|
Schedule of benefits - Chola Health Insurance
Plan |
|
|
|
Benefit Type |
|
A |
B |
C |
D |
|
|
Level of Benefits |
Limits |
Limits |
Limits |
Limits |
|
General limit per person per policy
year |
Applicable on sections 1a,1b,1c & 1d |
Rs 1,000,000 |
Rs 750,000 |
Rs 500,000 |
Rs 400,000 |
|
Co-Insurance per person per policy
year |
Applicable on eligible expenses
caused by Non-network provider subject
to being pre-authorised |
10% |
10% |
10% |
10% |
|
Hospitalisation class |
|
CLASS A |
CLASS B |
CLASS B |
CLASS B |
|
Section 1a Basic Hospitalisation
Services Co-Insurance |
100% of eligible expenses up to the
General Limit |
Covered |
Covered 15% if class A |
Covered 15% if class A |
Covered 15% if class A |
|
Section 1c Pre- Hospitalisation |
100% of eligible expenses up to the
General Limit |
60 days prior to Hospitalisation |
60 days prior to Hospitalisation |
60 days prior to Hospitalisation |
60 days prior to Hospitalisation |
|
Section 1b Post- Hospitalisation |
100% of eligible expenses up to the
General Limit |
90 days after Hospitalisation |
90 days after Hospitalisation |
90 days after Hospitalisation |
90 days after Hospitalisation |
|
Section 1d Day Care Services |
100% of eligible expenses up to the
General Limit subject to Pre-authorisation;
otherwise it is not covered |
Covered |
Covered |
Covered |
Covered |
|
Section 1e Local Ambulance Services |
100% of eligible expenses up to the
General Limit |
Covered up to 2,000,00 per person per
policy year |
Covered up to 2,000,00 per person per
policy year |
Covered up to 2,000,00 per person per
policy year |
Covered up to 2,000,00 per person per
policy year |
|
Benefit Type |
E |
F |
G |
H |
I |
|
|
Limits |
Limits |
Limits |
Limits |
Limits |
|
General limit per person per policy
year |
Rs 300,000 |
Rs 200,000 |
Rs 150,000 |
Rs 100,000 |
Rs 50,000 |
|
Co-Insurance per person per policy
year |
10% |
10% |
10% |
10% |
10% |
|
Hospitalisation class |
CLASS B |
CLASS B |
CLASS B |
CLASS C |
CLASS C |
|
Section 1a Basic Hospitalisation
Services Co-Insurance |
Covered |
Covered 15% if Class A |
Covered 15% if Class A |
Covered 15% if Class B 25% if Class A |
Covered 15% if Class B 25% if Class A |
|
Section 1c Pre- Hospitalisation |
60 days prior to Hospitalisation |
60 days prior to Hospitalisation |
60 days prior to Hospitalisation |
60 days prior to Hospitalisation |
60 days prior to Hospitalisation |
|
Section 1b Post- Hospitalisation |
90 days after Hospitalisation |
90 days after Hospitalisation |
90 days after Hospitalisation |
90 days after Hospitalisation |
90 days after Hospitalisation |
|
Section 1d Day Care Services |
Covered |
Covered |
Covered |
Covered |
Covered |
|
Section 1e Local Ambulance Services |
Covered up to 1,000,00 per person per
policy year |
Covered up to 1,000,00 per person per
policy year |
Covered up to 1,000,00 per person per
policy year |
Covered up to 1,000,00 per person per
policy year |
Covered up to 1,000,00 per person per
policy year |
