JIO – Vado - Aug 2023-24 Trust managed Health Subscription with OPD discount Benefit (COI, Income tax benefit under 80-D deductions not available in trust managed subscription.)
A NEW Innovative Subscription Offer With Medical Benefit For all Shravak-Shravika members of JIO – Shravak Arogyam ( For all JAIN Sects, like Shwetamber, Digamber, Sthanakwasi, Terapanthi etc.)
Scheme Enrollment Closed on 15-08-2023
For any query please call on 1800 1211 63177 or you can mail us on: service@jio.net.in
Health Subscription Terms: (Aug 2023-2024):
Subscription start date: 2nd August 2023 to 1st August,2024.
Specialized Health Subscription in which member will get 20% discount on only Prescribed Medicine order through Kenko Health app and 10% discount on Doctor consultation, Diagnostic test order through Kenko Health app.
In case of hospitalisation eligible initial amount (Pre-auth) will be transferred in members account after uploading requisite documents in app. At the time of discharge final amount will be transferred in member’s account after uploading requisite documents. Member can avail cashless facility in Vidal healthcare cashless hospital network.
- Entry AGE is up to 90 Years and Renewal till LIFETIME
- Family Subscription offer with medical benefit for 8 members. This includes Self, Spouse, 4 unmarried Dependent Children up to 25 years, 2 Dependent Parents or Parents-In-Laws (No cross combination will be possible in the Subscription). Allmembers have to be Jain only.
- Family option for 4 members. This includes Self, Spouse, 2 Dependent Unmarried Children up to 25 years.
- NO Health Check-Up Required prior to Subscription.
- Home care treatment for COVID allowed on reimbursement basis only. Maximum limit for home care COVID treatment is 25,000 per person on reimbursement basis only.
- Hospital ROOM RENT & ICU CHARGES limitation (Per Day):
|
Maximum Benefit Amount |
Room, Boarding Expenses in Rs. |
|
|
|
Normal Room |
ICU |
|
2,00,000 |
1500 |
3000 |
|
5,00,000 |
3750 |
7500 |
|
10,00,000 |
7500 |
13000 |
|
In case, the enrolled person is admitted in a room with rent HIGHER than the eligible room rent limit, the total hospitalization benefits shall be reduced in proportion of eligible room rent limit. e.g. If you are admitted in 4000 Room and you are eligible for 2000 Room rent, then your all claim will get deducted by 50%. |
||
- PRE-EXISTING DISEASE: For new members for PRE-EXISTING DISEASES benefits are not provided in year 1.
75% benefit from 2nd year and 100% from 3rd year subject reasonable, customary and Medically Necessary charges***.
- Pre-Existing Disease Definition :
Any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice / treatment within 48 months prior to the start of the subscription.
- 1st Year Exclusion Disease
For New members: 1st year exclusion applicable (the list given in point no. 33)
From 1st Year continuing members: 75% of the benefit is payable on all specific disease expenses ( Except procedure mentioned in capping list )
From 2nd Year continuing members: 100% of the benefit is payable on all specific disease expenses ( Except procedure mentioned in capping list )
- Compulsory deductions of 20% applicable on non-capped ailment upto 50,000 for treatment taken outside the Trust approved list of hospital.
- Maaru Hospital, Parel (Ratanbai Palan Maru Hospital)
- Navneet Jain Health Center, Dadar
- Manav Kalyan Kendra, Dahisar (Run by Prince Health Center)
- Navneet Hi Tech Hospital, Dahisar
- Navneet Hospital, Borivali (E)
- Dialysis Center, Borivali (E)
- Eye Retina Care Center, Borivali (E)
- Navneet Hospital, Nalasopara
- Dialysis & Eye Hospital, Nalasopara
- Diagnostic and Eye Care center, Dombivali
- Mahavir Hospital, Dombivali
- Shree Mahavir Jain Hospital , Thane
- AYUSH Treatment: benefit up to 25,000.00 on reimbursement basis only. Domiciliary Hospitalisation is out of scope.
- Emergency Ambulance Charges: up to Rs.2,500 or actuals whichever is less.
- Internal Congenital diseases are provided maximum up to Rs. 50,000 per family.
- 30 Days Pre- Hospitalisation & 60 Days Post Hospitalisation expenses covered.
- MATERNITY BENEFIT (for self & Spouse) : Maternity benefits, applicable. From the second year onwards same is provided subject to overall limit of Rs.25,000/- for normal and Rs.30,000/- for caesarean delivery (for first 2 live children). In case the member has already 2 or more living children, then they will not be eligible for Maternity Benefit. No Pre-post claim allowed in Maternity claims. No Maternity benefit for individual Subscription.
