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Edelweiss Health Insurance FAQs
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Edelweiss Health Insurance FAQs
1. Does Edelweiss Family Health Insurance policy coverage include pre- and post-hospitalization expenses?
Yes, Edelweiss family health insurance includes pre- and post-hospitalization costs:
Plan Variant Pre-hospitalistion Cover Post-hospitalistion Cover Silver Plan 30 days 60 days Gold Plan 60 days 90 days Platinum Plan 90 days 180 days
2. What is the age limit for women to enlist in any Edelweiss health insurance plan?
The maximum entrance age for females insured in the Edelweiss medical insurance plan is 65 years in Silver and Gold variants. At the same time, there is zero maximum registration age limit in the Platinum variation.
3. Does Edelweiss health insurance offer any particular plan for children?
No, Edelweiss does not provide a separate health insurance plan for children, but it covers children under its family policies.
4. Is Edelweiss health insurance offering free annual healthcare check-ups?
Yes, Edelweiss offers a free health screening every year that is claim-free if the insured is 18 or older.
5. How can I use Edelweiss's cashless treatment service?
To use the cashless service, you must present the insurance company's health card at any network hospital. You may reach them at 1800 12000 or 022 423 12000 for assistance.
6. How much ambulance coverage does Edelweiss medical insurance provide?
The following are the maximum restrictions applicable each policy year under various types of this policy:
- The Silver plan offers INR 1,500.
- The Gold plan offers INR 3,000.
- The Silver plan offers INR 10,000.
7. Is portability available with Edelweiss health insurance?
Yes, Edelweiss health insurance offers customers the option of portability. With this function, you may effortlessly move your existing health insurance policy into Edelweiss in accordance with IRDAI regulations without sacrificing any continuity benefits.
8. Which relatives are eligible for coverage under the Edelweiss health insurance plan?
Individual plans include self, spouse, children, parents, grandparents, siblings, dependent parents-in-law, and any other connection with an insurable interest.
9. What is the waiting tenure for maternity coverage under the Edelweiss General Insurance plan?
Maternity benefits are available under Edelweiss's family floater policy after a 48-month waiting term.
10. What is the level of coverage for maternity expenditures provided under an Edelweiss insurance plan?
Edelweiss medical insurance plan provides maternity coverage for up to a limit of INR 50,000 with the Gold variation and up to a limit of INR 2 Lakh with the Platinum version.
Edelweiss Health Insurance Renewal FAQs
1. Is it possible for me to pay for the Edelweiss health insurance renewal online?
Yes, you can make the Edelweiss health insurance online payment for renewal. In addition, you have offline payment options. It is also possible to visit the insurer's branch and pay by demand draft or cheque. Be aware that some insurers only accept cash payments up to a certain amount when renewing medical insurance coverage in cash.
2. What transpires if I don't pay the renewal fee by the due date specified in the Edelweiss health insurance policy?
We suggest paying the premium prior to the policy's expiration date in order to benefit from the plan. In the event of unexpected circumstances, Edelweiss health insurance offers a 30-day grace period to settle the premium; however, insurance benefits are suspended during this time.
3. Do health insurance contracts renew themselves automatically?
Edelweiss health insurance plans are often sold as one-year contracts that need to be renewed annually. A renewal notification may be sent by the insurer.
4. Can I renew my Edelweiss health insurance policy if I fail to do so on the due date?
According to IRDAI, you have 60 days from the payment due date to renew your coverage only when your existing Edelweiss health insurance policy ends.
5. Does Edelweiss General Insurance provide portability as a feature?
Yes, policyholders of Edelweiss General Insurance have access to the portability option. With this, you may simply move your plan into Edelweiss General Insurance in accordance with IRDAI regulations without losing any continuity benefits. You can apply for the portability option only at the time of renewal.
Edelweiss Health Insurance Claim Settlement FAQs
1. How much time do you get to make a claim settlement?
Seven working days after obtaining the last "required" document, the corporation normally responds to claims. However, the deadlines are sometimes extended. These shouldn't last more than 30 days.
2. What factors led to the claim amount being reduced?
The amount of a claim may be lowered for any of the following reasons:
- Not having the proper paperwork or prescriptions.
- The cost of meals, phone calls, and other non-medical costs are not covered by reimbursement.
- There are price restrictions for each unique service or benefit, and there are no longer any real records or invoices.
- Any research or therapy that is unrelated to the condition wherein the patient is being treated comes at a cost.
- Beyond the bounds of sub-limits.
- When to make a co-payment.
- The insurance sum has been spent.
This information is merely being given as an example and could change depending on your insurance coverage.
