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Top Up Health Insurance: Extra Care Plus Policy

Top-up health insurance policy

Add-on health insurance plan
Extra care plus top up health insurance policy

Top-up health protection for extra coverage

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What’s in it for you?

 Cover 09 plans/options with Health Prime Rider

Sum Insured Index Sum Insured

Sum insured options from Rs 3 lakh to Rs 50 lakh. 

Free health check-up

Maternity Expenses

Maternity cover

Why choose Bajaj Allianz Extra Care Plus policy?

We all love a little extra something; whether it is an extra set of helping hands or extra time to complete an exam, it always comes in handy. Our Extra Care Plus plan, a top-up health cover, provides an add-on cover to your existing health insurance policy It acts like a ‘stepney’ to your health insurance policy after you use up your sum insured limit. Our Extra Care Plus is the top-up health protection your existing health cover needs.

Let’s consider why you might need this additional buffer. Imagine that an unfortunate incident lands you in the hospital. Your basic health policy is only going to cover a limited sum insured, leaving you to fend for funds at the worst possible time.

However, with Extra Care Plus, once your basic medical insurance cover is exhausted, this shield will kick in. It will help you clear the additional bills that your hospitalisation may rake up and pay the expenses incurred above the aggregate deductible opted by you. That’s why this top-up plan is a wise investment.

Also, consider the fact that with rising inflation a basic health insurance cover may not be adequate. Furthermore, a high sum insured may not be affordable. Hence, this policy is the perfect fit for a more expansive health insurance coverage to take care of the rising healthcare expenses. The best part? You don’t even need a basic health insurance plan to buy this policy!

We offer a whole lot when it comes to Extra Care Plus policy

Key Features

We take your health insurance very seriously and we have years of experience and global knowledge to back us. We ensure that a safe and secure top-up health insurance plan will see you through an unfortunate hospitalisation. Here are the main features of our Extra Care Plus policy:

  • Top-up health policy

    Opt from a wide range of sum insured and aggregate deductible options available under the Extra Care Plus policy.

  • Pre-existing diseases cover

    Pre-existing diseases covered after 12 months from your first Extra Care Plus policy.

  • Maternity cover

    Maternity expenses including maternity-related complications are covered under the policy, subject to terms and conditions.

    Sum Insured: Rs 10 lakh, Aggregate Deductible Opted: Rs 2 lakh

    Claim Details

    Date of Hospitalisation

    Total Claim Amount 
    (in Rs)

    Deductible Utilisation
    (in Rs)

    Balance Deductible 
    (in Rs)

    Payable by insured 
    (if any) (in Rs)

    Payable under Extra Care Plus Policy (in Rs)

    Claim 1

    10-Aug-2017

    1.5 lakh

    1.5 lakh

    50,000

    1.5 lakh

    0

    Claim 2

    10-Sep-2017

    3 lakh

    50,000

    0

    50,000

    2.5 lakh

    Claim 3

    10-Oct-2017

    7.5 lakh

    0

    0

    0

    7.5 lakh

  • Pre and post hospitalisation cover

    This policy covers medical expenses 60 days immediately before and 90 days immediately after hospitalisation.

  • Emergency ambulance cover

    Avail emergency ambulance cover up to Rs 3,000 per claim. You can also opt for an air ambulance cover as an add-on.

  • Floater cover for entire family

    Covers your spouse, dependent children and parents under a single policy.

  • Entry age up to 80 years

    With the extended age limit, the policy can cover members up to 80 years of age.

  • No pre-policy check-up up to 55 years

    This policy requires a pre-policy health check-up only for members above the age of 55 years.

  • Daycare procedures cover

    This policy covers medical expenses incurred during the treatment of listed daycare procedures or surgeries.

To know more about our top-up health insurance plans, watch this video:.

