OPD, dental, vision, and annual health checkup

OPD

OPD reimbursement allows you to claim reimbursement against doctor consultations as well as investigations and medicines as prescribed by the consulted doctor.

Inclusions:

• Consultations and investigations prescribed by a doctor/specialist 
• Cost of medicines as mentioned in the prescription
• Diagnostic tests prescribed by a specialist (i.e. routine blood work, X-ray, ECG, MRI, CT scans, etc.)
• Free, unlimited online consultations with general practitioners, pediatricians, gynecologists, dermatologists, and nutritionists through Connect & Heal

Exclusions:

• Non Allopathic/Non specialists consultations, medicines and treatments are not covered

Dental

Dental reimbursement allows you to claim reimbursement against regular dental check-up for yourself and your enrolled dependents. A doctor's prescription is required for reimbursement. Following are the inclusions and exclusions under this benefit.

Inclusions:

• Dental examination
• X-ray
• Fluoride treatment
• Fillings
• Root canal treatment
• Extractions (non-cosmetic in nature)
• Scaling and braces

Exclusions:

• Cosmetic and aesthetic treatment

Vision 

Vision reimbursement allows you to claim reimbursement against regular eye check-up for yourself and your enrolled dependents. Following are the inclusions and exclusions under this benefit.

Inclusions:

• Vision tests
• Cost of spectacle glass (without frame) or lenses based on vision test and doctor's prescription
• Doctor consultations and medicines as prescribed by the doctor

Exclusions:

• Cosmetic changes
• Contact lenses
• Frames cost

Annual health checkup

Get a free annual health checkup for you and one registered dependent under Group Medical Insurance at select leading hospitals and diagnostic centers. You can also choose to get the tests at home by opting for home sample collection.

Your annual checkup may includes:

• General examination and consultation
• Diabetes assessment
• Cardiac assessment
• Kidney function test
• Spirometry test
• Liver function test
• Thyroid profile
• Vitamin profile
• Iron profile
• Total iron-binding capacity (TIBC)
• Transferrin saturation
• Apolipoprotein A&B
• Postprandial blood sugar (PPBS) (Note: collection can only be performed in clinics and hospitals)
• Electrocardiogram (ECG) for members over age 35
• C-reactive protein test (CRP) for members over age 35

Checkups can be conducted in a clinic or through home collection. Additionally, you can choose to book a health package for your enrolled dependents at a discounted rate, the cost of which will be borne by you.

Claims Procedures

When you or a family member book and receive care through Connect & Heal, there are no out-of-pocket costs, up to the INR 30,000 OPD limit.

If you use a provider outside the Connect & Heal network, you will pay for care at the time of service and submit documents through the Connect & Heal app (CNH Care) for reimbursement. Your claim must be submitted within 60 days from consultation date/purchase of medicine/investigations. A copy of the prescription from the treating doctor should be uploaded with the claim for all investigations, procedures and medicines. All treatment and pharmacy bills need to be uploaded in original form, and claims that do not match the doctor’s prescription will not be reimbursed.