Bajaj Allianz My Health Care Plan

At a Glance

Introducing a unique health insurance plan that cares for you the way you want. Now, transforming care your way. The ‘My Healthcare Plan’ is a modular plan that offers the flexibility to curate an individual bouquet of features best suited for you and your family.

The Policy Covers

Base Covers

1. In-patient Hospitalization Treatment
2. Pre and Post-hospitalization Expenses
3. Out Patient Treatment Expenses
4. Modern Treatment Methods
5. Day Care Treatment
6. Organ Donor Expenses
7. Ayurvedic and Hospitalization Cover
8. Road Ambulance
9. Maternity Expenses
10. Baby Care
11. Home Nursing Benefit
12. Domiciliary Hospitalization
13. Cost of Prescribed External Medical Aid
14. Sum Insured Reinstatement
15. Airlift Cover
16. Cumulative Bonus
17. Family Visit
18. Renewal Premium Waiver Benefit
19. Consumable Expenses

Optional Covers

• Loss of Income Cover
• Major Illness and Accident Multiplier (Indemnity)
• International Cover – Emergency Care only

Cover Level

Sum Insured Option.

Rs. 3 lakh/4 lakh/5 lakh/7.5 lakh/10 lakh/15 lakh/20 lakh/25 lakh/30 lakh/35 lakh/40 lakh/45 lakh/ 50 lakh/75 lakh /Rs. 1 crore/2 crore/3 crore/4 crore and 5 crores.

Plan Benefits:

Coverage and Benefit

Key Features

1. In-patient Hospitalization Treatment- Room and boarding expenses, ICU expenses, nursing expenses, Fees for Specialist ,surgeon, anesthetist, etc. that are medically necessary and prescribed by the treating doctor.
2. Pre and Post-hospitalization Expenses -medical expenses incurred 60 days prior to and 90 days post hospitalization respectively with options to customize as per the requirement.
3. Out Patient Treatment Expenses- A cover is provided to the insured in respect of an admissible claim during the policy term for any or all of the following covers as per the limits specified:
   • Tele (Insta) Consultation Cover
   • Doctor Consultation Cover (In-clinic)
   • Doctor Prescribed Investigations Cover – Pathology & Radiology Cover
   • Annual Preventive Health Check-ups cover
4. Modern Treatment Methods- Any medical expenses when undergoing modern treatment methods and advancement in technologies procedures.
5. Day Care Treatment - Any medical expenses for daycare procedures or surgeries taken as an inpatient in a hospital or daycare centre.
6. Organ Donor Expenses- Medical expenses incurred for organ donor’s in-patient treatment for harvesting of the organ donated provided if the insured is the receiver of the organ.
7. Ayurvedic and Hospitalization Cover - Medical Expenses for ayurvedic, or homeopathic treatment on the advice of a doctor because of illness/accidental bodily injury during the policy period.
8. Road Ambulance -The expenses incurred on a road ambulance for transferring you to the nearest hospital with adequate emergency facilities following an emergency. We also reimburse the expenses incurred on a road ambulance offered for transferring you from the hospital.
9. Maternity Expenses- Medical expenses for the delivery of a baby (including cesarean section). Or expenses related to medically recommended and lawful termination of pregnancy, limited to a maximum of 2 deliveries or termination or either during the lifetime of the insured.
10. Baby Care- The hospitalization expenses incurred for your newborn baby, on the advice of a doctor because of Illness or Injury sustained or contracted during the cover term
11. Home Nursing Benefit - If a registered nurse is engaged for post-hospitalization care, a fixed weekly benefit amount for a period of up to 10 weeks subject to rest terms and conditions will be paid.

Eligibility

Entry Age- Adults 18 years to 65 years and For Dependent Children/ Grandchildren: 3 months to 30 years

Type of Plan- Individual and Family Floater Health Insurance

Policy Period- 1 year/2 years or 3 years

Premium Payment Term- Quarterly, Monthly, Half-yearly, or Yearly

Renewal Age – Lifetime.