Video

Extra Care Plus policy pays the hospitalization expenses incurred above the aggregate deductible opted by you. Let’s consider an example of how this works:

View example

Sum Insured: 10 Lakhs, Aggregate Deductible Opted: 2 Lakhs

Claim Details Date of Hospitalisation Total Claim Amount
(in Rs)
Deductible Utilisation
(in Rs)
Balance Deductible
(in Rs)
Payable by insured
(if any) (in Rs)
Payable under Extra
Care Plus Policy (in Rs)
Claim 1 10-Aug-2017 1,50,000 1,50,000 50,000   0
Claim 2 10-Sep-2017 3,00,000 50,000 0 1,50,000 2,50,000
Claim 3 10-Oct-2017 7,50,000 0 0 50,000 7,50,000

While a free medical check-up is an additional benefit for which aggregate deductible is not applicable, at the end of every continuous period of 3 years during which you hold the Extra Care Plus policy with us, we will reimburse the free medical check-up expenses follows:

  1. The actual amount of medical check-up expenses up to Rs 1000 for policy covering one member.
  2. The actual amount of medical check-up expenses up to Rs 2000 for policies covering more than one member under the same policy.

**On the health insurance premium paid for self, spouse, children and parents, the deduction can be availed up to Rs 25,000 per annum, provided the age of the individual is not above 60. If the premium paid by an individual is towards health insurance policy for his or her parent who is a senior citizen of age 60 or more, the maximum is capped at Rs 30,000. A taxpayer may, therefore, maximize tax benefit under section 80D to a total of Rs 55,000 if his age is below 60 and parents age is above 60. For those taxpayer individuals who are of age 60 or more and are also paying health insurance premium for their parents, the maximum tax benefit under section 80D would, therefore, be a total of Rs 60,000.

*Health CDC is a feature in the Bajaj Allianz Insurance Wallet App which enables you to raise claim requests up to Rs 20000 through the app. This is the easiest way to make claim requests as you

EASY, HASSLE-FREE AND QUICK CLAIM SETTLEMENT

Cashless claim process (only applicable for treatment at a network hospital)

Cashless facility at network hospitals is available 24x7, throughout the year without any interruption in service. You must check the hospital list before getting admitted to the hospital. Hospitals that provide cashless settlement are liable to change their policy without notice. The updated list is available on our website and with our call centre. Bajaj Allianz Health Card along with a government ID proof is mandatory at the time of availing cashless facility.

When you are opting for cashless claims, the process is as follows:

  • Get the pre-authorisation request form at the hospital’s insurance desk.
  • Fill and sign it and have the treating doctor/hospital sign it too.
  • The network hospital will fax the request to HAT.
  • HAT doctors will examine the pre-authorisation request form and decide on cashless availability, as per the policy guidelines.
  • Authorisation letter /denial letter/additional requirement letter is issued within 3 hours depending on the plan and its benefits.
  • At the time of discharge, the hospital will share the final bill and discharge details with HAT and based on their assessment, final settlement will be processed.

Important points to note:

  • In case of planned hospitalisation, register/reserve your admission as per the network hospital’s procedure for admission in advance.
  • Admission at network hospital is subject to availability of a bed.
  • Cashless facility is always subject to your policy terms and conditions.
  • The policy does not cover the following : Telephone charges Food and beverages for relatives Toiletries The cost of the above services have to be borne by you and paid directly to the hospital before discharge.
  • In-room rent nursing charges are included. However, if a higher room is used then the incremental charges will be borne by you.
  • In case the treatment is not covered as per the policy terms and conditions, your claim- cashless or reimbursement, will be denied.
  • In case of inadequate medical information, pre authorisation for cashless claim can be denied.
  • The denial of cashless facility does not mean denial of treatment and does not in any way prevent you from seeking necessary medical attention or hospitalisation.

Reimbursement of pre/post hospitalisation expenses

Relevant medical expenses incurred before admission and after discharge from the hospital will be reimbursed as per the policy. Prescriptions and bills/receipts of such services should be submitted to Bajaj Allianz General Insurance along with the duly signed claim form.

Reimbursement claim process

  • Inform the Bajaj Allianz General Insurance HAT about the hospitalisation. To register your claim online click here To register your claim offline, please call us on our toll-free number: 1800-209-5858.
  • After discharge, you must submit the following documents to HAT within 30 days: Duly filled and signed claim form with mobile number and email ID. Original hospital bill and payment receipt. Investigation report Discharge card Prescriptions Bills of medicines and surgical items Details of pre-hospitalisation expenses (if any) In-patient department (IPD) papers, if required.
  • All documents to be sent to HAT for further processing and based on the assessment, the final settlement will be done within 10 working days.
  • Post hospitalisation claim documents must be sent within 90 days from the date of discharge.

