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Health Insurance: What is Covered?

Coverage

Total connect with your health insurance

Coverage

What does the Liberty Health Connect health insurance cover?

The health insurance benefits of the policy by Liberty Videocon provide cover for the following occurrences:

  • Hospitalisation Expenses:
    • In-Patien​t Treatment: Following any Illness or Injury, the mediclaim policy provides for in-patient care expenses incurred at any Hospital/Nursing Home in India. Expenses incurred towards Room, Boarding expenses, Intensive Care Unit bed charges, Doctor’s fees, Nursing Expenses, Surgical Fees, Operation Theatre Charges, Anesthetist, Anesthesia, Blood, Oxygen and their administration, Physical Therapy, Prescribed Drugs and medicines consumed on the premises, Investigation Services such as Laboratory, X-Ray, Diagnostic tests, Dressing, Ordinary splints and plaster casts, as well as the Cost of Prosthetic devices if implanted during a surgical procedure
    • Day Care Treatment: This health insurance covers medical expenses for more than 140 listed day care procedures, which require less than 24 hours of hospitalization due to technological advancement of the procedures that let people check out before the day is over.
  • Pre-Hospitalisation Expenses: The health insurance covers medical expenses incurred for a specified number of days immediately before the hospitalization. This includes expenses like those towards consultations, tests & medications.
  • Post-Hospitalisation Expenses: The health insurance covers medical expenses incurred for a specified number of days immediately after the discharge from the Hospital. These may include expenses towards follow-up visits, confirmatory tests, medications & physiotherapy.
  • Domiciliary Hospitalisation Treatment: The health insurance covers medical expenses incurred for treatment taken at home in India as the patient cannot be moved to a hospital, or the patient takes treatment at home on account of non-availability of room in a hospital.
  • Hospital Daily Cash Allowance: The health insurance pays a Hospital Daily Cash allowance on a per day basis to take care of non-medical expenses incurred for each continuous and completed period of 24 hours of hospitalization of the Insured Person for a maximum up to 10th day of continuous hospitalization. A deductible* of first 48 hours of hospitalization is however applicable as per the mediclaim policy.
  • Emergency Local Road Ambulance Charges: The health insurance covers expenses incurred towards transfer of Insured Patient to nearest Hospital having adequate emergency facilities. These charges will be paid up to a specific amount mentioned in the Schedule of Benefits.
  • Organ Donor Expenses: The health insurance covers expenses incurred towards an organ donor’s screening & treatment for harvesting of the organ donated.
  • Second Opinion: We will arrange for a second opinion consultancy, once during the medical insurance policy period, to augment confidence in the proposed medical diagnosis and treatment plan.
  • Recovery Benefit: The health insurance pays a lump-sum amount in case of hospitalization for more than 10 days
  • Nursing Allowance:​ The health insurance pays a daily allowance towards engaging the services of a qualified nurse for a specified amount of time, either at the hospital or at the insured person’s residence.

 

This is not an exhaustive list. For a detailed list of inclusions & other details, please read the policy wordings.

What does the Health Connect health insurance not cover?

  • Waiting Period Exclusions:
    • 30 days Waiting Period Exclusion: A waiting period of 30 days from the commencement date of the first mediclaim insurance policy will apply to all disease/ illness contracted other than accidental bodily injury requiring hospitalization.
    • First Year Waiting Period Exclusion: During the first year of operation of this health insurance cover, expenses on treatment of the following diseases are not payable under the health insurance quotes: Cataract, Benign Prostatic Hypertrophy, Hernia, Hydrocele, Fistula in anus, piles, Sinusitis and related disorders, Fissure, Gastric and Duodenal ulcers, gout and rheumatism; internal tumors, cysts, nodules, polyps including breast lumps (each of any kind unless malignant); Hysterectomy/ myomectomy for menorrhagia or fibromyoma or prolapse of uterus, polycystic ovarian diseases; skin tumors unless malignant, benign ear, nose and throat (ENT) disorders and surgeries (including but not limited to adenoidectomy, mastoidectomy, tonsillectomy and tympanoplasty); dilatation and curettage (D&C); & Congenital Internal Diseases.
    • Two Year Waiting Period Exclusion: During the first two years of the operation of this health insurance cover, the expenses on treatment of following diseases are not payable: Calculus diseases of Gall bladder and Urogenital system, Hypertension and Diabetes and related complications, Joint Replacement due to Degenerative condition, Surgery for prolapsed inter vertebral disc unless arising from accident, Age related Osteoarthritis and Osteoporosis, Spondylosis / Spondylitis, Surgery of varicose veins and varicose ulcers.
      Diabetes & related complications including but not limited to: Diabetic Retinopathy, Diabetic Nephropathy, Diabetic Foot/Wound, Diabetic Angiopathy, Diabetic Neuropathy, Hypo/Hyperglycemic Shocks. Hypertension & related complications including but not limited to: Coronory Artery Disease, Cerebrovascular Accident, Hypertensive Nephropathy, Internal Bleed/Haemorrhages. If these diseases are pre-existing at the time of proposal or subsequently found to be pre-existing, exclusion below shall be applicable under the health insurance plan.
    • Pre- Existing Condition Exclusion: Pre-existing Conditions and any complications arising from the same will not be covered under the health insurance plan until 48 months, 36 months or 24 months of continuous medical insurance coverage have elapsed, as per the plan chosen, since inception of your first Policy with Us.
  • Any condition directly or indirectly caused by or associated with any sexually transmitted disease, including Genital Warts, Syphilis, Gonorrhea, Genital Herpes, Chlamydia, Pubic Lice & Trichomoniasis, Acquired Immuno Deficiency Syndrome (AIDS) whether or not arising out of HIV, Human T Cell Lymphotropic Virus Type III (HTLV-III or IITLB-III) or Lymphadinopathy Associated Virus (LAV) or the mutants derivative or Variations Deficiency Syndrome or any Syndrome or condition of a similar kind will not be covered under this health insurance plan.
  • Any treatment arising from or traceable to pregnancy (including voluntary termination), miscarriage (unless due to an Accident), childbirth, maternity (including caesarian section), abortion or complications of any of these are also not covered under the health insurance. This exclusion will not apply to ectopic pregnancy.
  • Any treatment arising from or traceable to any fertility, infertility, sub fertility or assisted conception procedure or sterilization, birth control procedures, hormone replacement therapy, contraceptive supplies, or services including complications arising due to supplying services or Assisted Reproductive Technology will not be covered under the health insurance policy.
  • Any dental treatment or surgery unless requiring hospitalization are not covered under the health insurance policy.
  • Treatment taken from anyone who is not a Medical Practitioner or from a Medical Practitioner who is practicing outside the discipline for which he is licensed or any kind of self-medication are not covered under the health insurance policy.
  • Charges incurred in connection with cost of spectacles and contact lenses, hearing aids, routine eye and ear examinations, laser surgery for correction of refractory errors, dentures, artificial teeth and all other similar external appliances and /or devices whether for diagnosis or treatment are not covered under the health insurance policy.​

 

This is not an exhaustive list. For a detailed list of exclusions &​ other details, please read the policy wordings.

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