Additional Benefits & Optional Covers

1. Loss of Income Cover

   If this cover is opted and if the Insured Beneficiary is Hospitalized during the Policy Period for a minimum of 72 consecutive hours because of Accidental Injury and Any Illness/Any Illness excluding Infection as per the plan opted and mentioned on the Policy Schedule, then a weekly payment as per below grid , subject otherwise to all other terms, conditions and exclusions of the Policy

   No. of Days Per Hospitalization	No. of Weeks Benefit Paid
   3 days to 5 days	1 week
   6 days to 10 days	2 weeks
   11 days to 20 days	4 weeks
   21 days to 30 days	6 weeks
   Above 30 days	8 weeks

2. Major Illness and Accident Multiplier (Indemnity):If the insured is hospitalized for any critical illness or due to Accidental Bodily Injuries during the policy term, then the sum insured for such major illnesses/injury will be increased up to 2 times.

   • Cancer
   • Open Chest Coronary Artery Bypass Grafting (CABG)
   • Kidney Failure Requiring Regular Dialysis
   • Major Organ Transplantation
   • Multiple Sclerosis with Persisting Symptoms
   • Permanent Paralysis of Limbs
   • Open Heart Replacement or Repair of Heart Valves
   • End Stage Liver Failure
   • End Stage Lung Failure
   • Bone Marrow Transplant
3. International Cover- Emergency Care Only:The insurance company will indemnify the insured person for hospitalization expenses incurred anywhere across the world for emergency care only up to the amount specified in the policy schedule. subject otherwise to all other terms, conditions and exclusions of the Policy .

Waiting Period

1. Expenses related to any admission primarily for enforced bed rest and not for receiving treatment
2. Surgical treatment of obesity
3. Any treatment, including surgical management, to change characteristics of the body to those of the opposite sex
4. Treatment for correction of eyesight due to refractive error less than 7.5 dioptres
5. Change of gender treatments
6. Sterility and infertility
7. Any cosmetic or plastic surgery
8. Participating in any hazardous or adventure sports

**This is an indicative list of exclusion, please refer to policy wordings for complete details

Key Things You Should Know

1. Flexibility to Design Plan:-With this mediclaim policy you can easily customize the plan as per your prerequisites.
2. Select an Adequate Sum Insured: The My Healthcare Plan offers multiple sum insured options ranging from Rs. 3 lakhs to Rs. 5 crores. Choose an adequate sum insured that suits your budget.
3. Bouquet of Coverages: Ensure that the mediclaim insurance for family offers an array of coverage for expenses incurred towards hospitalization, modern treatment methods, etc.
4. Annual Preventive Health Check-up: Look at if you can avail of free preventive health check-ups once in every policy year in any of the network hospitals. At Bajaj Allianz General Insurance, we are growing strong with 18,400 + network hospitals* across the nation.
5. With My Healthcare Plan, now you need not buy separate maternity insurance cover or baby cover. This plan offers an in-built cover maternity cover, nursing cover and baby cover.
6. CASHLESS CLAIMS PROCEDURE - The cashless facility can only be availed at any of the network hospitals. To avail of the cashless treatment benefits, the below procedure needs to be followed:
   • For a planned treatment or hospitalization, you must intimate the insurance company almost 48 hours prior. You should request pre-authorization by way of the written form.
   • If satisfied with the request, the insurer will send an authorization letter to the network hospital. Keep your authorization letter, health ID card and other relevant documents handy. It needs to be produced at the network hospital at the time of admission.
   • If the above process is followed, you need not pay at the network hospital. Keep the original bills and treatment evidence carefully. Please note that all the expenses may not be covered subject to the terms and conditions mentioned in the policy schedule.
   • In case a treatment/procedure is taken on an emergency basis, the insurance company should be informed about the same in writing within 24 hours of hospitalization.
7. REIMBURSEMENT CLAIMS PROCEDURE - If the medical treatment has been taken outside the listed network hospital, you can opt for a reimbursement claim process.
   • In case of an emergency, the insurance company needs to be informed in writing within 48 hours of hospitalization. If it’s a planned treatment, the insurer must be informed 48 hours prior.
   • You should promptly within 30 days of discharge from the hospital give the documentation of the treatment availed.
   • In case the insured passes away, anyone claiming on their behalf should immediately inform in writing to the insurance company. Likewise, a post-mortem report also needs to be shared within 30 days.
   • If the original documents are submitted with the co-insurer, then photocopies attested by the co-insurer should be duly submitted.
8. SAVE TAX WITH HEALTH INSURANCE PLAN - Having suitable health insurance coverage also helps to save on taxes as well. Now, you can claim tax deductions against the family health insurance premium. Here, under Section 80D of the Income Tax Act of 1961, if you are less than 60 years of age, you can claim up to Rs. 25,000 tax deduction by choosing a family floater health insurance. Besides, the mediclaim insurance premium paid for parents is subject to tax deductions additionally. As per Section 80D of the Income Tax Act of 1961, you can obtain a deduction for up to Rs. 50,000, if the parents are 60 years of age and above.

