Mediclaim policies offered by Insurance Companies

Benefits Health Wallet- Apollo Health On- Apollo ENERGY Star Health Gain Insurance Policy-Star Health
Plans  Silver Plan cost for wellness tests is excluded , Gold plan cost for wellness tests is included,
Sum Insured (in Lakhs) 3, 5, 10, 15, 20, 25 & 50 Basic Sum Insured per Insured Person per Policy Year (Rs. in Lakh)  Rs. 200,000; 300,000; 500,000 and 10,00,000 1/2/3/4/5(In Lakhs)
Policy Type Individual / Family floater – relationships spouse, dependent children and dependent parents and dependent
in laws.
Individual Individual/Family
Entry age  91 days to 65 years Children between 91 days and 5 years can be insured provided either parent is getting insured under this policy. 91 days to 25 years if unmarried 18 years to 65 years. maximum entry age is restricted upto 65 years. at entry,
who are currently diagnosed with Type II Diabetes or Pre-Diabetes
(Impaired Fasting Glucose/ Impaired Glucose Tolerance) or Hypertension.
proposer; 18 years and 65 years
dependent children from 91 days up to 25 years
Policy Term 1 year 1 year, 2 years 1 year 1 year
Relationship members covered under one policy Individual / Family  – relationships spouse, dependent children and dependent parents and dependent
in laws.  Maximum 6 members under single policy; In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy. The 4 adults can be a combination of Self, Spouse, Father,
Father in law, Mother or Mother in law.
i) In a family floater policy, a maximum of 2 adults and a maximum of 5 children can be included in a single policy. The 2 adults can be a combination of Self, Spouse,
Father, Father in law, Mother or Mother in law.
individual only on
individual Sum Insured basis.
Self ,Spouse, Dependent Child
Inpatient Treatment Covered Covered Covered Covered
Day Care Procedures Covered Covered Covered covered
Pre-Hospitalisation Covered, upto 60 days Covered, upto 90 days Covered, upto 30 days 30 days
Post-Hospitalisation Covered, upto 90 Days Covered, upto 180 Days Covered, upto 60 Days 60 days
Domiciliary Treatment Covered Covered NA Not Covered
Organ Donor Covered Covered Covered Not Covered
Ambulance Upto Rs.2,000 per Hospitalisation Upto Rs.2,000 per Hospitalisation Rs. 2000 per Hospitalisation. Covered Ambulance charges for transporting the patient to the hospital upto a sum of
Rs.750/- per hospitalization and overall limit of Rs.1500/- per policy period.
Dental Treatment in case of Accidents NA NA covered
AYUSH Benefit Covered-This benefit is not applicable if optional Deductible is chosen NA Not Covered
Daily Cash for accompanying an Insured child NA Covered NA NA
Vaccination (in case of Post Bite Treatment) NA NA Covered
Out-Patient Treatment Cover after waiting period of 3 years NA NA Covered
a) Out-patient Consultation Covered
b) Diagnostic Tests
c) Dental Treatment Covered
d)Spectacles, Contact Lens, Hearing Aids
Convalescence Benefit NA NA NA
Maternity Expenses NA NA NA
New Born Baby cover NA NA NA
Restore Benefit Equal to 100% of Basic Sum Insured Equal to 100% of Basic Sum Insured NA NA
Cover for People Suffering from HIV NA NA
Cumulative Bonus Multiplier Benefit: Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%. In case of claim, bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal Multiplier Benefit: Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto
100%. In case of claim, bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal
NA NA
Health Check-up Coupon  Preventive Health Check-up:  As per grid mentioned in the benefit 3 lacs -5 lacs-Upto Rs. 2500 per policy at the end of each year at renewal. (Individual & family floater)

10 lacs- 15 lacs-Upto Rs. 5000 per policy at the end of each year at renewal.(Individual & family floater)

20 lacs – 50 lacs-Upto Rs. 10000 per insured person at the end of each year at renewal.(Individual)

Upto Rs. 10000 per policy at the end of each year at renewal.(Family floater)

NA NA
Dial a Doctor NA NA NA
Health Educational Library for People(HELP) NA NA NA
Second Option NA E-Opinion in respect of a Critical Illness NA NA
Specialist Consultation with Two follow up session NA NA NA
Wellness Package NA Wellness Offer with a discount or
as part of a special scheme, at our discretion.
NA
Newsletter NA NA NA
Personal Accident NA NA NA
Critical Illness USD 250,000, USD 500,000 & USD 10,00,000
Offered if base policy Sum Insured is Rs. 10 lacs & above Illness covered under the rider are as following
a. Cancer Treatment:
b. Coronary Artery by-pass surgery:
c. Heart Valve replacement or repair:
d. Neurosurgery:
e. Live-donor organ transplant:
f. Bone Marrow Transplant:
g. Aorta Graft Surgery
h. Pulmonary artery graft surgery
NA NA
Hospital Daily Cash NA NA NA
Sub limits Applicability NA NA NA
Treatment only in tiered Network NA NA NA
Family Discounts on Individual Sum Insured Basis NA 10% if 2 or more family members are covered under a single Health On Policy. NA NA
Long Term Discount NA 7.5% will be provided if insured person is paying two year premium in advance as a single premium. NA NA
Pre-existing diseases 36months 36months 48months 48 month
Specified Diseases 24months 24 months 24 months and  36 months 24 months
Other benefits Reserve Benefit Sum Insured: Rs. 5000; 10,000; 15,000; 20,000; 25,000 per Insured Person per Policy Year ( Rs).
Optional Deductible: 2 Lac; 3Lacs; 5 Lacs & *10 Lacs (*10 Lacs deductible available for SI of 20 lacs and above)per Insured Person per Policy Year ( Rs in Lakh)
Recovery Benefit: Rs 10,000 for hospitalisation exceeding consecutive 10 days (This benefit is not applicable if optional Deductible is chosen)
Worldwide Emergency Care: 50% of Sum Insured upto a maximum of Rs.20 lacs
Co-payment: 20% of eligible claim amount payable if claim  benefits In-patient Treatment, Pre & Post Hospitalisation
Expenses, Day Care Procedures , Organ Donor and Emergency Ambulance
Wellness Discount-
Upto 25 % discount as indicated in Wellness Programme on renewal premium for better management of health condition.
NA