Medical Insurance

{"medical_insurance":{"title":"Medical Insurance","description":"

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Medical Insurance for the year 2024 - 2025 : Policy Period : 20th June 2024 to 19th June 2025 - Insurance Co : Liberty General Insurance Ltd.<\/strong><\/p>\r\n\r\n

ALPA India strives for the betterment of Indian pilots regardless of their country of employment. ALPA India offers its pilots and their family a medical insurance plan as part of its commitment to securing their future.<\/strong><\/p>\r\n\r\n

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SNO<\/td>\r\n\t\t\tCOVERAGE<\/td>\r\n\t\t\tCOVERAGE<\/td>\r\n\t\t\tNEW TERMS<\/td>\r\n\t\t\tADDITIONAL BENEFITS<\/td>\r\n\t\t<\/tr>\r\n\t<\/thead>\r\n\t
1<\/td>\r\n\t\t\tFamily Definition<\/strong><\/td>\r\n\t\t\t\r\n\t\t\t

A family floater policy is a health insurance plan which covers the entire family on the payment of a single annual premium. The sum assured covers the entire family and can be used in case of multiple hospitalizations in the family<\/p>\r\n\t\t\t<\/td>\r\n\t\t\t

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  • Children OR Parents or Parents in-law  (size of the family should not be more than 1+5)<\/li>\r\n\t\t\t\t
  • Only dependent and unmarried children  upto 25 years covered. Rest - 99 years.<\/li>\r\n\t\t\t<\/ul>\r\n\t\t\t<\/td>\r\n\t\t\t
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  •   Children upto 25 yrs<\/li>\r\n\t\t\t\t
  • Permanent disabled child, covered without any age limit<\/li>\r\n\t\t\t<\/ul>\r\n\t\t\t<\/td>\r\n\t\t<\/tr>\r\n\t\t
2<\/td>\r\n\t\t\tSum Insured family floater basis<\/strong><\/td>\r\n\t\t\tThe sum insured is the maximum value for a particular year that the insurance company can pay if hospitalized. Any amount exceeding the sum insured will have to be borne by the employee. Agreed amount on the sum insured will be the maximum amount received in case of medical treatment or hospitalization.<\/td>\r\n\t\t\tSUM INSURED     03 Lakhs \/ 05 Lakhs 10 Lakhs \/25 Lakhs & 30 Lakhs<\/td>\r\n\t\t\tYou can select the coverage as per your family's requirement<\/td>\r\n\t\t<\/tr>\r\n\t\t
3<\/td>\r\n\t\t\tRoom Rent Restrictions<\/strong><\/td>\r\n\t\t\tSub-limit on room rent would mean that the insurer defines the maximum amount it will pay towards the room rent. ICU No limit.<\/td>\r\n\t\t\tNormal Room Rent For 3 Lakhs - 3k    5 Lakhs - 6k \/  10 Lakhs - 8k \/   25 Lakhs -12.5k & 30 Lakhs  - 15k      All other charges in accordance with the Room Rent restriction<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
4<\/td>\r\n\t\t\t30 days , 1st, 2nd 3rd & 4th Year waiting<\/strong><\/td>\r\n\t\t\t1.Coverage of Pre-existing Conditions without any waiting period. 2. Waiver of the exclusions relating to the first 30 days of the Policy period.<\/td>\r\n\t\t\tWaived<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
5<\/td>\r\n\t\t\tMaternity Day 1<\/strong><\/td>\r\n\t\t\tNo waiting period for Maternity  <\/td>\r\n\t\t\tNormal & C-section Rs. 1.5 lacs<\/td>\r\n\t\t\t <\/td>\r\n\t\t<\/tr>\r\n\t\t
6<\/td>\r\n\t\t\tPre & Post Natal expenses<\/strong><\/td>\r\n\t\t\tPre- and post-natal expenses would mean costs pertaining to ultrasound, regular checkups, doctor's consultation fee, medicines and so on. These are similar to pre- and post-hospitalization expenses that are admissible under a standard health insurance policy.<\/td>\r\n\t\t\tPre - Within Maternity limits , Post within full Sum insured<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
7<\/td>\r\n\t\t\tNew born Baby Cover<\/strong><\/td>\r\n\t\t\tCover Medical Expenses towards the medical treatment of the Insured Person's New Born Baby while the Insured Person is Hospitalized for Inpatient Care for delivery.<\/td>\r\n\t\t\tCovered within Family Floater SI from Day 1<\/td>\r\n\t\t\tNo additional premium required for new born baby<\/td>\r\n\t\t<\/tr>\r\n\t\t
8<\/td>\r\n\t\t\tPre-existing Disease Covered - day 1<\/strong><\/td>\r\n\t\t\tAny condition, ailment or injury or related condition(s) for which you had signs or symptoms, and \/ or were diagnosed, and \/ or received medical advice \/ treatment within 48 months prior to the first policy issued by the insurer.<\/td>\r\n\t\t\tCovered for all Members<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
9<\/td>\r\n\t\t\tPre & Post Hospitalization period<\/strong><\/td>\r\n\t\t\tThe Policy pays the Medical Expenses incurred as
\r\n\t\t\tdefined for an ailment \/ disease \/ Injury not different from the one for which hospitalization was
\r\n\t\t\tnecessary during the Pre and Post Hospitalization period.<\/td>\r\n\t\t\t		60 & 90 days <\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
10<\/td>\r\n\t\t\tDomiciliary hospitalization<\/strong><\/td>\r\n\t\t\tDomiciliary hospitalization means medical treatment for a period exceeding three days for such an illness\/disease\/injury which in the normal course would require care and treatment at a hospital but is actually taken while confined at home under any of the following circumstances:
\r\n\t\t\t- the condition of the patient is such that he\/she is not in a condition to be removed to a hospital, or
\r\n\t\t\t- the patient takes treatment at home on account of non-availability of room in a hospital.<\/td>\r\n\t\t\t		10% of SI<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
11<\/td>\r\n\t\t\tEmergency Ambulance charges \/ Air fare<\/strong><\/td>\r\n\t\t\tExpenses for utilizing Ambulance service for transporting Insured Person to Hospital in case of an emergency or from one hospital to another if medical services required are not available.<\/td>\r\n\t\t\tEmergency ambulance charges - air fare - Max of Rs 10 k - emergency. Air ambulance charges - Max Rs 2 lacs. Incl\/ Commercial Airlines<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
