Acko Platinum Health Insurance Plan

Let’s Get To Know The Intricacies Of The Plan!

Acko Platinum Health Insurance, provided by Acko General Insurance Company Limited, is a comprehensive health insurance policy that caters to all your healthcare requirements. It comes with numerous advantages and features customised to suit your needs. Notably, the plan stands out with its Zero Waiting Period, ensuring you receive instant benefits without any delays for any medical condition. This policy aims to protect your health and offers peace of mind, assuring you of top-notch medical care without any financial concerns.

Know If You Qualify for the Product

The policy covers adults aged 18 years to 99 years.

Check Out The Product’s Benefits and Limits

The Acko Platinum Health Insurance Plan covers expenses related to inpatient hospitalisation i.e. charges for a hospital stay that is more than 24 hours. This includes room and nursing fees, medical practitioner's fees, prescribed medicines, drugs, ICU charges, and other associated costs. Here's a summary of some of the other expenses covered under this plan –

Pre & Post Hospitalisation Expenses
If the doctor needs to run tests before or after admitting you to the hospital, you will not have to worry as the insurance company will cover these expenses. The policy will pay up to the sum insured for 60 days before hospitalisation and 120 days after you leave the hospital. You should keep in mind that the insurer will only cover these expenses if they are related to the medical condition for which you were hospitalised and your claim is approved under inpatient hospitalisation.

Daycare Treatment Coverage
A daycare treatment refers to a medical procedure or surgery that used to require a long hospital stay but can now be done within 24 hours due to medical advancements. The Acko Platinum Health Insurance Plan covers all daycare procedures without any restrictions, meaning it will cover the expenses up to the sum insured.

Domiciliary Treatment Coverage
Domiciliary treatments are medical treatments for illnesses or injuries that need immediate attention in a hospital but are provided at home due to the patient's severe condition or the unavailability of hospital beds nearby. The Acko Platinum Health Insurance Plan covers the expenses for domiciliary treatment up to the sum insured.

Organ Donor Coverage
The Acko Platinum Health Insurance plan includes coverage for organ donor expenses. It pays for the inpatient expenses when obtaining an organ from the donor for transplantation (where the insured is the recipient), up to the sum insured.

Modern Treatment Coverage
Healthcare is constantly progressing, thanks to technology, This has made once-impossible modern treatments a reality. The Acko Platinum Health Insurance Plan is designed to match these advancements and cover the expenses for modern treatments up to the sum insured.

Non-Medical Expenses
Apart from medical expenses, the Acko Platinum Health Insurance Plan also includes coverage for non-medical expenses. These are costs for essential items like gloves, nebulization kits, oxygen masks, and other necessities used during treatment. These consumables can be costly, but the plan covers them up to the sum insured, easing the financial burden.

No Claim Bonus
You get a No Claim Bonus of 10% on your base sum insured. You can avail of this bonus if you renew your policy with the insurer. This bonus can go up to a maximum of 100% of the base sum insured.

Restore Sum Insured
With this feature, your sum insured is replenished if it gets used up within a policy year. Acko Platinum Health Insurance offers 100% restoration of your basic sum insured for future claims, providing additional protection for you and your family. This benefit is triggered when you use a part or full sum insured and can be used for subsequent claims within the policy year. You can avail of this restore benefit unlimited times in a policy year throughout your lifetime, as long as you keep renewing your policy.

Room Rent Limit
The maximum amount your insurance company will pay for the room you stay in during hospitalisation is called the room rent limit. If you choose a room that falls within this limit, you won't have any additional expenses to pay. However, if you select a room with a higher rent than the limit specified, you'll have to pay a proportional share of the total bill, not just the difference in room rent. With Acko Platinum Health Insurance, you have the freedom to choose any room you prefer, be it a shared room, single room, deluxe room, or any available room. The policy does not impose any restrictions on room rent, so you can pick the room that suits you best.

Wait! There Are More Impressive Features…

Zero Waiting Period
Acko Platinum Health Insurance brings a unique advantage you won't find elsewhere - the Zero Waiting Period. This means that as soon as you enrol, you get immediate and complete coverage without having to face any waiting periods. Unlike other plans, this feature eliminates both the Initial Waiting Period and the Specific Disease Waiting Period, giving you instant access to all the benefits.

Out-Patient Department (OPD) Medical Services
This Add-on Benefit offers coverage not just for hospitalisation expenses but also for various out-patient medical needs. Whether you need to visit a doctor, get prescribed tests done, or buy medications, the Acko Platinum Health Insurance Plan has got you covered, so you can concentrate on your well-being without the burden of hefty medical bills.

Annual Preventive Health Check-up
Regular medical tests and screenings need to be done regularly even when you don't have any noticeable symptoms or illnesses. By getting these check-ups done, you can catch potential health problems early, identify risk factors, and take steps to prevent or manage them effectively. The plan covers specific preventive check-ups, for people aged above 18 years.

Waiting Periods? What’s That?

When you buy a health insurance policy, some illnesses and diseases will not be covered for a certain time frame - called the waiting period. This means you cannot claim for those conditions until the waiting period is over. After this period ends, you can claim for those conditions.

Types of waiting periods –

Initial Waiting Period
In most cases, there is an initial waiting period for all medical conditions except accidents. During this period, you cannot make a claim for hospitalisation except for accidents. However, Acko Platinum Health Insurance does not have this initial waiting period. So, you can raise a claim right after the policy starts.
Waiting Period for Pre-Existing Diseases
A pre-existing disease is a medical condition/illness you have experienced in the last 48 months before getting the health insurance policy. Under Acko Platinum Health Insurance Plan, there is no waiting period for pre-existing diseases.
Waiting Period for Specific Diseases
Insurance companies often have a list of medical conditions with a waiting period, regardless of whether you had those diseases before or not. This waiting period is set by the insurer and is not related to your current health condition. However, the Acko Platinum Health Insurance Plan does not have any waiting period for specific diseases.

