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Micro Health Insurance
This
program will provide the following services and benefit package to its members.
These services and facilities are available only at the authorized hospital and
pharmacy. In case of any confusion, please contact the Office of VDRC.
Services Available:
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1) |
Normal check-up
and consultation :
It includes all
kinds of normal checkups or tests and re-inquiry. The patient can benefit
from all the services except the one defined as excluded by this insurance
program (The same ticket has to be used for 10 days). |
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2) |
Hospital admission :
For upto 5 days, this program will bear the
hospital admission charges of the patient. If the admitted days are more
than five, then the member will have to bear it by him/her. |
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3) |
Normal Delivery:
This includes the admission charges for
normal delivery (normal bed) and pre and post delivery services. But the
expenses for the private cabin and pre-membership pregnancy won’t be
provided by this program. |
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4) |
Major Delivery: |
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A normal bed to
use and the services for major delivery case will be provided. But the
expenses for separate room on cabin and pre-membership pregnancy won’t be
provided by this program. |
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5) |
Laboratory Tests: |
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All sorts of laboratory tests (Pregnancy and
HIV test) are included in the service package of this program. But if the
same check ups are done repeatedly and if, without any illness, a health
checkup is done just for self satisfaction, the program won’t be bearing
any expenses. |
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6) |
Bone Fractures: |
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In case of any fractures, this program will
provide all the expenses except for the duplicate body parts or other
appliances like spectacles, wheelchairs, crutches, belts etc. |
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7) |
Radiology and other tests: |
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This includes X-ray, ultrasound, endoscopy,
ECG but not MRI and C.T scanning. |
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8) |
Minor operations: |
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All kinds of minor
operations will be included but the expenses for surgery regarding
pre-membership illness won be provided by this program. |
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9) |
Major operations |
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All kinds of operations (services available only
in authorized hospitals) are included but not the expenses for the surgery of
pre membership illness. |
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10) |
Normal Heart Problems: |
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Normal heart problems are treated in the
authorized hospitals. Heart problems requiring special treatment are
not included. |
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11) |
Normal Dental problem: |
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Tooth ache, tooth
plucking and other simple treatments are included here. Regular
dental check ups, fill ups, scaling and replacement (tooth) are not
included. |
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12) |
Ambulance Service : |
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This service is available only to transport the
patient up to the authorized hospital. But repeatedly for the same case, this
service is unavailable. |
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13) |
25% of the total cost of the medicine will be
borne only if the medicines are prescribed and bought from the authorized
hospital and pharmacy respectively. But the medicines which has to
be used for more than a month and the health tonics, vitamins, lotions and
powders are not included. |
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Services which are not included by the health semi-insurance program |
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Treatment for the long lasting
diseases like Asthma, Sugar, Cancer, AIDS, Paralysis is not included in this
program. But the primary treatment for these kinds of diseases for up to one year
from the date of disease identification is available through this program. |
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Treatment for the injuries and
illness due to carelessness caused by using alcohol and drugs wont be included
in this program. |
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The service to abort wont’ be
available until and unless, it could affect the mother’s health and apart from
it favoring the law, it should also be recommended by the doctor clearly. |
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No services will be provided in
case of use of poison and un-prescribed medicines. |
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If in case, any argument arises on
any decision has to be taken regarding the programs decided by health semi
insurance program and its services, the decision taken by VDIC will be the final
one. These services can be increased or decreased by the organization after
re-observation in mind the durability of the program. |
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Insurance Premium:
The person on the family interested to be a member
of this health semi-insurance program and use these services has to pay the
premium of the following kind. Sometimes, the organization could decide and
bring in some different packages for the charge.
| S.No. |
Pattern of the family |
Premium rate
per head
per year |
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1) |
Family with maximum 5 members |
Rs.325 |
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2) |
Family with maximum 10 members |
Rs.300 |
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3) |
Family with maximum 11 members or more |
Rs.275 |
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4) |
As a favour, an employee of any united organization can also be a member |
Rs.375 |
Note: If the number of the family increases after the card is made, the premium
will be same as the previous one.
Limitations of the service and excess expense fulfillment:
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This program will provide an amount of Rs.15,000
at a time, totaling to Rs.30,000 (maximum) in a year to the insured members.
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If the insured members knowingly or
unknowingly take more services than allowed, the excess amount has to be
fulfilled to the organization. If not done, the services to the member will
be paused. And, in case of sickness during that period, no services will be
provided.
Other Information about the Membership:
Just a person or some persons from a family couldn’t be a member. But the
member, who are not here for most of the time, could be excluded. In such case,
the information should be given to the organization.
The 1st 30 days, from the membership issued date will be waiting period and the
services will be provided to the member from the 31st day
I do hereby state that I have earnestly studied the information’s about the
benefit package. I promise solemnly to obey the rules and regulations and it
abide by the same.
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