Bajaj Allianz Silver Health Plan for Senior Citizens- Eligibility & Benefits

Published: 17-01-2019 10:33:13 AM

The cost of healthcare services and medical treatment is getting ever higher. This increases with age as more natural illnesses start to show up. This means major responsibilities and additional financial burden on their shoulders. To avail top-quality healthcare facilities and cover additional expenses, senior citizens often pay out of their savings. A good health insurance plan specifically designed for senior citizens can be really helpful in covering unexpected medical expenses with ease. To protect the hard-earned savings of senior citizens, Bajaj Allianz presents an extensive range of health insurance plans. Bajaj Allianz Silver Health Plan for Senior Citizens is particularly designed to protect the policyholder and their spouse in case they need immediate or emergency expensive medical attention.

Eligibility Criteria for Bajaj Allianz Silver Health Plan For Senior Citizens

To buy this plan, one needs to fulfil the following:

• Entry Age: To buy this plan, an individual must be between the age group of 46 years to 70 years. Before and after this age group, no one can buy this plan.
• Policy Renewal Age: Just like entry age, this plan also comes with a certain age group for renewal. Under normal circumstances, this plan can be renewed lifelong except on the grounds of moral hazard, fraud or misrepresentation.
• Sum Assuredor Sum Insured: The health insurance plan offers several sum insured options to choose from. One can choose between Rs. 50,000, Rs. 1 lakh, Rs. 1.50 lakh, Rs. 2 lakh, Rs. 3 lakh, Rs. 4 lakh and Rs. 5 lakh.
• Policy Period: Generally, an insurance plan has a fixed policy period, but this is an annual health insurance policy.

Features of Silver Health Plan for Senior Citizens

The health plan offers an extensive range of features to the policyholders. And some of them are listed below:

• Cashless Treatment Facility:The health insurance plan for senior citizens gives direct access to the wide network of hospitals across the country to avail cashless treatment facility. However, this benefit is a subject to certain conditions and exclusions. It is advisable to thoroughly read policy documents to avoid last-minute hassles.
• Reimbursable Expenses:Apart from the empanelled one, this plan can also be availed for spouse. In such a case, the medical expenses incurred due to their treatment in one of the network hospital can be reimbursed by the policyholder within 14 business days from the date of document submission.
• Waiver of Co-Payments:The health insurance plan also provides the insured with co-payment facility. Up to 20% of co-pay the admissible claims to be provided by the policy owner if the treatment has not been taken in one of the network hospitals. However, the waiver of co-pays is available on the payment of additional premiums.

Benefits of Silver Health Plan for Senior Citizens

 Mentioned below are some of the major benefits of the plan: 

• Additional Bonus and Discount:The insurance policy provides the insured with cumulative bonus of 10% to their indemnity limit for each claim-free policy year. This bonus can go up to maximum 50%. In addition to this, the policy also provides the insured with 5% family discount if 2 or more members are covered in the plan. 

• Income Tax Benefit:The health insurance plan offers tax exemptions under section 80D of the Income Tax Act, 1961 on the premiums paid towards the plan. However, income tax benefits depend on the extant tax laws. Consult an expert tax advisor to know the benefits. Section 80C benefits are not included. 

• Quick Settlement of Claims:The health plan provides Health CDC benefits to the policy owners. A quick claim settlement can be done through the official app of Bajaj Allianz.

Coverage Offered by Silver Health Plan for Senior Citizens

The health insurance plan designed for senior citizens offers the following to the policyholder:

• The health plan covers all hospitalisation or medical expenses and an amount equal to 3% of the admissible pre-hospitalisation and post-hospitalisation expenses.
• The insurance policy provides the policy owners with the coverage of expenses incurred due to ambulance facility. The limit of ambulance expense provided is Rs. 1,000.
• A number of health plans do not provide coverage to pre-existing illnesses or diseases. This plan covers pre-existing diseases/ illnesses/ injuries/ conditions from the 2^nd year of the health plan.

