The '10K Tax Saver Health Insurance Policy' has a fixed premium and enables you to save up to Rs. 3,366* under Section 80 D of the Income Tax Act.
10K Tax Saver Health Insurance Plan
Under this policy, the insurance premium remains the same at Rs. 10,000. What changes is the Sum Insured (amount of coverage) depending on the age and the number of members covered. The amount of the premium (Rs. 10,000) is fully deductible under Section 80D of the Income Tax Act. Thus, you save Rs. 3366 on your tax payable.
* For highest income tax slab of 33.66% (including 10% surcharge for income above Rs. 8.50 Lakh and education cess @ 2%).
Fixed premium payable for all the plans: Rs. 10,000/- |
Age of senior most family member |
Plan 1 Sum Insured for 2 members |
Plan 2 Sum Insured for 3 members |
Plan 3 Sum Insured for 4 members |
| 19 – 45 years |
500,000 |
400,000 |
350,000 |
| 46 – 55 years |
300,000 |
250,000 |
200,000 |
| 56 – 60 years |
250,000 |
200,000 |
NA |
10K tax Saver Health Insurance - Policy Coverge
The policy covers medical expenses:
- Incurred as an inpatient during hospitalisation for more than 24 hours, including room charges, doctor’s / surgeon’s fee, medicines, diagnostic tests, etc.
- 30 days prior to hospitalisation.
- 60 days post hospitalisation.
- Pre-existing disease can be covered after the 4th year provided the policy is renewed with us for four consecutive years.
- Technologically advanced treatment that do not need 24-hour hospitalisation but are covered under this policy are:-
- Cataract
- Lithotripsy (Kidney Stone Removal)
- Tonsillectomy
- Eye Surgery
- Dialysis
- Dilatation & Curettage
- Chemotherapy
- Radiotherapy
- Coronary Angiography
- Cardiac Catheterization
Coverage limit for specific ailments / conditions:
Certain specific ailment(s) / surgery(s)/ procedure(s) are covered up to pre-defined limits under this policy (subject to the total sum insured).
The Company's obligation to make payment in respect of the following ailment(s)/surgery(s)/procedure(s) shall, subject always to limit of indemnity be as per the table below.
Name of the Ailment/Surgery/Procedure |
Sub-limit (Rs.) |
| Cataract (Each Eye) |
16000 |
| Tympanoplasty |
18000 |
| Fistula, Piles, hydrocele, Sinusitis (FESS) |
20000 |
| Appendicitis, Hernia |
25000 |
| Benign Prostatic Hypertrophy (TURP), Hysterectomy |
30000 |
| Cholecystectomy, Lapchole |
40000 |
| Tonsilitis / Tonsillectomy |
12000 |
| Joint Replacement (Each Joint) |
150000 |
| Coronary Artery Diseases/Lschemic Heart Disease requiring Angioplast/PTCA |
140000 |
10K Tax Saver Health Insurance - Key Benefits
- Floater benefit – One Premium for the entire family. The floater health plan covers your entire family under one policy with one sum insured and one premium. This takes care of hospitalisation expenses in case of a sudden illness, accident or planned surgery of the entire family.
- Maximum income tax benefit under section 80 D. Click here to know more about Tax Benefit
- Fixed premium of Rs 10,000 for all plans.
- Cashless claim facility available at over 3,500 network hospitals across India.
- No health check up required upto the age of 45 years(as on last birthday).
- Medical checkup mandatory for insured of age 46 years and above. An adult aged 46 years and above has to undergo the following medical tests:
- Complete Blood count
- Fasting Blood Sugar
- ESR
- Serum Creatinine
- SGPT
- Urine Routine
- ECG
- Medical Examination with BP recordings - By a physician
Our representative will call the proposd insured (s) for prior appointment for the medical tests (mentioned above) within 2 days of receipt of full premium.
Tax Benefit u/s 80D
How does Tax Benefit work?
For e.g. A premium of Rs. 10,000 is fully deductible under Section 80D of the Income Tax Act. You would save Rs. 3366 on your tax payable.
Key Points to note
- Premium paid for medical insurance qualifies for rebate under Section 80D of the Income Tax Act.
- Section 80D benefit remains over and above Rs.1 Lakh benefit of 80C (ELSS, Principal component of home loan, Life Insurance etc
- Tax benefit goes to the person making payment, Person covered can be his/her dependant (spouse, children)
- The qualifying amounts under Section 80D is maximum upto Rs 10,000/-.
- A higher amount of upto Rs 15,000/- is permitted if the person, for whose health insurance the premium was paid, was aged 65 years or more at any time during the financial year in which the premium was paid.
Additional Benefits:
- Double Benefit: A benefit of Rs.10,000/- is paid, if more than one member of the family (covered under one policy) are simultaneously hospitalised for a period of 5 consecutive days or more.
- Convalescence Benefit : A benefit of Rs.10,000/- is paid, if the period of hospitalisation is 10 consecutive days or more. This benefit is paid once in a year.
10K Tax Saver Health Insurance - Eligibility
- The enrolment age (of the senior most family member) should be between 19 years to 60 years.
- Other members in the plan can be less than 19 years of age (i.e. up to 91 days)
- At least two members must be insured under this policy.
- The policy cover is renewable till the age of 70 years.
- The customer can buy the policy only for his (two or more) family members - defined as self, spouse, dependent children and dependent parents for the purpose of income tax exemption u/s Sec. 80D.
10K Tax Saver Health Insurance - Policy Exclusions
All health policies have following set of temporary and permanent exclusions:
30 Days exclusion
Medical charges incurred, except those arising out of accidental injuries, within the first 30 days from the start date of the policy are not covered. This clause does not apply for subsequent renewal (without a break) of this policy with us.
2 Years exclusions
Expenses incurred on treatment of following diseases within the first two years from the start date of the policy are not covered:
- Cataract
- Benign Prostatic Hypertrophy
- Myomectomy, Hysterectomy unless because of malignancy
- Hernia, Hydrocele
- Fistula in Anus, Piles
- Arthritis, Gout, Rheumatism
- Joint replacement, unless due to accident
- Sinusitis and related disorders
- Stone in the urinary and biliary systems
- Dilatation & Curettage
- Skin and all internal tumors / cysts / nodules / polyps of any kind, including breast lumps, unless malignant / adenoids and hemorrhoids
- Dialysis required for chronic renal failure
- Surgery on tonsils and sinuses
- Gastric and duodenal ulcers
These above diseases are covered from third year, if the policy is renewed with us for two consecutive years (4 years, if these are pre-existing diseases at the time of inception of the policy).
Permanent
- Any internal congenital illness.
- Non-allopathic treatment, pregnancy and childbirth related diseases, cosmetic, aesthetic and obesity related treatment.
- Expenses arising from HIV or AIDS and related diseases, use or misuse of liquor, intoxicating substances or drugs as well as intentional self injury.
- War, riots, strike, terrorism acts, nuclear weapon induced treatment.
10K Tax Saver Health Insurance - Need for 10K
- Healthcare costs have been rising at more than 20 percent on an annualised basis and out of pocket spending on healthcare still continues to be around 75 percent. Source TOI
- Save Tax up to Rs. 3366 u/s 80 D of the Income Tax Act Supplements employer-based health plans with higher sum insured and medical benefits
- Individuals require to have an insurance that caters solely to their health needs, apart from life insurance and investments, that provides cover against expenses incurred during hospitalization, as well as before and after
- Avail cashless hospitalisation through ICICI Lombard's network of 3500 hospitals across India
10K Tax Saver Health Insurance - Claim Process
Know all about making a claim
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