In the event of an illness or accident, IFFCO-Tokio Swasthya Kavach Family Health Insurance is a family floater plan that pays for medical care, hospitalisation, surgery, and organ transplant costs. You can cover yourself and your family members under this policy for a sum insured ranging from INR 1-5 lakh. A single sum insured is available for your family members under this plan. So as and when you or any of your insured family members get hospitalised, coverage for room charges, ICU charges, ambulance charges, etc., will be included in this health insurance plan. What’s special about IFFCO-Tokio Swasthya Kavach Policy is the no co-payment clause, which requires policyholders to share healthcare expenses with the insurer in case of hospitalisation. Let’s check the details of this IFFCO-Tokio health insurance plan.
Key Features of IFFCO-Tokio Swasthya Kavach Policy
- It covers the proposer, their spouse, and up to three dependent children, siblings, nieces, or nephews.
- All dependents must be between the ages of 3 months and 23 years old when the coverage starts.
- Dependent children aged from 3 months to 23 years are covered under IFFCO-Tokio Swasthya Kavach Policy.
- Prior medical examination is not necessary till the age of 60. But before the purchase date of the insurance, if you are over 60, you must have medical examinations (blood sugar, ECG, urine, etc.). Advanced diagnostics like cholesterol profiles, kidney function tests, and eco tests are necessary for some persons.
- Unless the treatment is necessary for one of 121 designated daycare procedures, hospitalisation will only be taken into account if the insured has been admitted for longer than 24 hours.
What is Covered Under the IFFCO-Tokio Swasthya Kavach Base Plan?
- Hospitalisation costs, such as daily room rent charges of 1.0% of the insured amount and ICU costs of up to 2% of the insured amount.
- Service fees and hospital registration fees up to a maximum of 0.5% of the basic sum insured.
- During the hospital stay, nursing costs, as recommended by the doctor.
- Fees of medical professionals such as doctors, surgeons, specialists, consultants, anesthesiologists, etc.
- Medical practitioners, including surgeons, doctors, specialists, consultants, anaesthetists, etc., are reimbursed for medications, oxygen support, blood units, anaesthesia, medical and diagnostic tests, and operating room fees.
- The policy pays the cost of prescription drugs, oxygen therapy, blood transfusions, anaesthesia, diagnostic tests, and operating room fees.
- The price of a pacemaker, chemotherapy, radiotherapy, dialysis, artificial limbs, etc.
- Charges for ambulances up to a maximum of INR 750
- A daily cash hospitalisation allowance of INR 150
- Up to 20% of domiciliary hospitalisation expenses are reimbursed, which would otherwise necessitate 3 days in the hospital but are instead incurred at home for certain predetermined circumstances.
- Pre- and post-hospitalization expenses are covered for 30 days. .
- The amount that would be reimbursed for post-hospitalization costs is 7% of the insured amount, up to a maximum of INR 7500. (exclusive of room rent)
- The costs of organ donors will also be paid.
- You can select from the recommended hospital package rates for particular treatments, which can be paid up to 80% of the insured amount or the actual costs, whichever is smaller.
What is Covered Under the IFFCO-Tokio Swasthya Kavach Wider Plan?
- hospitalisation costs, with a maximum of 1.5% of the basic sum assured for room rates and 2.5% for ICU expenditures.
- a maximum of 0.5% of the basic total insured for hospital registration fees, service fees, other fees, etc.
- Nursing costs incurred both before and after the hospital stay
- Fees charged by medical professionals, such as anesthesiologists and surgeons.
- Medicines, anaesthetic, diagnostic and pathological tests, blood, oxygen, operating rooms, chemotherapy, dialysis, and other hospital fees are all included.
- A maximum of Rs. 1,500 can be used to offset ambulance costs.
- Rs 250 per day for hospitalisation allowance
- In the event of domiciliary hospitalisation charges, 20% of the basic sum insured will be paid. This applies to medical treatment needed for longer than 3 days that would normally need hospitalisation but is instead received at home for a variety of reasons. This clause may be subject to sub-limits.
- Pre-hospitalization costs will be covered for a maximum of 30 days, while post-hospitalization costs will be covered for a maximum of 60 days.
- Hospitalization costs related to organ transplantation will be covered up to the sum assured limit or in accordance with the terms of the policy.
- The cost of health check-ups will be covered at 1.0% of the average basic sum insured when four years without a health insurance claim have passed.
- Depending on the sub-limits described in the policy document.
- As stated in the aforementioned plan, hospitalisation costs for a certain sickness will be reimbursed at a rate of 80% of the insured amount or the actual expenses, whichever is smaller.
IFFCO-Tokio Swasthya Kawach Policy Exclusions
- Any illness that existed before buying the policy for up to four years of continuous coverage.
- Any therapy received within the first 30 days of the policy's launch, barring an accident,
- Dental procedures, unless they are necessary due to accidents
- The price of any form of hearing aid, contact lenses, or eyewear
- Congenital disorders, general weakness, and recuperation times are not taken into consideration
- Problems associated with pregnancy, unless it is an ectopic pregnancy
- The costs associated with inpatient stays at home and outpatient care
- purchasing external medical equipment
- Illness or injuries brought on by risky hobbies, occupations, or activities
- Medical costs related to HIV/AIDS
- Nuclear attacks, terrorist attacks, and war conditions
- HRT for obesity and treatment for obesity
- Medical bills for alternative medicine and research
- Prescription drugs, acupressure, acupuncture, and related therapies
Conclusion
The IFFCO-Tokio Swasthya Kavach health plan was briefly discussed in this article. For individuals looking for health coverage up to INR 5 lakh, this plan is appropriate. Additionally, it would be a good idea to cover your spouse and children under the same plan if you want to. To increase the current coverage level, you may ask for a hike in the sum insured on renewal. The health insurance company will hike your premium accordingly. Anyway, the sum insured will rise on renewal should you not claim in a policy year, that too without any hike in the premium.
