Health Care Program (HCP) Guidelines

Purpose of the Health Care Program Initiative

UNITY LIFE HEALTH CARE (ULHC) – ULHC is a member-focused Health Care Partner that helps individuals and families access affordable, reliable medical support through a trusted network of hospitals and service providers.

1. General Terms

• Beneficiaries are eligible for healthcare services only at empanelled (listed) hospitals specified by ULHC.
• This benefit is available to individual registered beneficiaries only – it does not cover family members and cannot be converted into a family floater plan.

Right to Revise or Amend Policy: Unity Life Health Care reserves the right to review, revise, amend, or withdraw the Health Care Program (HCP) guidelines at any time without prior notice.

2. Benefits Covered

General Benefits

• Discount on pharmacy, laboratory, and radiology services.
• Free second medical opinion from listed experts.
• Assistance in procuring surgical implants and materials (costs borne by the beneficiary).

Outpatient Department (OPD)

OPD consultation costs are borne by the patient; however, discounted prices apply on pharmacy and diagnostic (lab) services.

Day Care Procedures

Currently not allowed under the HCP. The beneficiary must be admitted to a listed hospital for at least 1 day (24 hours).

Inpatient Department

• Once admitted as an in-patient in a listed hospital, the following are provided free of cost: Doctors fees, DMO fees, Nursing fees, Operation theatre charges, General ward/bed.
• The HCP covers in-patient expenses for up to 6 days. Additional costs after that are borne by the beneficiary.
• Any required surgical implants and medical materials are borne by the beneficiary.

3. Exclusions (Not Covered)

This HCP does not cover the following:

• Open Heart Surgery
• Suicide or self-harm related cases
• Infertility related procedures
• Radiation oncology (cancer treatment)
• DVH – Dental/Vision/Hearing (unless hospitalization required)
• Organ transplant surgeries
• Pre-existing conditions (36 months prior)
• Cosmetic/aesthetic procedures
• Genetic or hereditary diseases
• Psychiatric treatment
• Substance abuse related injuries
• Alternative medicine (Ayurveda, Homeopathy, etc.)
• Beneficiaries below 6 or above 60 years
• HIV/AIDS treatment
• Sexual/gender-change surgeries
• De-addiction/Rehab centres
• Non-treatment related health checkups
• Ophthalmology/dental (only discounts provided)
• Specified surgical procedures admissible only after 1 year waiting period.

4. Pre-Existing Diseases

Examples include: Cancer, COPD, PCOD, Diabetes, High blood pressure, Acne, Asthma, Sleep apnea, Extreme obesity, Anxiety, Atherosclerosis, etc.

5. Terms & Conditions

• Services are available only at ULHC empanelled hospitals.
• Health Card claims are covered only after 90 days from the issue date.
• Service-related queries should be addressed to customer care via registered contact number.
• Customer care staff cannot provide medical advice – only registered medical professionals can.
• Cashless claims facility is not available under this program.

Ambulance Facility

Patient attendants must arrange their own ambulance – hospitals do not provide this facility.

6. Additional Clauses

• Misuse / False Claims: ULHC may suspend or terminate membership and initiate legal action.
• Transfer of HCP: Non-transferable and only valid for the insured beneficiary.
• Medical Advice Validity: Only treatments from listed hospitals/doctors are considered valid.
• No Third-Party Representation: ULHC has not appointed any third-party agency. Future authorizations will be officially communicated.