It is a human’s nature that everybody wants to get the best of its kind products and services. Similarly, when it comes to health insurance, people want to have a comprehensive plan that could offer maximum coverage. They want to enjoy life to the fullest and thus, want cover that can include all their medical bills.
Insurers have brought numerous medical insurance products to offer the required healthcare cover to the Indian citizens, but among them, there are very few plans could fulfil this volition. One such comprehensive coverage offering plan that is known as India’s first 360 degree product is Maxima, brought by Apollo Munich, a joint venture between the Apollo Group of Hospitals and Munich Health. Both the partners are well experienced in the field of healthcare and insurance. Thus, the company has successfully launched this plan, ‘Maxima’, the most extensive coverage offering medical insurance plan.
One of the unique aspects of this plan is that it offers cover not only to inpatient expenses, but also to outpatient expenses, up to a certain limit. Thus, one gets coverage for both big and small illnesses and need not have to worry about his/her medical bills. The ‘Maxima’ plan comes with a long list of benefits for its customers such that they get the overall coverage. A few of these benefits are as follows:-
Like other health insurance plans, ‘Maxima’ also offer coverage to in-patient treatment expenses that are incurred due to an illness or an accident. It includes medical expenses for room rent, nursing, boarding expenses, ICU, surgical appliances, anaesthesia, medical practitioners, medicines, blood, oxygen, diagnostic procedures, operation theatre charges, cost of prosthetic or any device, if implanted during a surgical practice.
In addition to it, the cover includes pre- and post-hospitalization expenses.
Pre-hospitalization coverage includes treatment expenses incurred for 30 days, immediately before a policy holder was hospitalized.
Post-hospitalization coverage includes medical expenses incurred in 60 days immediately after the policy holder discharges.
Both these benefits are subjected to the condition that the cause of these expenses and hospitalization should be the same. The number of days for which coverage is offered increases to 60 days in pre-hospitalization and 90 days in post-hospitalization, if claim is intimated 5 days before hospitalization (in case of planned hospitalization).
A policy holder also gets cover for 140 Day-care procedures, which include minor surgical treatments which do not require hospitalization for more than 24 hours. The inpatient treatment coverage further includes domiciliary treatment, which include medical expenses incurred for availing medical treatment at home, which would have otherwise required hospitalization.
It continues to offer cover to organ donor, (in an event of organ transplantation) and emergency ambulance charges for transporting an insured from the place where an accident occurred to a hospital, subject to maximum of Rs.2000. It also includes daily cash for choosing shared accommodation and for accompanying an insured child.
An individual buying ‘Maxima’ is entitled to consultation coupons, which can be used for seeking advice in specified network of hospitals by a general Medical Practitioner(s) or a specialist Medical Practitioner(s). One can also go and consult doctor in non-network hospital, if desired. In this case, he or she gets the specific amount of money reimbursed (as per plan’s terms and conditions) in return of consultation coupon.
A policy holder also gets coverage for diagnostic tests within specified network of diagnostic laboratories. These tests should not necessarily be prescribed by network Medical Practitioner. One can also get cover for pharmacy within specified network, subject to the condition that these medicines have been prescribed in writing by a Medical Practitioner (not necessarily to be Network Medical Practitioner).
‘Maxima’ further offers coverage to any required dental cure taken by an insured from a network dentist, subject to the condition that it shall not include any dental cure that consist of cosmetic treatment. It also includes cover for spectacles, contact lenses within specified network, subject to condition that these have been prescribed for the policy holder by an eye specialist network Medical Practitioner(s). Furthermore, one also gets entitlement certificate for annual health check-up within specified network.
There is a limit of each and every of the outpatient coverage module, which is clearly stated in policy wordings of the plan.
Policy holders get optional coverage for critical illnesses on payment of additional premium. In an event of an insured getting diagnosed with any of the covered major disorder, an insured is provided with lump sum payment, which is subject to the plan’s terms and conditions. Here, the plan offers cover to eight major illnesses, which are first heart attack, coronary artery surgery, paralysis, kidney failure, stroke, major organ transplantation, cancer and multiple sclerosis.
One can also opt for maternity coverage, if desired, this part of benefits work on principle of benefit that pays an insured lump sum money in an event of child birth. This coverage can be availed only after 4 years of policy issuance, as that is a waiting period associated with the same. The amount a person gets depend upon a condition whether it is a normal or caesarean delivery. One can also opt for optional coverage for new born baby for first 90 days, if desired.
‘Maxima’ is a unique plan that also offers cover to any pre-existing conditions that require outpatient care, without any waiting period. In case of Inpatient coverage, pre-existing conditions will be covered after a waiting period of three years. There are many more benefits that a person gets on buying Maxima.