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Group Medical Insurance

Group Medical Insurance is a type of health insurance policy provided by employers or organizations to cover employees and their dependents. It offers financial protection against medical expenses incurred due to illnesses, injuries, hospitalization, and other healthcare services.

Coverage

Hospitalization Expenses

Covers the cost of hospital room charges, medical tests, surgeries, anesthesia, and other hospital-related expenses incurred during the insured's hospital stay.

Emergency Medical Services

Coverage for emergency medical services, ambulance transportation, emergency room visits, and urgent care treatment for sudden illnesses or injuries.

Outpatient Treatment

Coverage for medical consultations, diagnostic tests, specialist visits, medications, and outpatient procedures performed outside of the hospital setting (pre and post-hospitalization)

Chronic Disease Management

Coverage for ongoing treatment, medications, and management of chronic medical conditions such as diabetes, hypertension, asthma, and heart disease.

Add-On

Maternity Benefits - Coverage for prenatal care, childbirth, delivery expenses, postnatal care, and newborn baby care, for expectant mothers and their newborns.

Dental Coverage - Coverage for dental treatments and major dental procedures such as root canals, crowns, and orthodontic treatment.

Preventive Care - Covers preventive healthcare services such as annual check-ups, vaccinations, screenings, and wellness programs.

Vision Coverage - Coverage for vision care services such as eye exams, prescription eyewear (glasses or contact lenses), and corrective vision procedures such as LASIK surgery.

Alternative Medicine - Coverage for alternative or complementary medical treatments such as acupuncture, chiropractic care, naturopathy, and homeopathy, in addition to conventional medical treatments.

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Exclusions

1. Medical conditions or illnesses that existed before the policy’s effective date (unless specifically sought as a waiver)

2. Cosmetic procedures such as plastic surgery, liposuction, cosmetic dentistry, and hair transplantation, unless medically necessary.

3. Medical treatments, procedures, drugs, or therapies considered experimental, investigational, or unproven.

4. Injuries or illnesses resulting from intentional self-harm, suicide attempts, or participation in illegal activities.

5. Expenses unrelated to medical treatment, such as personal comfort items, private nursing, transportation, and accommodation, are excluded from coverage unless specifically covered under the policy.