Documents required for reimbursement claim

  • Original pre-numbered hospital payment receipt duly sealed and signed.
  • Original prescriptions and pharmacy bills.
  • Original consultation papers (if any).
  • Original investigation and diagnostic reports along with original bills and payment receipt for the investigation done within and outside the hospital.
  • If you availed a cashless claim but did not utilise it, a letter from the hospital stating so.
  • A letter from the treating doctor mentioning incident details (in case of an accident).
  • Hospital registration certificate and hospital infrastructure on the letterhead.
  • A cancelled cheque bearing IFSC code and name of the insured.
  • Indoor case paper copy attested from the hospital from the date of admission to the date of discharge with detailed medical history and doctor’s notes with temperature, pulse and respiration charts.
  • X-ray films (in case of a fracture).
  • Obstetric history from treating doctor (in maternity cases).
  • FIR copy (in case of accident).
  • Additional requirements for some special cases: In case of a cataract operation, lens sticker with a bill copy. In case of a surgery, implant sticker with a bill copy. In case of a heart-related treatment, stent sticker with a bill copy.

All original claim documents need to be submitted to the following address:

Health Administration Team

Bajaj Allianz House, Airport Road, Yerawada, Pune-411006

Mention your Policy Number, Health Card Number and Mobile Number clearly on the face of the envelope.

Note: Keep a photocopy of the documents and courier reference number for your records.

LET'S SIMPLIFY HEALTH INSURANCE

What is a top-up health insurance policy?

A top-up health insurance policy is an additional coverage for those who are already insured by a health insurance plan or mediclaim policy. Nonetheless, you can opt for our Extra Care Plus policy even if you are not insured by a primary medical insurance plan.

Do I need a top-up health policy if I already have a mediclaim/health insurance cover in place?

It’s human tendency to take extra care of all the things we love; what with double lining delicate items with bubble wrap, baby-proofing homes, etc. So, why not take an extra measure for your healthcare as well?

You might assume that your existing health insurance coverage is sufficient for all your health-related needs but what if the coverage offered is not able to meet your medical bills? Your present cover may be sufficient to pay for minor illnesses but it may not be enough in the event of a bigger medical emergency. Our Extra Care Plus policy is a top-up health insurance that plays a crucial part in covering your excess medical expenses and protects your savings.

What coverage do I enjoy under a top-up health insurance plan?

With Bajaj Allianz’s Extra Care Plus policy, you enjoy the following coverage:

  • In-patient hospitalisation cover.
  • Pre and post hospitalisation expenses that occur 60 days prior to hospitalisation or 90 days after hospitalisation.
  • Organ donor expenses.
  • Emergency road ambulance cover.
  • Covers expenses for all daycare treatments.

Can I save tax on the premium paid for this policy?

Yes, the premium paid for Extra Care Plus top-up plan is exempted under Section 80D of the Income Tax Act.

What is the Health Administration Team?

The Health Administration Team comprises of doctors and paramedics who are responsible for health underwriting and claims settlement. It is a single window assistance to all the health insurance policyholders for healthcare-related services. This in-house team resolves issues related to health insurance customers and ensures faster claim settlement as a single point of contact. 

Spreading Smiles Through Our Services

ASHISH JHUNJHUNWALA

My happiness and satisfaction regarding my claim settlement which was approved within 2 days...

SUNITA M AHOOJA

Speed with which insurance copy was delivered in times of lockdown. Hats off to the Bajaj Allianz team

Reni George

I would like to thank the team of Bajajallianz Vadodara, Specifically Mr. Hardik Makwana and Mr. Ashish...

Extra care and protection with our top-up health insurance plans!

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No medical tests needed up to 55 yrs of age.

That’s not all, here are additional benefits with your Extra Care Plus policy

We provide extensive medical coverage along with other benefits:
Tax saving

Tax saving

Tax saving up to Rs 1 lakh under Section 80D of the Income Tax Act.* Read more

Tax saving

Tax saving up to Rs 1 lakh under Section 80D of the Income Tax Act.*

*On opting for Extra Care Plus policy for yourself, your spouse, children and parents, you can avail Rs 25,000 per annum as a deduction against your taxes (provided you are not over 60 years). If you pay a premium for your parents who are senior citizens (age 60 or above), the maximum health insurance benefit for tax purposes is capped at Rs 50,000. As a taxpayer, you may, therefore, maximise tax benefit under Section 80D up to a total of Rs 75,000, if you are below 60 years of age and your parents are senior citizens.  If you are above the age of 60 years and are paying a medical insurance premium for your parents, the maximum tax benefit under Section 80D is, then, Rs 1 lakh.

