Magma HDI One Health (Support Plus)

The Magma HDI One Health (Support Plus) plan is a health insurance policy offered by Magma HDI General Insurance Company Limited.

This health insurance plan stands out for its affordability in comparison to other options available in the market. While covering hospitalisation and associated expenses, it goes the extra mile by including treatments such as bariatric surgery, infertility, etc. However, it's essential to note that the plan does have sub-limits for common treatments like cataracts, potentially resulting in substantial out-of-pocket costs. Additionally, the absence of a monthly premium payment option may be a drawback for some individuals. Our research indicates a higher number of complaints related to policy purchase, indicating a less favourable experience in that aspect. On the positive side, the insurer has a commendable record in terms of claim settlement and has received fewer claim-related complaints.

What are the benefits offered by the Magma HDI One Health (Support Plus) plan?

• Inpatient hospitalisation coverage: The Magma HDI One Health (Support Plus) plan covers inpatient hospitalisation costs. This includes expenses you incur when you need to stay in the hospital for over 24 hours, such as room and board charges, nursing fees, doctor fees, prescription medication costs, ICU expenses, etc.
• Pre-hospitalisation coverage: Pre-hospitalisation expenses refer to the medical costs you incur before you get admitted to the hospital. These costs involve lab tests, consultations, checkups, medical reports, etc. These expenses are covered only if they are related to the medical condition that leads to hospitalisation and the claim is approved as part of inpatient hospitalisation coverage. The Magma HDI One Health (Support Plus) plan provides coverage for pre-hospitalisation expenses for 30 days before hospitalisation, up to the sum insured.
• Post-hospitalisation coverage: You might incur extra medical expenses after you leave the hospital called post-hospitalisation costs. These expenses include fees for doctor visits, health checkups, rehab programs, physical therapy, and various medical treatments. To qualify for coverage, these expenses must be directly linked to your initial hospital stay, and your claim should be approved as part of your inpatient hospitalisation coverage. The Magma HDI One Health (Support Plus) plan extends coverage for post-hospitalisation expenses for 60 days after your hospital stay, up to the sum insured.
• Daycare treatment coverage: Certain medical procedures that once demanded lengthy hospital stays can now be done in under 24 hours. These are referred to as daycare treatments. The Magma HDI One Health (Support Plus) plan offers coverage for 541 daycare treatments up to the sum insured without any limit.
• Domiciliary treatment coverage: Domiciliary treatments are medical treatments for illnesses or injuries that require immediate attention at the hospital but are administered at home due to the severity of the patient’s condition or the unavailability of beds in nearby hospitals. The Magma HDI One Health (Support Plus) plan offers coverage for all domiciliary treatment expenses up to the sum insured.
• Organ donor coverage: Magma HDI One Health (Support Plus) plan offers coverage for all inpatient expenses of the donor, up to the sum insured, in the case of an organ transplant surgery where you are the recipient. It does not cover the donor's pre- and post-hospitalisation expenses.
• Modern treatment coverage: Recent years have witnessed remarkable progress in the medical field, where groundbreaking treatments like stem cell therapy, radio surgery, etc. provide hope for individuals confronting diverse medical challenges. The Magma HDI One Health (Support Plus) plan recognises the importance of these groundbreaking treatments and offers coverage up to the sum insured without any limit.
• Non-medical expenses coverage: Non-medical expenses include costs related to consumables such as nebulisation kits, gloves, oxygen masks, and other similar items. The Magma HDI One Health (Support Plus) plan does not provide coverage for non-medical expenses.
• No Claim Bonus: The Magma HDI One Health (Support Plus) plan offers a reward called a No Claim Bonus if you don’t file any claims in a policy year. You’ll receive 10% of the sum insured as the No Claim Bonus. The best part is that you can maintain this accumulated bonus even if you make a claim in a policy year. In fact, you have the potential to accumulate a maximum bonus of up to 100% of the sum insured under this plan.
• Super No Claim Bonus: The Super No Claim Bonus is an upgraded version of the No Claim Bonus. However,  the Magma HDI One Health (Support Plus) plan does not offer the Super No Claim Bonus.
• Restoration Benefit: The restoration benefit is a valuable feature that refills your sum insured if it is used up within a policy year. This benefit kicks in if your sum insured and No Claim Bonus is partially exhausted during a policy year. The restoration benefit is applicable to unrelated illnesses, and you can make use of this benefit up to 5 times in a policy year for subsequent claims.

