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Plan Name
Health Insurance (501) - Plan 2
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Coverage
৳1,000,000
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Insurance Provider
Pragati Life Insurance
Health Insurance (501) - Plan 2
Back to Quotes
৳1,000,000
30 days waiting period.
30 days waiting period.
List of Network Hospitals Eligible for Cashless/Direct Payment Facility: Click Here
Lifestyle Benefit Network (up to 45% Discount on selected services): Click Here
WHAT IS COVERED
- This policy covers you for the diagnosis and treatment of medical conditions that arise after the start of your policy. It may also provide coverage for medical conditions that you had prior to taking out your policy, but only if you declare about them when you apply for cover and the insurance company agrees to cover them.
- It will cover the items detailed in your table of benefits subject to any limits detailed
- Insurance company will pay for treatment received during the period of cover for which the premium has been received
- Insurance company will only pay reasonable and customary charges
WHAT IS NOT COVERED (EXCLUSIONS)
- Medical Expenses incurred for any disease/illness within 30 days of the commencement of the Policy Period and claims arising out of any medical conditions where signs or symptoms or diagnosis of an ailment/sickness occurring during the first 30 days of cover and leading to any hospitalization after the 30 day waiting period is over. Accidents would be covered from Day 1.
- treatment received before the inception of the policy or after its expiry, or for any period for which you have not paid premium
- Acts of terrorism, war, and illegal acts
- Alcohol or drug abuse
- Alternative therapies
- Chemical exposure
- Circumcision
- Congenital conditions
- Cosmetic treatment
- Costs covered elsewhere
- Dental treatment
- Developmental issues
- Domestic and long term care
- Eating disorders
- External prosthesis
- Experimental treatment and drugs
- Failure to seek medical advice
- Flying
- Hearing tests or aids
- Hazardous sports
- HIV, AIDS, and sexually transmitted disease
- Infertility and gender reassignment
- Mental or psychiatric illness - except where specifically included
- Non-medical charges
- Not medically necessary or reasonable and customary
- Obesity
- Optical care
- Organ donation
- Personal medical exclusions - any treatment of any medical condition shown on your Policy Schedule as excluded
- Police or military service
- Pre-existing Conditions
- Pregnancy, maternity, childbirth, and foetal surgery
- Routine medical examinations
- Removal of foreign bodies
- Self-inflicted injuries or suicide
- Sleep disorders
- Medical expenses incurred for conditions having a waiting period of 24 months of continuous coverage:
-Deviated Nasal Septum/ Nasal & Paranasal Sinus Disorders (except Malignancy), Treatment for Chronic Suppurative Otitis Media (CSOM) and Serous Otitis Media (Grommet Insertion)
-Medical or Surgical management of diseases of Tonsils / Adenoids (except Malignancy)
-Surgery of Thyroid Gland excluding for the reason of Malignancy
-All types of Hernias and Cataract excluding traumatic cataracts
-Hydrocoele / Varicocoele / Spermatocoele
-Piles / Fissure / Fistula-in-Ano / Rectal Prolapse / Pilonidal Sinus
-Benign Prostatic Hypertrophy
-Treatment of all gynecological conditions (Such as but not limited to Uterine Fibroid, Dysfunctional Uterine Bleeding,
Hysterectomy, Uterine Prolapse, Endometriosis, Adenomyosis Uteri, Ovarian Cyst, etc.) except those arising from malignancy
-Diabetes, Peripheral Vascular Disease due to Diabetes, Diabetic Foot / Hypertension, and related complications
-Skin and all internal cysts / tumors / nodules / polyps / ganglions / lipomas of any kind unless malignant
-Calculus Diseases of any etiology
-Retinopathy / Retinal Detachment
-All types of CRF and acute on chronic Renal Failures but not ARF, including Renal Failure due to Diabetes
-Osteoporosis / Pathological Fracture / Degenerative Joint Diseases / Prolapsed Intervertebral Disc
-Treatment for degenerative joint conditions including joint replacement surgeries. However, joint surgeries necessitated due to accidents would not be a part of this exclusion
-Treatment for benign breast disorders fibroadenoma, fibrocystic diseases, etc.
-Treatment for Carpal tunnel syndrome and Peripheral Vascular disease including varicose veins
*Please read the policy wording document for detailed terms and conditions of this insurance policy.
Policy Wording File
Download - pragati-health-insurance-501-policy-wording62821e85b86a2.pdfClaim submission guideline: Download
1. Cashless/Direct Payment Process
Cashless/Direct Payment will be applicable only at the network hospitals of the insurance company.
If you receive treatment from a network hospital, the insurance company will pay pre-authorized eligible treatment charges directly to the hospital. You do not need to worry about the bill payment. You will only need to pay any costs or fees not covered under your insurance policy.
To enjoy a cashless/direct payment facility, you must notify the insurance company before admitting to the hospital. If the hospitalization is due to an emergency medical condition, you should inform the insurance company within 48 hours of admission.
Send an email to ihealth@pragatilife.com by providing the following information to raise a Guarantee of Payment:
- Name of Policy Holder
- Policy Number
- Policy date
- Plan name (i.e., 501 - Plan 1 or 2)
- Address
- Phone number
- Email address
- Patient Name (should be same as the policyholder)
- Hospital Name
- Date of admission
- Bed/Cabin/Ward Number
- Provisional Diagnosis
- Approximate date of discharge
2. Reimbursement Process
When your treatment cost is not pre-authorized, or there is any out-patient or pre and post-hospitalization cost, in that case, you need to pay for the charge by yourself and then claim the expense for reimbursement. You should submit reimbursement claims within 7 days of discharge from the hospital.
Fill up the claim form and submit it to the insurance company/Bimafy for reimbursement.
