Ambulance Cover in Health Insurance

No Room Rent Capping | No Medical Check-up up to 55yrs | Tax Benefit up to Rs. 75,000 | Buy Health Insurance starting @ ₹160 pm Check Plans

Almost all indemnity-based health insurance plans offer a cover for the expenses incurred on an ambulance service for the transportation of an insured individual to the nearest hospital or from hospital to hospital. Ambulance cover though common depends on the sum insured or a predefined amount. Generally, health insurance policies offer ambulance cover up to INR 2,000 per claim, however, this amount can also go up to INR 20,000 in case of a more comprehensive policy with a high sum insured. If your health plan does not offer ambulance cover, you can also include it as an add-on.

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024.

The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918

Road and Air Ambulance Cover in Health Insurance

Now that you know what an ambulance cover is, let’s take a look at how road and air ambulance covers work.

When a policyholder who has included an ambulance cover as part of their health insurance gets injured during an accident or faces any other emergency health situations like a heart attack, they can simply avail the services of an ambulance for transporting themselves safely to a hospital for treatment.

Since they have the cover, the cost that they paid for availing the road or air ambulance service out of their pocket, can be claimed as a reimbursement from the insurance service provider. The reimbursement that they receive from the insurer would be subject to the limits specified under the policy.

To be eligible to avail this cover, you would have to satisfy a couple of conditions. Firstly, the ambulance that you used to transport yourself to a hospital is required to be from a registered healthcare service provider or a registered ambulance service provider. And secondly, you will also need to produce a certificate from the medical practitioner treating you, certifying the need for an ambulance for transportation.

Health Insurance Plans by Bajaj Allianz, Aditya Birla & Care Health with Ambulance Cover

Here’s a quick look at a few of the most popular health insurance plans from Bajaj Allianz, Aditya Birla, and Care Health that come with an ambulance cover.

Insurance Plan	Ambulance Cover
Care Family Health Insurance Plan	Up to Rs. 5,000 (dependent on sum insured)
Care Health Insurance for 45+	Up to Rs. 2,000
Care Plus - Youth Health Insurance Plan	Up to Rs. 2,000
Bajaj Allianz Extra Care Plan	Up to Rs. 3,000
Bajaj Allianz Health Infinity Plan	Up to Rs. 5,000
Bajaj Allianz Health Guard Plan	Up to Rs. 20,000
Aditya Birla Activ Health Platinum Enhanced	Up to the actual expense (in case of network hospitals) Up to Rs. 5,000 (in case of non-network hospitals)
Aditya Birla Activ Assure Diamond	Up to Rs. 5,000 (dependent on sum insured)
Aditya Birla Activ Care	Up to Rs. 2,000

Conclusion

There are other health insurance covers like OPD cover, Ayush cover, Room Rent Waiver, but ambulance cover a very important feature of a health insurance plan since it compensates you financially for the expenses that you incur for transporting yourself to the nearest hospital. While some health insurance plans provide ambulance cover as part of the base plan, others might require you to opt for an optional add-on to receive this benefit. Therefore, this is something that you should keep in mind when purchasing a health insurance plan.

Are there more than one type of ambulance cover insurance?

Yes. There are two different types of ambulance covers that you can opt for - an emergency ambulance cover and a comprehensive ambulance cover. The emergency cover provides financial compensation only when you avail an ambulance during an emergency situation. A comprehensive cover is for both emergency and non-emergency situations.

Is the cost of an ambulance covered under a base health insurance plan?

While some health insurance plans provide coverage for the cost of an ambulance in their base policy itself, others require you to opt for an optional ambulance cover above your base health insurance plan.

Is the coverage under ambulance cover limited?

Yes. Almost all insurance service providers limit the coverage under the ambulance cover. For more information on the limit, make sure to read through the terms and conditions of the health insurance plan that you’ve opted for.

Can I make a claim under this cover even when I use a non-registered ambulance for transportation?

No. To claim the ambulance cover, you should make use of an ambulance that’s from a registered healthcare provider or from a registered ambulance provider.

Can I avail the ambulance cover more than once in a year?

Some health insurance policies allow you to avail the cover more than once in a given year, while others don’t. Therefore, it is advisable to read through the terms and conditions of the health insurance plan to determine whether you can make use of it more than one.