12<\/td>\r\n\t\t\tExternal congenital<\/strong><\/td>\r\n\t\t\tThe Policy is extended to provide coverage for surgical treatment on in-patient basis for External congenital disease\/s in life threatening situation upto the limit specified in the Policy Schedule towards this benefit.<\/td>\r\n\t\t\tCovered Under Life threatening conditions<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
13<\/td>\r\n\t\t\tCo-pay clause<\/strong><\/td>\r\n\t\t\tHowever capped ailment like cataract will not attract any Co-pay.<\/td>\r\n\t\t\t20% Co Pay on Parental Claims, No Co-pay on others.<\/td>\r\n\t\t\tNo co-pay for member, spouse, children and siblings<\/td>\r\n\t\t<\/tr>\r\n\t\t
14<\/td>\r\n\t\t\tCataract<\/strong><\/td>\r\n\t\t\tA cataract is a cloudiness or opacity in the normally transparent crystalline lens of the eye. Cataract surgery is a procedure to remove the lens of your eye and, in most cases, replace it with an artificial lens.<\/td>\r\n\t\t\tCataract INR 70,000 per eye<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
15<\/td>\r\n\t\t\tCochlear Implant treatment <\/strong><\/td>\r\n\t\t\tA cochlear implant is a small electronic device that electrically stimulates the cochlear nerve (nerve for hearing)<\/td>\r\n\t\t\tRestricted to 40% of Sum Insured <\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
16<\/td>\r\n\t\t\tCyber Knife treatment and stem cell tplt.<\/strong><\/td>\r\n\t\t\tThe Cyber Knife — one of the most advanced forms of radiosurgery — is a painless, non-invasive treatment that delivers high doses of precisely targeted radiation to destroy tumors or lesions within the body. It uses a robotic arm to deliver highly focused beams of radiation.<\/td>\r\n\t\t\tCovered with 40% Co-pay<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
17<\/td>\r\n\t\t\tCorporate Buffer<\/strong><\/td>\r\n\t\t\tCorporate Buffer limit to take care of any defined emergencies which exceed the individual\/ Family limit of the Sum Insured specified under the Policy. This additional limit is available basis Per person\/ family limit subject to the overall corporate buffer limit specified in the Policy Schedule selected for the full policy period. The Corporate Buffer will not be available for diseases \/procedures \/ treatments where specific sub-limit\/s is \/are applicable in the Policy.<\/td>\r\n\t\t\tRs. 50 Lacs - Equivalent to family SI - For Critical illness<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
18<\/td>\r\n\t\t\tDay Care procedures<\/strong><\/td>\r\n\t\t\tWe will pay the Medical expenses incurred for the Day care procedures which do not require 24 hours Hospitalization due to technological advancement. This excludes all procedures or treatment taken in Out-patient departments.<\/td>\r\n\t\t\tCovered as per Insurer standard coverage list (List attached)<\/td>\r\n\t\t\t <\/td>\r\n\t\t<\/tr>\r\n\t\t
19<\/td>\r\n\t\t\tTerrorism Related Hospitalization<\/strong><\/td>\r\n\t\t\tCovered<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
20<\/td>\r\n\t\t\tLGBTQ Cover\/ Live In partner <\/strong><\/td>\r\n\t\t\tMedical insurance to same-sex partners\/ 1 live in partner <\/td>\r\n\t\t\tCovered<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
21<\/td>\r\n\t\t\tOral chemotherapy<\/strong><\/td>\r\n\t\t\tOral chemotherapy is a cancer-fighting drug given by mouth in tablet, capsule, or liquid form. It is prescribed by your doctor, nurse practitioner, or physician's assistant, and has the same benefits and risks as chemotherapy given by infusion. Today, many cancer patients receive oral chemotherapy as a treatment.<\/td>\r\n\t\t\tCovered for all members<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
22<\/td>\r\n\t\t\tOPD Expenses @ 10k Per Family<\/strong><\/td>\r\n\t\t\tThe Policy is extended to include consultations, pharmacy, diagnostics, medical and surgical procedures taken on an Out-Patient basis upto the amount as stated in the Policy.<\/td>\r\n\t\t\t( Health check - 4,000\/ Dr., Dental , Vision Consultation, Cost of lens -3500\/ Medicines with dr. Prescription 3000\/- )<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
23<\/td>\r\n\t\t\tLasik Surgery<\/strong><\/td>\r\n\t\t\tThis extension covers charges incurred towards correction of refractive errors by using lasik surgery in case of compound myopic astigmatism in both eyes to the level of (-)7.5D and above.<\/td>\r\n\t\t\tIf power of eye is above +\/- 7.5, is payable<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
24<\/td>\r\n\t\t\tIn case of Death of Member<\/strong><\/td>\r\n\t\t\tValidity of the policy, after the demise of the Main Policy Holder (ALPA member)<\/td>\r\n\t\t\tContinued cover of dependents, No copay or deductions on claims<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
25<\/td>\r\n\t\t\tPsychiatric Ailments<\/strong><\/td>\r\n\t\t\tAlso called mental health disorders, refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behaviour. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviours.<\/td>\r\n\t\t\tIn such case only on doctor prescription and admission an amount of INR 30,000 can be claimed per family (in-patient \/ under hospitalization)<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
26<\/td>\r\n\t\t\tBalloon Sinuplasty<\/strong><\/td>\r\n\t\t\tThis minimally invasive technique is used to treat chronic or recurrent sinusitis or sinus infections when medical therapy has not provided adequate relief<\/td>\r\n\t\t\tCovered and restricted to 50% of the sum insured<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
27<\/td>\r\n\t\t\tPermanent disabled child<\/strong><\/td>\r\n\t\t\t <\/td>\r\n\t\t\tCovered without any age limits<\/td>\r\n\t\t\t\"\"<\/a><\/td>\r\n\t\t<\/tr>\r\n\t\t
28<\/td>\r\n\t\t\tGenetic Disorders<\/strong><\/td>\r\n\t\t\t <\/td>\r\n\t\t\t10% of sum insured or 1 Lakh whichever is lower will be applicable for genetic disorder admissions, applicable for all members of the family.<\/td>\r\n\t\t\tNew Coverage<\/td>\r\n\t\t<\/tr>\r\n\t<\/tbody>\r\n<\/table>\r\n\r\n