3. Is my claim still going to be approved if I don't submit it by the due date?
Yes. Generally speaking, the firm must receive the completed claim form together with any necessary supporting documents within the allowed period. Provided the deadline is missed, the claim will still be approved if the insurer can provide evidence that the delay was justified and unavoidable.
4. What alternative requirements are there if the claimant misplaces the original policy document?
The indemnity bond for loss of policy document, which needs to be prepared on 200-rupee stamp paper and properly notarized, is what the claimant must provide if they've lost the original policy bond.
5. How can I find out if my Edelweiss claim has been approved or not?
Call Toll Free -1800 12000 / Paid Landline - 022 423 12000, send an email to firstname.lastname@example.org and visit the Edelweiss General Insurance branch that is most convenient for you or use any other available method to get the information you need about the Edelweiss health insurance claim settlement ratio.
Edelweiss Health Insurance Policy Download FAQs
1. What is the process of downloading my Edelweiss health insurance policy paperwork?
The original Edelweiss policy paper will be sent to your registered email address after your purchase. But you can also obtain the Edelweiss health policy download from the official company website, or you can also call 1800-103-5499 and ask customer service for some extra help.
2. Is the member ID the same as the policy number for the Edelweiss health policy download online?
On the card, your member ID number is often listed as your health insurance plan number. This number may be easily found on your health card, making it available for use by your doctor to confirm your eligibility and coverage.
3. What is a policy document?
The policy document is an official process that is recognised as being legally enforceable; as a result, its intent, definitions, and obligations set forth within its material must be respected in order for it to be utilised to support a person or the Trust in court. You can acquire the Edelweiss health policy download online.
4. What are the elements of Edelweiss's health insurance plan?
Any insurance policy has five elements: exclusions, insurance contracts, insurance declarations, definitions and conditions. The sixth section of most policies is endorsements.
5. What is an Edelweiss insurance policy note?
An Edelweiss Insurance policy note is a cover note provided by the insurance company at times in the absence or delay of authentic policy details. The Edelweiss health insurance copy download process is available on their official page.
Edelweiss Health Insurance Benefits FAQs
1. What sets in-patient therapy distinct from outpatient treatment?
The primary difference between inpatient and outpatient care is that the former requires an overnight hospital stay while the latter does not. Medical professionals will watch over you while you receive treatment and recover in a hospital if you need in-patient care.
2. What are the Edelweiss Health Insurance policy's exclusions?
Edelweiss healthcare plans have a variety of exclusions you should keep in mind. Different policies have different lists of exclusions, so you may choose one that best matches your needs.
- If you already have the sickness when you get an Edelweiss health policy, it will be viewed as a pre-existing condition. It won’t get covered till the designated waiting period, which can stretch to a maximum of four years from policy inception.
- Edelweiss health insurance does not provide the expense of cosmetic treatment.
- If the insured voluntarily causes his or her own injuries, Edelweiss health insurance does not cover them. This includes all injuries caused by self-inflicted harm or failed suicide attempts.
- Edelweiss health insurance may not always cover the expenses of alternative treatment modalities, such as electromagnetic therapy, acupuncture, naturopathy, homoeopathy, and lifestyle-related disorders.
- Edelweiss health insurance plans have a cap on a variety of costs, such as rent, ambulance expenses, and doctor visits.
- Numerous individuals often file claims for the expenses of diagnostic It is important to note that Edelweiss health insurance plans do not cover the cost of these tests.
3. What is the one-crore health insurance from Edelweiss?
Critical illness coverage under a standalone INR 1 crore critical illness insurance or an INR 1 crore healthcare insurance policy. If any of the aforementioned circumstances are found under this plan, the insurer will make a flat payment to you.
4. What benefits can you expect from choosing Edelweiss health insurance that pays for AYUSH treatments?
Some of the most well-known alternative healthcare systems in use today include Homoeopathy, Yoga, Ayurveda, Siddha, and Unani; obtaining healthcare coverage with AYUSH treatment coverage from Edelweiss health insurance will enable you to research holistic healing methods. As part of wellness and protective healthcare, you can also register for AYUSH treatment coverage.
5. What is the 8 people - 1 policy from Edelweiss health insurance?
You may cover a total of eight individuals with the Edelweiss health insurance plan benefits, including yourself, your spouse, parents, in-laws, children, and siblings, with a separate sum covered for each person. The family floater plan allows you to insure up to five people, comprising your spouse, three children, and yourself.
