Top Health Insurance Plans

A regular health insurance policy covers only the hospitalization expenses. However, a significant amount is spent Out of pocket on OPD doctor consultations, pharmacy costs and diagnostic tests. A good OPD cover pays for these expenses.

Waiting period is the time a customer needs to wait before making a claim in the policy. There are 3 types:

Super topup is a very low cost plan that provides additional coverage, over and above your base health insurance plan.

For Example

If you have a base policy of ₹5 lacs, you can buy a Super top-up of ₹95 lakhs at a very minimal cost to make your overall health cover of ₹1 crore.

Cashless hospitalization refers to a process in which you don’t pay the claim yourself but the claim amount is directly paid to the hospital by the insurer. You simply need to inform the insurer about the hospitalization within 24 hours and submit all the required documents for cashless approval.

For Example

You are a policy holder of health insurance company ABCD, which has a tie-up with 10,000+ hospitals across India. If you face a medical emergency and wish to seek the cashless facility, you need to get medical treatment from a hospital that is a part of this 10,000+ network.

The feature is available to one-year policy holders. It can also be availed by debit and credit card holders"

The word secure resonates with being safe and tension-free. Under Optima Secure plan, we provide you with the secure benefit. This health insurance plan offers additional coverage up to 100% of the base sum Insured immediately upon purchase at no extra charge. This additional amount can be utilised for any number of admissible claims. Now isn't this truly a benefit that can keep you secure.

Example: You have bought an Optima Secure Health Insurance plan with a health cover or sum insured of ₹5 lacs. In this case, your sum insured instantly gets doubled up to offer you a total health cover of ₹10 lacs instead of a basic ₹5 lacs health cover for which you paid your valuable premium. This additional amount can be utilised for any number of admissible claims. That means you can now make claims up to ₹10 lacs instead of ₹5 lacs.

Optima Secure Health Insurance plan restores up to 100% of your base sum insured for subsequent claims, for any illness, or any insured person. Your base sum insured is the actual sum insured that you had chosen when buying the policy. This helps you in case you exhaust your existing sum insured for any claim or number of claims. Suppose today you have bought an Optima Secure Health Insurance plan with a health cover or sum insured of ₹5 lacs, and, you register a claim of ₹8 lacs in year one. In such a scenario, you will be able to settle hospital bills worth ₹5 lacs from your base sum insured and the remaining ₹3 lacs from your secure benefit. If there is a subsequent claim in the same policy year, you will have automatic restore benefit up to your base sum insured for your immediate usage. Automatic restore benefit kicks from your 2nd claim onwards once you exhaust Base Sum Insured, Plus Benefit (after 1st year), Secure Benefit (in this order) and is available every policy year. Unutilised automatic restore benefit is not carried forward to the next policy year.

Optima Secure plan is available for the sum insured up to ₹2 Cr. Various sum insured options are available such as ₹5, ₹10, ₹15, ₹20, ₹25, ₹50 lacs and ₹1Cr. You can buy the best health insurance policy of a sum insured that best suits your needs.

Yes, all COVID- 19 expenses are covered under Optima Secure plan. You need not buy a separate health insurance policy when you get it all under one policy.

When filing for a claim or cover under the cheapest Mediclaim policy, including Mediclaim for senior citizens, you need to remember that you will need to furnish required documents within 30 days. All kinds of relevant documents, papers, certificates and other prescriptions and papers will be required to be duly filed along with the claim form.

When you buy a Mediclaim Policy from us, you can make claims under the Mediclaim policy as many times as you want. However, you will not be covered for any costs of medical expenses if your basic sum insured has been exhausted.

• Health plans from IFFCO Tokio for individuals covers everything, from hospitalization, surgeries, injuries and even day-care procedure for some ailments.
• However, you must remember that our policy will allow you an insurance claim only if your treatment is done by a registered medical practitioner.

Investing your money in health insurance is a good method of saving up on tax. Under the section 80D of the Income Tax Act, you get a deduction upto Rs. 30,000 on premiums paid for Mediclaim policy including Mediclaim policy for senior citizens.

A pre-existing condition refers to any kind of disease or ailment that the insured person has been suffering from, before having bought an insurance policy at our company. The coverage for such diseases under our Mediclaim policy including Mediclaim for senior citizens is offered to you only after 48 months have elapsed since the commencement of your Mediclaim policy with us. But in case you port your policy including Mediclaim for senior citizens, from some other company and have been covered under the same policy for a while, we will consider the coverage for such pre-existing diseases.

At IFFCO Tokio, we understand that every person needs a different kind of plan to meet their requirements, for them. We make sure that you find the perfect Mediclaim policy to fit your needs. We offer you two broad kinds of individual health insurance plans. One out of these is where you sign the papers and authorize us to take up the full responsibility of your expenses. However, our reimbursement will not exceed the full sum insured to you, in any case. Apart from this, we offer you the option of co-pay insurance plans as well. Here according to the papers you sign, half of the expenses for your medical care are borne by us and the other half of it is borne by you. The rates and the percentages of such expense sharing are predetermined, and is signed by the insured person during the purchase of the insurance.

