Health Insurance

Health Insurance

Health Insurance, by Shikhar Insurance covers a whole range of expenses and offers Cashless Treatments in many hospitals in Nepal and over 4,000 hospitals all over India. The health insurance is re-insured by ICICI Lombard and offers 100% coverage arising from medical expenses incurred during hospitalization for more than 24 consecutive hours, as well as specific day care surgeries also covering pre-hospitalization expenses.

Claims Assistance: Incase of Medical Emergency, SPECIALITY INANA will provide a complete medical assistance service to the insured, anywhere in the world and can be accessed by telephone, or email.


1. In-Patient Treatment Hospitalization

Covers hospitalization expenses incurred as an in-patient in a Hospital which will include:

  • Room, Boarding and Operation Theatre charges
  • Fees of Surgeon, Anesthetist, Nurses, Specialists
  • Cost of diagnostic tests, medicines, blood, oxygen, appliances like pacemaker, artificial limbs and organs etc.

    In-Patient Treatment requires a hospitalization for a minimum period of 24 hours.

2. Day Care Procedures/Treatments (Hospitalization less than 24 hrs.)

  • Expenses for 150 day care surgeries and treatments are also covered, even though the hospitalization is for less than 24 hours (refer to full list).

3. Pre-Hospitalization and Post-Hospitalization Expenses

  • Pre-hospitalization Medical Expenses for 30-day period.
  • Post-hospitalization Medical Expenses for 60-day period .

Types of Hospitalization

  • Planned Hospitalization: Covers Surgeries or treatments that is planned in advance at the advise of a doctor. The patient may choose to seek cashless treatment in any of the network hospitals in Nepal or India.
  • Emergency Hospitalization: patient may directly be taken to the hospital and can avail cashless facility among Shikhar Network Hospitals.
  • Incase of an emergency medical condition, the policyholder maybe hospitalized in network hospitals or otherwise. Incase of non-network hospitals, the policyholder can claim for reimbursement.

4. Cashless Facility in Networking Hospitals

  • Cashless facility can be availed in 21 hospitals of Nepal with a growing number of hospitals being added every year. In addition, clients can also avail cashless facility in 4,000 network hospitals of ICICI in India. The clients can also present their bills for reimbursements of any hospital in Nepal or India.

For Corporate Enquiries Call

01-4414486

Special Features

  • One Year Policy Period
  • Individual, Family & Corporate plans
  • Sum Insured from NRs. 2 Lakhs upto NRs. 20 Lakhs (Individual/Family Floater)
  • Cashless treatment in the 21 network hospitals in Nepal & over 4000 hospitals in India
  • Eligibility from 5 to 65 years of age.
  • Medical checkup required for 45 years of age and/or policies above Rs. 500,000
  • 30 Days Pre-Hospitalization & 60 Days Post–Hospitalization Expenses
  • Covers 150 Day care surgeries & 24 hr plus hospitalization and surgical expenses

* Ginger Assurance provides complete support for Claims Assistance.

Exclusions

The policy has permanent exclusions for pre-existing diseases for 4 years, waiting period for certain treatments, medical expenses incurred within 30 days of policy inception, non medical expenses, higher category rooms (i.e. suites, however this does not apply to single standard AC room/ Cabin). Please refer to full list for details.

List of Cashless Hospitals