- 1 Features of Digit Health Care Plus Plan for Pregnancy
- 2 Eligibility for Digit Health Care Plus Plan for Pregnancy
- 3 What are the inclusions in Digit Health Care Plus Plan for Pregnancy?
- 4 What are the exclusions in Digit Health Care Plus Plan for Pregnancy?
- 5 Maternity benefit and New Born Baby cover
- 6 What makes health insurance through Digit great?
- 7 How to claim online the Digit Health Care Plus Plan for Pregnancy?
- 8 What is the claim settlement procedure in the Digit Health Care Plus Plan for Pregnancy?
- 9 What are the documents needed for the claim?
- 10 Cancellation of Digit Health Care Plus Plan for Pregnancy?
- 11 Take Away
- 12 FAQs
For women, being pregnant is a transformative event. She requires the utmost care before giving birth. A woman who purchases a Digit Health Care Plus Plan for Maternity is completely covered for any delivery-related costs, including those associated with both normal and cesarean deliveries. When selecting a hospital, a woman doesn’t have to worry about the delivery costs if she has the policy. Not only that, but the insurance coverage also supports her by paying for the baby’s medical care up to 90 days after birth.
Features of Digit Health Care Plus Plan for Pregnancy
- Available on a floating basis for both individuals and families.
- The minimum amount covered is Rs. 2 Lakh.
- The insurance is renewable for life.
- E-opinion from a specific doctor’s panel for serious illnesses
- Insured amount refill benefit
- Long-term hospital cash benefit
- No claim discount during a year without claims
Eligibility for Digit Health Care Plus Plan for Pregnancy
A woman must be covered by the Digit Plus Policy in order to get maternity benefits. The entry age cap is 60 years old. However, in addition to the mother, a kid up to 1 year old can also be covered.
What are the inclusions in Digit Health Care Plus Plan for Pregnancy?
- Costs associated with both natural and C-section deliveries.
- Fees related to pregnancy complications and maternity expenses for delivering a baby.
- Costs associated with a legally or medically required termination.
- Treatment provided as an outpatient (OPD), i.e., without incurring hospital costs.
- Hospitalisation costs both before and after.
- Fees for the newborn baby’s immunizations up to 90 days (or up to age 5 if the child is enrolled as an insured person) following the delivery date.
What are the exclusions in Digit Health Care Plus Plan for Pregnancy?
- Prenatal and postpartum costs, unless they result ihospitalizationon until the waiting period has passed, pre-existing conditions.
- Costs of artificial life maintenance.
- Medical costs associated with an unjust termination.
- Costs associated with stem cell collection and storage when done as a preventative strategy.
Maternity benefit and New Born Baby cover
- Maternity Benefit Digit Simplification
One of the rare times when going to the hospital is for a little bundle of joy. If You have opted for this Cover, the company will pay the Maternity Expenses incurred towards the delivery of a baby and/or treatment related to any complication of pregnancy or medically necessary termination. This is up to the Sum Insured opted by you against this section, during the Policy Period provided that:
a) Female Insured Person legally married spouse is also covered under this Policy unless specifically waived by the company. For example, if you are a single parent, this clause will not apply. This also has a waiting period. The waiting period as opted by you and mentioned in your Policy Schedule shall apply from the date of inception of the first policy with the company, provided that the policy has been renewed continuously with the company without break, with maternity as a benefit.
b) The maternity benefit is limited to cover up to two living children. However, there is no restriction on the number of medically necessary and lawful terminations of pregnancies.
c) If on renewal without any break in coverage, the sum insured is increased, there is a fresh waiting period as opted by you and mentioned in Your Policy Schedule applied to the increased part of the Sum Insured.
d) Any complications arising out of or as a consequence of maternity/childbirth will also be covered within the limit of the Sum Insured, available under this benefit.
- Digit Simplification
Sticking with the company has its advantages. If we had already accepted a claim for Maternity Expenses for your first living child under this benefit, then for the subsequent Maternity Expenses i.e. for the delivery of Your Second child, the company Go Digit General Insurance Ltd. Digit Health Care Plus policy and shall pay up to the percentage of the Sum Insured opted under this Section provided the Policy is renewed with the company continuously without break with Maternity Benefit & New Born Baby Cover benefit.
The plan shall not pay for the following under this Section:
a) Expenses for the harvesting and storage of stem cells when carried out as a preventive measure against possible future illness.
b) Medical Expenses for Ectopic Pregnancy will be covered. In-patient Accidental & Medical Treatment and not under the Maternity Benefit.
c) Pre-natal and Post-natal Medical Expenses are not covered unless leading to Your Hospitalization.
- New Born Baby Benefit Digit Simplification:
Your babies need all the love, care, and cover they can get. Under this cover, the company will also pay the Medical Expenses, within the limit of the Sum Insured available.
The Maternity Benefit Section of the Policy provided that the company has accepted a claim.
A. Maternity Benefit, incurred towards:
B). The medical treatment of the Insured Person’s New Born Baby while the Insured Person is hospitalized as an inpatient for delivery.
C). The New Born Baby’s hospitalization charges as a result of any medical complications, up to 90 Days from the date of delivery.
