Super Speciality Care - Features and Benefits

What is Super Speciality Care?

With medical inflation being on the rise, it becomes extremely important to invest in a good healthcare insurance plan. Particularly for super speciality care as it can be both- essential and expensive.

Bajaj Markets brings you the Super Speciality Care plan by EBH. This plan covers a range of lab tests, specialist doctor consultations and also offers network discounts. Read on to know more about the Super Speciality Care plan by EBH.

 

You’re all set! You should receive your welcome and membership details pack on your registered email ID.

Eligibility Criteria

Here’s the eligibility criteria for the Super Speciality Care:

● Applicant must be a resident of India

● Applicant’s age should be at least 18 years or above

What's Covered Under Super Speciality Care?

OPD / Doctor Consultation Benefit

This benefit offers coverage to consult a doctor (specialty or general) that has a BAMS, BHMS, BDS or MBBS degree. 

 

Policyholders are to present a clear and legible invoice of their consultation with all relevant details in order for the reimbursement claim to be processed. This reimbursement claim should have adequate information regarding the consultation fees, customer details, the doctor’s name and specialty, date of consultation, doctor stamp and registration number for reimbursement. The total extent of the benefit may be claimed within one visit or can be spread across multiple visits to the doctor provided they fall within the benefit amount that has been indicated in the policy document.

 

Lab Test Package (Prime Network)

This package provides you with a range of predefined tests that are aimed at identifying and minimising risks in addition to help you detect illnesses early on. Policyholders are entitled to undergo a checkup each policy year for a pre-defined lab test package based on the package selected by them. These tests are available to only those mentioned under this policy. These tests can only be taken at Bajaj Finserv Health Prime partner hospitals and laboratories which are updated regularly.

 

Network Discounts

Discounts provided under this plan include a 10 percent discount for health packages and plans, OPD consultations, radiology and lab, pharmacy expenses, spectacles, and dental procedures. A 5 percent discount is applicable to the room rent. In the event of an IPD admission, the ambulance ride is free. These discounts will be applicable to only those that operate within the Bajaj Finserv Health Prime network, there may be exclusions to this. 

 

Policy Plan Details & Specifications

Super Speciality Care
Benefit Name	Benefits up to/Doctor visits	Membership fee
Lab and Radiology Benefit (Open Network)	Rs. 4000	Rs. 2999
OPD / Doctor Consultation Benefit (Open Market)	Rs. 3200 (Maximum visits: 4)
Any super speciality from below
Cardiologist - Heart health
Endocrinologist - Diabetes & Thyroid
Neurologist - Nervous system
Nephrology - Kidney
Oncologist - Cancer
Network Discounts (Prime Network)	- 10% discounts on doctor consultation, preventive health check-up, lab tests, dental procedures, spectacle and pharmacy - Free ambulance service on IPD admission - 5% discount on IPD room rent

 

This policy plan is valid for a period of one year. 

What’s not Covered?

Policyholders of this plan are not provided with coverage for the following.

 

What’s not covered under Lab Test Package – 

 

• This package is not applicable in any medical centre that is outside of the Bajaj Finserv Health Prime network. 

• In exceptional cases, the home collection service may not be available. In such an event, you may have to visit your nearest centre.

• This package is only available to adults mentioned in this policy and is not eligible to be transferred to another member.

• Carry forwards aren’t permitted even if the policy plan is renewed. 

• Benefits cannot be redeemed against cash. 

 

Exclusions Under OPD/Doctor Consultation Benefit – 

 

• This benefit will not provide coverage isn’t provided for any medical treatments or procedures a policyholder might undergo. 

• Benefits may not be transferred.

• Carry forwards are not permitted even if the plan is renewed for the upcoming year. 

• The consultation benefit can’t be added to another facility or benefit. 

 

Exclusions to Network Discounts –

 

• Discounts cannot be merged with other benefits or services.

• These discounts are only available at locations specified under the Bajaj Finserv Health Prime network.

*Kindly look through the policy carefully for a better understanding. 

