Schedule of benefits - Chola Hea

A
Benefit Type Level of Benefits
Limits
General limit per person per policy year Applicable on sections 1a,1b,1c & 1d Rs 1,000,000
Applicable on eligible expenses caused
Co-Insurance per person per policy year by Non-network provider subject to 10%
being pre-authorised
Hospitalisation class CLASS A

Section 1a Basic Hospitalisation Services Co- 100% of eligible expenses up to the

Covered
Insurance General Limit

100% of eligible expenses up to the 60 days prior to

Section 1c Pre- Hospitalisation
General Limit Hospitalisation
100% of eligible expenses up to the 90 days after
Section 1b Post- Hospitalisation
General Limit Hospitalisation
100% of eligible expenses up to the
General Limit subject to Pre-
Section 1d Day Care Services Covered
authorisation; otherwise it is not
covered
Covered up to
100% of eligible expenses up to the 2,000,00 per
Section 1e Local Ambulance Services
General Limit person per policy
year
e of benefits - Chola Health Insurance Plan
B C D E F G
Limits Limits Limits Limits Limits Limits
Rs 750,000 Rs 500,000 Rs 400,000 Rs 300,000 Rs 200,000 Rs 150,000

10% 10% 10% 10% 10% 10%

CLASS B CLASS B CLASS B CLASS B CLASS B CLASS B

Covered 15% if Covered 15% if Covered 15% if Covered 15% if Covered 15% if
Covered
class A class A class A Class A Class A

60 days prior to 60 days prior to 60 days prior to 60 days prior to 60 days prior to 60 days prior to
Hospitalisation Hospitalisation Hospitalisation Hospitalisation Hospitalisation Hospitalisation
90 days after 90 days after 90 days after 90 days after 90 days after 90 days after
Hospitalisation Hospitalisation Hospitalisation Hospitalisation Hospitalisation Hospitalisation

Covered Covered Covered Covered Covered Covered

Covered up to Covered up to Covered up to Covered up to Covered up to Covered up to

2,000,00 per 2,000,00 per 2,000,00 per 1,000,00 per 1,000,00 per 1,000,00 per
person per policy person per policy person per policy person per policy person per policy person per policy
year year year year year year
 H I
Limits Limits
Rs 100,000 Rs 50,000

10% 10%

CLASS C CLASS C
Covered 15% if Covered 15% if
Class B 25% if Class B 25% if
Class A Class A
60 days prior to 60 days prior to
Hospitalisation Hospitalisation
90 days after 90 days after
Hospitalisation Hospitalisation

Covered Covered

Covered up to Covered up to
1,000,00 per 1,000,00 per
person per policy person per policy
year year
 Schedule of benefits - Chola Family Insurance Plan
General Limit (per Family per year) Applicable Sections
Rs 5,00,000 Rs 4,00,000
1a,1b,1c,1d,1e,1f and Room Rent

Co-Insurance (per Family per year) Applicable on eligible expenses

10% 10%
caused by Non-network provider subject to being pre-authorised

Room Rent per day upto Rs 3,000 upto Rs 2,500

Section 1a Basic Hospitalisation Covered Covered
90 days after 90 days after
Section 1b Post- Hospitalisation
Hospitalisation Hospitalisation
60 days prior to 60 days prior to
Section 1c Pre- Hospitalisation
Hospitalisation Hospitalisation
Section 1d Day Care Services only within Network; subject to Pre-
Covered Covered
authorisation; otherwise it is not covered

Section 1e Local Ambulance Services (per Family per policy year) Rs 1,000 Rs 1,000

Section 1f Hospital Daily Allowance Daily benefit Maximum days Rs 500 Rs 400
covered per Family per policy year 14 Days 10 Days
Section 1g External Aids and Appliance Rs 1,000 Rs 1,000
Section 1h Home Nursing Care Allowance Daily benefit Maximum Rs 300 Rs 300
days covered per Family per policy year 10 Days 10 Days
ance Plan
Rs 3,00,000 Rs 2,00,000

10% 10%

upto Rs 2,000 upto Rs 1,500

Covered Covered
90 days after 90 days after
Hospitalisation Hospitalisation
60 days prior to 60 days prior to
Hospitalisation Hospitalisation

Covered Covered

Rs 1,000 Rs 1,000
Rs 300 Rs 200
7 Days 7 Days
Rs 1,000 Rs 1,000
Rs 200 Rs 200
7 Days 7 Days