Health Insurance

Health Insurance covers a wide range of expenses and offers Cashless Treatments in 28 listed hospitals in Nepal and over 5,800 hospitals all over India. If the hospital is part of the provider network, a cashless facility will be granted; otherwise, reimbursement facilities will be applicable. It can be taken by individuals, couples, families, and corporate employees.

In-Patient Treatment (Hospitalization)

Covers hospitalization expenses incurred as an in-patient in a Hospital, which will include:

• Room, Boarding, and Operation Theatre charges
• Fees of Surgeon, Anesthetist, Nurses, and Specialists
• The cost of diagnostic tests, medicines, blood, oxygen, appliances like pacemakers, artificial limbs and organs, etc.

Conditions:

• In-patient treatment requires hospitalization for a minimum period of 24 hours, and an Intravenous (IV) should be open.
• And more.

Day Care Procedures/Treatments (Hospitalization less than 24 hrs.) 

Due to the advancement of technology, hospitalization expenses for certain treatments/diseases (150 daycare surgeries) are covered even though the hospitalization is for less than 24 hours.

Conditions:

• It should be an Operation Theatre (OT) treatment.
• And more. 

Some of the treatments covered are:

• Cardiac catheterization
• Cataract
• Oral Chemotherapy
• Dialysis
• Dilation and Curettage
• Eye Surgery
• Hernia Repair
• Lithotripsy (Kidney Stone)
• Radiotherapy
• Tonsillectomy, and many more. 

Pre-Hospitalization and Post-Hospitalization Expenses

• Pre-hospitalization Medical Expenses incurred by the Insured for 30 days immediately before Hospitalization
• Post-hospitalization Medical Expenses incurred by the Insured for 60 days immediately post-hospitalization.

Exclusions

• Permanent Exclusions
• 4 Years for Pre-existing Diseases
• 2 Years Waiting Period for Certain Treatment
• Medical Expenses Incurred Within 30 Days of Inception of the Policy
• Non-medical expenses (i.e. Sanitary napkins, towels, toothbrush, birth certificate, thermometer, etc.)
• Ambulance Charges
• Higher Category Room (i.e., suites; however, this does not apply to single standard AC Room/ Cabin)