   Note: The tax benefits are subject to change as per existing laws.

9. NETWORK HOSPITALS - You can now easily locate your nearest network hospital with us and avail best of class medical treatment. We have a strong network of 18,400 + network hospitals* in PAN India. If you are existing Bajaj Allianz Health Insurance, click Here to locate the nearby network hospital.
10. Get Health Claims settled by Direct Click
    1. Claims up to INR 20,000 can be quickly settled through our app.
    2. Download the Caringly Yours app and add your details for swift settlements.
    3. Follow 3 easy steps to submit your claim for processing via the app

11. DISCOUNT

    Zone Discount Below discount will be applicable on Zone A Premium based on residential address of the proposer or insured person

    Zone B: 15%

    Zone C: 25% There are three Zones for Premium payment
    (Zone A- Delhi / NCR, Mumbai including (Navi Mumbai, Thane and Kalyan), Hyderabad and Secunderabad, Kolkata, Ahmedabad, Vadodara and Surat
    Zone B - Rest of India apart, from the states/UTs/cities classified under Zone A and Zone C, are classified as Zone B.
    Zone C - Goa, Punjab, Chandigarh, Chattisgarh, Bihar, Jharkhand, Andaman & Nicobar Islands, Arunachal Pradesh, Himachal Pradesh, Jammu & Kashmir, Manipur, Meghalaya, Mizoram, Nagaland, Odisha, Sikkim, Tripura, Uttarakhand )

    Family Discount 10% family discount shall be offered if 2 eligible Family Members are covered under a single Policy and 15% if more than 2 of any of the eligible Family Members are covered under a single Policy. Moreover, this family discount will be offered for both new policies as well as for renewal policies. Family discount is not applicable to Floater Policies.

    Long Term Discount a. 4% discount is applicable if Policy is opted for 2 years b. 8% discount is applicable if Policy is opted for 3 years
    Note: This will not apply to policies where premium is paid in instalments.

    Early Entry Discount 5% discount shall be offered if, Insured Proposer is opting the My Health Care Plan long term policy prior to 35 years of age. In policies where Proposer is also an Insured member, and his/her age is 35 years or below, this discount shall be extended to all other insured members also who are aged 35 years and below. This discount shall be applicable at inception of policy as well as at each subsequent renewal, irrespective of claims, until the Insured member/s completes 45 years of age. This discount will apply only if long term policy is opted
    Note: This will not apply to policies where premium is paid in instalments

    Fitness Discount The Insured member will be eligible for a Fitness Discount of 5%, if the below criteria is fulfilled 1. The Insured member submits completion certificates of at least two 5km marathons run in the past 12 months prior to policy inception date. This discount shall only be applicable at the inception of the Policy with us for the first time.

    Voluntary co-payment Discount a. If the Voluntary co-payment option is opted, then a discount corresponding to the co-payment opted would be applicable. b. If a claim has been admitted under In-patient Hospitalization Treatment then, the Insured shall bear a 5% or 10% or 15% or 20% ( proportion to extent to discount availed) of the eligible claim amount payable under this Policy and Our liability, if any, shall only be in excess of that sum and would be subject to the Sum Insured.

