What’s not included in the Plum Lite?
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Maternity: Hospitalization expenses due to maternity
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Home healthcare: Treatments taken at home
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Foreign treatments: Treatments taken outside India
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Ayurvedic treatments
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Infertility: Infertility treatments such as IVF and surrogacy
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Lasik surgery
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Mental Illness: Treatment of mental illness
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OPD: Routine doctor visits not including hospitalization and daycare.
Note: Plum Lite is currently applicable only to Employee only OR Employee + Spouse + Child policy types. Parental coverage is not available on Plum Lite.
Age restrictions for Plum Lite:
Entry Age - Min
Adult: 18 years Child:91 Days
Entry Age - Max
Adult: 60 years Child: 24 years (for Parents 75 Years)
Exit Age
Adult: Lifelong* Child: 25 years
Specified pre-existing diseases
In case an employee is having any of the below specified pre-existing diseases, treatment of those pre-existing diseases will be permanently excluded
Category
Disease
Heart-related
Any open/closed surgeries related to heart and heart attack
Cancer-related
All types of cancer including chemo and radiotherapy
Kidney related surgeries
Nephrectomy
Brain and spinal surgeries
Any surgery related to brain or spinal cord
Surgery related to abdominal organs
Any surgery related to liver, spleen or pancreas
Bone related surgeries
Any surgery related to fracture – internal fixation required in hip, knee,long bone (thigh, leg, arm and forearm), and shoulder complex
Amputation of legs, arms, toes and foot for non-malignant lesions
Open surgery of chest and related
Any surgery related to lungs or thorax
Major Burns
Any surgery related to second and third degree full thickness burns (excluding surgery for cosmetic purposes)
Oro-maxillofacial surgery
Major reconstructive oro-maxillofacial surgery for trauma (excluding surgery for cosmetic purposes)
Major organ transplant
Transplant of kidney, liver or heart
Are there any waiting periods?
Yes, 1 year on named ailments, and 30 days on any non-accidental treatments.
For a list of ailments that have a waiting period, visit here.