The voluntary health product covers up to US$222 (Rs. 10,000) hospitalization per family and US$222 (Rs. 10,000) per person personal accident (only policy holder and spouse). The product also covers up to US$33 (Rs. 1500) for normal delivery and US$67 (Rs. 3000) for Cesarean Section after the first six months. Pre-existing conditions such as cataracts, hysterectomy, kidney stones, ulcers, hernia, and arthritis are covered after the first year. Major exclusions include AIDS/HIV, STDs, vaccinations, experimental treatment, dental, suicide or self-injury, fertility procedures, occupational injury, and injury or death to mother or child during childbirth.
The premium is US$6.60 (Rs. 300) for a family of four per year. Additional family members can be added for US$2.20 (Rs. 100) per person per year. Individuals must be under 80 years of age at the time of enrollment (as of 2008).
Policyholders and their families can make a cashless claim at network hospitals. While policyholders can receive coverage for visits to out-of-network providers, they must pay for services upfront and have their claims reimbursed.
