Mediclaim Policy Details

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Mediclaim Policy Details – Complete Guide to Employee Health Coverage

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    What is a Group Mediclaim Health Insurance Policy?

    A group mediclaim health insurance plan is an employer-provided coverage that offers hospitalization and medical benefits to employees and their dependents. Unlike individual plans, it allows organizations to secure uniform health protection for all members under a single contract.

    At Edify, we make understanding your mediclaim policy details simple — from inclusions and limits to the claim and renewal process. Our expert advisory helps companies customize their group mediclaim structure to fit their workforce size and needs.

    What are the Typical Coverages in a Group Mediclaim Policy?

    Here’s a quick overview of what most group mediclaim policies cover:

    Coverage Type

    Description

    Hospitalization Expenses

    Covers room rent, doctor fees, surgery, and treatment charges during hospital stay.

    Pre & Post-Hospitalization

    Medical expenses before and after hospitalization (usually 30–60 days).

    Day-Care Procedures

    Coverage for treatments not requiring 24-hour admission (e.g., cataract, dialysis).

    Maternity & Newborn Cover

    Optional add-on for childbirth and newborn medical care.

    Ambulance Services

    Emergency transportation costs to and from the hospital.

    Cashless Treatment

    Access to network hospitals for direct billing.

    Edify helps organizations compare and enhance mediclaim health insurance benefits for optimal value and employee satisfaction.

    Common Exclusions and Waiting Periods in Group Mediclaim Policies

    Even the best mediclaim policy details come with exclusions and waiting periods that must be understood clearly.
    Typical exclusions include:

    • Cosmetic or experimental procedures
    • Dental and vision treatments (unless added as riders)
    • Injuries from self-harm or intoxication
    • Non-medical expenses

    Waiting periods usually apply to:

    • Pre-existing diseases (up to 2–4 years for new members)
    • Maternity cover (9 months, unless waived)
    • Specific ailments like hernia or joint replacements

    At Edify, our consultants negotiate reduced or zero waiting periods to make your group mediclaim insurance more employee-friendly.

    How to Add Employees and Dependents to a Group Policy

    Adding new members is quick and efficient. Here’s how it works:

    1. Submit new employee data to your insurer or HR admin portal.
    2. Provide dependent details (spouse, children, parents if covered).
    3. Ensure timely premium adjustments for mid-term additions.
    4. Receive updated mediclaim policy details and digital e-cards for instant access.

    Edify offers integrated systems that automate this process, saving HR teams time and ensuring no employee is left uncovered.

    Documents Needed to Buy Group Mediclaim Insurance

    To initiate or renew your group mediclaim health insurance, you’ll typically need:

    • Company registration certificate
    • Employee list with DOB and designation
    • Sum insured and coverage structure
    • Previous year’s claim history (if applicable)
    • Employee and dependent details for enrollment

    Edify’s advisors handle the entire documentation and insurer coordination process — ensuring compliance and ease.

    Why Choose Edify for Corporate Mediclaim Health Insurance

    • Expert advisory on policy design, pricing, and customization
    • Access to top-tier insurers and corporate-specific plans
    • Seamless onboarding and claims assistance
    • Transparent breakdown of mediclaim policy details

    With Edify, companies gain clarity, control, and confidence over their group mediclaim insurance. Protect your people, and your business with precision.

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