Please note that the limits and conditions mentioned in the above benefits and features are for Rs. 10 Lakhs sum insured.

Magma HDI One Health (Support Plus) Plan: Financial Limits

• Room rent limit: It is the maximum amount your health insurance policy will cover for the room you stay in during your hospitalisation. Staying within this limit ensures that you will not be left with additional expenses. But, if you select a room that surpasses this limit, a proportional deduction will be applicable. This means you will need to pay a proportionate portion of the total bill rather than just the room rent difference. The Magma HDI One Health (Support Plus) plan offers you the freedom to pick any room type without any restrictions.
• ICU rent limit: The Magma HDI One Health (Support Plus) plan covers the expenses linked to your ICU stay without any limit up to the sum insured.
• Copayment: Copayment is a certain percentage of the approved claim amount that you are responsible for paying before your insurer takes care of the remaining amount. Under the Magma HDI One Health (Support Plus) plan, you have the option to choose either 10% or 20% as the copay limit.
• Deductible: A deductible is a certain amount you must pay from your end before your insurer starts covering your medical costs. Under the Magma HDI One Health (Support Plus) plan, you can choose a deductible of Rs 2 lakhs, Rs 3 lakhs, Rs 4 lakhs, Rs 5 lakhs, or Rs 10 lakhs as an option.
• Limits on surgeries/treatments: It is the maximum amount your health insurance plan will cover for certain procedures and surgeries. Some policies may place a cap on the amount that they will cover for specific procedures, while others may not. The Magma HDI One Health (Support Plus) plan covers cataract treatment up to Rs 35,000/- per eye per policy year and joint replacement surgery up to the sum insured. 

Please note that the above financial limits are taken for a 30-year-old individual opting for a sum insured of Rs. 10 Lakhs.

Magma HDI One Health (Support Plus) Plan: Waiting Periods & Exclusions

👉Waiting period

Health insurance policies do not cover certain medical conditions or illnesses for a certain time frame right after buying them. Once this waiting period is over, you can claim these health conditions. Here are some of the types of waiting periods –

• Initial waiting period: The Magma HDI One Health (Support Plus) plan has an initial waiting period of 30 days for all medical conditions, except in the case of accidents. During this period, you will not be able to claim hospitalisation expenses, except in the event of an accident.
• Waiting period for pre-existing diseases: A pre-existing disease is any health condition you had in the past 36 months before applying for a health insurance policy. In the Magma HDI One Health (Support Plus) plan, there is a waiting period of 36 months for pre-existing diseases. During this period, you cannot claim for any expenses related to your pre-existing condition.
• Waiting period for specific diseases: Insurance companies may apply waiting periods on certain medical conditions or illnesses apart from your pre-existing diseases. These waiting periods are decided by the insurer and are not based on your current state of health. Magma HDI One Health (Support Plus) plan has a 24-month waiting period for specific diseases.

👉Exclusions

Health insurance policies do not cover certain medical conditions or situations at any cost. These are called exclusions. Some of the exclusions include –

• Standard permanent exclusions: In India, health insurance providers must adhere to a set of "standard permanent exclusions" established by the Insurance Regulatory and Development Authority of India (IRDAI). Some of the standard exclusions include –

1. Investigation and Evaluation: Hospitalisation solely for monitoring or observation.
2. Rest Cure, Rehabilitation, and Respite Care: Admission to facilities for rest or respite where no active medical treatment is provided.
3. Obesity/Weight Control: Medical or surgical procedures for the purpose of weight control or managing obesity.
4. Change of Gender Treatment: Medical procedures to alter the body's characteristics to that of the opposite gender.
5. Plastic/Cosmetic Surgery: Medical or surgical procedures intended for enhancing appearance or changing body features.
6. Profession in Hazardous or Adventure Sports: Medical expenses incurred while participating as a professional in adventure activities like skydiving, bungee jumping, scuba diving, etc.
7. Breach of Law: Expenses related to treating a person involved in criminal activities.
8. Excluded Providers: Treatment from medical practitioners or hospitals excluded by the insurance company.
9. Narcotics: Expenses related to treating addictive conditions such as alcohol addiction, drug usage, etc.
10. Treatments in Establishments for Domestic Purposes: Expenses incurred in health spas, nursing homes, or similar facilities arranged mainly for domestic reasons.
11. Dietary Supplements and Non-Prescription Substances: Costs associated with vitamins, minerals, and other dietary supplements not prescribed by a medical practitioner.
12. Refractive Error: Expenses related to correcting refractive errors up to 7.5 diopters for improved eyesight.
13. Unproven Treatments: Surgical or medical procedures and treatments not proven to be effective.
14. Expenses Related to Birth Control, Sterility, and Infertility: Costs associated with contraception, sterilisation, artificial insemination, and advanced reproductive technologies like IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc.
15. Maternity Expenses: Costs related to pre/post-natal care, childbirth hospitalisation, etc.

