utilizing Ambulance service for transporting Insured Person to Hospital in case of an emergency or from one hospital to another if medical services required are not available. Emergency ambulance charges - air fare - Max of Rs 10 k - emergency. Air ambulance charges - Max Rs 2 lacs. Incl/ Commercial Airlines
12 External congenital The Policy is extended to provide coverage for surgical treatment on in-patient basis for External congenital disease/s in life threatening situation upto the limit specified in the Policy Schedule towards this benefit. Covered Under Life threatening conditions
13 Co-pay clause However capped ailment like cataract will not attract any Co-pay. 20% Co Pay on Parental Claims, No Co-pay on others. No co-pay for member, spouse, children and siblings
14 Cataract A cataract is a cloudiness or opacity in the normally transparent crystalline lens of the eye. Cataract surgery is a procedure to remove the lens of your eye and, in most cases, replace it with an artificial lens. Cataract INR 70,000 per eye
15 Cochlear Implant treatment  A cochlear implant is a small electronic device that electrically stimulates the cochlear nerve (nerve for hearing) Restricted to 40% of Sum Insured 
16 Cyber Knife treatment and stem cell tplt. The Cyber Knife — one of the most advanced forms of radiosurgery — is a painless, non-invasive treatment that delivers high doses of precisely targeted radiation to destroy tumors or lesions within the body. It uses a robotic arm to deliver highly focused beams of radiation. Covered with 40% Co-pay
17 Corporate Buffer Corporate Buffer limit to take care of any defined emergencies which exceed the individual/ Family limit of the Sum Insured specified under the Policy. This additional limit is available basis Per person/ family limit subject to the overall corporate buffer limit specified in the Policy Schedule selected for the full policy period. The Corporate Buffer will not be available for diseases /procedures / treatments where specific sub-limit/s is /are applicable in the Policy. Rs. 50 Lacs - Equivalent to family SI - For Critical illness
18 Day Care procedures We will pay the Medical expenses incurred for the Day care procedures which do not require 24 hours Hospitalization due to technological advancement. This excludes all procedures or treatment taken in Out-patient departments. Covered as per Insurer standard coverage list (List attached)  
19 Terrorism Related Hospitalization Covered
20 LGBTQ Cover/ Live In partner  Medical insurance to same-sex partners/ 1 live in partner  Covered
21 Oral chemotherapy Oral chemotherapy is a cancer-fighting drug given by mouth in tablet, capsule, or liquid form. It is prescribed by your doctor, nurse practitioner, or physician's assistant, and has the same benefits and risks as chemotherapy given by infusion. Today, many cancer patients receive oral chemotherapy as a treatment. Covered for all members
22 OPD Expenses @ 10k Per Family The Policy is extended to include consultations, pharmacy, diagnostics, medical and surgical procedures taken on an Out-Patient basis upto the amount as stated in the Policy. ( Health check - 4,000/ Dr., Dental , Vision Consultation, Cost of lens -3500/ Medicines with dr. Prescription 3000/- )
23 Lasik Surgery This extension covers charges incurred towards correction of refractive errors by using lasik surgery in case of compound myopic astigmatism in both eyes to the level of (-)7.5D and above. If power of eye is above +/- 7.5, is payable
24 In case of Death of Member Validity of the policy, after the demise of the Main Policy Holder (ALPA member) Continued cover of dependents, No copay or deductions on claims
25 Psychiatric Ailments Also called mental health disorders, refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behaviour. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviours. In such case only on doctor prescription and admission an amount of INR 30,000 can be claimed per family (in-patient / under hospitalization)
26 Balloon Sinuplasty This minimally invasive technique is used to treat chronic or recurrent sinusitis or sinus infections when medical therapy has not provided adequate relief Covered and restricted to 50% of the sum insured
27 Permanent disabled child Covered without any age limits
28 Genetic Disorders 10% of sum insured or 1 Lakh whichever is lower will be applicable for genetic disorder admissions, applicable for all members of the family. New Coverage
     

PREMIUM FOR THE YEAR 2023 - 2024 (Policy period 20th June 2023 to 19th June 2024)

Sum Insured Premium incl. GST
3 Lakhs ₹ 30,000
5 Lakhs ₹ 97,000
10 Lakhs ₹ 1,08,000
25 Lakhs ₹ 1,26,500
30 Lakhs ₹ 1,37,000
Plus Rs. 2,500/- as Admin Charges
Sum Insured Premium incl. GST
3 Lakhs ₹ 30,000
5 Lakhs ₹ 97,000
10 Lakhs ₹ 1,08,000
25 Lakhs ₹ 1,26,500
30 Lakhs ₹ 1,37,000
Plus Rs. 2,500/- as Admin Charges