Monday 6 August 2018

Is there any health insurance company in India which covers Infertility treatment?

National Parivar Mediclaim Plus offers - Infertility treatment Cover - Up to INR 50,000.


Infertility treatment Cover –

Plan A – Up to INR 50,000

Plan B – Up to INR 1,00,000

Plan C – Up to INR 1,00,000.

Infertility Cover
The Company shall pay to the hospital or reimburse the insured, in respect of the medical expenses of the insured and his spouse, if covered by the Policy, for treatment undergone as an in-patient or as a day care treatment, for procedures and/ or treatment of infertility, provided the Policy has been continuously in force for twenty four months from the inception of the Policy or from the
date of inclusion of the insured person, whichever is later. The medical expenses for either or both the insured person shall be
subject to the limit as shown in the Table of Benefits.
Exclusions
The Company shall not be liable to make any payment in respect of any expenses incurred in connection with or in respect of
1. Insured and insured persons above forty five years of age.
2. Diagnostic tests related to infertility
3. Reversing a tubal ligation or vasectomy
4. Preserving and storing sperms, eggs and embryos
5. An egg donor or sperm donor
6. Experimental treatments
7. Any disease/ injury, other than traceable to maternity, of the surrogate mother.

Conditions
1. Expenses advanced procedures, including IVF, GIFT, ZIFT or ICSI, shall be payable only if the Insured person has been
unable to attain or sustain a successful pregnancy through reasonable, and medically necessary infertility treatment.
2. Maternity expenses of the surrogate mother shall be payable under Section 2.1.14 (Maternity). Legal affidavit regarding
intimation of surrogacy shall be submitted to the Company.
3. Maximum of two claims shall be admissible by the Policy during the lifetime of the insured person if he has no living child
and one claim if the insured has one living child.
4. Any one illness (Definition 6.2) limit shall not apply.
Definitions for the purpose of the Section
1. Donor means an oocyte donor or sperm donor.
2. Embryo means a fertilized egg where cell division has commenced/ under the process and has completed the pre-embryonic stage.
3. Gamete Intra-Fallopian Transfer (GIFT) means a procedure where the sperm and egg are placed inside a catheter separated
by an air bubble and then transferred to the fallopian tube. Fertilization takes place naturally.
4. Infertility means the inability to conceive after one year of unprotected sexual intercourse or the inability to sustain a
successful pregnancy. However the one year period may be waived, provided a medical practitioner determines existence of a medical condition rendering conception impossible through unprotected sexual intercourse, including but not limited to
congenital absence of the uterus or ovaries, absence of the uterus or ovaries due to surgical removal due to a medical condition,
or involuntary sterilization due to chemotherapy or radiation treatments.
5. Intra-Cytoplasmic Sperm Injection (ICSI) means an injection of sperm into an egg for fertilisation.
6. In Vitro Fertilization (IVF) means a process in which an egg and sperm are combined in a laboratory dish where fertilization
occurs. The fertilized and dividing egg is transferred into the uterus of the woman.
7. Surrogate means a woman who carries a pregnancy for the insured person.
8. Zygote Intra-Fallopian Transfer (ZIFT) means a procedure where the egg is fertilized in vitro and transferred to the
fallopian tube before dividing.

Optional cover (by paying additional premium) 

Pre-existing Diabetes & Hypertension –

First yr – up to 25% of SI

Second yr – up to 50% of SI

Third yr – up to 75% of SI

Critical Illness Benefit amount – INR 2,00,000/3,00,000/5,00,000/10,00,000/15,00,000/20,00,000/25,00,000 in addition to the SI

Out-patient treatment Limit of cover per family- INR 2,000/ 3,000/4,000/ 5,000/ 10,000/ 15,000/ 20,000/ 25,000 in addition to the SI

Other features

Good Health Incentives :-

Plan A – Every 2 yrs., up to INR 5,000 irrespective of claims

Plan B – Every 2 yrs., up to INR 7,500 irrespective of claims

Plan C – Every 2 yrs., up to INR 10,000 irrespective of claims

No claim discount on Premium- 5% discount on base premium

Discounts

Online discount- @5% for new policies, @2.5% for renewal policies

Long term discount - @4% for a two years’ term policy & @7.5% for a three years’ term policy

Discount in lieu of Maternity/ Infertility cover after 45 years of age- @3% on the base premium for self and spouse

Zonal discount-

@4.4% for opting for Zone –II

@11.11% for opting for Zone- III

@20% for option for Zone-IV

Two years waiting period applicable.

 

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