United India Health Insurance policy for Senior Citizen, Best Above 60 years mediclaim insurance for Older citizens and parents

Senior citizen Health insurance review

Benefits
Claims Procedure
Exclusions

Benefits under Senior citizen Insurance Plan

Hospitalisation expenses

Room, Boarding and Nursing expenses not exceeding 1% of the Sum Insured or actuals whichever is less.
ICU not exceeding 2% of the Sum Insured or actual whichever is less.
Expenses incurred for Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialists Fees.
Expenses incurred on Anesthetic, blood, oxygen, Operation theatre charges, surgical appliances, Medicines & drugs, dialysis, chemotheraphy, radiotheraphy, cost of artificial limbs, cost of prosthetic devices implanted during surgical procedure like Pacemaker, orthopaedic implants, infra cardiac valve replacements, vascular stents, relevant laboratory/diagnostic tests, x-ray and similar expenses that are medically necessary and hospitalization expenses (excluding cost of organ) incurred for donor in respect of organ transplant to the insured.
If the insured person opts for a room with rent higher than the entitled category, the charges payable above shall be limited to the charges applicable to the entitled category only. However, this will not apply for Medicines & drugs and implants.

Other expenses covered

Cataract, Hernia, Hysterectomy	Actual expenses or 25% of SI whichever is less.
Major illness/surgeries	Actual expenses or 70% of SI whichever is less.
A copay on 80:20 basis applicable for all Major illness charged as a total package.0

Pre-hospitalisation

Pre-hospitalisation expenses incurred upto 30 days prior to date of admission

Post-hospitalisation

Post-hospitalisation expenses incurred upto 60 days from the date of discharge.

Day Care Treatment

Specified Day Care procedures which require less than 24 hours hospitalization.

Ayush Treatment

Treatment taken in a Government Hospital or in any Institute recognized by the Government and/or accredited by Quality Council of India/National Accreditation Board on Health.

Cashless facility

Cashless facilities at more than 7000 hospitals across India.

Free Look period

15 days shall be applicable at the inception of the first policy.

Medical Check up

Free Medical check-up once at the end of every three underwriting years provided no claims reported during the block and subject to policy renewed without any break.

Tax

Premium paid for self, spouse, dependent children and dependent parents are exempt from Income Tax under Section 80-D of the IT act as per rules in force.

Family discount of 5% on the total premium if policy is taken for self and any one or more family members viz. spouse or dependent children.

Clamis under Senior citizen Insurance Plan

All claims shall be paid in Indian Rupees only.
Upon happening of any event, notice of Intimation about the hospitalization or claim should be sent to the address of Insurer/TPA stated in the Policy. In case of emergency hospitalization, notice of intimation to be sent within 24 hours from the time of hospitalization.
Claim form should be collected on intimation of claim. The completed claim form along with all required/relevant hospitalization documents should be submitted to servicing TPA within 15 days from the date of discharge from the hospital.
For Cashless treatment, the Insured or the representative has to submit the Pre-authorisation Cashless form to TPA through the hospital where the treatment is taken. No separate intimation is required if the pre-authorisation form is submitted immediately on admission.
In case of Reimbursement claims, the insured should submit documents in respect of the hospitalization expenses incurred within 15 days from the date of discharge from hospital.