AFGIS is likely to start medical / health insurances in addition to ECHS facilities already exist for the veterans of IAF. In this regard a clarification on various aspects of the proposed health insurance has been published and reproduced below :-
FAQs ON THE PROPOSED HEALTH INSURANCE SCHEME FACILITATED BY AFGIS – FOR AIR VETERANS
|Who will be the insurance agency /TPA for the proposed health insurance scheme?
|AFGIS while working on this concept of health insurance, had discussions with all the leading insurance companies providing medical insurance viz Star Health. HDFC Ergo, Care health and ICICI Lombard. Finally, after comparing all plans, premium and conditions, ICICI Lombard was zeroed in as Third Party Agency (TPA) and they will be providing the insurance cover
|What age group will the insurance policy be covered?
|The insurance policy premium worked out isfor age group 57 to 80 years. However for Short Service Commission officers and airmen retiring early, a category of 35 to 56 and for veterans above 80 years, separate premium can be worked out depending on response & willingness from the Air Veterans.
|What does OPD cover include?
|OPD cover will include dental, vision, pharmacy, diagnostics and consultations and will be on floater basis i.e. amount can be utilized by both husband & wife during the term of policy.
|How will OPD bills bereimbursed?
|Reimbursement of OPD bills will be faceless through “IL app– of ICICI Lombard. Further the app will also provide other services such as consultation, customer care help, settlement of claims status etc.
|Is the health Insurance cashless &what will be the claim settlement process? Is there any limit of expenditure for particular disease?
|Hospitalization expenditure will be on cashless basison the basis ofa card issued by the TPA to the policy holders. All diseases will be covered and there will be no limit on expenditure on any particular disease. Only condition for reimbursement of expenditure is that the expenditure should be within the overall limit of the plan selected.
|Benefits of proposed
|Benefits of scheme include OPD cover, tax deduction
The proposed Health Insurance – Dpubt clear
|under 80 D, faceless reimbursement of claims through IL app, best in class claim settlement ratio, wide range of hospital network etc. Also, after negotiations, the requirement of medical examination was waived off and many other benefits including reduced premium as compared to plans available in the markets was arrived at.
|Why PED for one year & whether policy starts from day 1?
|As regards Pre Existing Diseases (PED), generally the insurance companies have a clause of waiting period up to 4 years.However after negotiation with the insurance company, they have agreed for PED clause for a period of onlyone year for those diseases for which individuals are already on medications. However. PED doesn’t debar from reimbursement of hospitalization expenses for diseases contracted after commencement of the policy. So, technically the policy starts from Day 1.
|Will the proposed scheme will have effect on existing medical arrangements?
|For the proposed scheme 2 adults that are eligible are husband and wife.
|Is the scheme also applicable for parents / In laws?
|This proposed scheme is in addition to the existing ECHS and in no way would dilute or discontinue existing medical arrangements which presently Air Veterans have through ECHS.
|Note:Presently, only opinion of the Air Veterans is being sought on the scheme. Based upon the response, a final proposal will be made and circulated for acceptance by the Air Veterans.
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