Family floater insurance is a single health insurance policy that covers one or more members of your family. They can be your legally wedded spouse, dependant parents and parents-in-law, and dependant children aged 3 months to 25 years. It doesn't cover children above 18 years of age who are financially independent. The total sum insured in a family floater plan is available for each policy member. So, if the total sum insured is ₹10 lakhs, and member one claims ₹3 lakhs, ₹7 lakhs will be the available sum insured amount for the remaining members in the plan for that given policy year.

The minimum age limit for taking this policy is 18 years, and the maximum is 65 years.

If you wish to switch your existing health insurance to any ICICI Lombard plan, please provide your application, including a duly filled portability form and your previous policy documents. Kindly share these at least 45 days before the renewal date of your existing health policy.

With Income Tax benefits under Sec 80D, you can claim tax deductions up to a maximum of ₹25,000 when you purchase a policy for yourself, or spouse, or your children. For dependant parents above 60, you can claim a tax deduction up to a maximum of ₹50,000.

There are 6700+ network hospitals where you can avail of cashless facilities. You can claim reimbursement if your treating hospital is not a network hospital.

With the Apex plan in Health AdvantEdge product, you can avail of the maternity benefits add-on that includes coverage for newborns from birth.

You can contact us on our toll-free number, 1800 2666 or SMS "HEALTHCLAIM" to 575758 for a callback. Use the health card at any network hospital to avail of our cashless service. Contact us within 24 hours of hospitalisation for cashless emergency hospitalisation.For cashless emergency hospitalization, we need to be contacted within 24 hours of hospitalization.

This plan has a 0% copay clause. You can opt for 10% or 20% based on your needs & budget.

The primary difference between the Silver Smart, Gold Smart, and Platinum Smart plans lies in the available Sum Insured (SI) options:
1. Silver Smart: Offers SI options of 3, 4, and 5 lakhs.
2. Gold Smart: Provides SI options of 7.5, 10, and 15 lakhs.
3. Platinum Smart: Offers a wider range of SI options, including 20, 25, 50, and 75 lakhs.
While the coverage features may be similar across the plans, the available SI options allow customers to choose the level of coverage that best suits their individual needs and budget.

Geographical jurisdiction to avail medical treatment is India only.

Home healthcare is a special cashless cover that allows the insured to receive treatment at home if advised by their medical practitioner. This coverage includes services such as chemotherapy, gastroenteritis treatment, hepatitis treatment, fever management, dengue treatment, and more.

Notify Us: Inform us immediately upon diagnosis of the illness, providing basic policy details, treatment plans, and your preferred date and time for the initial assessment.
Inform Home Healthcare Service Provider: We will then inform our Home Healthcare service provider about your case. They will arrange to meet the treating medical practitioner to assess the situation.
Assessment and Coordination: The Home Healthcare service provider will check if the patient requires any equipment or devices and will collaborate with the treating medical practitioner to develop a care plan and estimate the treatment costs.
Submission of Documents: Once all necessary documents are gathered, including the care plan and treatment cost estimation, please submit them to us.
Authorization or Rejection: Upon receipt of complete documentation, we will review the case and may issue an authorization letter specifying the sanctioned amount for the claim. If necessary, we may reject the cashless request.
Overall, the process operates similarly to any other cashless hospitalization claim procedure, ensuring that you receive the necessary support and coverage for home healthcare services.

Sum Insured Rebound Cover is a feature that adds an additional amount to the Sum Insured of your policy. This additional amount is equivalent to the last claim amount under the policy, but it's subject to a maximum of the basic Sum Insured. One can claim for same illness multiple times in the policy year,however,claim related to Chemotherapy and Dialysis will be paid only once in the lifetime of the policy.Also,balance rebound sum insured will not be carried forward to the next policy year.

No,you need not pay for pre-policy medical tests in case it is taken up at our network Diagnostic Centers.It is cashless. However, if your policy is rejected due to adverse medical findings, 50% of the pre-policy check-up cost will be deducted from the premium refund amount.

No,OPD is not covered under my:health Suraksha.

Yes, a younger spouse can indeed be the proposer under my:health Suraksha. However, it's important to note that the premium calculation is based on the age of the eldest family member proposed.

In the case of organ transplantation, certain expenses related to the donor are covered, such as screening, organ harvesting, and donor hospitalization expenses. However, the cost of the organ itself is typically not covered by the insurance policy.

