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Bajaj Allianz Silver Health Plan

Bajaj Allianz Silver Health Plan is a specialized health insurance policy designed for senior citizens, offering protection against healthcare expenses. Whether you’re retired or not, you can now enjoy your golden years free from financial concerns related to healthcare. The Silver Health Plan by Bajaj Allianz is a comprehensive medical insurance policy tailored for senior citizens, ensuring financial security for critical illnesses, hospitalization, medical check-ups, and more. Invest in this health insurance policy for senior citizens to safeguard both your parents and yourself from potential financial setbacks arising from unforeseen situations.

With Bajaj Allianz Silver Health Plan, you can give your parents emotional and financial security as it will cover in-hospitalization expenses and other expenses on healthcare treatment in some of the best hospitals in your city.

Read on to learn more about the Bajaj Allianz Silver Health Plan’s eligibility criteria, features and benefits, exclusions, claim process, premium illustration, and more.

Eligibility Criteria

Here are the eligibility criteria for the Bajaj Allianz Silver Health Plan.

ParametersDetails
Age (Individual) + (Individual/Floater (Self + Spouse)/Dependent Parents/Parent in Laws)46 years to 80 years
Policy Period1 year, 2 years OR 3 years.
Coverage

Self and Spouse can be covered under the individual option

Self, Spouse, 2 Parents/ Parent laws can be covered under the floater option

Pre & Post Hospitalization30 days for Pre-Hospitalization & 60 Days for Post Hospitalization
Road AmbulanceMaximum of Rs. 1000/-
Domiciliary ExpenseCovered
Room Rent CappingRoom rent limit of 1% of hospitalization Sum Insured up to maximum Rs. 7,500 per day
Pre-policy check-upPre-Policy medical tests are mandatory for every proposal
Discount
  • 5% family discount
  • 20% employee discount
  • 5% Online/Direct Business Discount

Long Term Policy Discount

  • 4 % discount is applicable if Policy is opted for 2 years
  • 8 % discount is applicable if Policy is opted for 3 years
Cataract (Per Eye)10% of Sum Insured, Max up to 40,000 per claim (whichever is lower)

What Features and Benefits Does Bajaj Allianz Silver Health Plan Offer?

Here are the key features and benefits of the Bajaj Allianz Silver Health Plan. 

  • Pre-existing illness cover

The insurance policy includes protection for pre-existing illnesses, which are medical conditions that existed before obtaining the insurance coverage. The coverage for these pre-existing conditions is applicable for a specific duration, precisely up to one year from the date when the insurance policy is issued.

  • Pre and Post-Hospitalization Expenses

This policy provides coverage for both pre-hospitalization and post-hospitalization expenses. Pre-hospitalization expenses, referring to medical costs incurred before a hospital stay, are covered for up to 60 days. Similarly, post-hospitalization expenses, which include medical costs after discharge, are covered for a period of up to 90 days.

  • Co-Payment Waiver

You have the option to choose a co-payment waiver. By opting for the co-payment waiver, you can avoid paying the specified percentage yourself, and we will take care of the entire covered amount, providing you with greater financial flexibility and peace of mind.

  • Ambulance charges

This policy includes coverage for ambulance charges in case of an emergency, with a specified limit of Rs 1,000. This means that, under emergency circumstances, the policy will reimburse or cover expenses related to ambulance services up to a maximum amount of Rs 1,000.

  • Free Health Check-up

You are eligible to receive a complimentary health check-up at our designated medical centers after completing four consecutive claim-free years. This benefit is a reward for maintaining a claim-free record over the specified duration, offering you the opportunity to monitor and assess your health status through a free health examination at our designated facilities.

  • Covers Modern Treatment

Modern treatment methods and advancements in technologies will be covered up to the base sum insured in the insurance policy. It implies that the insurance coverage extends to include medical treatments and technologies that fall within the specified modern and advanced categories. This ensures that individuals are aware of the specific medical treatments and technologies covered by the insurance policy and can make informed decisions about their healthcare needs.

  • Room Rent Capping

If you choose to avail of this coverage, you will be eligible for a daily room rent limit equivalent to 1% of the hospitalization sum insured, with a maximum cap of Rs. 7,500 per day. This means that the insurance policy will cover the expenses associated with your hospital room daily, and the amount covered per day will be determined based on a percentage of the hospitalization sum insured.

  • Cumulative Bonus

If you choose to renew your “Silver Health” policy without any break and there have been no claims in the preceding year, we will enhance the Limit of Indemnity by 10% of the base Sum Insured per annum. This means that as a reward for maintaining a claim-free record and continuously renewing your policy, the coverage limit will be increased by 10% of the initial sum insured each year.

  • Policy Migration

The insured person has the option to migrate the policy to other health insurance products or plans offered by the company. This implies that, under certain conditions and as per the terms outlined in the policy, the policyholder has the flexibility to switch to different health insurance products or plans provided by the same insurance company.

  • Family Discount

A 5% family discount will be provided if two or more eligible family members are covered under a single policy. This means that when multiple members of a family are included in the same insurance policy, a discount of 5% will be applied to the overall premium.

Exclusions Under the Bajaj Allianz Silver Health Plan

Listed below are the things not covered under the Bajaj Allianz Silver Health Plan.