 

How to Make a Claim

Radiology and Lab Benefit/ Doctor Consultation Benefit

You can raise a claim in any of the following methods:

Bajaj Finserv Health App

• Download the Bajaj Finserv Health application

• Sign-up or sign-in using your mobile number

• Select your purchased plan from the ‘Health Plans’ section

• Select ‘Radiology and Lab Benefit’ or ‘Doctor Consultation’, whichever is applicable

• Enter relevant details

• Upload your invoice

• Share your bank account related details 

• Attach one image of a cancelled cheque to validate your account

• Submit your claim

• Your claim shall be reimbursed in forty eight working hours 

 Bajaj Finserv Health Website

• Log on to the Bajaj Finserv Health website

• Select your purchased plan in the ‘Health Plans’ section

• Select ‘Radiology and Lab Benefit’ or ‘Doctor Consultation’, whichever is applicable

• Fill in the relevant details

• Upload an image of your invoice

• Share your bank account related details 

• Upload one cancelled cheque to validate your account

• Submit your claim

• Your claim amount shall be reimbursed in 2 working days

 Emailing the Customer Service

• Send an email to the email ID-  customercare@bajajfinservhealth.in

• In your attachments, add a legible copy of the invoice

• Mention all relevant details in your email

• Share your  bank details and add a cancelled cheque for validation purpose

• Your claim will be reimbursed within a period of 48 hours  

Teleconsultation Benefit

Raise a claim through any three of the following methods:

Bajaj Finserv Health App

• Download the Bajaj Finserv Health app

• Log in to the app using your mobile number

• Select your purchased plan under the ‘Health Plans’ section

• Choose the ‘Teleconsultation’ option

• Choose your preferred physician from the dropdown list

• Select preferred time and date

• Click on the ‘Submit’ icon to finalise your claim

• 15 minutes prior to the scheduled time, you’ll receive a link

• The consulting physician shall join the call during the stipulated time period

 Bajaj Finserv Health Website

• Go on to  bajajfinservhealth.in

• Log in using your mobile number

• Choose you purchased plan under the ‘Health Plans’ sections

• Select the ‘Teleconsultation benefit’ 

• Choose your preferred doctor from the given list 

• Select preferred time and date 

• Click on ‘Submit’

• You will receive a link  15 minutes prior to the consultation

• Your doctor shall join the video or voice call during the scheduled time period

Lab Test Package (Prime Network Only)

Make cashless claims through any of the following methods: 

Bajaj Finserv Health App

• Download the Bajaj Finserv Health app from AppStore or PlayStore. 

• Sign-up or sign-in using your mobile number

• Choose your purchased plan under the ‘My Health Plans’ section 

• Choose ‘Lab test package’ option

• Choose your preferred lab or hospital

• Mention your redemption date, then confirm your option

• You will receive a voucher link, you may use this to claim benefits and offers. 

Bajaj Finserv Health Website

• Begin by visiting the bajajfinservhealth.in website

• Log in using your mobile number

• Choose your purchased plan under ‘My Health Plans’ section 

• Select ‘Lab test package benefit’ tab

• Choose your preferred lab or hospital

• Type in your redemption date and confirm

• You will receive a voucher link, you may use this to claim benefits and offers. 

 

Emailing to Customer Service

• You may begin by emailing customercare@bajajfinservhealth.in

• Enter relevant details like date, customer name, lab or hospital name

• A representative will get in touch with you to confirm your identity using an OTP

• You will receive a voucher link, you may use this to claim benefits. 

Network Discounts

Grab your Bajaj Finserv Health Prime Network benefits in any of the following way(s):

• Any lab or hospital under the Bajaj Finserv Health Prime Network will offer said benefits, you may visit any of these to claim the benefit

• Share relevant details with the representative 

• Share received OTP with the representative

• Once you’ve shared the OTP, you will be eligible to receive discounts on specified services

 

Customer Care Details

You can connect with us at $$BrandName$$%. Just write to us at insuranceconnect@bajajfinservmarkets.in in case of any queries.