Medisure Prime Insurance Eligibility

• Min Child age: 3 months
• Max adult age: 45yrs
• Max child age: 21yrs
• Members covered: Individual and family plan. You can avail this policy for maximum combination of 2A2C
• Policy Period: Policy available for 1yr and 2 yrs
• Policy Available for: Sum Insured Rs.3L-10L

Medisure Prime Insurance Benefits

• Hospitalisation Expenses up to Sum Insured limit
• Pre-hospitalisation expenses up to 60 days and Post hospitalisation expenses up to 90 days
• Ambulance Charges
• Hospital Cash & Expenses for accompanying person
• Cost of Health Check up

Medisure Prime Insurance Features

• No Sub-limits: my: health Medisure Prime has no sub-limits for any of the medical expenses incurred for eg. room rent, surgeon’s fees, operation theatre charges, etc. As long as the total cost of hospitalization is below the total sum insured that you have opted for and the claim is approved, we shall reimburse the total expense incurred.
• Two year Policy Option: You have the option to renew your policy once in two years. Not only is it convenient, but you also get the benefit of lower premium per year.
• Family Floater option: You can cover up to 4 members of your family – your lawful spouse and two dependent children up to the age of 18 years under a single policy and single sum insured.
• Family Discount: You can opt for individual sum insured for each of your family members under a single policy instead of opting for a Family Floater. For example, you may wish to cover each of your family members for a sum insured of Rs. 5 lac each instead of opting for a Rs 5 lac sum insured for your entire family. You are eligible to get a Family Discount on premium payable for more than 2 members which includes yourself, lawful spouse, dependent children and dependent parents only. Family discount will be available for a maximum of 6 persons only.
• Cumulative Bonus: The sum insured of your policy progressively increases by 5% on every renewal, for every claim-free year, subject to a maximum accumulation of 50% of your sum insured. If a claim is made, the Cumulative Benefit that has accrued will be available for claim but will become zero from the next renewal.
• Income Tax Benefit: You can get tax exemption on the premium paid under section 80D of the Income Tax Act.
• Free-look Period: You have the option to cancel the Policy within 15 days of receipt of policy documents if you are not satisfied with the coverage or terms of the Policy, provided there is no claim. A minimum premium for stamp duty and proportionate premium will be retained by us.
• Life time renewal of Policy: With my: health Medisure Prime insurance, you will be allowed to renew your policy every year irrespective of your age at the time of renewal. So no more worries that you will be without a health insurance policy in your old age.
• Instant Policy issuance without medical tests: We think you're too young for a test, even if you're 44. If you are below 45 years at the time of policy issuance with no adverse medical history, you need not go through any medical tests to be issued a my: health Medisure Prime Policy. Imagine the convenience! You get to purchase a policy with all its bells and whistles with just a phone call.
• Policy premium based on your location: Pay premium depending on which city you live in, since the cost of healthcare differs across cities.

Medisure Prime Insurance Claim Process

• For cashless* hospitalization: (*cashless facility is available only at our network hospitals)

  • You will need to contact us at the contact numbers provided on your health card immediately
  • You need to submit a Cashless Request form to us, along with all information and documents pertaining to illness as required
  • Our representative will guide you further and help you process the request and based on the coverage under your policy the cashless request will be approved.

• For a reimbursement of expenses: (at other hospitals outside of our network or at network hospitals where cashless is not availed):

  • You will need to collate the original bills along with other documents as required and submit it to the address mentioned in your Policy Schedule.

• In case of planned hospitalization, please inform us 72 hours in advance and in case of emergency within 24 hours of admission. Our Claims settlement procedure is quick and transparent. For any kind of support or information, please call our helpline 1800 209 5846 or write to us at myhealthclaim@ltinsurance.com. Undue delay in intimation of claim or submission of documents may prejudice a claim. To understand the claims process in detail, and to get a checklist of the documentation, please view the ‘claims process’ section.

Medisure Prime Insurance Exclusions

• The following ailments are only covered after 2 years of policy with:

  • Cataract, Benign Prostatic Hypertrophy, Congenital Internal Diseases, and Fistula in Anus, Piles, and Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Sinusitis and related disorders.
  • Pre-existing disease/illness/injury/condition will not be covered for first 2 years of the policy.
  • Any disease contracted during the first 30 days from start of the Policy.
  • Any domiciliary treatment.
  • Treatment due to suicide, self-inflicted injury or illness, mental disorder, anxiety, stress or depression, use of alcohol or drugs.
  • Diseases such as AIDS or HIV and its complications.