Coverage’s / Sum Insured Plan I Plan II Plan III Plan IV Plan V

Coverage Limit INR 5,000 INR 10,000 INR 20,000 INR 30,000 INR 50,000
Employee Employee Employee + Employee + Employee + Spouse
Family Definition + Spouse + Spouse + Spouse + Spouse + + Children + Parents
+ Children Children Children + Children +
Parents Parents
Consultations & Diagnostics ( All
Doctor Consultations, Lab Tests,
Imaging & Diagnostic Tests as
prescribed by the doctor) Upto full sum insured
including Teleconsultation **
Including consultation cosmetic
for Hair/Skin/Dietcian
OPD Procedures - All kind Upto full sum insured
All prescribed Routine Upto full sum insured
Diagnostics
Prescribed Medicines Upto 20% of Sum Insured Upto 30% Upto 40%
Vision Upto 40% of Sum Insured Upto 50% including Upto 60% including cost of
cost of frames frames
Non cosmetic Dental Upto 40% of Sum Insured Upto 50% Upto 60%
WHO Approved Preventive
Vaccination to be covered
upto 50% of Sum Insured.
WHO Vaccination (Non Not Covered (Flu Vaccination, Cervical
Prescribed Basis) Cancer Vaccination) for
Female Members including
Self, Spouse & Girl Child)
Prescribed Physiotherapy Covered Upto 50% of SI
Alternate Line of Medicine Covered as per above mentioned plan Sublimits, including AYUSH

Eligibility Criteria Employee + Spouse + Employee Employee Employee + Spouse +

Children + Spouse + + Spouse + Children + Parents
Children + Children +
Parents Parents