What you need to know
ICICI Lombard Health Care administers the medical insurance policy, which is 100% company paid.
Plan at a glance
| Benefit | Coverage |
|---|---|
| Sum insured | Base cover of INR 5,00,000 per family per year In case of a medical emergency, additional support of up to INR 7,50,000 per family per year can be requested via Corporate Buffer. |
| Voluntary top-up cover | Employees have flexibility to purchase an annual top-up cover ranging from INR 2,50,000 to INR 20,00,000 by electing to pay an additional premium. The top-up cover would provide supplementary support, which would be in addition to the annual base cover of INR 5,00,000 and the corporate buffer of INR 7,50,000, an overall annual cover of INR 12,50,000 (5L + 7.5L) provided by PayPal to all employees, per family. Married employees can choose to cover a 3rd and 4th parent / in-law for a sum insured ranging from 2 to 5 lakhs under the voluntary Additional Parental Policy and applicable premium will be paid by the employee. |
| Pre- and post-hospitalisation | Up to 30 and 60 days respectively |
| Intensive care unit with nursing staff (charges) | On actuals |
| Room rent (including charges for nursing staff) | Single, private, air-conditioned, with a cap of INR 12,000 per day on the room rent |
| Home nursing (with doctor's prescription) | Domiciliary hospitalisation benefit including nursing care at home up to INR 50,000 per family |
| Maternity care | INR 1,00,000 for normal delivery and INR 1,25,000 for a C-section for first 3 deliveries. Additional benefit of INR 25,000 in case of multiple births. Includes pre- and post-natal expenses. Same cover applies for surrogacy. |
| Newborn day one | Newborn child is covered from day one and can be added to your policy within 30 days of birth date |
| OPD treatment | Employees, their spouse, and children are covered up to INR 30,000 with the following limits: INR 6,000 consultation, INR 9,000 diagnostics, and INR 15,000 dental, vision, mobility aids and physiotherapy. Cost of spectacles/contact lenses is covered under vision sub-limit. |
| Ambulance service | Intensity ambulance service up to INR 10,000 and air ambulance up to INR 1,00,000 per person, up to three events per policy period |
| IVF / infertility treatment | Covered up to INR 2,00,000 on OPD / IPD basis |
| Flu vaccination | Up to INR 3,000 per family |
| AYUSH | INR 75,000 per family payable on a reimbursement basis |
| Copayment for parents or parents-in-law | 20% co-pay capped at INR 100,000 per claim, for parent / in-law claims only. |
| Same sex partner | Employees can enrol a same-sex partner under the medical insurance plan |
| Gender reassignment surgery | Covered up to the base sum insured, i.e., INR 5,00,000 |
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An on-site doctor and nurse are available in both the Chennai and Bangalore offices. Contact the office reception to be guided to the medical room.
Extensive coverage
The medical plan provides coverage for pre- and post-hospitalisation and comprehensive benefits for day-to-day medical and maternity expenses.
- Pre-existing conditions covered
- Internal and external congenital diseases
- Hospital miscellaneous services (X-rays, laboratory work, diagnostic tests)
- Surgical fees, operating theatre, anaesthesia, and oxygen
- Robotic surgery
- Oral chemotherapy
- Ailment coverage (no cap)
Daycare procedures
The 24-hours time limit for hospitalization claims will not apply for specific Daycare procedures. Please refer the list of Daycare procedures covered.
Exclusions
- Sterilisation
- Trial or experimental treatments
- Administrative, registration, service, and other miscellaneous charges
- Prosthesis-fitting expenses
- Any device, instrument, or machine contributing to or replacing an organ
- Holter monitoring