NEW BORN BABY Benefit: Request for addition of New Born Baby under the shall be allowed provided birth intimation received in mail within 30 days from Date of birth of child on service@jio.net.inemail id with child birth proof, Any delay / request coming after 30 days from DOB for addition of New Borne baby, shall not be considered.
Any hospitalization within this period i.e. from DOB of baby to 30 days shall be considered subject to receipt of the timely intimation to service@jio.net.in
Newborn baby expenses related to Hospitalization shall be provided from Day One of the birth up to 90 days up to 35,000 limit and thereafter up to Family Sum-Insured limit.
- Intimation /Submission: 10% deductions will be applicable over & above all terms & condition if intimation not done within 48 hrs. of admission.
10% deductions will be applicable over & above all terms & condition if submission not done within 30 days of discharge.
NEWLY MARRIED SPOUSE Benefit: Request for addition of newly married Spouse under the subscription shall be allowed within 30 days from marriage date provided written mail is received on service@jio.net.inemail id within 30 days from the date of marriage with marriage proof, Any delay / request coming after 30 days from marriage date for addition of Newly married Spouse, shall not be considered.
- Only newborn baby or newly married spouse name can be added if newborn birth or marriage is after 02.08.2023.
- ADVANCE SETTLEMENT, CASHLESS & REIMBURSEMENT facility available in subscription for medical benefit.
- As per INCOME TAX Act, Proposer will be not eligiblefor exemption under Sec 80D for Health Subscription amount.
- Dental treatment provided if due to ROAD ACCIDENT ONLY and requiring 24 hours Hospitalisation. Police MLC / FIR is compulsory.
- In all Benefits requests due to Accident (whatever cause, police MLC / FIR is compulsory)
- MID-TERM ADDITIONS allowed only for newly married spouse and natural additions (newborn baby) subject to intimation received within 30 days of marriage or birth (for newly married SPOUSE & new born BABY) in mail on service@jio.net.in. Any delay / request coming after 30 days shall not be considered.
- Any person CAN’T BE enrolled MORE THAN ONCE under same plan of JIO. If declared more than once, benefit would be payable under one Benefit limit of lower value only.
- No grace period will be considered as this is a community Subscription offer.
- From first year renewal onwards all Member will be considered as fresh member if renewed using different JIOJAC ID or any changes in members name / relation. Continuity benefit will be lost for all members.
- Kindly read Terms & Condition properly, if required then only call to call center number 1800 1211 63177
- *** REASONABLE AND CUSTOMARY CHARGES mean the charges for services or supplies, which are the standard charges for the specific provider/hospital and consistent with the prevailing charges in the geographical area for identical or similar services, taking into account the nature of the Illness / Injury involved. Your claim will be process as per reasonably and Customarily and Medically Necessarily charges.
- If proposer had died then please renew enrol for subscription offer as it is and informed service@jio.net.inwith death certificate of proposer within 5 days from payment. Respective team will get JIOJAC number transferred to Spouse of the deceased name. This will ensure continuity benefit. Your continuity under the is tracked by JIOJAC number only.
Any claim in deceased proposer’s family, amount will be released in sequence covered Spouse, covered elder child, father, mother name.
- The enrolled person can make a benefit payment request if her/his hospitalized stay is for over 24 hours. However, for certain treatments, such as dialysis, chemotherapy, cataract surgery, etc. the stay could be less than 24 hours.
- Waiting period applicable for COVID related benefit for all newly members. Patient should be diagnosed COVID positive after 30 days from subscription cover start date.
- Enrollment Amount
Annual subscription amount as per Highest Member’s age in the family per Year ##
Health Subscription for JIO-Vado – Aug 2023-2024
|
Plan |
Type |
Max. Person |
Max. Age |
Family Details |
Benefit Amount |
Enrollment Charges with Taxes, if any |
|||
|
A |
Family |
8 members |
90 years |
Self |
+ Spouse |
+ 4 unmarried children |
+2 Parents / In Laws |
10 lacs |
26,000 |
|
B |
5 lacs |
20,100 |
|||||||
|
C |
60 years |
Self |
+ Spouse |
+ 4 unmarried children |
+2 Parents / In Laws |
10 lacs |
21,850 |
||
|
D |
5 lacs |
15,400 |
|||||||
|
E |
4 members |
45 years |
Self |
+ Spouse |
+ + 2 unmarried children |
|
10 lacs |
15,950 |
|
|
F |
5 lacs |
11,650 |
|||||||
|
G |
Individual |
1 members |
65 years |
Self |
|
|
|
2 lacs |
7,700 |
|
H |
45 years |
Self |
3,720 |
||||||
|
*Rs 2000/- + GST (non-refundable/non-transferrable) will be charged additional per financial year for JIO Membership fees, if not paid.
