“Health Plan” is a policy which covers for “medical expenses” in the unfortunate event of hospitalization of the insured or policy holder due to sudden illness or accident. Prime health plan brings a radical change in our life by making this policy effective and advantageous. If any person takes this policy, he will get the monetary support as well as mental satisfaction through its offerings for the policyholders by bearing the cost of hospitalization up to striking sum insured.
The insurance provides comprehensive cover for all expenses (up to sum insured limit) related to coverage of group hospitalization which among other things includes room rent, treatment/surgery & other related expenses.
Our “Health Plan” provides health insurance for your employees and group of families with the following slabs:
|Health Plan||Benefit’s Slab|
Who all can opt Prime Health Plan
The product has been designed for groups and can include families of the members who are in good health and between the ages of 3 months and 65 years.
Benefit under the Plan
We have designed our benefits in two categories:
- Normal benefit
- Additional benefit
- 30 days pre and 60 days post hospitalization benefits.
- Hospitalization benefit including room rent 2% of sum insured per day (for 15 days), consultation fee, routine investigation, surgery (Major and Intermediate), medicines and ancillary services
- ICU facility, 3% of SI per day maximum for 10 days.
- Maximum Tk. 3,000/- for Ambulance services.
- Overseas treatment in India, Singapore and Thailand at 40% extra premium;
- Overseas treatment only in India at 20% extra premium;
- Maternity benefit on additional premium
- Critical illness benefit can be covered on additional premium as detailed. The plan is offered to anyone in good health and between the ages of 3 months and 45 years
- Following Critical Illness will be Covered Up To Sum Insured
- End stage renal Failure;
- Multiple Sclerosis;
- Major Organ Transplant;
- Myocardial Infarction;
- Heart Valve Replacement
- Coronary Artery Bypass Graft;
- Stroke; and
- Accidental Death cover and permanent total disability cover up to sum-insured.
Please note: Critical Illness will not be covered if it is discovered within 90 days after the issuance of insurance policy
- Pre-existing disease
- From the policy issuing date to first 30 days of commencement if any treatment is required for the hospitalization no claim will be paid by Prime, except an accidental case.
- Any insured person committing or attempting to commit a criminal or illegal act or intentional self injury or attempted suicide.
- Participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing.
- Abuse of intoxicants or hallucinogenic substances such as drugs and alcohol, including smoking cessation programs & the treatment of nicotine addiction or any other substance abuse treatment or services, or supplies.
- Obesity or morbid obesity or any weight control programs, where obesity means the Body Mass Index (BMI) is above 29 & morbid obesity where BMI is above 37.
- Psychiatric or mental disorders or exhaustion; congenital internal or external diseases, defects or anomalies; genetic disorders; stem cell implantation or surgery or growth hormone therapy; sleep-apnea.
- Pregnancy, miscarriage, maternity or birth except in case of ectopic pregnancy.
- Sterility, surrogate or vicarious pregnancy; birth control.
- Dental treatment & surgery of any kind, unless requiring Hospitalization
- Treatment of spinal subluxation; diagnosis & treatment by manipulation of the skeletal structure; muscle stimulation.
- Less than 24 hours of hospitalization cost;
- Nasal septum deviation; laser treatment for correction of eye due to refractive error; aesthetic or change-of-life treatments.
- Plastic or cosmetic surgery unless necessary as a part of medical treatment certified by the attending physician for reconstruction following an accident, cancer or burns.
- Any non-allopathic treatment.
- Convalescence, cure, rest cure, sanatorium treatment, rehabilitation measures, rejuvenation cures, thermal baths, private duty nursing, respite care, long-term nursing care or custodial care,
- Items of personal comfort and convenience.
- War risk, terrorism, violence, public defense, military or usurped acts.
- Optical treatment (lab test, glasses and contact lenses) cost except due to accident.
- Artificial limbs, crutches or any external appliance &/or device used for diagnosis or treatment.
- Organ transplant & medical expenses incurred for an organ’s donor’s treatment for the harvesting of organ donated.