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Individual Health Insurance Plans
New India Flexi Floater Mediclaim Policy
Health is your biggest asset, and the New India Flexi Floater Mediclaim policy is designed to protect this asset of yours. The Mediclaim offers coverage for the insured person and protects him/her from any financial distress by compensating for the hospitalization expenditures. New India Flexi Floater Mediclaim is like a boon for you and your family members in this fragile time.
Now you do not have to worry about the unexpected health expenses that might dismantle your entire budget. You can take good care of yourself and your close ones and keep working towards your life goals as New India Flexi Floater Mediclaim has got your back.
Let’s know more about New India Flexi Floater Mediclaim policy in detail!
Let’s first understand whether or not you are eligible to buy the New India Flexi Floater Mediclaim policy.
|Minimum age||18 years|
|Maximum age||65 years|
Minimum- 3 months
Maximum- 25 years (financially dependent)
|Sum insured||INR 2/3/5/8/10/12/15 lakhs|
|Minimum members to be insured||2|
|Maximum members to be insured||6|
Highlights of the New India Flexi Floater Mediclaim policy
Here’s a sneak peek into the premium features offered by the New India Flexi Floater Mediclaim policy:
|Policy coverage||The New India Flexi Floater Mediclaim policy offers ample coverage to you and your family members against hospitalisation expenditures.|
|Newborn baby cover||As per the policy, coverage is offered to a newborn baby whose mother has been under continuous coverage (for at least 24 months). The coverage is applicable from the date the baby is born to the date of expiry of the policy.|
|Optional covers available||There are three types of optional covers offered by the policy- “No proportionate deduction”, “Maternity expenses benefit”, and “Revision in the limit of cataract.”|
|Day care treatments||The policy covers around 139 daycare procedures which require just 24 hours (or less) of hospitalisation.|
|Policy renewal||Lifelong renewal facility|
|Ayurvedic/Homeopathic/Unani treatment||The policy offers maximum coverage of 25% of the Sum Insured for Ayurvedic/Homeopathic/Unani treatments. The patient should be admitted or treated in a registered AYUSH hospital.|
Features and Benefits of the New India Flexi Floater Mediclaim Policy
Have a look at all the benefits and features offered by the New India Flexi Floater Mediclaim policy!
Hospital Cash Benefit:
As per the policy guidelines, the insured patient will be entitled to Hospital Cash at a rate of 0.1% of the Sum Insured (on a per-day basis). You will be entitled to the Hospital Cash benefit only if the patient has been hospitalised for over 24 hours.
Critical Care Benefit:
When an insured member finds out that he/she is suffering from any critical health condition during the policy tenure, that person is eligible to claim 10% of the Sum Insured as the Critical Care Benefit. In addition to it, he/she will be entitled to the admissible claim amount as well.
Remember that Critical Care Benefit is paid to an insured individual just once in his/her entire lifetime. Also, he or she won’t get any Critical Care Benefits if that health condition is a pre-existing disease. The payment under Critical Care Benefit is always done in addition to the Sum Insured and is not deducted from the latter.
According to this feature, the Sum Insured amount will get increased by a whopping 25% after every successful renewal (given that the year has been claim-free). The maximum increase can be up to 50% of the sum insured. In case the claim has been made during the policy tenure, the cumulative bonus accrued will come down.
If you fail to renew the Mediclaim policy even after 30 days of the expiry, then you will lose the cumulative policy. Suppose you have reduced the Sum Insured during policy renewal; the cumulative bonus percentage will apply to the reduced amount.
Certain health conditions get covered only after the insured person has been under continuous coverage for a given time period. For instance, cataract treatment expenditure can be compensated only when the insured person is under 24 months of coverage. He should also keep renewing his policy at the right time every year. In order to get compensated against health check-ups once a year, you will have to stay under continuous coverage.
Newborn Baby Cover:
When a baby is given birth by a mother who is under Continuous Coverage for at least 24 months, that baby gets covered against any kind of injury or illness from his/her date of birth to the expiry of the Mediclaim policy. You need not have to pay any additional premium for the baby’s coverage.
However, any kind of expenditure that the baby has incurred because of pre-mature, post-natal or pe-term care does not get covered. Congenital External Anomaly also comes under the exclusion.
Treatment For Congenital Diseases:
Under the New India Flexi Floater Mediclaim policy, congenital internal diseases get covered after at least 24 months of continuous coverage. On the other hand, congenital external diseases get covered after at least 48 months of continuous coverage. There will be a limitation of up to 10% of the average sum insured in the last four years.
- If the insured person has been affected by the consumption of depressants or drugs (prescribed by a medical expert) and his intellectual faculties have been impacted, then as per the policy, he will be entitled to a maximum of INR 25,000 for treatment of his health condition.
