1. Policy Eligibility
- Individual Plan:
- Women aged 18-75 years.
- Floater Plan:
- Families with at least one adult female aged 18-75 years. Covers dependent children aged 91 days to 25 years.
- Unmarried and/or unemployed daughters are covered as dependents up to 30 years. After 30 years, treated as adults.
- Special Categories:
- Surrogate Mothers: 25-35 years (policy term restricted to three years).
- Oocyte Donors: 25-35 years (policy term restricted to one year for oocyte donor coverage).
2. Coverage
a. General Health Coverage
- Hospitalization Expenses:
- Room rent, nursing charges, ICU charges (as per sum insured limits).
- Coverage for surgeries, doctor fees, diagnostic tests, and medications.
- Pre-Hospitalization:
- Up to 60 days before hospital admission.
- Post-Hospitalization:
- Up to 90 days after discharge.
- Day Care Procedures:
- All are covered without sub-limits.
b. Maternity & Newborn Coverage
- Delivery Expenses:
- Includes normal and Caesarean deliveries (up to two deliveries).
- Pre-natal and post-natal care included within limits.
- Newborn Coverage:
- Covers congenital internal and external anomalies from birth.
- Vaccination expenses for the first year.
c. Women-Specific Benefits
- Assisted Reproductive Treatments (ART):
- Covers IVF and other fertility treatments after a 36-month waiting period.
- Coverage for one treatment cycle per policy year.
- In Utero Fetal Surgery:
- Advanced surgeries like fetoscopy, open fetal surgeries, and EXIT procedures.
- Voluntary Sterilization:
- Tubectomy or vasectomy for insured women after 24 months of policy inception.
- Cancer Lump-Sum Benefit (Optional):
- Lump-sum payout for first-time diagnosis of cancer. Coverage options: ₹5,00,000 to ₹25,00,000.
d. Modern & Advanced Treatments
- Bariatric Surgery:
- For morbid obesity, covered up to ₹2,50,000 or ₹5,00,000 (based on sum insured).
- Air Ambulance:
- Covers up to 10% of the sum insured (minimum sum insured ₹10,00,000).
- Rehabilitation and Pain Management:
- Covers up to 10% of the sum insured annually.
e. AYUSH Treatments
- Coverage for Ayurveda, Yoga, Unani, Siddha, and Homeopathy (excluding Naturopathy).
f. Wellness Benefits
- Wellness Program:
- Rewards for health-related activities, redeemable as premium discounts.
- Health Checkups:
- Includes consultations, diagnostics, and preventive health tests based on age.
3. Policy Terms
- Sum Insured Options:
- ₹5,00,000 to ₹1,00,00,000.
- Policy Tenure:
- One, Two, or Three years. Discounts available for longer terms:
- 10% for two years, 11.25% for three years.
- One, Two, or Three years. Discounts available for longer terms:
- No Medical Screening Required:
- Pre-acceptance screening is waived.
4. Waiting Periods
- General Illness: 30 days (excludes accidents).
- Maternity Benefits:
- 12 months (₹15,00,000+ sum insured).
- 24 months (₹5,00,000 or ₹10,00,000 sum insured).
- ART Benefits: 36 months.
- Voluntary Sterilization: 24 months.
5. Optional Add-ons
Lump-Sum Cancer Benefit:
- Eligibility: Women aged 91 days to 65 years.
- Waiting Period: 180 days.
- Lifetime limit: Once per policyholder.
6. Key Exclusions
- Pre-existing conditions for 24 months.
- Cosmetic treatments, weight loss surgery (except bariatric).
- Pregnancy termination unless due to an accident.
- Congenital external anomalies (except newborn coverage).
7. Premium Structure (Sample Rates Excluding GST)
Single Female Policyholder:
| Age Range (Years) | ₹5,00,000 | ₹10,00,000 | ₹15,00,000 | ₹20,00,000 | ₹25,00,000 | ₹50,00,000 | ₹1,00,00,000 |
|---|---|---|---|---|---|---|---|
| 18-35 | ₹7,965 | ₹10,300 | ₹12,740 | ₹13,955 | ₹15,970 | ₹18,645 | ₹22,680 |
| 36-40 | ₹9,160 | ₹11,860 | ₹14,530 | ₹15,960 | ₹18,175 | ₹21,405 | ₹25,990 |
Optional Cancer Benefit Add-on (Premiums):
| Age Range (Years) | ₹5,00,000 | ₹10,00,000 | ₹15,00,000 | ₹20,00,000 | ₹25,00,000 |
|---|---|---|---|---|---|
| 18-35 | ₹895 | ₹1,795 | ₹2,690 | ₹3,590 | ₹4,485 |
| 36-45 | ₹4,110 | ₹8,220 | ₹12,325 | ₹16,435 | ₹20,545 |
8. Claims and Renewal
- Claim Process:
- Inform within 24 hours for emergencies or 24 hours prior for planned hospitalizations.
- Cashless treatment available at network hospitals.
- Renewal Terms:
- Grace period of 30 days.
- No renewal penalty for claims in previous years.
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