Claim form: Download
What is Health Insurance?
Health insurance is a type of insurance policy that provides financial coverage against illness, diseases, and accident-related treatments. That means the insured person can get medical expense reimbursement or fixed cash benefit (based on the type of insurance policy) for treatments received due to the medical conditions.
Health insurance usage is relatively new in Bangladesh, and most of the insurance companies in Bangladesh do not offer retail health insurance policies to individual customers. Instead, insurance companies provide group health insurance plans to enterprises and corporates for their employees and workforce. For this reason, access to health insurance plans is still difficult for the mass people of Bangladesh. Bimafy is working with selected insurance companies to make health insurance easy and accessible for everyone. Bimafy offers different types of health insurance plans on its website and mobile app for you to choose from.
Why does everyone need a Health Insurance policy?
Everyone should have a health insurance policy because:
- Health insurance provides coverage against unexpected illness or accidental injuries to better manage your financial situation in case of an emergency hospitalization or treatment.
- Health insurance helps you to afford better healthcare services as you have the financial independence to seek quality healthcare services.
- Health insurance provides peace of mind as you are covered against unexpected situations and do not need to worry about spending your savings on treatment.
Types of Health Insurance policies available in Bangladesh
Regardless of the scarcity of up-to-date health insurance coverage and plans, mostly there are 3 types of health insurance products/plans available in our country, as per the following:
1. Hospital Reimbursement Plans
Hospital reimbursement plans are the most commonly used health insurance coverage by enterprises/corporates for their employees and workforce. These plans usually come with a yearly total coverage (sum-insured) amount up to which the policyholder or insured person can claim back the medical expenses incurred due to hospitalization. Sometimes, these plans come with bundled life insurance coverage and OPD (outpatient department services) coverage so that you can have peace of mind in case of any mishaps.
For example, if a reimbursement plan provides BDT. 50,000 yearly coverage for hospital treatment, and you had to spend BDT. 35,000 in total for an in-patient hospital treatment, the insurance company shall provide up to BDT. 35,000 as reimbursement against the claim. Some expenses may be excluded from the coverage on your policy, and those bills will not be paid back by the insurance company. Check the policy wording, coverage limits, and exclusions before buying a health insurance plan.
An important note to consider here is that reimbursement policies give back the medical expenses (subject to exclusion and deductibles) as per the hospital bill. You need to properly collect and preserve the medical documents and bills at the time of discharge to submit an insurance claim.
2. Hospital Cash Plans
Hospital Cash plans, or simply “hospicash” plans, are a more straightforward type of health insurance policy that provides daily fixed benefits per night of hospitalization. These plans do not consider the medical expenses incurred by the insured/policyholder. Instead, this health insurance policy provides a daily cash benefit to meet the lost income due to illness or accident. Often, these plans come with bundled life coverage, OPD coverage, and other benefits and are priced reasonably lower than reimbursement plans.
For example, if a hospital cash policy provides BDT. 3,000 per night of hospitalization, then you can get BDT. 9,000 benefits if you had to take treatment in a hospital for 3 consecutive nights. These plans usually come with waiting periods for claims and specific exclusions against particular diseases. So, please check the waiting periods and exclusions before buying a health insurance policy for yourself or your family members.
An important note to consider is that you must properly collect all medical documents, including hospital bills, to raise insurance claims. The insurance company will need these documents to verify the authenticity of your claim.
3. Critical Illness Plans
A critical illness (CI) plan is a type of health insurance policy that provides a fixed benefit or reimbursement of expenses up to the coverage amount in case of a diagnosis of a life-threatening illness. Hence it is called critical illness insurance. These plans usually cover severe or life-threatening diseases such as cancer, heart attack, stroke, coronary artery bypass surgery, major organ transplantation, etc. This list may include more diseases or illnesses based on the insurance company or plan. Critical illness health insurance policies are affordable and can be a lifesaver for you in an unfortunate situation.
Sometimes, critical illness coverages are bundled with reimbursement or hospital cash policies so that you can get complete coverage simply by purchasing a single policy. Otherwise, you can buy a reimbursement or hospital cash plan and get critical illness coverage separately to ensure better financial safety in an emergency.
Why is Bimafy the best place to buy health insurance policies?
Bimafy (bimafy.com) is the first digital insurance platform in Bangladesh, from where you can easily order the insurance policy you prefer or need and submit your insurance claims using the same platform digitally. Bimafy is not an insurance company; it is a digital platform through which you can take the insurance services provided by various insurance companies using digital channels. It is a new solution offered by Bimafy for the people of Bangladesh to make insurance easily accessible and more user-friendly.
Bimafy promotes and markets the insurance services of reputed insurance companies using its website and mobile app. People can now get many services through digital platforms like e-commerce, ride-sharing, doctor consultation, etc. But, before Bimafy, insurance was not available to people through digital channels, and Bimafy made it available to Bangladeshi people.
Through Bimafy, you can get the following insurance services: Health Insurance, Travel Insurance, Accident Insurance, Motor insurance, Life Insurance, and many more.
Bimafy is the best platform to get a health insurance policy for yourself and your loved ones. As it provides various insurance policies in one place, you can easily compare and select the best policy suited to your needs and budget.
Bimafy not only helps you get the best insurance policy for you but also assists you in submitting the insurance claims digitally and getting the settlement as fast as possible.
Various reputed insurance companies provide their insurance services through Bimafy. You can get your suitable health insurance plan today without any hassle through online purchases or with just a phone call. Bimafy considers customer satisfaction the highest priority and aims to provide the best insurance experience you have ever enjoyed.
To know more about health insurance and for any other information, send us an email or call Bimafy Customer Support.
Customer Support Hotline: +88 09606991991
Email address: cs@bimafy.com