Hassle-free claim settlement

Hassle-free claim settlement

We have an in-house claim settlement team that ensures a quick, smooth and easy claim settlement process... Read more

Hassle-free claim settlement

We have an in-house claim settlement team that ensures a quick, smooth and easy claim settlement process. Also, we offer cashless claim settlement at more than 8,600+ network hospitals across India. This comes in handy in case of hospitalisation or treatment wherein we take care of paying the bills directly to the network hospital and you can focus on recovering and getting back on your feet. 

Renewability

Renewability

You can renew your Extra Care Plus policy for your entire lifetime.

Portability benefit

Portability benefit

If you are insured under any top-up health insurance plan, you can switch to our Extra Care Plus policy with... Read more

Portability benefit

If you are insured under any top-up health insurance plan, you can switch to our Extra Care Plus policy with your accrued benefits (after due allowances for waiting periods) and enjoy the available benefits of the policy.

Preventive health check-up

Preventive health check-up

Free preventive health check-up at the end of a continuous period of 3 years during which your Extra Care Plus policy is active.

Important points to note before buying Extra Care Plus policy

  • Inclusions

  • Exclusions

Pre-existing diseases cover

Pre-existing diseases covered after 12 months from the date of policy issuance.

Free health check-up

Free health check-up available during policy renewal.

Maternity expense cover

Covers maternity expenses, including complications.

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We are not liable for a claim(s) amount falling within the aggregate deductible limit as opted for and mentioned in the policy.

Pre-existing condition, ailment or injury, which is declared on your proposal form and accepted by...

Read more

Pre-existing condition, ailment or injury, which is declared on your proposal form and accepted by us, until 12 months of continuous coverage have elapsed after the date of inception of the first Extra Care Plus policy with us. In case of enhancement of sum insured, this exclusion will apply afresh only to the extent of the amount by which the limit of indemnity has been increased, if the policy is a renewal of the Extra Care Plus policy without a break in cover.

Any disease contracted and/or medical expenses incurred by you with respect to any disease/illness...

Read more

Any disease contracted and/or medical expenses incurred by you with respect to any disease/illness during the first 30 days from the commencement of the policy, except for accidental injuries.

We will not be liable to make any payment under this policy related to maternity expenses within the first...

Read more

We will not be liable to make any payment under this policy related to maternity expenses within the first 12 months from the date of inception of the first policy with us. However, the 12 months waiting period would not be applicable in case of continuous renewal of Extra Care Plus.

Any medical expenses incurred due to a newborn baby.

Expenses incurred for dental treatment or surgery of any kind, unless requiring hospitalisation, and as a result of accidental injury to your natural teeth.

Any injuries or medical expenses incurred due to war, invasion, acts of foreign enemies, hostilities...

Read more

Any injuries or medical expenses incurred due to war, invasion, acts of foreign enemies, hostilities (whether war be declared or not), civil war, commotion, unrest, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalisation or requisition of or damage by or under the order of any government or public local authority.

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I hereby authorize Bajaj Allianz General Insurance Co. Ltd. to call me on the contact number made available by me on the website with a specific request to call back at a convenient time. I further declare that, irrespective of my contact number being registered on National Customer Preference Register (NCPR) under either Fully or Partially Blocked category, any call made or SMS sent in response to my request shall not be construed as an Unsolicited Commercial Communication even though the content of the call may be for the purposes of explaining various insurance products and services or solicitation and procurement of insurance business. Furthermore, I understand that these calls will be recorded & monitored for quality & training purposes, and may be made available to me if required.

Written By: Bajaj Allianz - Updated: 16th May 2022

Disclaimer

I hereby authorize Bajaj Allianz General Insurance Co. Ltd. to call me on the contact number made available by me on the website with a specific request to call back at a convenient time. I further declare that, irrespective of my contact number being registered on National Customer Preference Register (NCPR) under either Fully or Partially Blocked category, any call made or SMS sent in response to my request shall not be construed as an Unsolicited Commercial Communication even though the content of the call may be for the purposes of explaining various insurance products and services or solicitation and procurement of insurance business. Furthermore, I understand that these calls will be recorded & monitored for quality & training purposes, and may be made available to me if required.

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