Beyond the Safety Net: What Acko Platinum Health Insurance Doesn't Cover

Exclusions are situations that your health insurance policy will not cover at any cost. They include –

Standard Permanent Exclusions
All insurance companies are required to adhere to a set of exclusions called 'standard permanent exclusions', as established by the IRDAI. Here are some of the exclusions –

Investigation and evaluation: Hospital admission only for observation or monitoring purposes.
Profession in hazardous or adventure sports: Treatment expenses incurred while engaging as a professional in risky activities like river rafting, mountaineering, paragliding, scuba diving, skydiving, horse racing, etc.
Rest cure, rehabilitation, and respite care: Admission to a facility for bed rest without active treatment.
Obesity/weight control: Treatment or surgery for weight control or obesity.
Change of gender treatment: Treatment to alter the body's characteristics to those of the opposite sex.
Plastic/cosmetic surgery: Treatment to modify body characteristics or appearance.
Breach of law: Expenses for treating a person who has committed or intended to commit an illegal act.
Excluded providers: Treatment received from a medical practitioner or hospital not covered by the insurance company.
Narcotics: Expenses related to the treatment of conditions resulting from substance addiction, such as alcohol or drug dependency.
Treatments in establishments arranged for domestic purposes: Expenses for treatments undergone in health spas, nursing homes, or similar establishments primarily or partially used for personal, non-medical purposes.
Dietary supplements, substances purchased without prescription: Expenses incurred on dietary supplements or substances like vitamins and minerals not prescribed by a medical practitioner.
Birth control, sterility infertility: Costs associated with artificial insemination, contraception, sterilisation, IVF, ZIFT, GIFT, ICSI, gestational surrogacy, etc.
Maternity costs: Expenses associated with pre/post-natal healthcare, childbirth-related hospitalisation, etc.
Refractive error: Expenses for correcting refractive errors up to 7.5 diopters, aimed at enhancing eyesight.
Unproven treatments: Expenses related to surgeries, medical procedures, or treatments lacking sufficient evidence to demonstrate their effectiveness.
Additional Permanent Exclusions
Besides the standard permanent exclusions mentioned earlier, insurance companies may have more exclusions for specific situations or medical conditions. If you have certain diseases or severe medical conditions that insurers find risky to cover, they may permanently exclude them from your policy. However, it's important to note that insurers can only apply a permanent exclusion for illnesses listed by the Insurance Regulatory and Development Authority of India (IRDAI).
Non-Standard Exclusions (Specific Exclusions)
Apart from the standard permanent exclusions listed by the IRDAI, there are specific exclusions that insurance companies may apply. These exclusions can vary between insurers and depend on the terms and conditions of the policy.

Here are some specific exclusions under the Acko Platinum Health Insurance Plan –
Self-injury inflicted by the insured individual.
HIV and AIDS, whether they are sexually transmitted or not.
STDs or STIs (other than HIV and AIDS), including screening and prevention.
External Congenital Anomaly or defects.
Treatment other than Allopathic/AYUSH treatment.
Conditions related to disruption of normal sleep cycles or behaviours, such as sleep apnea and snoring.
Circumcisions, except when required due to illness/injury as part of treatment, and aesthetic or change-of-life treatments like sex transformation operations are not covered.
Growth hormone therapy and/or any form of hormone replacement therapy (HRT) and/or administration of other hormonal medication.
Use of an RF probe for ablation or other procedures, unless pre-approved in writing by the insurer in advance.
Prosthetics and non-surgically implanted devices, excluding cochlear implants, unless they are necessary due to an accident or are required during surgery.

Acko Platinum Health Insurance in a Nutshell

Product Benefits	Coverage Limits
Pre-Hospitalisation Expenses	60 days up to the sum insured
Post-Hospitalisation Expenses	120 days up to the sum insured
Daycare Treatment Coverage	Up to the sum insured
Domiciliary Treatment Coverage	Up to the sum insured
Organ Donor Coverage	Inpatient costs up to the sum insured
Modern Treatment Coverage	Up to the sum insured
Non-Medical Expenses	Up to the sum insured
Room Rent Limit	No Limit
No Claim Bonus	10% bonus on the base sum insured every year up to a maximum of 100%
Restore Sum Insured	100% restoration of the sum insured unlimited times in a policy year.
Pre-Existing Diseases	Covered from Day 1
Specific Diseases	Covered from Day 1

FAQs

What is the waiting period for Acko Platinum Health Insurance?
There is no waiting period under Acko Platinum Health Insurance. It doesn’t have initial, pre-existing disease, and specific disease waiting periods.
Are AYUSH treatments covered under Acko Platinum Health Insurance?
Yes, the Acko Platinum Health Insurance Plan covers Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) treatments.
Does the Acko Platinum Health Insurance Plan come with a room rent limit?
No, you can choose any room type available in the hospital, including single private room, shared room, deluxe room, Suite etc.
Are maternity costs covered by the Acko Platinum Health Insurance Plan?
No, maternity expenses are not covered under Acko Platinum Health Insurance.
Are consumables covered under the Acko Platinum Health Insurance Plan?
Yes, Acko Platinum Health Insurance covers all consumables and single-use medical supply costs, such as gloves, syringes, masks, cotton, etc.