D). Reasonable and Customary Charges for the Vaccinations of the New Born Baby as per the National Immunization Schedule as defined by the Government of India, up to 90 Days from the date of delivery. However, once the New Born Baby is added as an Insured Person under the Policy, the company will pay the Reasonable and Customary Charges for the Vaccinations of the New Born Baby as per National Immunization Schedule as defined by the Government of India until the New Born Baby attains 5 Years of age, provided that the Policy is continuously renewed with the company without break and with Maternity Benefit and New Born Baby Cover as a benefit since the inception of the first policy.
E). If the Policy Expires 90 days from the date of delivery, the New Born Baby will be covered only if the Policy is Renewed with the New Born Baby as an Insured Person. This is subject to our underwriting policy and payment of any additional premium.
F). After 90 Days from the date of delivery, the New Born Baby will be covered under the existing Policy only if it is Endorsed by the New Born Baby as an Insured Person. This is subject to our underwriting policy and payment of the Pro-Rata Additional Premium, for the balance period. This Cover is subject to terms, conditions, deductible, co-payment, limitations, and exclusions mentioned in the Policy.
What makes health insurance through Digit great?
- Easy online procedures: Everything is paperless, simple, quick, and hassle-free, from purchasing health insurance coverage to filing claims! Not even for claims, please!
- Includes additional coverage, and information about pandemics like the coronavirus: India is one of the nation’s most severely impacted by COVID-19. You don’t actually need separate coronavirus coverage because we cover the same as part of our health insurance.
- No copayment depending on age: There is no age-based copayment with our health insurance. This means that you won’t have to spend anything out of pocket when filing a claim with your health insurance.
- No restrictions on the number of rooms you can rent: We recognize that everyone has different preferences. We have no limitations on room rentals because of this. Select the hospital room of your choice.
- If you use up your sum insured and regrettably need it again throughout the year, we will refill it for you. 2X Sum Insured (for related illnesses only).
- Bonus cumulative: A benefit for maintaining good health! For years without a claim, you can receive a cumulative bonus each year.
- Any hospital can treat you. Choose from more than 10,000 hospitals in our network in India for cashless treatment or choose reimbursement.
How to claim online the Digit Health Care Plus Plan for Pregnancy?
- Visit the business website or get the app.
- Give your policy information.
- Add the patient’s or insured’s information, such as name.
- Include the diagnosis information as well as the insured’s status, such as released or OPD patient.
- Enter the hospital’s information, including name, address, zip code, etc.
- Choose the admission and discharge dates.
- Submit the necessary paperwork online
- You can create a claim number.
- Your claim has now been registered with the business; after it has been validated, a representative will get in touch with you to discuss claim settlement.
What is the claim settlement procedure in the Digit Health Care Plus Plan for Pregnancy?
Regarding Cashless Claims: For scheduled hospitalization, claim notification must be made 72 hours in advance and within 24 hours for emergency hospitalization. Start a claim request by giving the TPA properly completed claim request forms, eHealth cards, and pre-authorization forms. Once the application is granted, your claim will be resolved.
For Reimbursement: Intimate claim within two days after hospital admission for reimbursement. The business will give you a URL to upload the necessary files. Within 30 days of the date of discharge, upload all the necessary invoices and paperwork that has been properly signed. Keep the original nearby as well. Within 30 days of receiving all the required documentation, if the claim is approved, you will get the refund amount.
What are the documents needed for the claim?
Making a claim can occasionally be a difficult procedure, but you can make it easy by giving all the information upfront. The required paperwork may change from one claim to the next. The following documentation may be required, if appropriate, in order to submit a claim under the Digit Health Plus Policy:
- Complete and signed the Form for electronic health insurance claims
- Release description
- Papers on digital health and policies
- Health records (Indoor Case Papers, OT notes, PAC, Notes etc.)
- Authentication of the principal hospital invoice
- The original pharmacy invoices.
- Original copy of the hospital bill’s breakdown.
- Prescription of drugs.
- Investigation scans and reports.
- Consultation documents.
- KYC (Photo ID card, If applicable) (Photo ID card, If applicable)
- MLC/FIR report.
- Original receipt or sticker.
- Report Following Death (if applicable)
- A certificate of disability.
- Certificate from the attending physician
- Antenatal history
- Bank information and a voided check (If applicable)
- Birth registration (if applicable)
- Certificate of Death (If applicable)
Cancellation of Digit Health Care Plus Plan for Pregnancy?
By providing 15 days written notice, you may terminate this policy at any time. For the remaining length of the insurance, the business will refund the short-term rate premiums.
The company will reimburse all costs incurred during pregnancy if you have chosen this coverage option for your Digit Health Care Plus Policy. All costs connected with the child’s delivery will be covered by this choice. On the other side, if the newborn infant develops any complications, those costs will also be covered. The newborn infant will thereafter be protected for a maximum of 90 days.
What is the waiting period under this plan?
The waiting period for maternity benefits and newborn coverage is four years.
What are some of the specifics needed when notifying Digit of a claim?
· Name of insured.
· Assurance number.
· Name of the patient and their relationship to the proposal.
· Dates of admission and discharge.
· Information on diagnosis and treatment.
· Actual vs. Estimated Expense.
· Employee identification number (If applicable).
Who can purchase a Digit maternity health insurance plan?
Any woman who wants total protection against costs incurred during delivery, including for both regular and cesarean sections, should acquire a Digit maternity health insurance plan.