Product Name: Health Bima Pro

Policy Duration: 1 Year

Premium: BDT. 1499

Product Summary

Coverage Type Coverage Amount Waiting Period
Yearly Hospitalization Coverage Up to BDT 45,000 (BDT. 3,000 per day for 15 days) 15 days
Critical Illness Coverage BDT. 45,000 45 days
COVID-19 Isolation Coverage Up to BDT. 10,000 15 days
OPD Coverage Up to BDT 2,000 15 days

Coverage and Benefits

Up to BDT. 102,000 yearly health coverage subscription for 1 person

- BDT. 45,000 Hospitalization Cashback (BDT. 3,000 per night, up to 15 nights per year)

- BDT. 45,000 Critical Illness Benefit for 8 dread diseases (single time lump sum)

- BDT. 10,000 COVID-19 Benefit (BDT. 5,000 per claim, up to 2 times in a year)

- BDT. 2,000 Outpatient Benefit (BDT. 500 per Doctor Consultation/Diagnostic Test/Daycare Treatment, up to 4 times in a year, maximum BDT. 1,000 benefit in a calendar month)

* For more details about the product features, check https://bimafy.com/health-bima-features

Terms, Limitations, and Exclusions

Terms

  1. 1-year coverage duration from the date of registration
  2. For 1 Bangladeshi adult person with good health conditions
  3. Age limit - 18 to 64 completed years at the time of registration
  4. 15 days waiting period for COVID-19 and sickness related hospitalization claims, no waiting period for hospitalization due to accidents
  5. 45 days waiting period for Critical Illness related claims
  6. 180 days waiting period for any hospitalization claim related to maternity
  7. MBBS or above qualified doctor’s recommendation required for hospitalization
  8. Hospital must be registered with the government authority
  9. Outpatient services must be conducted under MBBS or above qualified doctor
  10. Claims must be submitted within 30 days of treatment/discharge

Limitations

  1. Maximum 5 nights’ coverage benefit can be claimed against a single admission in hospital
  2. Second claim of COVID-19 can be made after 60 days from the first illness due to COVID-19 for which a claim has been successfully settled
  3. In case of multiple claims against a single illness, only the higher benefit shall be payable
  4. Any pre-existing conditions shall not be covered under Critical Illness coverage

Covered Critical Illnesses (8 dread diseases)

  • Cancer
  • Heart Attack (Myocardial Infarction)
  • Stroke
  • Coronary Artery (Bypass) Surgery
  • Kidney Failure (End Stage Renal Disease)
  • Major Organ Transplantation
  • Paralysis
  • Multiple Sclerosis

Exclusions

  1. Any congenital infirmity
  2. Hospitalization, COVID-19 or any treatment taken during the waiting period
  3. Treatment or advice by a person or professional not registered under BMDC (Bangladesh Medical & Dental Council)
  4. Hospitalization due to any type of illegal activities
  5. Hospitalization, Diagnostic tests or any treatment conducted without recommendation from a MBBS doctor
  6. Periodic blood sugar tests, routine examination of urine/stool, IgE (allergen) tests
  7. Any procedures which are experimental or not generally accepted by the medical profession viz. acupuncture, herbal/ayurvedic/homeopathy treatment and any Alternative Medical Care (AMC) etc.
  8. Routine examination of eye and ear, fitting or replacement of eyeglasses (including contact lenses) or hearing aids, health screening including routine physical examinations (health check-ups), any dental treatment unless require hospitalization for reconstructive surgery as a consequence of an accident or disease;
  9. Circumcision, prophylactic, and immunization procedures
  10. Non-surgical treatment for tuberculosis, hepatitis B & C
  11. Mental, emotional or psychiatric disorders, alcoholism or any other narcotic addiction
  12. Obesity i.e., treatment for, or required as a result of obesity, any cosmetic or plastic treatment/surgery, unless required as reconstructive surgery as a consequence of an injury due to accidents, or burns
  13. Sleep disorders i.e., treatment for insomnia, sleep apnea, snoring, or any other sleep related breathing problem
  14. Treatment of family planning purposes including termination of pregnancy, sterility or treatment related to assisted reproduction
  15. The condition of Acquired Immune Deficiency Syndrome (AIDS), or any AIDS related illness or HIV virus

Required Documents for Claim

Hospitalization Benefit Claims (Scanned images or clear photographs):

  • Doctor’s advice/prescription for hospital admission
  • NID/Passport of the Covered Person
  • Discharge certificate from the hospital
  • Diagnostic test reports
  • Hospital bill/ticket
  • Treatment Sheet
  • Any other supporting documents which may be required

COVID-19 Isolation Benefit Claims

  • Doctor’s recommendation for COVID-19 test
  • NID/Passport of the Covered Person
  • COVID-19 positive report/SMS from a Government approved hospital, laboratory or diagnostic center, following Government approved test procedure(s) (where test center name, test and report delivery dates, Covered Person’s name are clearly mentioned)
  • Any other supporting documents which may be required

Critical Illness Claims

  • NID/Passport of the Covered Person
  • Doctor’s prescription/investigation report
  • Diagnostic test reports
  • Hospital discharge certificate
  • All other relevant medical documents as applicable

Outpatient Benefit Claims (Doctor Consultation/Diagnostic Test/Daycare Treatment)

  1. Doctor Consultation
    • Doctor’s prescription/Investigation report with doctor’s Name, Designation, Seal and signature
    • NID/Passport of the Covered Person
  2. Diagnostic Test
    • Doctor’s Prescription/Doctor’s recommendation for the test
    • NID/Passport of the Covered Person
    • Test reports (where Test Report date & Test Centre Name are clearly mentioned)
    • Test bill
  3. Daycare Treatment
    • Doctor’s Prescription/Hospital Emergency Ticket
    • NID/Passport of the Covered Person
    • Hospital bill/ticket