Also are there any eligibilty criteria like say the policy must have been 1 year old or so to claim mediclaim Please help looking to get lasik surgery done for myself .Its gonna cost me Rs40k
From India, Mumbai
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Mediclaim policies are taken for a year and renewed subsequently. Check the policy details. Pon
From India, Lucknow
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You have been covered by your company in a group or individual Mediclaim insurance policy. How will an outsider who does not have access to the policy or know its terms be able to say whether the surgery will be covered? Either check the policy or go and speak to the HR department of your company.
From India, Mumbai
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Dear Kezz,

Of course, there are certain restrictions. Soon after the Policy document containing the terms & conditions is received, everyone should go through the contents very carefully to fully understand what all the restrictions/curtailments are. To highlight some of these restrictions & exclusions, I will indicate/quote from one such Policy Provider with whom I interacted for your reference:

"3.12 GRACE PERIOD

Grace Period means the specified period of time immediately following the premium due date during which a payment can be made to renew or continue a policy in force without loss of continuity benefits such as "waiting periods" and coverage of pre-existing diseases. Coverage is not available for the period for which no premium is received.

VI Free Look period of 15 days shall be applicable at the inception of the first policy.

EXCLUSIONS:

All Pre-existing diseases up to 48 months of continuous coverage.

Any disease contracted during the first 30 days of the inception of the policy.

Waiting period of 2/4 years for certain specified illnesses/treatments.

Vaccination and Inoculation of any kind unless it is post-animal bite.

General debility and Run-down conditions.

Circumcision, Cosmetic surgery, Plastic surgery.

HIV/AIDS.

Psychiatric and psychosomatic disorders.

Injury arising out of drug/alcohol abuse.

Pregnancy, ailments related thereto, and childbirth.

War, act of foreign enemy, ionizing radiation, and nuclear weapons.

Naturopathy.

Experimental or unproven treatment.

All external equipment.

Dental treatments."

You will also need to read the full text of the Terms & Conditions, which is in my possession and attached for your guidance.

It is advisable that everyone first goes through the terms & conditions of various Policy Providers, get all the doubts clarified, satisfy themselves about them, and then decide which terms are more agreeable before paying the policy premium. These are only sample conditions and may vary from company to company. So, it is necessary that the terms & conditions of the respective Policy Providers should be taken into consideration. Almost all Policy Providers have placed their Terms & Conditions on their websites to facilitate easy reference.

From India, Bangalore
Attached Files (Download Requires Membership)
File Type: docx Medicare Health Insurance Policy conditions.docx (21.3 KB, 576 views)

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Dear,

There are different types of policies, and no one can provide the correct answer until they have read the policy. Your HR person will be the right individual to give you 100% clarification because they are the ones who dealt with the insurance.

Thank you.

From India, Bangalore
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I have one query: If an employer has made a provision of Mediclaim Insurance and general personal accident policy for an Employee, Can Employer deduct the premium cost from employees salary?
From India, Pune
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