Family Health Optima Insurance Policy Overview
The Family Health Optima Insurance Plan is a comprehensive family floater health insurance policy that provides wide-ranging medical coverage for the entire family under a single sum insured. It offers protection against hospitalization, daycare procedures, and modern treatments, ensuring affordable and extensive healthcare access.
Eligibility and Policy Terms
- Entry Age: 18 to 65 years (Adults), 16 days to 25 years (Dependent children)
- Policy Type: Family floater (self, spouse, dependent children, parents, and parents-in-law)
- Policy Tenure: 1 year (renewable for life)
- Sum Insured Options: ₹3 lakh to ₹25 lakh
- Renewal: Lifelong with no exit age limit
Plan Benefits
- Hospitalization expenses due to illness, disease, or accident
- Automatic restoration of the sum insured by 100% once in a policy year
- Newborn baby cover after 16 days from birth
- Coverage for AYUSH treatments (Ayurveda, Unani, Siddha, and Homeopathy)
- Emergency domestic medical evacuation and repatriation of remains
- Modern treatments covered as per IRDAI guidelines
- Air ambulance cover for higher sum insured plans
- Health check-up benefits after every claim-free year
Coverage Details
- Room Rent: Up to eligible room category based on sum insured
- ICU Charges: Covered up to specified limits
- Pre & Post-Hospitalization: 60 and 90 days respectively
- Daycare Procedures: All applicable procedures covered
- Organ Donor Expenses: Covered up to sum insured
- Maternity & Newborn Cover: Available after waiting period (subject to plan terms)
Exclusions & Limitations
- Pre-existing diseases covered after 36 months waiting period
- Treatment for self-inflicted injuries, substance abuse, or cosmetic surgery excluded
- War, nuclear, and hazardous sports injuries not covered
- For full exclusions, refer to policy document or insurer’s website