In the case of organ transplantation, certain expenses related to the donor are covered, such as screening, organ harvesting, and donor hospitalization expenses. However, the cost of the organ itself is typically not covered by the insurance policy.
1. Medical examination report by the physician
2. Blood and Urine test
3. ECG (Electrocardiogram)
Additional tests such as TMT (Treadmill Test), 2D Echo (Echocardiogram), Sonography, and others may also be included in the pre-policy medical checkup depending on factors like the sum insured and the age of the customer.

Coverage starts from 91 days onwards with a maximum entry age of 65 years.
A dependent child can be covered from the 91st day if either parent is covered under the policy.
Eligible family members include spouse, dependent children, dependent parents, and parents-in-law, who can be covered on an individual sum insured basis.
A maximum of 6 members can be added in a single policy, with a maximum of 4 adults and 5 children in an individual policy.
Premiums may change at renewal due to age or changes in applicable tax rates.
In a family floater policy, a maximum of 2 adults and 5 children can be included. The adults can be a combination of self, spouse, father, mother, father-in-law, or mother-in-law.

Initial 30 Days: All treatments within the first 30 days of cover are excluded, except for accidental injuries.
Pre-existing Conditions: Any pre-existing condition will be covered after a waiting period of 3 years.
Specific Waiting Periods: A waiting period of 24 months from the first policy commencement date will be applicable to the medical and surgical treatment of illnesses, diagnoses, or surgical procedures listed below. This waiting period will not apply if the underlying cause is cancer. Procedures as follows:
1. Organ/System: Ear, Nose & Throat (ENT): Illness/Diagnoses: Sinusitis, Rhinitis, Tonsillitis, Surgeries/Procedures: Adenoidectomy, Mastoidectomy, Tonsillectomy, Tympanoplasty, Surgery for Nasal septum deviation, Surgery for Turbinate hypertrophy, Nasal concha resection, Nasal polypectomy
2. Organ/System: Gynaecological. Illness/Diagnoses:Cysts, polyps including breast lumps, Polycystic ovarian diseases, Fibromyoma, Adenomyosis, Endometriosis, Prolapsed Uterus Surgeries/Procedures: Hysterectomy
3. Organ/System: Orthopaedic: Illness/Diagnoses: Non-infective arthritis, Gout and Rheumatism, Osteoporosis, Ligament, Tendon and Meniscal tear, Prolapsed intervertebral disk Surgeries/Procedures: Joint replacement surgeries
4. Organ/System: Gastrointestinal Illness/Diagnoses: Cholelithiasis, Cholecystitis, Pancreatitis, Fissure/fistula in anus, Haemorrhoids, Pilonidal sinus, Gastro Esophageal Reflux Disorder (GERD), Ulcer and erosion of stomach and duodenum, Cirrhosis (excluding Alcoholic cirrhosis), Perineal and Perianal Abscess, Rectal Prolapse Surgeries/Procedures: Cholecystectomy, Surgery of hernia
5. Organ/System: Urogenital Illness/Diagnoses:Calculus diseases of Urogenital system including Kidney, ureter, bladder stones, Benign Hyperplasia of prostate, Varicocele Surgeries/Procedures: Surgery on prostate, Surgery for Hydrocele/ Rectocele
6. Organ/System: Eye Illness/Diagnoses:Cataract, Retinal detachment, Glaucoma Surgeries/Procedures:Nil
7. Organ/System: Others Illness/Diagnoses:Benign tumors of Non-infectious etiology e.g. cysts, nodules, polyps, lump, growth, etc Surgeries/Procedures:Nil Additionally, surgery of varicose veins and varicose ulcers falls under the general waiting period, which is nil.

Here's a summary of the key points regarding the sum insured enhancements and benefits:.
Inform Home Healthcare Service Provider: We will then inform our Home Healthcare service provider about your case. They will arrange to meet the treating medical practitioner to assess the situation.
When your existing policy sum insured and multiplier benefit (if applicable) are fully or partially utilized during the policy year, we will instantly add 100% of the basic sum insured to your coverage.
The total amount available for all insured persons includes the basic sum insured, multiplier benefit, and restore sum insured.
This enhanced sum insured is available for all claims under the in-patient benefit during the current policy year.
However, a single claim in a policy year cannot exceed the sum of the basic sum insured and the multiplier benefit (if applicable).

Conditions for Restore benefit:
a. The sum insured will be restored only once in a policy year.
b. If the restored sum insured is not utilized in a policy year, it will expire.
In case of a family floater policy, restore sum insured will be available on floater basis for all insured persons in the policy
If the first claim itself is over and above the basic sum insured + multiplier benefit, then in that case will the restore sum insured triggered can be utilized for that same claim or only for the next future claims.
Restore will be triggered after the 1st claim, irrespective of the 1st claim amount and can be used for future claims.

No,you need not pay for pre-policy medical tests in case it is taken up at our network Diagnostic Centers.It is cashless. However, if your policy is rejected due to adverse medical findings, 50% of the pre-policy check-up cost will be deducted from the premium refund amount.