Notes: Self-managed health benefit scheme is run by Jain International Organisation for its members. Vidal Health Services will be running the adjudication as per scheme rules as above. Kenko will run the only OPD discount program for its subscribers and help in administration of the self-managed scheme of the NGO.
32. Not Payable benefit. In Patient Hospitalisation (This exclusion is related to - Hospitalisation benefit) 1. WAR like situation etc. :Treatment directly or indirectly arising from or consequent upon war or any act of war, invasion, act of foreign enemy, war like operations (whether war be declared or not or caused during service in the armed forces of any country), civil war, public defence, rebellion, uprising, revolution, insurrection, military or usurped acts, nuclear weapons / materials, chemical and biological weapons, ionizing radiation, contamination by radioactive material or radiation of any kind, nuclear fuel, nuclear waste.
2. SUICIDE attempt, CRIME etc.: A Person committing or attempting to commit a breach of law with criminal intent, intentional self-Injury or attempted suicide while sane or insane.
3. Risky Sports, Military: Willful or deliberate exposure to danger, intentional self-Injury, participation or involvement in naval, military or air force operation, circus personnel, racing in wheels or horseback, diving, aviation, scuba diving, parachuting, hang-gliding, rock or mountain climbing, bungee jumping, paragliding, parasailing, ballooning, skydiving, river rafting, polo, snow and ice sports in a professional or semi-professional nature.
4. Alcohol, Addiction etc.: Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol, including alcohol withdrawal, tobacco chewing, smoking cessation programs and the treatment of nicotine addiction or any other substance abuse treatment or services, or supplies, impairment of Covered Person's intellectual faculties by abuse of stimulants or depressants.
5. Weight management programs or treatment in relation to the same including vitamins and tonics, treatment of obesity (including morbid obesity).
6. Correction of eyesight: Treatment for correction of eyesight due to refractive error including routine examination. 7. Health check-ups: All routine examinations and preventive health check-ups, including corona virus when hospitalization is not done.
8. Cosmetic surgery, aesthetic and re-shaping treatments and Surgeries. Plastic Surgery or cosmetic Surgery or treatments to change appearance unless medically necessary and certified by the attending Medical Practitioner for reconstruction following an Accident, cancer or burns.
9. Circumcision (unless necessitated by Illness or Injury and forming part of treatment); aesthetic or change-of-life treatments of any description such as sex transformation operations.
10. Hospitalisation not required: Conditions for which treatment could have been done on an outpatient basis without any Hospitalization.
11. Experimental treatment: Investigational treatments, Unproven / Experimental treatment, or drugs yet under trial, devices and pharmacological regimens.
12. Diagnostic Only: Diagnostic tests/procedures/treatment/consumables not related to Illnessfor which Hospitalization has been done.
13. REST CURE: Convalescence, cure, rest cure, sanatorium treatment, rehabilitation measures, private duty nursing, respite care, long-term nursing care or custodial care, treatment taken in a clinic, rest home, convalescent home for the addicted, detoxification center, home for the aged, mentally disturbed remodelling clinic or any treatment taken in an establishment which is not a hospital.
14. PREVENTIVE CARE/Vaccination including inoculation and immunizations (except in case of post-bite treatment); any physical, psychiatric or psychological examinations or testing.
15. Admission for enteral feedings (infusion formulas via a tube into the upper gastrointestinal tract) and other nutritional and electrolyte supplements unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim.
16. Hearing aids & contact lenses or spectacles including optometric therapy, multifocal lens.
17. Baldness: Treatment for alopecia, baldness, wigs, or toupees, and all treatment related to the same.
18. Diabetic test strips etc.: Medical supplies including elastic stockings, diabetic test strips, and similar products.
19. External durable medical equipment: Any expenses incurred on prosthesis, corrective devices, external durable medical equipment of any kind, like wheelchairs crutches, instruments used in treatment of sleep-apnea syndrome or continuous ambulatory peritoneal dialysis (C.A.P.D.), devices used for ambulatory monitoring of blood pressure, blood sugar, glucometers, nebulizers and oxygen concentrator for bronchial asthma/ COPD conditions. Cost of artificial limbs, crutches or any other external appliance and/or device used for diagnosis or treatment (except when used intra-operatively). Sleep-apnea and other sleep disorders.
20. External Congenital Anomalies or diseases or defects.
21. Stem cell therapy etc.: Genetic disorders and stem cell implantation /Surgery, or growth hormone therapy.
22. Venereal disease, all sexually transmitted disease or Illness including but not limited to HPV, Genital Warts, Syphilis, Gonorrhoea, Genital Herpes, Chlamydia, Pubic Lice and Trichomoniasis.