Annual Premium for Silver Health Plan for Senior Citizens

The health plan has a breakup of premium as per the entry age and sum insured amount. Annual premiums for this plan have been tabulated below:

Sum Insured	Age of the Policyholder					Renewal Premiums
	46-50 years	51-55 years	56-60 years	61-65 years	66-70 years	71 years and above
Rs. 50,000	Rs. 1,995	Rs. 2,495	Rs. 3,824	Rs. 4,780	Rs. 7,170	Rs. 8,963
Rs. 1 lakh	Rs. 2,993	Rs. 3,742	Rs. 5,736	Rs. 7,170	Rs. 10,755	Rs. 13,444
Rs. 1.5 lakh	Rs. 3,741	Rs. 4,677	Rs. 7,170	Rs. 8,963	Rs. 13,444	Rs. 16,805
Rs. 2 lakh	Rs. 4,676	Rs. 5,846	Rs. 8,963	Rs. 11,203	Rs. 16,805	Rs. 21,006
Rs. 3 lakh	Rs. 5,845	Rs. 7,308	Rs. 11,203	Rs. 14,004	Rs. 21,006	Rs. 26,257
Rs. 4 lakh	Rs. 8,767	Rs. 10,962	Rs. 16,805	Rs. 18,905	Rs. 24,199	Rs. 30,248
Rs. 5 lakh	Rs. 10,959	Rs. 13,155	Rs. 21,006	Rs. 23,632	Rs. 29,039	Rs. 36,298

Exclusions under Silver Health Plan for Senior Citizens

The health insurance plan for senior citizen by Bajaj Allianz comes with numerous exclusions. And these exclusions are:

• All pre-existing illnesses/ injuries/ diseases/ conditions will one be covered after 12 months
• Any sort of disease or condition contracted during the initial 30 days from the date of policy commencement will not be covered
• Certain health conditions such as piles, hernia, benign pro-static hypertrophy, cataract and hysterectomy will only be covered after the 1 year of waiting period
• Other treatment methods such as Ayurveda, Homeopathic and Unani are not covered
• Expenses incurred due to the treatment of HIV/AIDS and related issues are not covered
• Any sort of aesthetic, cosmetic or related treatment expenses are excluded
• 4 years of waiting period is defined for joint replacement surgery except for accidental cases
• Expenses incurred due to the de-addiction of alcohol and drugs are not covered
• Medical cost of any psychiatric illness or mental disorder is not covered

How to Make Claims for Bajaj Allianz Silver Health Plan for Senior Citizens?

The claim process with Bajaj Allianz is quite easy. Look at the following table to know more about the process:

For Empanelled Hospitals	For Non-Empanelled Hospitals
· Get admitted in one of the network hospitals · Show health card to avail cashless treatment facility · Register the claim by calling on 1800-209-5858 (toll-free) number or filling the online claim registration form	· Get admitted in any hospital except the network ones · Pay the bills · Reimburse the amount paid by sending Bajaj Allianz a duly filled and signed claim form along with the original bills and all hospitalisation-related documents to the insurer

Documents Required

The following are the documents needed to intimate the claim process:

• First consultation letter which is given by the doctor
• Duly filled and signed claim and NEFT form
• Original documents of hospital discharge
• Original bills with detailed break-up of all the expenses incurred during the treatment including OT charges, doctor’s fees, visit charges, room rent, OT consumables, transfusions, etc.
• Original copies of money receipts with signature (insured) and revenue stamp
• All original diagnostic and laboratory test reports such as USG, ECG, x-ray, MRI scan, Haemogram, etc.
• IOL Sticker in case of a cataract operation
• Copies of Aadhaar card and PAN card (as needed)
• Other essential documents as may be requested by the insurer to complete the claim process.

FAQs

 Q1. How to contact Bajaj Allianz for plan-related queries?

The following are the contact details of Bajaj Allianz:

• Call:1800-209-5858 (BSNL), 1800-22-5858 (TATA), 1800-102-5858 (Bharti), 020-30305858 (Others)
• Email:bagichelp@bajajallianz.co.in

One can call on the mentioned above to know more about the top-up plans, NAV, premium paying term, etc.

Q2. How much tax benefit is provided under this health plan?

Tax benefit is provided to the policyholder under section 80D of the Income Tax Act on premiums paid towards the plan which is up to Rs. 1 lakh per annum.

Q3. Is pre-policy check-up mandatory for this plan?

Yes, pre-policy check-up is mandatory for every proposal. These check-ups will be arranged by the insurer at their empanelled diagnostic centres only.

Q4. What are the diseases for which the one year of period is applicable?

The following are the diseases for which this waiting period is applicable:

• Duodenal ulcers or gastric surgery
• Benign pro-static hypertrophy
• Hydrocele
• Piles/ Haemorrhoids/ Fissure/ Flstuler
• Endometriosis
• Stones in biliary and urinary systems
• Dysfunctional uterine bleeding
• Ears surgery
• Prolapse of genitourinary or intra-abdominal organs
• Cataracts
• Prolapsed inter-vertebral discs treatment
• Hernia (all types)
• Cysts, internal tumours, polyps/ nodules surgery
• Joint surgery
• Fibromyom
• Hysterectomy
• Treatment for malignant conditions, benign tumours or organomegaly.