- The Mediclaim also covers treatment expenses associated with stress, mental illness, psychological disorders or even neurodegenerative disorders. The waiting period for such diseases is 48 months and the limit is up to 25% of the Sum Insured.
- If the insured person is under an artificial life maintenance system, for instance, a life support machine, and there is absolutely no hope of him getting better, then he is entitled to 10% of the Sum Insured for up to 15 days for every policy period.
- The policy also covers genetic disorders up to 25% of the Sum Insured. And the waiting period, in this case, is 48 months.
- Coverage is offered for complications and health conditions that might arise because of menopause, puberty etc.
- ARMD or Age-Related Macular Degeneration gets covered up to 10% of the Sum Insured and the waiting period for this health condition is 48 months.
- Conditions like Dyslexia, adult personality disorder, stammering etc., gets covered with a limit of up to 25% of the Sum Insured.
Modern Treatments Coverage:
A total of 12 modern treatments, such as Balloon Sinuplasty, Oral Chemotherapy, and Robotic surgeries, are covered under the Mediclaim policy. To know more about the limit of coverage, refer to the policy brochure.
No Proportionate Deduction:
This is one of the optional covers and is applicable for those insured persons who have Sum Insured worth INR 2 lakhs or more. By paying an additional premium for every insured individual under the policy, a proportionate deduction of the policy will be stopped for the members.
Maternity Expenses Benefit:
If your sun insured is INR 5 lakhs or more, you are eligible to get this optional cover. You need to pay an additional premium to avail of this optional cover. One needs to wait for at least 36 months after opting for this cover to avail of the compensation.
Revision in the Limit of Cataract:
For those insured persons whose Sum Insured is INR 8 lakhs or above, this optional coverage is available. On paying an extra premium, the policy agrees to pay an additional amount for Cataract treatment. The waiting period for this optional coverage is 36 months.
The following expenses will not be included or compensated for under the New India Flexi Floater Mediclaim policy:
- The policy does not cover any kind of family/cognitive/behaviour therapy for which the insured person does not have to get hospitalised.
- New India Flexi Floater Mediclaim policy won’t entertain any claim if the expenses have been incurred because of the following:
- Diagnosis expenses for medical investigation and evaluation.
- Prescribed bed rest, custodial care at the hospital, etc.
- Surgical treatments meant for weight control or obesity.
- Gender change treatments.
- Adventure or hazardous sports activities.
- Plastic or cosmetic surgery, until and unless it is prescribed by the medical practitioner for reconstruction purposes, followed by instances of burns, accidents and cancer.
- Some criminal activity by the insured person.
- Treatment by any doctor or hospital that you have specifically excluded earlier.
- Treatment for any kind of addiction, such as substance abuse, drugs etc.
- Purchase of dietary supplements that can be bought over the counter without any prescription.
- Treatment for correction of eye-sight conditions which is lesser than 7.5 dioptres.
- Treatment infertility and sterility issues
- Unproven health treatments which do not come with any kind of medical documentation to prove their efficiency.
- Therapies which involve acupuncture, acupressure etc.
- Maternity expenses such as caesarean sections, miscarriage, childbirth etc.
- Luxury tax, surcharges, and service charges which is being levied by the hospital you are admitted in.
For detailed exclusions, you must have a look at the policy prospectus available on the official website of New India policy.
Premium Calculation For New India Flexi Floater Mediclaim Policy
Now that you know the intricate details of the policy, you must get an idea of the premium that you will be paying to the company to avail of the Mediclaim coverage.
Here’s a story for you to understand premium calculation closely!
Suppose Mr A wants to buy the New India Flexi Floater Mediclaim policy for himself, his wife and his elder brother. He is a software engineer in a reputed company. His wife and elder brother bother are financially dependent on Mr A. Besides, the brother is mentally challenged.
Mr A chooses the sum insured to be INR 12 lakhs. So, the premium that he has to pay on a per-person basis is INR 18,691. This amount excludes GST etc.
|Age of Proposer||36|
|Age of Wife||31|
|Age of brother||42|
|Sum Insured||INR 12 Lakhs|
|Estimated premium (excluding GST)||INR 18,691 per person|
Frequently Asked Questions
Yes, you can shift to another hospital in the middle of the treatment if you require better treatment.
It is not possible to place a claim within the first 30 days of buying a Mediclaim. But in case of hospitalisation due to accidents, you can place a claim within the first 30 days as well. And for certain health conditions, there are waiting periods that range anywhere between 2 to 4 years.
You can add at least 2 and maximum 6 family members to your Mediclaim policy.
You get a grace period of 30 days after the expiry of the renewal date of your policy.