Edelweiss Health Insurance Network Hospitals FAQs
1. Is the COVID-19 coverage plan available on the Edelweiss health insurance hospital list near me?
Coverage for COVID-19 is included in the range of the policy. The insurance programme provides coverage for COVID-19-related hospital stays and medical procedures. To see if there are any Edelweiss health insurance hospital lists near me, you can check it online.
2. How can I submit an insurance claim to a hospital outside of my network?
If you decide to undergo a procedure at a hospital that is not part of your insurance network, you will have to pay the hospital bills out of pocket after being released. Later, you can contact the insurance company and file a claim for a refund.
3. How many network hospitals are there in the Edelweiss health insurance plan?
The Edelweiss health insurance policy plan lists more than 3281 network hospitals. They are widely dispersed around the nation and are easily accessible for medical care.
4. What does an insurance network hospital mean?
A network hospital is one that has a deal with the insurance company and offers the covered people cashless care. Your insurance company will cover the out-of-pocket costs of your medical bills if you obtain treatment at a hospital in the network.
5. What is excluded from a cashless hospital?
In the case of an emergency hospitalisation or if you ever need to receive scheduled medical care, health insurance coverage is designed to protect you from the costs of required medical expenses. As a result, you can be charged for some non-medical items which your cashless healthcare insurance claim won't pay for, like:
- Medical facility registration costs
- Money spent on toiletries
- Services fees
- Entrance fees
Edelweiss Health Insurance Premium Calculator FAQs
1. What is the cost of monthly health insurance?
The monthly premium you pay for health insurance varies from insurer to insurer. And, the plan or coverage that you have opted for. Moreover, it also depends on a lot of factors like age, medical history, profession, etc.
2. How can I make my premium less expensive?
Following are some tips for reducing your premium:
- Longer term of employment
- Start paying premiums right now
- Choose an annual premium amount
- Keep up your fitness
- Avoid only useful riders
3. Why should I use the premium calculators that are offered online?
A premium calculator not only helps to save time and work but is also simple to use. No authentic papers are required to get top quotations. One may get premium quotations for various alternatives in under 1 minute by providing a few basic facts, such as annual income, identity, birth date, and so forth. A person can get health insurance online without the need for an agent's assistance if they make an informed decision.
4. How is the insurance maturity amount calculated?
The basic structure is Final Additional Bonus (if declared) + Bonuses + Sum Insured. Business policy dictates that the insurance company includes bonuses and the most recent incentive all through the maturity value.
5. How do premium calculators operate?
An online tool known as a health insurance premium calculator allows a potential customer to calculate the premium cost for a specific health insurance plan. With medical prices rising, figuring out the premium becomes more crucial.
Edelweiss Health Insurance Top Up Plans FAQs
1. Is it possible to get more coverage than the insured sum amount in Edelweiss health top up plan?
Yes. Edelweiss offers a restoration add-on to their top up insurance as optional coverage. If the policyholder opts for it, the company restores 100% of the insured sum amount if the initial coverage is exhausted.
2. Are children eligible to join Edelweiss Super Top-Up Plan?
Yes. Dependent children are eligible to join from the age of 91 days. They will be eligible for coverage until the age of 25 years. After that, they can still remain in the coverage but they will be counted as adults. However, you can also purchase a newborn add-on to make sure your child is protected from day one.
3. What is the minimum deductible limit of Edelweiss top up plans?
The minimum deductible limit of Edelweiss top up plans is INR 50,000.
4. Does Edelweiss offer any discount on their top up plans?
Edelweiss offers the following discounts on their top up plans:
- 7.5% discount on a 2-year insurance plan
- 10% discount on a 3-year insurance plan
- 15% discount on online policy purchases from the official Edelweiss website
5. Do you need to undergo a pre-policy medical check-up under Edelweiss health insurance top up plans?
Yes, Edelweiss may want you to undergo pre-policy medical check ups based on your sum insured, age, deductible amount chosen, BMI, etc.
Edelweiss Health Insurance Critical Illness Plans FAQs
1. How many members of the household can be covered?
The policy covers self, spouse and three dependent children between the age of 3 months and 21 years.
2. What is the minimum age requirement to be eligible for Edelweiss health insurance critical illness cover?
The minimum age requirement to be eligible for Edelweiss health insurance critical illness cover is 3 months.
3. Does the Edelweiss health critical illness policy cover AYUSH therapy?
Yes. AYUSH therapy expenses are covered by this policy.
4. Does the Edelweiss health critical illness policy cover cancer treatment?
Yes. Specified severity cancer treatment is covered under this policy.
5. Does the Edelweiss health critical illness policy allow co-payment?
Yes. This policy offers a voluntary co-pay of up to 20%.
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