Yes there are sub limits –
a) Room rent, Board & Nursing Expenses for Gold plan (for Sums Insured ₹ 50000/-, ₹ 1 lakh and ₹ 1.5 lakhs)– up to 1% of the Sum Insured (excluding Cumulative Bonus) per day for non-ICU room. If admitted into Intensive Care Unit (ICU) up to 2% of the Sum Insured per day. All admissible claims under Room rent, Board & Nursing Expenses sectionduring the Policy year, shall be payable maximum up to 35% of the Sum Insured per claim. b) Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialists Feesfor Gold plan (for Sums Insured ₹ 50000/-, ₹ 1 lakh and ₹ 1.5 lakhs) – up to 35% of the Sum Insured (excluding Cumulative Bonus) per claim.
c) Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Cost of Pacemaker, prosthesis/internal implants and any Medical expenses incurred which is integral part of the operation for Gold plan (for Sums Insured ₹ 50000/-, ₹ 1 lakh and ₹ 1.5 lakhs) – up to 40% of the Sum Insured (excluding Cumulative Bonus) per claim.
d) Hospital cash benefit for Platinum plan – ₹ 500/- per day, up to 60 days.
e) Patient care benefit for Gold and Platinum plans –₹ 500/- per day, maximum up to 10 days and 30 days in a policy period.
f) Accompanying Person for Gold and Platinum plans – ₹ 500/- per day for child up to 10 years, maximum up to 30 days in a Policy Year.
g) Ambulance chargesfor Gold and Platinum plans – ₹ 2000/- per hospitalization.
Future Health Suraksha – Topaz and Ruby Plans
a) Room rent, Board & Nursing Expenses for Topaz and Ruby Plans – up to 1% of the Sum Insured (excluding Cumulative Bonus) per day for non-ICU room.
b) Pre-Hospitalisation Medical expenses for Topaz and Ruby Plans – up to 1% of the Sum Insured (excluding Cumulative Bonus).
c) Post-Hospitalisation Medical expenses for Topaz and Ruby Plans – up to 1% of the Sum Insured (excluding Cumulative Bonus).
d) Hospital cash benefit for Ruby plan – ₹ 500/- per day, up to 60 days.
e) Patient care benefit for Topaz and Ruby plans –₹ 350/- per day, maximum up to 10 days and 30 days in a policy period.
f) Accompanying Person for Topaz and Ruby plans – ₹ 500/- per day for child up to 10 years, maximum up to 30 days in a Policy Year.
g) Ambulance chargesfor Topaz and Ruby plans – ₹ 750/- per hospitalization and overall limit of ₹ 1500/- per policy period.
h) Disease wise sub-limits for Topaz and Ruby plans
Sub-limits table applicable for Topaz and Ruby Plans |
---|
Procedure/ Treatment |
Topaz Plan |
Topaz Plan |
Topaz Plan |
Ruby Plan |
|
1,00,000
|
2,00,0003,00,000 |
4,00,0005,00,000 |
6,00,0007,50,00010,00,000 |
Cataractsurgery (per eye) |
10000 |
20000 |
30000 |
40000 |
Hysterectomy |
20000 |
35000 |
45000 |
55000 |
Gall Bladderremoval |
20000 |
35000 |
45000 |
55000 |
Surgery onpiles |
15000 |
20000 |
30000 |
40000 |
SurgeryFissure, Fistula, Sinus |
15000 |
20000 |
30000 |
40000 |
Surgery ofDeviated Nasal Septum correction |
15000 |
20000 |
30000 |
40000 |
Angiographyinvasive |
10000 |
15000 |
20000 |
30000 |
PercutaneousTransluminal Coronary Angioplasty (PTCA) |
40000 |
80000 |
120000 |
150000 |
Appendectomy |
20000 |
30000 |
40000 |
50000 |
Hernia |
20000 |
30000 |
40000 |
50000 |
Surgery ofrenal stone/ Lithotripsy |
20000 |
30000 |
40000 |
50000 |
ProstateSurgery TURP |
30000 |
75000 |
100000 |
120000 |
CoronaryArtery Bypass Grafting (CABG) |
80000 |
100000 |
150000 |
200000 |
Total KneeReplacement (per knee) |
40000 |
80000 |
120000 |
150000 |
Total HipReplacement (per hip) |
40000 |
80000 |
120000 |
150000 |
Tonsillectomy/Adenoidectomy |
15000 |
25000 |
35000 |
45000 |
Transplantsurgery(this includes total cost of organ donor surgery, recipient surgery andhospitalisation) |
80000 |
100000 |
150000 |
200000 |
Dialysis(policy limit) |
10000 |
15000 |
20000 |
30000 |