    Loyalty Discount Discount of 5% shall be offered if the insured member is having any of the listed active Bajaj Allianz General Insurance Co. Ltd.’s retail policy of Motor, Health, Home, Cyber and Pet Insurance with a minimum premium of 2500 INR

    Wellness Discount- Up to 10% discount at each renewal of My Health Care Plan with Us, subject to fulfilment of defined criteria by You during the preceding Policy Year.

Unique Selling Points

1. Flexibility to customize your plan as per your needs
2. Choice of room preference and waiting periods
3. 2x OPD benefit (twice the premium)
4. Free yearly preventive health check-ups
5. Tax benefit of 80 D
6. 18400+Network Hospital in Pan India
7. Sum insured options upto 5 Crore
8. Unlimited Sum Insured Reinstatement
9. Option to add international cover ( emergency situations only)
10. Inbuilt Baby Care cover
11. Inbuilt home nursing cover
12. 50% Cumulative Bonus
13. Inbuilt Maternity cover

Policy wording and Policy Brochure - https://www.bajajallianz.com/health-insurance-plans/health-insurance-documents.html

For more details on risk factors, Terms and Conditions, please read the sales brochure before concluding a sale.
Note: It is mandatory to keep updated your policy with your correct contact details and bank account details, to process any of your service requests faster and hassle-free. To update your contact details i.e., Mobile No., Email ID, PAN Card, and Bank Account details, please use chatbot, visit our website, contact your agent or nearest branch.

CIN: U66010PN2000PLC015329 | UIN: BAJHLIP23143V012223 BJAZ-B-0372 /19-08-2024 Policy holders can download Caringly Yours app for one -touch access Available on:

For more details https://www.bajajallianz.com/health-insurance-plans/my-health-care-plan.html

Disclaimer

Bajaj Allianz My Health Care Plan is an IRDAI approved product with UIN: BAJHLIP23143V012223 , which is underwritten and serviced by Bajaj Allianz General Insurance Co. Limited. This brochure is not a contract of Insurance. Please refer policy document for exact terms and conditions and specific details applicable to this Insurance. Your participation in this insurance product is purely on a voluntary basis. We advise you to take your own professional advice before you participate.

DBS Bank India Limited (IRDA of India Registration Number: CA 0257) having the registered office at GF: Nos. 11 & 12, Capitol Point BKS Marg, Connaught Place, Delhi - 110001 is the Corporate Agent of Bajaj Allianz General Insurance Company Limited (IRDA of India Regn.No.113) CIN: U66010PN2000PLC015329 having the Registered office address at Yerwada Pune - 411006. DBS Bank India Limited (Bank) does not underwrite the risk or act as an insurer. My Health Care Plan by Bajaj Allianz with UIN: BAJHLIP23143V012223, is underwritten by Bajaj Allianz General Insurance Company Limited. The contract of insurance is between the insurer and the insured and not between the Bank and the insured. Bank does not give any warranty, as to the accuracy and completeness of the policies. Bank does not accept any liability or losses attributable to your contract of Insurance. Participation by the Bank’s customers in the insurance products is purely on a voluntary basis and is not linked to availment of any other facility from the bank. ISNP registration valid.

The contents and product information of this web site are given strictly for your convenience and is indicative in nature and ‘as is’ received from the Insurer. Nothing contained herein is to be construed as advice, recommendation, offer for a policy or any other assistance. Bank does not guarantee that this website reflects latest amendments/ information at all times or at any time. Bank shall have no liability to the customer for any loss or damage of any kind incurred for reliance on the content and product information available on this website.

For more details on risk factors, terms and conditions, exclusions, please read sales brochure of insurer and policy terms and conditions carefully before concluding a sale. Tax benefits are available as per the prevailing tax laws, which are subject to change.

Contact our 24-hour toll free customer service helpline number 1-800-209-4555 / 1-860-267-1234 or our overseas customer service number 91-44-66854555 or write to us at customercareindia@dbs.com. Visit us at: www.dbs.com/in

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