Bajaj Allianz Tax Gain Health Plan

Bajaj Allianz Tax Gain Health Plan

This is a unique floater health plan that covers outpatient (OPD) expenses and hospitalization expenses and helps you in tax management. You can gain OPD benefits as well as save tax under this single policy on floater basis. Here’s a quick rundown of the plan details:

Read More

Features of Bajaj Allianz Tax Gain Health Plan

The key features of the plan are listed below:

• Cashless treatment in more than 6000 hospitals across India
• Hospitalization and OPD expenses are covered in a single plan on floater basis
• Emergency ambulance expenses up to INR 1000
• Provision to cover 130 daycare procedures ( subjected to T&C)
• Free health check-up facilities are provided after completion of four claim-free years (no hospitalization claims). It is available to only one of the insured members.
• If the admission is taken in a non-network hospital then 10% of co-pay is applicable to the claim amount. By paying an additional premium you can opt for waiver of co-payment.

Benefits of Bajaj Allianz Tax Gain Health Plan

Here is a list of the benefits of buying this policy:

• The premium remains the same for the age group between 18 and 55 years. And for the age group between 56 and 75 years
• In the case of out-patient expenses, there is no restriction on the waiting period
• Under the OPD section you also get coverage for dental treatment and related procedures
• Cost of dentures, spectacles, and crutches is also covered under the OPD Section
• In-house settlement of health claims without the hassle of dealing with the TPA department
• Tax exemption benefits u/s 80 D of Income Tax Act

Inclusions of Bajaj Allianz Tax Gain Health Plan

By purchasing this plan you will be covered for the following expenses:

• Hospitalization and out-patient expenses on the floater basis ( for self and spouse)
• Pre and post hospitalization expenses to be covered up to the specified OPD expenses
• OPD expenses are recompensed
• Ambulance expenses in case of emergency hospitalization up to 1000 rupees
• 130 daycare procedures are covered
• Under free health check-up facility once you complete the 4 claim-free years the cost of crutches will be covered from day 1 at the insurer’s assigned empanelled diagnostic center
• Tax saving benefits
• Availability of senior citizen plans that cover both hospitalization and OPD expenses
• 10% co-payment is applicable for the treatments taken in a non-network hospital

Bajaj Allianz Tax Gain Health Plan Variants

Eligibility Criteria

The eligibility criteria to buy this plan are as follows:

• Anyone between the age group of 18 and 75 years can buy this plan
• For Plan A (Bajaj Allianz Tax Gain 4999) the entry age ranges from 18 to 55 years. For Plan B (Bajaj Allianz Tax Gain 9999) and Plan C (Bajaj Allianz Tax Gain 14999) the entry is the same i.e. 18 to 55 years.
• For Plan D (Bajaj Allianz Tax Gain 19999) the entry age ranges from 56 to 75 years and it comes with lifelong renewability

Exclusions of Bajaj Allianz Tax Gain Health Plan

Following medical expenses will not be covered under this plan:

• Any pre-existing illness, injury or ailment shall not be covered until 48 months of continuous coverage from the policy commencement date
• There is a waiting period of 4 years in case of joint replacement surgeries unless it is an accidental injury
• Any other treatment than Allopathy
• There is a waiting period of 30 days from date of policy commencement for any disease/illness unless it is an accidental bodily Injury
• Circumcision, aesthetic or cosmetic treatments, or a gender change surgery
• Plastic surgery unless it is required for accidental injuries, burns or treatment of cancer
• The cost of contact lenses, spectacles, hearing aids, artificial teeth, artificial limbs, crutches, dentures, and any other external device or medical equipment’s is not included
• Congenital external diseases, convalescence, general debility, genetic disorders or defects or anomalies, stem cell etc.
• Dental surgery or treatment of any kind unless it has resulted due to an accidental bodily injury requiring hospitalization.
• Any intentional or self-inflicted injury
• Hospitalization required due to use or misuse of alcohol or any intoxicating drugs
• Ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction
• Treatment arising from or traceable to uterine or extra uterine pregnancy and childbirth including caesarian section, and also pre and postnatal care.
• Any sterilization procedure, fertility, , impotence or assisted conception operation
• Experimental treatments
• War, acts of foreign enemies, invasion, hostilities, civil war, unrest, commotion, insurrection, rebellion, military or usurped power, revolution, or confiscation or nationalization or any damage under the order of any public local authority or government
• Claims arising due to nuclear materials or weapons

Claim Process of Bajaj Allianz Health Insurance Plans

The cashless claim settlement procedure is as follows -

• You can visit one of the nearest network hospitals for medical treatment
• Fill the pre-authoriation form.
• The Hospital will cross verify the details in the form and will send it to the insurance provider
• Once the preautorization request details are verified with the policy inclusions, approval is granted
• Once approved, you can begin with the cashless treatment till the discharge date
• In some cases the insurer seek additional detials and your claim will be approved
• If rejected, then it will be coveyed to the hosptial and you can pay your treatment and file a reimbursement request

Procedure for reimbursement of claims:

• Once you are discharged from the hospital, the insurer will ask you to furnish all the documents including medical tests, cash memos, prescriptions, payment bills etc.
• All the documents will be then verified by the Bajaj Allianz health insurance team
• In case the insurer asks for additional documents then you will need to submit them timely
• Upon timely submission, your claim process will be initiated within 15 days of filing the claim. Failure to do so, will mean closure of your claim request within 45 days

Bajaj Health Insurance Tax Exemption Benefits

Apart from health insurance cover, you can avail tax benefits under Section 80/D of the Income Tax Act. The amount of premium that you pay helps you save tax every year. Listed below are tax saving benefits of Bajaj Allianz health insurance policy:

The table below captures the quantum of tax deduction that an individual taxpayer can avail under various circumstances: