Magma HDI OneHealth Insurance Policy Health Insurance

If policy is taken on an individual basis, then only that particular individual is covered under the policy. On the other hand, the family floater plan provides a large coverage – insuring up to 4 adults and 3 kids under the single insurance cover. The entry age limit of the proposer should be a minimum of 18 years of age, even though the policy allows entry of members of 5 years of age under an individual plan and 91 days when opted for a family floater plan. Magma HDI OneHealth Insurance Plan offers lifetime renewability option to its policy holders and the maximum entry age limit is 65 years of age.  

The policy provides multiple options for sum insured between the range of Rs.2 lakhs to Rs.50 lakhs to the policy holders. Having flexibility when it comes to selecting plans as per one’s affordability limit is a great way to attain customer satisfaction. Plans are available under several variants like Support, Support Plus, Shield and the Premium plan. The underlining factor differentiating these plans is that the sum assured limit varies and so do some of the benefits offered to insure.

The policy provides quite an extensive and comprehensive coverage to the policy holders as and when required by them. The below are the details of the coverage provided by Magma HDI OneHealth Insurance Plan- 

In-patient Treatment Care: When a patient (Insured) is required to be admitted to the hospital for any treatment then the insurance company offers to provide the following benefits and coverage of medical expenses- 

• The doctor’s consultation charges or fees
• Nursing charges, boarding charges and room rent expenses
• ICU charges are also borne by the insurer
• Operation theatre expenses in case of serious illness and treatment 
• When patient is required to go for examinations then those diagnostic procedure costs are also included under the coverage
• Prescribed medicines, drugs and other related consumables as medically suggested
• Injection administration charges and costs billed when blood transfusion or supply of intravenous fluids is required 
• Procedural expenses such as oxygen, blood supply, internal implantation of equipment during surgeries and also cost of anaesthesia 
• In case of room rent charges, there are certain sub-limits which are applicable based on the policy variant chosen by the applicant - 

Support Variant: The limit here is restricted to 1% of the total sum insured amount per day. If a person is admitted to the ICCU, then the limit is increased up to 2% of the total sum insured per day. 

Secure Variant: Patient opting for a private room on single basis is eligible for complete cost coverage as well as ICCU expenses provided for in actuals 

Support Plus, Shield and Premium Variant: Since these are premium variants there is no room rent limit in this case 

• Pre-hospitalization Expenses: All medical expenses paid out of pocket of the insured will be reimbursed by the insurer in full even if billed before the date of the hospitalization.
• Post-Hospitalization Expenses: Once the discharge is signed off all the expenses incurred after that will be reimbursed in full to the insured. 

• Day Care Treatment: All the expenses incurred within the period of 24 hours under the category of day care treatment will be covered 
• Note: Special focus is given that any OPD treatment undertaken in any day care centre or hospital would not be eligible for cover under this plan 
• Ambulance Cover: When need for hospitalization arises then ambulance facility is required for patient and family members. Hence, on-road cost of the transportation would also be covered under this head.
• Organ Donor Expenses: All expenses right from documentation to final organ donation and post-surgery charges for donor will be borne by insurer
• AYUSH Treatment: As a part of the treatment if any patient is required to undergo AYUSH treatment in a recognised centre or any of the government hospitals then cost will be covered. AYUSH includes alternate therapies like Ayurveda, Yoga, Unani, Siddha and Homoeopathy.

• IVF Treatment Cover: Any patient requiring IVF Treatment due to medical complexities and as prescribed by the specialist medical practitioner would be eligible to recover costs from insurance company. There are 3 conditions in place to fulfil before being eligible to benefits. Firstly, the age limit of the patient should be less than 40 years. Secondly, there will be a waiting period of 3 years for claims to be admissible under the plan. Finally, third-party surrogate, consultation and diagnostic expenses or infertility process would be excluded. 

• Bariatric Surgery Cover: Patient being 18 years of age or above having severe sleep apnea, Type 2 diabetes or coronary heart disease can apply for reimbursement. 
• Psychiatric Treatment Cover: Following conditions or disorders are eligible after waiting period of 36 months:

1. Severe Depression
2. Schizophrenia and Psychosis
3. Bipolar disorder
4. Post-traumatic stress disorder
5. Obsessive-compulsive disorders
6. Panic disorders including anxiety
7. Personality and related disorders

• Lasik Surgery Cover: In case of refractive error person having a refractive index of plus/minus 7.5 or more can claim benefits after 3 years waiting period.
• HIV/AIDS Cover: 4 years of waiting period and pre and post hospitalization expenses up to Rs.50,000. 

There are certain modern-day treatments covered under this policy, they are: 

• Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
• Balloon Sinuplasty
• Deep Brain stimulation
• Oral chemotherapy
• Immunotherapy- Monoclonal Antibody to be given as an injection
• Intra vitreal injections
• Robotic surgeries
• Stereotactic radio surgeries
• Bronchial Thermoplasty
• Vaporization of the prostate (Holmium laser treatment or green laser treatment)
• IONM – (Intra Operative Neuro Monitoring)
• Stem cell therapy

Certain optional covers that can be availed by buying some additional premium costs are as follows: 

Critical illness cover:

• Cancer of Specified Severity
• Myocardial Infarction (First Heart Attack of specific severity)
• Open Chest CABG
• Repair of Heart Valves or Open Heart Replacement surgery 
• Coma of Specified Severity
• Kidney Failure requiring Regular Dialysis
• Stroke resulting in Permanent Symptoms
• Major Organ / Bone Marrow Transplant
• Permanent paralysis of Limbs
• Motor Neurone Disease with Permanent Symptoms
• Multiple Sclerosis with Persisting Symptoms

Personal Accident Cover:

• When there is an Accidental Death
• Unfortunate Permanent Total Disablement due to an accident
• Aggregate Deductible – If you opt for this optional cover, this policy becomes a top-up policy wherein claims are admissible only after a deductible limit chosen by you.
• Voluntary Co-Payment – Under this optional cover, a co-payment applies to your Policy schedule irrespective of your age

• Any illness arising out of usage of drugs not advised in prescription
• Damages/injuries caused due to riots, terrorist acts, war
• Any kind of addictive disorders or conditions