Oriental Insurance HOPE - Health of Privileged Elders

• Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
• 10,000+ hospitals for cashless treatment
• Claim up to Rs. 55,000 deduction under section 80D**

This unique health insurance plan has been designed to cater to the medical needs of senior citizens. The cover is provided for certain specified treatments and diseases mentioned in the policy.

Eligibility of HOPE - Health of Privileged Elders

• Senior citizens i.e. persons above the age of 60 years can avail this policy.
• A pre-acceptance medical checkup should be conducted in an authorised diagnostic centre as listed by the insurer. The list of medical reports required include physical examination, urine test, glycosylated haemoglobin test, ultrasonography examination, X-ray of both knees, complete eye test, and stress test.

Sum Insured

The sum insured is the total amount payable by the insurer to the insured towards medical expenses.

Features of Oriental Insurance HOPE- Health of Privileged Elders

• The policy is exclusively for senior citizens above the age of 60.
• Cashless hospitalisation can be availed in any of the network hospitals upto an amount of Rs.1 lakh.
• Pre-hospitalisation expenses incurred upto 30 days prior to admission in the hospital are covered.
• Post-hospitalisation expenses upto 60 days from the day of discharge from the hospital are covered.
• In-patient and day-care treatment is covered by the policy.
• Only diseases specified in the policy will be covered.
• Ayurvedic, Homeopathic, and Unani treatments in government hospitals and colleges are also covered.
• Hospitalisation and domiciliary treatments will be covered only within India.
• Claim documents including receipts, bills, cash memos, etc. should be submitted to the insurer within seven days from the date of discharge of the policyholder.
• The insurer can cancel the policy if the policyholder has misrepresented facts. The insurer will send a 30-day notice to the insured in such circumstances.
• The insured can cancel the policy and the insurer will refund the premium with a certain rate of premium levied, provided no claim was made during the policy period.
• Policyholders can avail a tax benefit under Section 80D of the Income Tax Act, 1961.

Benefits of Oriental Insurance HOPE- Health of Privileged Elders

Exclusions of Oriental Insurance HOPE- Health of Privileged Elders

• Any health condition that is not enlisted in the policy.
• Any pre-existing ailment during the first two policy years.
• Any disease mentioned in the policy but contracted in the first 30 days of the policy term.
• Treatment of certain specific ailments mentioned in the policy.
• Injuries resulting from war, invasion, or nuclear materials.
• Circumcision, vaccination, change of life, cosmetic or aesthetic treatment, or hair transplant.
• Plastic surgery unless required due to an accident.
• Correction of eyesight; spectacle and contact lens expenses.
• Convalescence, rest cure.
• Congenital external diseases or defects, sterility, fertility or sub-fertility procedures, assisted conception procedures, and venereal diseases.
• Intentional self-injury, suicide, and psychiatric disorders.
• Treatments arising from substance abuse.
• Expenses and complications arising from HIV/AIDS and other sexually transmitted diseases.
• Evaluation or diagnostic procedures not followed by hospitalisation.
• Expenses on mineral water, vitamins, allied items, and tonics unless utilised for the treatment of a disease or injury.
• Naturopathy, experimental treatments, or alternative medicine like acupressure.
• Treatment expenses incurred that is unrelated to the disease hospitalised for.
• External durable and non-medical equipment like ambulatory devices. These include walkers, belts, crutches, slings, braces, etc. Also, glucometer, nebuliser, etc.
• Non-medical expenses related to convenience and comfort.
• Change in the system of treatment unless agreed by the TPA or company.
• Any weight-reduction or obesity-related treatments.
• Treatment arising from participation in hazardous activities.
• Service charges, registration fees, surcharges, file charges, etc. charged by the hospital.
• Doctor’s consultation charges while insured is treated at home. Nursing charges incurred during pre-hospitalisation and post-hospitalisation.

Other Key Features