OneHealth Premium in one table
| Insurer | Magma General Insurance Limited |
|---|---|
| Sum insured | ₹10 lakh to ₹3 crore on the Premium plan, in tiers of 10 / 15 / 20 / 25 / 30 / 50 lakh and 1 / 2 / 3 crore |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What OneHealth Premium covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from Magma General's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| Co-payment | 20% on every claim if the insured was 61 or above at policy inception · 20% to 35% if you treat in a costlier zone than you paid for | No Co-payment |
| Room Rent Limit | No cap on the Premium plan – room rent, boarding and nursing charges paid at reasonable actuals | No room rent capping |
| Disease sub-limit | Cataract ₹1 lakh per eye a year · psychiatric ₹50,000 for listed conditions · bariatric ₹1 lakh · LASIK ₹25,000 · IVF ₹50,000 | No sub-limit |
| Cumulative Bonus | 33.33% of sum insured a year, capped at 100%, paid whether or not you claimed – a guaranteed bonus, not a no-claim bonus | 50% each year (Minimum upto 100%) |
| Restoration Benefit | Recharge of Sum Insured: 100% an unlimited number of times a year, from the second claim onwards, for an unrelated illness only | 100% restoration once in a year |
| Pre and Post Hospitalization | Set in your Product Benefits Table. Optional covers lift them to 60 and 90 days, or to 60 and 180 with the Super Saver Pack | At least 60 and 120 days |
| Consumables | Excluded from the base plan – the optional Non-payable Expense Cover adds them back | Consumables covered |
| Air Ambulance | Up to ₹1 lakh, built into the plan | Included |
| Worldwide Emergency Hospitalization | 50% of sum insured or ₹20 lakh, whichever is lower, after a ₹2 lakh deductible | Included |
| Maternity | Up to ₹1 lakh, with ₹50,000 for the newborn, behind a 48-month wait | Included |
| Free Health Check-up | Every year for adults over 25, regardless of claims, with the test panel scaling with the sum insured | Included |
| Entry age | Proposer from 18, with no cap on maximum entry age · lifetime renewability | No maximum entry age |
OneHealth Premium add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
OneHealth Premium discounts you can ask for
Published discounts on this plan. Most are applied at quote stage rather than offered, so it is worth naming the ones you qualify for. Every figure is a ceiling, not a promise - what you actually get depends on the case.
| Discount | Worth | When it applies |
|---|---|---|
| Fitness Rewards | Up to 10% | Points worth up to 10% of your premium, redeemable as a renewal discount. 1% for taking the health check-up with all results in range, 1.5% for finishing a 10 km run, 2% for a year's gym or yoga membership, 2.5% for another professional sporting event and 5% for a health programme the insurer sponsors. |
| Aggregate deductible and voluntary co-payment | Priced to the option | Clear a fixed amount of claims each year yourself, or accept a 10% or 20% co-payment on every claim, and the premium falls. |
| Room Rent Modifier | Priced to the option | Trading the Premium plan's uncapped room down to a twin-sharing eligibility reduces the premium. |
From the plan prospectus. OneHealth prices most of its flexibility through the optional covers rather than a discount grid.
OneHealth Premium waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days |
|---|---|
| Critical Illness optional cover | 90 days |
| Specific Illness | 24 months |
| Psychiatric treatment for listed disorders | 36 months |
| IVF, bariatric surgery and LASIK | 3 years |
| Maternity | 48 months |
The named illnesses that wait 24 months
Payable once the policy has run 24 months without a break; the wait does not apply to an accident, and an optional cover shortens it. This list is indicative – the customer information sheet carries all 17 named conditions.
OneHealth Premium exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where OneHealth Premium falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
OneHealth Premium questions, answered
How many times does the sum insured recharge?
An unlimited number of times in a policy year, each time at 100% of the sum insured, but with two conditions people miss. It only starts from the second claim of the year, and each recharge is available only for an illness or injury unrelated to one already paid that year for the same person. Same-illness recharge exists, but as a separate optional cover you have to buy.
Is the 33.33% bonus a no-claim bonus?
No, and the distinction matters. The wording is explicit that OneHealth pays the cumulative bonus at the end of each policy year irrespective of a claim being made, provided the policy is renewed without a break. On the Premium plan that is 33.33% of the sum insured a year up to a 100% ceiling, so a ₹10 lakh cover reaches ₹20 lakh in three years whether you claimed or not.
Is there a co-payment?
Two, both of which can be missed at the quote stage. Anyone aged 61 or more when the policy starts pays 20% of every admitted claim. Separately, treating in a costlier zone than the one you paid for triggers 25% moving from Zone 2 to Zone 1, 20% from Zone 3 to Zone 2 and 35% from Zone 3 to Zone 1. The zone one can be bought out; the age one cannot.
Does the Premium plan cap room rent?
No. The room rent cap applies to the Support plan, at 1% of sum insured a day, and to Secure, at a single private room. Support Plus, Shield and Premium have no cap, and the wording pays reasonable room, boarding and qualified nursing charges as billed. If you later take the Room Rent Modifier option for a lower premium, that changes.
Are consumables covered?
Not in the base plan. Everything on List I of Annexure II – gloves, syringes, PPE, administrative charges and the rest – is excluded, and the Non-payable Expense Cover option adds them back under both the in-patient and day-care sections. There is also a small Green Channel benefit that pays ₹1,000 or ₹2,000 towards non-payable items if you use a preferred-network hospital.
What are the waiting periods?
Thirty days for any illness at the start, 24 months for the named specific-illness list, and a pre-existing disease wait set on your policy schedule. On top of those sit longer clocks: 36 months for listed psychiatric disorders, three years for IVF, bariatric surgery and LASIK, and 48 months for maternity. Optional covers shorten the first three.
Read it from the insurer
We summarise. The policy wording is the contract, and it is the only document that settles a dispute. These links go to the insurer's own pages.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.