  • Costs associated with admission primarily for diagnostic and evaluation purposes are not covered.
  • Diagnostic expenses that are unrelated or not incidental to the current diagnosis and treatment are not covered.
  • Costs associated with any treatment, including surgical interventions, aimed at altering the characteristics of the body to those of the opposite sex are not included.
  • Costs for treatment directly resulting from or consequent upon an Insured Person committing or attempting to commit a breach of the law with criminal intent are not covered.
  • Treatment expenses accrued in any hospital, by any Medical Practitioner, or from any other provider explicitly excluded by the Insurer and disclosed on its website or notified to policyholders are not eligible for reimbursement.
  • Medical treatments obtained in health hydros, nature cure clinics, spas, or similar establishments, as well as private beds registered as a nursing home attached to such facilities, or where admission is arranged wholly or partly for domestic reasons, are not covered under the policy.
  • Costs associated with any unproven treatment, services, and supplies for or in connection with any treatment are not covered. Unproven treatments refer to those procedures, treatments, or supplies that lack significant medical documentation to support their effectiveness.
  • Costs related to miscarriage (unless resulting from an accident) and lawful medical termination of pregnancy during the policy period are covered by the insurance.
  • The insurance policy does not cover damages, losses, or liabilities arising from war, invasion, acts of foreign enemies, hostilities (whether war is declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power, or confiscation, nationalization, requisition, or damage by or under the order of any government or public local authority.

Premium Illustration of Bajaj Allianz Silver Health Plan

Meet Mr. Lokesh, a vibrant and wise senior citizen aged between 56-60 years. With his retirement on the horizon, he understands the importance of safeguarding his health and well-being. After conducting extensive research, he stumbled upon the Bajaj Allianz Silver Health Plan—a dedicated insurance plan tailored to meet the unique needs of senior citizens like him.

Impressed by the comprehensive coverage and benefits offered, Mr. Lokesh decided to secure his future by purchasing the Bajaj Allianz Silver Health Plan with a sum insured of Rs. 5 lakhs. Let’s follow his journey:

AgeGenderSum InsuredPolicy TenurePremium Amount
55-60 YearsMaleRs. 5, 00, 0001 YearRs. 24,215 per annum

How to Buy Bajaj Allianz Silver Health Plan?

To purchase the Silver Health plan by Bajaj Allianz, please contact the Customer Service team at Bajaj Allianz. Their knowledgeable representatives will assist you throughout the entire process, providing guidance and answering any questions you may have. Feel free to reach out to them to initiate the purchase and ensure a seamless experience.

  • Service chat: +91 75072 45858 (WhatsApp)
  • Tollfree: 1800-209-0144 | 1800-209-5858
  • Email id: bagichelp@bajajallianz.co.in
  • For senior citizens: seniorcitizen@bajajallianz.co.in

How To File a Claim for Your Bajaj Allianz Silver Health Plan?

Cashless Claim Process:

The cashless facility at network hospitals is accessible 24×7, year-round, without any interruption in service. However, hospitals offering cashless settlement may alter their policies without prior notice. It is essential to verify the hospital list before admission. The updated list is accessible on the company’s website and through its call center. To avail of the cashless facility, it is mandatory to present the Bajaj Allianz Health Card and a government ID proof at the time of admission.

When you are opting for cashless claims, follow the steps given below:

  • Fill out the preauthorization request form at the hospital’s insurance desk, have the treating physician or hospital fill it out, and sign it, as well as you or a family member.
  • The request will be faxed to the Health Administration Team (HAT) by Network Hospital.
  • By policy rules, HAT physicians will review the preauthorization request form and determine whether cashless availability is possible.
  • Depending on the plan and its benefits, an authorization letter (AL), rejection letter, or additional requirement letter is provided within three hours.
  • The hospital will give HAT access to the final bill and discharge information at the time of discharge, and the final settlement will be handled depending on their evaluation.

Reimbursement Claim Process:

Share the date and reason for hospitalization with the BAGIC HAT team. Please give a call to the toll-free number, 1800-209-5858, to register your claim offline. Within 30 days after being discharged, you or a family member must give HAT the following paperwork:

  • Completed and signed claim form including email address & mobile number, original receipt for payment and hospital bill.
  • Investigation report.
  • The discharge card.
  • Medication guidelines
  • Medical bills and surgical item bills.
  • Information on any pre-hospitalization costs.
  • In-patient documentation, if necessary

All paperwork must be submitted to the HAT for additional processing, and the final settlement will be completed in ten working days after the assessment.

After the date of discharge, post-hospitalization claim paperwork needs to be sent within ninety days.

Documents required for reimbursement claim

  • The original, properly sealed, and signed hospital payment receipt, pre-numbered.
  • Original consultation papers (if any).
  • Original prescriptions and pharmacy bills.
  • Original diagnostic and investigative findings, as well as original invoices and proof of payment, for both hospital-based and non-hospitalized investigations.
  • A letter from the hospital confirming that you or a family member used a cashless claim but did not utilize it.
  • In the event of an accident, a letter detailing incident details from the treating physician.
  • On the letterhead, the hospital’s infrastructure and registration certificate.
  • A canceled check with the insured’s name and IFSC code on it.
  • An authenticated copy of the interior case file, including a comprehensive medical history, doctor’s notes, and charts for temperature, pulse, and respiration, attested from the hospital from admission to discharge.
  • X-ray (should a fracture occur).
  • The treating physician’s obstetric history (in cases of pregnancy).
  • A copy of the FIR (in case of an accident).

All original documents need to be submitted to the following address:

Health Administration Team:

Bajaj Allianz House, Airport Road, Yerawada, Pune-411006.

On the front of the envelope, make sure to mention your policy number, health card number, and mobile number.

Frequently Asked Questions

More than 8,000 network hospitals can accept cashless claims through Bajaj Allianz.

The insurance amount offered by the plan ranges from 1.5 lakhs to 1 crore.

The maximum policy period offered is 3 years.

A co-payment provision in a health insurance policy divides the expense of medical care into portions paid by the policyholder and the insurance company.

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