Reliance
Health Gain Prime
Reliance Health Gain Prime is a decent plan that does most things you expect from a health insurance plan. You can customise the accommodation type you’d prefer. You can reduce your waiting periods through add-ons. You can avail a loyalty bonus (on your sum assured) during renewal and you can buy the policy at a reasonable premium. The only downside is that Reliance General has had a tough few years due to the precarious financial situation of their erstwhile promoter Anil Ambani. Will things start looking up for the insurer soon? Well, that’s a bet you will have to make if you are buying the plan. Also, note that the Prime Variant only offers cover options of 25, 30, 50 Lakhs and 1 Crore.
What's good here?
Loyalty Cover
The insurance company shall provide a loyalty cover to the insured members up to a specified limit based on the renewal timeline for Accidental Death and Permanent Total Disability, Critical Illness, Hospital Cash, etc.
The insurance company shall provide a loyalty cover to the insured members up to a specified limit based on the renewal timeline for Accidental Death and Permanent Total Disability, Critical Illness, Hospital Cash, etc.
You most likely don't have to split the bill
If you bought this policy after you turned 61, you have to pay 20% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
Pre & Post hospitalization expenses covered
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 90 days after discharge. This includes the cost of medication by the way.
Day Care treatments covered
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.
Full coverage even if you are forced to hospitalize at home
The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.
You always have full cover irrespective of the disease
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Good Restoration Benefit
Even after you claim part of the cover on one occasion, you will have 100% of the cover restored once for different illness and 20% for the same illness, so that you can use this benefit in the event you have to endure multiple hospitalizations.
Special Bonus for being healthy and not claiming insurance
Your sum insured increases by 33% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 100%. Also, the bonus amount will reduce at same rate each time you make a claim. But hey, it's still a bonus.
Covers Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.
What's okay here?
You can pick any room you like
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Reasonable waiting period for pre-existing diseases
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
What's lacking here?
Your insurer doesn’t provide free health check-ups
If you want to get a full-body checkup just to make sure you’re in fine working condition, be ready to pay for it yourself or get an add-on to cover free health check-ups under the policy by paying a little extra in the premiums.
If you want to get a full-body checkup just to make sure you’re in fine working condition, be ready to pay for it yourself or get an add-on to cover free health check-ups under the policy by paying a little extra in the premiums.
Add-ons
PED Modification
This optional cover reduces the applicable pre-existing waiting period from 36 months to either 24 months, or 12 months. If you are currently diagnosed with any condition and want to reduce the waiting period, it makes sense to opt for this add-on.
Annual Health Check-up
Insured members get a free annual health check-up at network centres so long as they get medical tests prescribed in the policy along with Vaccination Coverage for a list of vaccines including Typhoid, Hepatitis or Anti-Rabies, etc. up to specified amount.
Family Cover
With this add-on, the insurance company will cover the cost fo medical expenses related to listed home treatments like Dialysis, Chemotherapy, etc. along with a fixed daily amount payout to the one who accompanies the insured member while getting treated in a hospital. This benefit also covers for children’s expenses in case you are hospitalised and can’t take care of them at home.
Convenience Cover
With this add-on, the insurance company will increase your pre & post hospitalisation limit to 90 and 180 days respectively. Provides coverage for air ambulance and Radio Taxi. The insurer will also pay an additional lumpsum amount, on hospitalisation for a minimum period of 7 continuous and consecutive days.
Room Rent Modifier
With this add-on, the insurance company modifies the room rent restriction from any room to a Single Private Room.
Enhanced Cover
With this add-on, the insurer will keep the unutilized bonus intact even if a claim has been made, offers unlimited restoration that will restore your cover in full every time a claim is settled for any illness along with extended coverage for generally excluded items like syringes, gloves, PPE kits etc
Hospital Cash
The insurer pays a lumpsum by adding a fixed sum (daily cash) every day until the day of discharge so you can deal with any potential loss in income during this time. The money will be reimbursed to you after you submit the required documents post-discharge, and while this looks like a neat benefit to have, we don’t recommend it since the benefit doesn’t compensate for the extra premium you pay.
Smart Cover
With this add-on, the insurance company indemnifies you for the medical expenses incurred towards the correction of eyesight due to refractive error of +-6.0 Dioptres or above and also covers you for the cost incurred towards availing a second opinion from a medical practitioner.
Double Cover
With this add-on, the insurance company gives an additional 100% of the sum insured for the same claim.
Aggregate Deductible
If you ever have to make a claim, then you’ll be expected to pay a sum before insurance company settles the claim. This amount is called the deductible. So if you want to buy a policy at a better price, you can opt to pay a higher deductible i.e. you can pay lower premiums by offering to pay a sum (a deductible) when a claim comes up.
Frequently Asked Questions
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