Domiciliary Hospitalisation is a state where a person/patient is unwell that he/she requires medical attention at home itself because he/she is not in a position to go the hospital or there is no Place in the Hospital. Upon, Doctor certification stating the patient's position, the Patient becomes eligible for a claim under Mediclaim for Treatment at home.

Hospitalisation Benefit means that if you are confined to hospital for a number of days (specific details in key features documents) then you will be paid a benefit for each day you are kept there. This can be claimed on much earlier than your deferment period. Not all companies offer this benefit so if you are interested in it either contact us or consult your key features or policy documents.

a) The request for Authorization (Pre- Authorization) for planned treatment has to be filled up. This form has to be filled up by the Doctor recommending Hospitalisation. The form must be filled fully in Block letters indicating the Doctors Name, Registration Number and Telephone Phone number. Should our Medical Officer need any clarification he may contact your doctor before he initiates action on your request.

Hospital where the treatment is done should be a reputed hospital, having at least 15 beds, an emergency unit (24 hrs open) and a separate Operation Theatre. 3.) There are certain exceptions in the nine months waiting period is there for maternity cases. Few diseases are not getting covered like Cataract, BPH in first year. Pre-existing will not get covered/ninth month, and first years

You are eligible for hospitalization benefits as long as you are warded in a hospital. The hospitalisation benefits are $30 for the first 10 days and $40 thereafter. In addition, you may claim $20 per day when warded in hospital for upto 365 days in a calendar year if you are also a member of the AUPE Multi-purpose Co-operative.

When the condition of the patient is such that he cannot be moved to the hospital or when there is no bed available in any of the hospitals, then the treatment taken at home only if it is like the treatment given at the hospital / nursing home is reimbursable under the Mediclaim policy.

A Hospital, which has an agreement with TTK for providing Cashless treatment, is referred to as a 'Network Hospital'. Cashless facility is provided ONLY at the network hospitals. Non-network hospitals are those who have not agreed to the TTK terms and conditions and any policyholder seeking treatment in these hospitals will have to pay for the treatment and later claim as per normal procedure

The plan aims to cover those who are hospitalised due to sickness or injuries and therefore treatment must be involved. If your surgical expenses have been fully reimbursed by a third party, you will not receive further reimbursement from HospitalSurance under surgical benefit. However, you are still entitled to daily hospital cash benefit if you are hospitalised due to a covered medical condition.

Mediclaim covers room, boarding charges, nursing expenses, surgeon, anaesthetist / doctor's fees, blood, oxygen, operation theatre charges, x-ray, other tests pertaining to sickness, etc.

Under Mediclaim, the limit of compensation is low and for certain diseases like asthma, bronchitis, diabetes, epilepsy, etc it is not available. Mediclaim covers pre-hospitalisation (limited up to 30 days) and post-hospitalisation (limited to 60 days from discharge) expenses also if they are connected with the sickness / accident for which the hospitalisation takes place.

Ans: Generally it is necessary. However, in many policies there is a provision for Day Care Treatment under which medical expenses towards specific technologically advanced day care treatments/surgeries are covered. For such treatments, 24 hour hospitalisation is not required.

In case of admission to a Network Hospital the hospital will admit the patient as per the procedure of the hospital. The hospital will then contact TTK and send us a request for authorization. At times the policyholder relative may be required to contact TTK for clarification. The policyholder/relative must send the pre-authorization request completely filled. TTK will revert within 6 hours of receipt of the request.

The Mediclaim Policy allows reimbursement of medical expenses incurred towards the ailment/ disease for which hospitalisation was necessitated prior to hospitalisation and up to a certain number of days after discharge. This is subject to the limits as described in the policy. The medical expenses incurred prior to Hospitalisation are called pre- hospitalisation expenses and those incurred subsequent to discharge as post Hospitalisation expenses.

No. Any claims in respect of pregnancy, childbirth (including diagnostic tests for pregnancy and surgical delivery), miscarriage, abortion and pre-natal or postnatal care are excluded