Key Features of the Policy
- Covers only HIV infected individuals
- No age limit for the applicant
- The Period of Insurance is for one year like any other Mediclaim Policy
- Sum Insured is for Rs 30,000/-, Rs 40,000/- and Rs 60000/-
- 50% of the SI is covered for Hospitalization and 50% on reaching AIDS Stage
- The HIV Care Policy is issued to a group of persons infected with HIV
- Policy taker must be a member/beneficiaries of the proposer
- The policy should be proposed by Govt. Agencies, NGO’s societies or other registered bodies serving the cause of the persons infected with HIV
- Pre Insurance screening is mandatory for all applicants (CD4 cell count should be above 300 and clinical reports should be within 45 days) to rule out AIDS stage
- Inpatient Services/Hospitalization
- Pre Hospitalization expenses for 30 days
- Post hospitalization expenses for Rs 5000/-
- All diseases/injuries which are Pre–Existing
- Any disease contracted by the Insured person during the first 30 days of the policy
- An Insured has to fulfilled the eligibility criteria before enrolling into the policy
- A photo Id card will be issued by the Insurance company to all insured
- The Photo Id card contains, ID no. Policy no. Validity
- Toll free helpline numbers and address of the Insurer
- This card will facilitate cashless hospitalization in all Network of hospitals which is over 3000 across the country
- When an insured gets admitted in a Network Hospital he/she can go in for Cashless Hospitalization
- A pre–authorization form has to be filled in by the treating doctor at the hospital
- This form will be send across to Insurance company for approval
- Based on the policy terms and conditions, sum insured etc the Medical Officer at Insurance company will authorize the same
- On authorization the patient can be discharge without paying the expenses incurred
- The hospital and Insurance company will settle the claim directly without the insured intervention
Member Reimbursement Claim (MRC)
- For MRC, Insurance has to be intimated within 24 hours of the accident/illness/hospitalization either through the Call Centre/24 hr helpline/Network Representative
- Intimation can be given Claim must be filed within 15 days from date of discharge from the hospital.
- All the documents pertaining to hospitalization must be submitted in original to Insurance Company for processing
- Original documents include Discharge summary, hospital bill with break up, lab reports, receipts etc
Insured Amount | Premium in Rs |
30,000 | 1511 |
40,000 | 1919 |
60,000 | 2445 |
Contact Person
State Coordinator Insurance
Project Connect
Network of Maharashtra People with HIV (NMP+)
Telephone: +91 20 26336084/87
E-mail: connect@nmpplus.net
