What’s not included in the Plum Lite?

  • Maternity: Hospitalization expenses due to maternity

  • Home healthcare: Treatments taken at home

  • Foreign treatments: Treatments taken outside India

  • Ayurvedic treatments

  • Infertility: Infertility treatments such as IVF and surrogacy

  • Lasik surgery

  • Mental Illness: Treatment of mental illness

  • 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.