Eligibility Criteria of Extra Care Plus

Bajaj Allianz Extra Care Plus is a smart top-up health insurance plan designed to enhance your existing coverage without increasing your base premium significantly. It offers high sum insured options at affordable rates, making it ideal for managing large and unexpected medical expenses. With flexible deductible choices and wide hospitalization coverage, Extra Care Plus ensures stronger financial protection against rising healthcare costs:

Basic Features of Extra Care Plus

Bajaj Allianz Extra Care Plus is a reliable top-up health insurance plan created to strengthen your financial safety during major medical emergencies. It provides higher sum insured options at cost-effective premiums, helping you handle expensive hospitalization bills with ease. The plan supports coverage for in-patient care, select daycare treatments, and related medical expenses beyond the deductible limit. It is a practical choice for those looking to upgrade their health insurance coverage without increasing their base policy cost significantly:

1. Hospital expenses - The plan covers expenses related to in-patient hospitalization, including room rent as per eligibility, surgeries, and a wide range of daycare procedures that do not require 24-hour admission.
2. Day care expenses - The plan covers expenses related to in-patient hospitalization, including room rent as per eligibility, surgeries, and a wide range of daycare procedures that do not require 24-hour admission.
3. Pre and post hospitalization expenses - Medical costs incurred before hospital admission and after discharge are covered for a specified number of days, ensuring complete financial support during the recovery period.
4. Modern treatment expenses - Expenses for treatments using advanced medical procedures and modern healthcare technologies are included, helping policyholders access quality and innovative care.
5. Organ donor expenses - The policy provides coverage for medical expenses related to organ donor hospitalization during the transplant process, when the insured is the recipient.
6. Ayush treatment hospitalization - Hospitalization expenses for alternative treatments such as Ayurveda, Yoga, Unani, Siddha, and Homeopathy are covered when taken under medical supervision.
7. Maternity and new born care expenses - Under selected plans, maternity-related expenses including delivery and initial medical care for the newborn baby are covered as per policy terms.
8. Ambulance cover – Emergency ambulance expenses are covered to ensure timely transportation to the hospital during medical emergencies.

Optional Benefit of Extra Care Plus

Bajaj Allianz Extra Care Plus offers valuable optional benefits that allow policyholders to customize their top-up health insurance coverage as per their medical and financial needs. These add-on features enhance protection by covering specific healthcare expenses beyond standard hospitalization benefits. By choosing suitable optional benefits, you can strengthen your overall health insurance plan and stay better prepared for unexpected medical costs.

1. Non-medical expenses - The plan offers coverage for essential non-medical items such as gloves, syringes, and consumables used during hospitalization, up to the applicable sum insured, reducing out-of-pocket expenses.
2. Health prime rider - With the Health Prime Rider, policyholders can access added wellness benefits like doctor consultations (online or in-person), dental care support, and diet or nutrition guidance as per the selected option.
3. Respect Rider - Designed especially for senior citizens, this rider provides emergency assistance services including SOS alerts, doctor-on-call facility, and 24x7 ambulance support for enhanced peace of mind.
4. Air ambulance Cover - The policy includes coverage for air ambulance services, ensuring quick medical transportation by helicopter or airplane from the accident or illness site to the nearest appropriate hospital during the policy term.

Exclusions of Extra Care Plus

Like all other plan this super top up plan has some exclusions and term & condition under this plan. Here are the exclusion that are not covered under this plan:

1. Medical Investigation & Evaluation Expenses - Diagnostic tests or medical evaluations that are not directly connected to the ongoing treatment or confirmed diagnosis are generally not covered under the policy.
2. Dietary Supplements & Consumables - Costs of vitamins, minerals, and other dietary supplements purchased without a valid doctor’s prescription as part of treatment are excluded from coverage.
3. Cosmetic & Aesthetic Procedures - Expenses for cosmetic or appearance-enhancing treatments are not covered unless they are medically necessary for reconstruction following an accident, burns, or a critical medical condition.
4. Self-Inflicted Injuries & Risky Activities - Medical expenses arising from self-harm, illegal acts, or participation in hazardous activities are excluded under the health insurance policy.
5. Deductibles & Co-Payment Clause - If you have opted for a deductible or co-pay option, a portion of the claim amount will be borne by you, while the insurer will pay the remaining eligible expenses as per the policy agreement.
6. Refractive Error Treatment - Costs related to eyesight correction for refractive errors below 7.5 diopters are not covered under the standard policy benefits.
7. Sterility & Infertility Treatments - Expenses associated with infertility treatments, assisted reproduction procedures, or sterility-related medical care are not included in the coverage.
8. Reversal of Sterilization Procedures - Costs for procedures such as vasectomy reversal or tubal ligation reversal are excluded as per the policy’s terms and conditions.