L&T Medisure Classic Plan

Day Care Treatments

Includes surgical processes conducted using local or general anaesthesia which requires less than 24 hours of hospitalization because of technological advancement in healthcare. Each company has a specific list of processes which are covered under this category.

No-Claim Benefits

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Pre Hospitalization

Medical expenses incurred immediately before the insured individual is hospitalized are covered under this benefit. Usually, expenses up to 30 to 90 days before hospitalization are covered under the policy only after the in-patient hospitalization claim is accepted by the insurance company.

Post Hospitalization

Medical expenses incurred immediately after the hospitalization are covered under this benefit.The coverage under this benefit would be available only for approved in-patient hospitalization claim is accepted by the insurance company. Usually, expenses up to 30 to 180 days post discharge are covered under the policy.

Restore Benefits

A benefit offered by some of the insurance companies which reinstates your sum insured when it gets exhausted within a policy period based on the terms and conditions of the plan.

OPD Expense Cover

Includes coverage for expenses on treatments which do not require 24 hours of hospitalization.

Daily Hospitalization Allowance

Includes lump sum compensation offered in some plans on a daily basis after every 24 hours of hospitalization.The amount offered under this benefit could be used to cover expenses additional to hospitalization expenses.

Health Check-up

Includes complimentary health check-up provided by the insurance companies for certain health insurance plans.

Home Hospitalization/ Domiciliary Hospitalization

Includes coverage for expenses borne when active treatment is provided to the insured (especially older patients) by health care professionals in the patient's home.

Non- Allopathic Treatment Expense Cover

Includes coverage for expenses on treatment which do not use allopathic methods like Aurveda, Homeopathy, etc. The terms and conditions are different for different policies. This benefit is also refered to as Ayush benefit or Alternative treatment by some the insurers.

Emergency Ambulance

Includes coverage for expenses on ambulance for hospitalization of the insured.

Eye-cover

Includes coverage for expenses on out-patient treatment of eyes. In some cases cost of spectacle is also covered under this benefit.

Maternity Cover

Includes coverage for delivery or related expenses of the insured. At times coverage for the new-born child is also provided under this benefit. Read More on Maternity Cover

Dental Coverage

Includes coverage for out-patient dental treatment expenses.

Recovery Benefit

Includes lump sum benefit offered to an insured by some of the insurance companies after the hospitalization exceeds certain number of days. This benefit is also refered to as Convalescence benefit by some companies.

FREE LOOK PERIOD

CRITICAL ILLNESS COVER

WAIVER OF ROOM RENT SUB LIMIT

Room Rent / Room Category

Hospitals have a fixed tariff or rate chart for all rooms. Mediclaim depends on the amount of room rent limit specified in the policy document. The amount varies depending on the type of room category chosen.

Co-Payment

The fixed amount the policyholder has to pay for covered services when they get the service. When both insured and insurer pay part of the medical expenses, it is called as cost sharing. This is applicable based on the policy you choose.

Cooling Off Period

The period begins right after commencement of the policy within which you cannot claim for any illness except claims related to accident. This period is not applicable for subsequent renewals.

Specific Illness

The ailments of specific severity listed in the policy document are included under this category.

Pre-Existing Illnesses

The ailments that the insured was already diagnosed with before taking the policy.