userMedi Classic Insurance Policy offers comprehensive health coverage tailored for individuals, with added benefits under the Gold Plan.
Plan Essentials:
1. Sum Insured Options:
Regular plan: ₹1.5/2/3/4/5/10/15 lakhs.
Gold plan: ₹3/4/5/10/15/20/25 lakhs.
2. Automatic Restoration: Restores 200% of the Basic Sum Insured once during the policy year, applicable for unrelated illnesses or diseases.
3. Instalment Options: Premiums can be paid monthly, quarterly, half-yearly, annually, biennially, or triennially.
4. Non-Allopathic/AYUSH Cover: Covers treatments under Ayurveda, Unani, Siddha, and Homeopathy systems in AYUSH hospitals (up to 25% of Sum Insured, capped at ₹25,000).
5. New Born Cover (Gold Plan): Covers hospitalisation expenses for newborns from the 16th day onwards, provided the mother has been insured for 12 months.
6. Day Care Procedures: Covers medical treatments and surgeries requiring less than 24 hours of hospitalisation due to technological advancements.
7. Organ Donor Expenses (Gold Plan): Covers hospitalisation expenses for organ transplantation if the insured is the recipient.
8. Zone-wise Premium: Premium is calculated zone-wise for wider coverage.
Key Highlights:
1. Entry Age:
Regular Plan: 5 months to 65 years.
Gold Plan: 16 days to 65 years.
2. In-Patient Hospitalisation: Covers expenses for hospitalisation lasting more than 24 hours due to illness, injury, or accidents.
3. Pre- and Post-Hospitalisation:
Pre-hospitalisation: Up to 30 days.
Post-hospitalisation: Up to 60 days.
4. Room Rent:
Regular Plan: Up to 2% of Sum Insured or ₹5,000/day.
Gold Plan: As per policy clause.
5. Road Ambulance:
Regular Plan: ₹750 per hospitalisation, max ₹1,500 per policy period.
Gold Plan: ₹2,000 per hospitalisation.
6. Modern Treatments: Covers Oral Chemotherapy, Robotic Surgeries, and more, as per policy limits.
7. Cataract Treatment: Covered up to the specified limits.
8. Domiciliary Hospitalisation: Covers expenses exceeding 3 days, including AYUSH treatments.
9. Cumulative Bonus:
Regular Plan: 5% per claim-free year (max 25%).
Gold Plan: 25% in the second year, then 20% annually (max 100%).
10. Health Check-Up: Covered up to ₹5,000 for every 4 claim-free years for Sum Insured of ₹2,00,000 or above.
11. Hospital Cash Benefit (Gold Plan): ₹1,000/day for up to 7 days per hospitalisation (max 14 days per policy period).
12. Shared Accommodation Benefit: Cash benefit for opting for shared accommodation in a network hospital.
13. RTA Additional Sum Insured (Gold Plan): 50% of the Sum Insured is added for Road Traffic Accidents after exhaustion of basic coverage.
14. Patient Care Benefit: Covers attendant expenses post-discharge, up to ₹400/day (max 14 days per policy period).
15. Family and Organ Donor Discounts:
Family Discount: 5% for insuring 2 or more members.
Organ Donor Discount: 25% for donors, applicable even on renewals.
16. Co-payment: 10% co-pay for insured persons aged 61 years or above, applicable for fresh and renewed policies.
Gold Plan Highlights:
Includes Super Restoration: An additional 100% of the Sum Insured restored once per policy year for all claims.
New Born Baby Coverage: Covers newborn hospitalisation (16th day onwards), up to 10% of Sum Insured or ₹50,000 (whichever is lower).
Benefits Summary:
- Wide Sum Insured options with comprehensive coverage.
- Enhanced benefits under the Gold Plan, including organ donor expenses and super restoration.
- Rewards claim-free years with cumulative bonuses and health check-up benefits.
- Flexible premium payment options with lifelong renewals.
For detailed policy terms, refer to the official policy documents.
FAQs
Rahul Khanna
