Chola MS Tax Plus Healthline: Day-to-day Medical Expenses..!


Introducing Chola MS Tax Plus Healthline, a one-of-a-kind health policy that covers your hospitalization and non-hospitalization expenses (including OPD) i.e. your day-to-day medical expenses.

?  What are the primary features of Tax Plus Healthline?

        * Wide range of sum insured options - Rs.1, Rs.2, Rs.3, Rs.4, Rs.5 Lakhs
        *  First time purchase is allowed up to 65 years of age
        *  No medical check up required for up to 55 years of age

?  What is the Chola MS Advantage?

       * Wide range of sum insured options
        * Chola MS has over 6 million happy customers across India who believe in us, our products and our processes
        * Cashless claims at over 2,700 network hospitals across India
        * 24 x 7 claims assistance through our in-house TPA (Chola MS HELP)

? Who is covered under this policy?

       * Entry age is 18 to 65 years
        * You, your spouse, parents & dependent children (3 months to 35 * years) can opt for this insurance policy
        * If you are above 55 years of age, your policy issuance is subject to approval of pre-policy medical check-up
        * Lifetime policy renewal

    * 35 years for dependant female child & 25 years for dependant male child

? What are the medical tests required to be done?

    * For persons upto 55 years of age, no medical tests are required. For persons above 55 years of age, the medical tests required are -

    * Medical Examination Report, Complete Blood Count, Electrocardiogram, Complete Urine Examination, Fasting Blood Sugar, Liver Function test & Renal Function Test.

* The tests can be done at any of the firms authorised diagnostic centres at convenience and 50 per cent of the cost will be reimbursed by us after approval of policy application.


? What is the premium payable for this policy?

   *  Section 1 - Hospitalization Cover
    (In - patient hospitalization expenses covered up to Rs. 5 lakh on individual or / family floater basis)
  * Room Rent : 1 % of Sum Insured (SI) Per day
  *  Room Rent :  ICU 2 % of Sum Insured Per day
  * Pre Hospitalization : Up to 60 days, Maximum 5 % of Claim
  * Post Hospitalization :            Up to 90 days, Maximum 10 % of Claim and up to Rs. 50,000
  *  Ambulance Charges :           Rs.3,000 per hospitalization
   *  Sub-limits :  Cataract - 7.5 % of the Section 1Sum Insured up to Rs.20,000 per eye Hernia or /  Hydrocele - 10 % of Section 1 Sum Insured up to Rs.30,000 Fistula in Anus, Anal Fissure, Piles - 10 % of Section 1 Sum Insured up to Rs.30,000 Sinusitis - 10 % of Section 1 Sum Insured up to Rs.30,000 Tonsillitis or / Adenoids - 15 % of SI up to Rs.40,000 Knee and Joint replacement surgery - 50 % co-pay applicable
    * No co-pay in case of accidents.
    * Section 2 - Non-Hospitalization Cover
    * Out-patient medical expenses covered up to plan limits
    * Treatment of injury / illness incurred without hospitalization  
    * Pre & post natal     
    * All pre-existing diseases    
    * All dental treatments          
    * Treatments under Allopathic and any system of Indian medicine (other than naturopathy)      
   *  Spectacles, contact lenses, hearing aids, prosthetic appliances, etc., supported by prescriptions of a doctor / medical practitioner       

    *   All deductibles under a valid claim made under Section 1 of this policy which may arise due to imposition of sub-limits            

? Does the Claim Free Bonus work?

     *  5 % increase in Section 1 limit for every claim free year, subject to a maximum of 50 %.
        Claim free bonus is not applicable on Section 2

? What are the Tax Benifits (Section 80 DD)?

Rs.15,000 towards premium for self, spouse and children
Rs. 20,000 towards premium for parents over 60 yrs of age
Tax benefits are subject to changes in applicable laws from time to time
Chola MS from time to time and subject to IRDA approval, will revise the premium rates./ SI Limits /. terms and conditions based on experience
     
? What is not covered under the policy?

  * Benefits will not be available for pre-existing conditions until 48 months of continuous coverage from first policy start date
 
   * Expenses during first 30 days of commencement of policy except in the case of accidents. This is not applicable for renewals
  * During the first year of operation of the insurance on surgeries / procedures relating to Hernia /  Hydrocele, Benign Prostate Hypertrophy, Fistula in Anus, Anal Fissure, Piles, Tonsillitis or Adenoids, Congenital internal diseases / conditions. If these illnesses are pre-existing, claims due to these illnesses will be considered as per exclusion - 1 above
  * During the first two (2)  years of continuous operation of insurance cover on surgeries / procedures relating to hysterectomy for non-malignant lesions, gall bladder stones, gastric or duodenal ulcer, all benign lumps and tumours, knee replacement surgery (other than caused by an accident), joint replacement surgery (other than caused by an accident), Spondylosis / Spondylitis & other Degenerative Disc Disorders, chronic kidney disease / chronic renal failure, Prolapses of intervertebral disc (other than caused by accident), Varicose veins and Varicose ulcers, Thyroiditis and treatment of Goitre, Fibroid in Uterus and Prolapsed Uterus Deviated Nasal Septum, Dilatation And Curettage, Gout And Rheumatism, Cataract, Sinusitis, Renal calculi, Arthritis, Glaucoma, Tympanoplasty, Mastoidectomy. If these illnesses are pre-existing, claims due to these illnesses will be considered as per exclusion -1 above
(For complete list of exclusions, please read the policy wordings)

? What is the Claim procedure?

  * You can avail of cashless hospitalization at over 2,700 network hospitals across India.

  * In non-network hospitals, payment must be made up-front and then reimbursement will be effected on submission of relevant documents
  * For a planned hospitalization or / day care procedure, kindly inform us and obtain the pre-authorisation by calling Chola MS HELP, our in-house TPA for 24 hrs assistance at 1800 22 5544 (Toll Free) or fax to 1800 425 2200
  * In case of emergency hospitalization, intimate us within 24 hours of hospitalization
Section 2
  Submit your bills along with prescriptions, diagnostic reports, etc
  First claim can be made only after 3 months of inception of the policy
  * Claims can be made not more than on two (2) occasions in a policy year for the family.

About Cholamandalam MS..!
Cholamandalam MS, a General Insurance Company in India, offers a wide range of insurance policies for individuals& corporates.

For individuals, there are products such as Car insurance, Travel Insurance, Health Insurance, Accident Insurance and Home Insurance.

For SME's and Corporate Insurance clients, Chola MS offers customized solutions encompassing insurance and risk consulting services like Engineering Insurance, Liability Insurance, Marine Insurance, Property and Miscellaneous Insurance..!

Src: Cholamandalam MS 
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