Kshema Group Health Insurance Policy
- Covers in-patient hospitalisation expenses
- AYUSH and day-care treatment coverage
- Pre- and post-hospitalisation benefits
- Cashless and reimbursement claim options available
- Optional benefits for enhanced coverage
Why Choose Kshema Group Health Insurance Policy?
In-patient Hospitalisation Expenses
Covers eligible in-patient hospitalisation expenses, including room rent, ICU charges, nursing care, medical practitioner fees, medicines, diagnostics, implants and other admissible expenses.
AYUSH Treatment
Covers inpatient treatment at eligible AYUSH hospitals.
Day-care Procedures
Coverage for medically necessary day-care procedures performed at an eligible hospital or day-care centre when advised by a medical practitioner.
Pre- and Post-Hospitalisation Expenses
Coverage for eligible medical expenses incurred before and after hospitalisation for the same condition, subject to policy terms.
Optional Benefits
Ambulance Cover
Coverage for eligible emergency ambulance transfers between residence and hospital, or between hospitals.
Organ Donor Expenses
Coverage for hospitalisation expenses incurred for harvesting a donated organ, subject to policy terms and applicable laws.
Domiciliary Hospitalisation
Coverage for domiciliary treatment when medically necessary and advised by a medical practitioner, subject to policy limits and conditions.
OPD Treatment
Out-patient treatment cover may be available when specifically opted for under the policy, subject to applicable co-payment and benefit limits.
Mental Illness Treatment
Coverage for treatment at an eligible mental health establishment or hospital department, subject to waiting periods and applicable sub-limits.
Eligibility & Family Coverage
- Eligible for employer-employee groups and recognised non-employer groups.
- Adults can be covered from 18 years of age.
- Dependent children are covered from 3 months to 25 years of age.
- Coverage can include the group member, legally married spouse, parents, parents-in-law and up to five dependent children.
- Policy term is one year.
- Treatment within India is covered under the policy.
- Premium is determined based on available group data and applicable discounts or loadings.
- Standard Waiting Period.
Renewal & Continuity
- Renewal is subject to mutual consent and payment of the applicable premium.
- Migration and portability options are available subject to applicable policy conditions and guidelines.
Exclusions
- Diagnostic admissions not related to treatment.
- Rest cure, custodial care, rehabilitation and respite care.
- Experimental or unproven treatments.
- Treatments that are not medically necessary.
- Certain cosmetic procedures.
- Infertility and assisted reproduction treatments.
- Maternity-related expenses.
- Professional hazardous or adventure sporting activities.
- Criminal acts.
- Substance abuse and intoxication-related conditions.
- Treatment received outside India.
- Routine vaccination.
- Specified non-medical and personal comfort expenses.
- Dental treatment unless required due to accidental bodily injury requiring hospitalisation.
Request a callback now!
- Coverage for personal accidents and hospital cash benefits.
- Premiums calculated based on individual preferences and optional covers.
We have sent the Kshema app download link to your mobile via SMS and WhatsApp +91-
