Galaxy health insurance offers extensive benefits for surrogacy and fertility treatments. Details here

A comprehensive health insurance plan that covers the entire gamut of treatments is something that customers look forward to while buying a policy. Now, Galaxy Health Insurance Company, offers coverage for a whole host of treatments from surrogacy, oocyte donor expenses and organ transplantation—all under its ‘Galaxy Promise Signature’ plan.

There will be no change in the premium till the insured makes a claim or up to 55 years of age whichever is earlier.  ‘Assisted Reproduction Treatment’ is covered up to ₹5 lakh. Under this, surrogacy and oocyte donor expenses are covered. The plan offers the insured the option of a ‘No claim discount’ in the place of ‘No claim bonus’ which is usually given by insurers in a claim-free year. The no-claim discount is 2%-4% depending on the sum insured. 

Here are the salient features of the product:

Both the husband and wife should be covered under this policy for a minimum period of two years continuously either under individual or floater plans to claim the benefits of ‘Assisted Reproduction Treatment’ (ART). The insurer will pay for one ‘Assisted Reproduction Treatment’ cycle in a policy year.

The surrogate mother and oocyte donor should be 25 years to 35 years of age and the proposer has to be one of the intending couples. “The proposal for insurance must be made 30 days before the embryo transfer for the surrogate mother and/or 30 days before ovarian stimulation for the oocyte donor. Proposer must be one of the intending couples,” Galaxy Health Insurance said.

Automatic restoration of sum insured is not available for ‘Assisted Reproduction Treatment’. Pre and post treatment expenses are also excluded. Pre and post-natal care and delivery expenses for the surrogate mother are not payable.

“After completion of a 36 months period, surrogacy cover will be excluded for the surrogate mother and all other coverage will continue. After completion of a 12-months period, oocyte donor cover will be excluded for the oocyte donor and all other coverage will continue,” Galaxy Health Insurance, a standalone health insurance company promoted by the Chennai-based TVS Group and V Jagannathan, the founder of Star Health and Allied Insurance Company, said.

The coverage excludes payment for services rendered to a surrogate, costs associated with cryopreservation and storage of sperm, eggs and embryos, selective termination of an embryo, surgery/procedures that enhances fertility like “Tubal Occlusion, Bariatric Surgery, Diagnostic Laparoscopy with Ovarian Drilling and such other similar surgery/procedures.”

“Intending couples, the surrogate mother and the surrogacy clinic must comply with the Surrogacy Act and ART Act. Surrogacy and oocyte donation should be carried out in a recognized centre registered with the National ART and Surrogacy Registry at https://artsurrogacy.gov.in/,” the company said. The same applies for oocyte donors also.

The policy also covers maternity expenses of up to ₹2 lakh or 10% of the sum insured, whichever is less. It offers cover for the new born baby for up to ₹5 lakh or 10% of the sum insured whichever is less. The waiting period is two years for the floater policy and four years for single woman policy for the first delivery. There is no waiting period for subsequent deliveries. The insurer covers cataract expenses up to the full sum insured amount under the plan.

Here are some of the other features of the policy:

Insta Care Cover

Asthma, blood pressure, cholesterol covered from 31st day

No co-payment is required

Automatic restoration: Unlimited restoration of sum insured (applicable for same disease/ different diseases)

Consumables and other charges:68 consumables plus admission, record and insurance processing charges are covered

Cumulative bonus: 100% of the sum insured will be provided, if no claims are made in the first year of the policy. 25% of sum insured will be provided for every subsequent claim free year subject to a maximum of 500%.

All day care procedures are covered

Home care treatment: Covered up to 10% of sum insured or maximum up to ₹5 lakh whichever is less.

Family size: Covered up to 2A+3C. (Two adults plus three children). Parents can be covered as a separate unit.

Sum insured options: ₹5 lakh, ₹7.5 lakh, ₹10 lakh, ₹15 lakh, ₹20 lakh, ₹25 lakh, ₹50 lakh and ₹1 crore. The policy term is for one-year, two years and three years.

Entry age: Adult—18 years to 65 years. Dependent Children—16 days to 25 years.

Room rent: Sum insured ₹5 lakh to ₹20 lakh covered up to ‘Deluxe’ room. Sum insured ₹25 lakh and above—Covered up to any room.

Pre-existing diseases: Specified disease from 24 months to 18 months* and pre-existing disease from 36 months to 25 months*. The waiting period can be reduced to 24 months or 12 months on payment of additional premium. * (* applicable for Signature plan, 3 years term).

Pre and post hospitalisation cover:90 days and 180 days respectively.

Domiciliary hospitalisation: Covered up to sum insured, second medical opinion is also covered.

Hospice care: Covered up to 10% of sum insured or maximum up to ₹5 lakh whichever is less.

Organ transplantation: Covered up to sum insured.

No claim discount in-lieu of cumulative bonus: Sum insured of ₹5 lakh & ₹7.5 lakh- 3% of sum insured, ₹10 lakh & above - 1%.

Organ donor expenses for insured: Covered up to sum insured, if the insured donates organs.

For donor: Additional sum insured, covered up to basic sum insured for any complications that necessitate a Redo surgery/ ICU admission.

Air ambulance: Covered up to 10% of sum insured or maximum up to ₹2.5 lakh.

Modern treatment and robotic surgeries: Covered up to sum insured.

Road ambulance: Covered up to actuals. 

Allirajan M is a journalist with over two decades of experience. He has worked with several leading media organisations in the country and has been writing on mutual funds for nearly 16 years.