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PREMIUM FOR THE YEAR 2023 - 2024 (Policy period 20th June 2024 to 19th June 2025)<\/p>\r\n\r\n

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Sum Insured<\/th>\r\n\t\t\tPremium incl. GST<\/th>\r\n\t\t<\/tr>\r\n\t<\/thead>\r\n\t
3 Lakhs<\/td>\r\n\t\t\t\u20b9 34,200<\/td>\r\n\t\t<\/tr>\r\n\t\t
5 Lakhs<\/td>\r\n\t\t\t\u20b9 1,10,579<\/td>\r\n\t\t<\/tr>\r\n\t\t
10 Lakhs<\/td>\r\n\t\t\t\u20b9 1,23,462<\/td>\r\n\t\t<\/tr>\r\n\t\t
25 Lakhs<\/td>\r\n\t\t\t\u20b9 1,43,640<\/td>\r\n\t\t<\/tr>\r\n\t\t
30 Lakhs<\/td>\r\n\t\t\t\r\n\t\t\t

\u20b9 1,48,199<\/p>\r\n\r\n\t\t\t

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Plus Rs. 2,500\/- as Admin Charges<\/td>\r\n\t\t<\/tr>\r\n\t<\/tbody>\r\n<\/table>\r\n\r\n\r\n\t\r\n\t\t\r\n\t\t\t
 <\/td>\r\n\t\t<\/tr>\r\n\t<\/tbody>\r\n<\/table>"}}