| Name of policy |
Reliance Mediclaim Individual |
Health advantage plus |
Health Guard |
Health Suraksha (gold,basic,silver) |
| Eligibility |
3mon - 80yrs |
5 yrs - 65 yrs |
3 months- 55 yrs |
3mon - 70yrs |
| Renewable |
for 80 yrs |
for 70 yrs |
for 70 yrs |
for 70 yrs |
| Min -Max S.I limit |
Rs 15000-5lac.
|
Rs 2lac - 4lac |
1lac - 10lacs |
Rs 1lac - 5lac. For platinum Rs 6lac - 10lac |
| Policy Coverage |
| Pre- and Post-Hospitalisation |
30 and 60 days |
30 and 60 days |
60 and 90 days |
60 and 90 days upto 8% & 10% of the eligible per hospitalisation exp respectively. |
| Domiciliary Hospitalisation |
Covered |
Not covered |
Not covered |
Not covered |
| Cummulative Bonus |
5% on every claim-free renewal. maximum of 50%. |
On sum assured of 5% for every claim free year to a maximum of 25% |
5 % is added to your sum assured for every claim free year. |
5% dis on premium for each claim free renewal |
| Compulsory health check up |
After 45 yrs |
After 55 yrs |
After 45 years.
No health check up required for SI 10 lacs |
After 55 years.
Ages 46-55 years, if SI is upto 3lac no health check is required. |
| Cost of health check up |
reimburse actual cost to max of 1% of Average SI of 4 claim free years |
Free health check up is valid for 1 year |
Reimbursement upto maximum of Rs. 1000 /- at the end of continuous 4 claim free years |
1% of total SI to max of 2500(for 2 people max limit Rs 4000) at the end of every 4 claim free year. |
| Family Discount |
Not mentioned |
Not available |
Family discount of 10 % is applicable |
10% is applicable |
| Co-pay |
Not mentioned |
Not available |
10%, if treatment is not under the hospital network. |
30% in Mumbai & Delhi, 20% in Chennai, Kolkata, Ahmedabad, Hyderabad & Banglore. |
| Day care treatment |
Cover medical expense which do not require hospitalisation |
Not mentioned |
130 days |
100 day care procedure |
| Emergency Ambulance Charges |
Not mentioned |
Covered |
subject to limit of Rs. 1000 /- |
upto 1% of SI, max of Rs 1500/- |
| Coverage |
- Room charges,boarding exp
- operation theatre charges,
- nursing expenses,
- fees of doctor, surgeon, anaesthetist and consultants,
- cost of medicines,tests,oxygen,blood, organs, surgical appliances,diagnostic material and X-ray, radiotherapy, pacemaker, artificial limbs and organs. etc.
|
It should be minimum 24 hours of Hospiatlization. Illness that requires less than 24 hrs hospitalization are:
- Cataract
- Dilatation and curettage
- Cardiac Catheterization
- Lithotripsy (Kidney Stone removal)
- Chemotherapy
- Tonsillectomy
- Radiotherapy
- Eye Surgery
- Coronary Angiography
- Dialysis
Cover OPD expense
- Room charges,boarding exp
- operation theatre charges,
- Dental treatment
- nursing expenses,
- fees of doctor, surgeon, anaesthetist and consultants,
- cost of medicines,tests,oxygen,blood, organs, surgical appliances,diagnostic material and X-ray, radiotherapy, pacemaker, artificial limbs and organs. etc.
|
Room charges,boarding exp
operation theatre charges,
nursing expenses,
fees of doctor, surgeon, anaesthetist and consultants,
diagnostic test,ICU expense
cost of medicines,tests,oxygen,blood, organs, surgical appliances,diagnostic material and X-ray, radiotherapy, pacemaker, artificial limbs and organs. etc.
|
Room,boarding,nursing & service charges - min 1% & max 35% of SI/day exp
ICU charges - min 2% & max 35% of SI/day,
fees of doctor, surgeon, anaesthetist and consultants,specialist - 35% of SI/illness or injury
cost of medicines, tests, oxygen, blood, surgical appliances, anaesthesia, OT charges - 40% of SI/illness or injury.
For platinum all the above expenses are are fully covered |
| Pre-existing disease |
Not applicable |
After 2 continuous policy renewals |
After 4 continuous policy years |
After 4 continuous policy years |
| Cashless facility |
Available |
Available |
Available |
Available |
| Tax benefit on premium |
Max. Limit as per Section 80D |
Max. Limit as per Section 80D |
Max. Limit as per Section 80D |
Max. Limit as per Section 80D |
| Exclusion |
| First 30 days |
Any illness contracted during first 30 days except accidents. |
Any illness contracted during first 30 days except accidents. |
Any disease contracted during first 30 days of start of policy. |
Any disease contracted during first 30 days of start of policy |
| After 1st year / 2nd year or 3rd year |
1st year
Cataract, Benign Prostatic Hyperthropathy, Hysterectomy, Hernia, |
2nd year
Cataract **
Benign Prostatic Hypertrophy
Hernia, Hydrocele
Fistula in Anus, Piles
Arthritis, Gout, Rheumatism
Joint replacement, unless due to accident
Sinusitis and related disorders
Stone in the urinary and biliary systems
Dilatation Curettage
Skin and all internal tumors / cysts / nodules / polyps of any kind, including breast lumps, unless malignant / adenoids and hemorrhoids
Dialysis required for chronic renal failure
- Surgery on tonsils and sinuses
Gastric and duodenal ulcers
Deviated Nasal Septum
|
2nd year
- Hernia, piles, gastric, sinuses,
- stone in urinary system
- surgery of skin ailment,
- all internal or external tumours, tonsils
- cataract (upto 10% of SI, max. upto Rs. 25,000),
|
1st year Diseases/surgeries of gallstones or renal stones.
2nd year Diseases like cataract, hernia and tumor.
3rd year Joint replacement surgery |
| Permanent Exclusion |
- Any pre-existing illness,
- Treatment related to HIV / AIDS,
- Treatment due to abuse of alcohol or intoxicants,
- Vaccination and inoculation,
- Nuclear and war perils,
- Naturopathy treatment,
- Specified illness in case of domiciliary hospitalisation.
|
- Congenital disease
- Non-allopathic treatment,
- Expenses arising from HIV or AIDS and related diseases,
- liquor, intoxicating substances or drugs as well as international self injury!
- War, riot, strike, nuclear weapons induced hospitalization!
|
- Non Allopathic medicine,
- Expense arising from AIDS
- Cosmetic, aesthetic or related treatment
- Congenital diseases
- use of drugs, intoxication,
- joint replacement surgery
|
- Non-allopathic treatment.
- Congenital diseases.
- All expenses related to AIDS and related diseases.
- Use of intoxicating drugs or alcohol.
|
