Sunday, June 05, 2016
Changes in Mediclaim benefits
Re: Changes in benefits and other policy conditions under Group Mediclaim Policy 2016-17
Group Mediclaim Policy for the year 2016-17 has been issued. Following changes in benefits and other policy conditions have been incorporated in the above policy.
1. Registration/Admission charges and Service Tax/Surcharges are payable.
2. Expenses in respect of claim relating to Physiotherapy shall be limited to actual or maximum of Rs.30,000/- per person per year, whichever is less.
3. Maximum charges payable for Biopsy (Diagnostic Test without hospitalization) per insured has been increased from R.3000/- to Rs.4000/-.
4. One additional Diagnostic Test without hospitalization, i.e. PET Scan has been included for which actual or maximum of Rs.15000/- per insured, whichever is less, shall be reimbursed.
5. Age Related Macular Degeneration (ARMD) and/or treatment for retinal disease by intravitereal/ intraocular injection/intervention are admissible. Actual or maximum of Rs.25000/- per eye per annum for each insured, whichever is less, shall be payable.
6. Robotic surgery for Malignant Cancer/Cancer, Brain and Spine only are payable.
7. Maximum payable ambulance charges per hospitalization has been increased from Rs.2500/- to Rs.5000/-.
8. Artificial limbs will be covered, except the Robotic Limbs which may be paid at the rate of conventional artificial limb.
9. Genetic disorders and stem cell implantation/surgery are not covered. However, treatment for Thalessima, Haemophilia, Sickle Cell Anemia, Hemolytic Anemia, Myeloma, etc requiring hospitalization is covered subject to maximum of 75% of Floater Sum Insured of the family.