• Additional Permanent Exclusions: In addition to the standard permanent exclusions defined by the IRDAI, insurance providers also have the authority to impose permanent exclusions for certain medical conditions or situations that they deem to be high-risk. It's important to note that the insurers can apply these additional exclusions only to conditions already listed by the IRDAI. They cannot permanently exclude any disease or medical condition beyond this list
• Non-standard exclusions (Specific exclusions): In addition to the permanent exclusions, insurers also impose specific exclusions based on their individual terms and conditions. It is crucial to understand that these exclusions can differ across insurers. Here are some of the specific exclusions under the Magma HDI One Health (Support Plus) plan –

1. Expenses for non-allopathic or alternative treatments, except for AYUSH treatment.
2. Use of a ventilator for a patient in a vegetative state (brain dead) with no chance of recovery.
3. Circumcision, unless medically necessary to treat a disease or injury.
4. Injury or illness caused indirectly or directly by terrorism, war, riot, nuclear or chemical contamination, etc.
5. Expenses for treating external birth defects.
6. Dental treatment, except when needed due to an accident.
7. Treatment for hereditary conditions.
8. Costs for private nursing or attendant services before or after hospitalisation.
9. Issuance of fitness certificates and fitness examinations.
10. External diagnostic or treatment equipment of any kind.
11. Medical equipment for home use, like walkers, crutches, diabetic footwear, etc.
12. Preventive care, vaccination, inoculation, and immunisation costs (excluding newborn vaccinations).
13. Treatment for intentionally self-inflicted injuries or attempted suicide.
14. Treatment for any sexual problems.
15. Treatment for sexually transmitted diseases.
16. Treatment for sleep disorders.
17. X-rays, lab tests, or other diagnostics unrelated to a specific illness or injury, regardless of hospitalisation necessity.

What to expect in terms of claims experience if you buy from Magma HDI General Insurance Company Limited?

• Speed of claims: Magma HDI General Insurance Company Limited has settled 100% of claims in just 30 days. This ensures that your claims will be handled promptly.
• Claim-related complaints: As per our research, Magma HDI General Insurance Company Limited has a low complaint rate regarding claim settlements in comparison to other insurance providers, accounting for 0.12%. This reflects their commitment to providing efficient service and ensuring customer satisfaction.
• Claims incurred ratio: The claims incurred ratio is a measure of the financial performance of an insurer. It is the ratio of total claims paid out compared to total premiums received in a fiscal year. Magma HDI General Insurance Company Limited has a claims incurred ratio of 87.46%.
• Claim settlement ratio: The claim settlement ratio is the ratio of the total number of claims settled to the total number of claims received in a fiscal year. Magma HDI General Insurance Company Limited has a claim settlement ratio of 77.63%.
• Network hospitals: Magma HDI General Insurance Company Limited has over 8,400+ hospitals in their network. This means you can access a broad spectrum of healthcare providers across various locations with the convenience of cashless treatments.

How is the Customer Service of Magma HDI General Insurance Company Limited?

• Policy purchase-related complaints: As per our research, Magma HDI General Insurance Company Limited. has a higher number of policy complaints when compared to other insurers, accounting for 0.01%.
• Response on Toll-Free: According to our research, Magma HDI General Insurance Company Limited's toll-free number offers quick assistance compared to other insurers.
• Response on Twitter: As per our research, Magma HDI General Insurance Company Limited is not currently active on Twitter.

About Magma HDI General Insurance Company Limited

Magma HDI General Insurance Company is a subsidiary of the Rising Sun Group, led by Adar Poonawalla. Sanoti Properties LLP holds a majority of the company's shares, and key shareholders also include HDI Global SE, Celica Developers Private Limited, and Jaguar Advisory Services Private Limited. The company provides a wide range of insurance products for both retail and commercial sectors. In the retail space, they offer motor insurance, health insurance, personal accident insurance, and home insurance, and in the commercial sector, they offer fire insurance, engineering insurance, liability insurance, and marine insurance. Founded in 2009, the company is headquartered in Mumbai, Maharashtra. Mr. Rajive Kumaraswami is its CEO and MED.