23. "AIDS"(Acquired Immune Deficiency Syndrome) and/or infection with HIV (Human Immunodeficiency Virus) including Opportunistic infections but not limited to any conditions related to or arising out of HIV/AIDS such as ARC (AIDS Related Complex), Lymphomas in brain, Kaposi's sarcoma, tuberculosis, Pneumocystis Carinii Pneumoniae etc.
24. Voluntary termination, miscarriage (except as a result of an Accident or Illness)
25. Infertility: Treatment for sterility, infertility, sub-fertility or other related conditions and complications arising out of the same, assisted conception, surrogate or vicarious pregnancy, birth control, and similar procedures; contraceptive supplies or services including complications arising due to supplying services.
26. Organ donor screening: Expenses for organ donor
27. Illegal Organ Transplantation: Admission for Organ Transplant but not compliant under the Transplantation of Human Organs Act, 1994 (amended).
28. Spinal subluxation: Treatment and supplies for analysis and adjustments of spinal subluxation, diagnosis and treatment by manipulation of the skeletal structure; muscle stimulation by any means except treatment of fractures (excluding hairline fractures) and dislocations of the mandible and extremities.
29. Dental Treatment: Dentures, implants and artificial teeth, Dental Treatment and Surgery of any kind, unless requiring Hospitalization due to an Accident.
30. Cost incurred for any health check-up or for the purpose of issuance of medical certificates and examinations required for employment or travel or any other such purpose.
31. Artificial life maintenance including life support machine use, where such treatment will not result in recovery or restoration of the previous state of health.
32. Treatment for developmental problems, learning difficulties eg. Dyslexia, behavioural problems including attention deficit hyperactivity disorder (ADHD).
33. Treatment for Age Related Macular Degeneration (ARMD), Rotational Field Quantum Magnetic Resonance (RFQMR), External Counter Pulsation (ECP), Enhanced External Counter Pulsation (EECP), Hyperbaric Oxygen Therapy, high intensity focused ultrasound, balloon sinuplasty, Deep Brain Simulation,
34. Non-Medical Expenses (1):Expenses which are medically not necessary such as items of personal comfort and convenience including but not limited to television (if specifically charged), charges for access to telephone and telephone calls (if specifically charged), food stuffs (save for patient's diet), cosmetics, hygiene articles, body care products and bath additives, barber expenses, beauty service, guest service as well as similar incidental services and supplies, vitamins and tonics unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim.
35. Treatment taken from a person not falling within the scope of definition of registered Medical Practitioner with any state medical council/ medical council of India.
36. Treatment charges or fees charged by any Medical Practitioner acting outside the scope of license or registration granted to him by any medical council.
37. Treatments rendered by a Medical Practitioner who is a member of the Covered Person's family or stays with him, except if pre- approved by Us.
38. Any treatment or part of a treatment that is not of a reasonable charge, not medically necessary, drugs or treatments which are not supported by a prescription.
39. Non-Medical Expenses (2): Administrative charges related to a Hospital stay not expressly mentioned as being covered, including but not limited to charges for admission, discharge, administration, registration, bio-medical, linen, documentation and filing, including MRD charges (medical records department charges).
40. Non-Medical Expenses (3): including but not limited to RMO, CMO, DMO charges, Bio-Medical waste charges, Infection Control Charges etc. surcharges, night charges, service charges levied by the Hospital under any head are not payable because they are part of Nursing Charges and as specified in the Annexure for Non- Medical Expenses Click Here for more details
41. Treatment taken outside India.
42. Covered Person whilst flying or taking part in aerial activities except as a fare-paying passenger in a regular scheduled airline or air charter company.
43. Robotic surgery (whether invasive or non-invasive) and Any form of Laser Surgery
44. All forms of Bariatric surgery.
45. Use of Radio Frequency (RF) probe for ablation or other procedure.
46. Admission primarily for diagnostic purposes not consistent with the treatment taken.
47. Blacklisted Hospital, Doctor: Treatment in any Hospital or by any Medical Practitioner or any other provider of services that We have blacklisted as listed on Our website.
48. Treatment provided by anyone with the same residence as Insured Person or who is a member of the Covered Person's immediate family.
49. Holmium Laser Enucleation of Prostate, KTP Laser Surgeries, Femto laser surgeries, bio-absorbable stents, bioabsorbable valves, bioabsorbable implants, oral chemotherapy, Hormonal Chemotherapy, Adjuvant Chemotherapy, Neo-adjuvant Chemotherapy, Immuno-therapy, use of Monoclonal antibody e.g. Trastuzumab , Antibody cocktail , Infliximab, rituximab, avastin, lucentis group of drugs.
50. Domiciliary Hospitalisation, OPD treatment is not covered.
51.Consumables are not payable.
52.Any consequential or indirect loss arising out of or related to Hospitalization.
53.Air Ambulance.
OPD Discounts-out of Scope
Vision Corrections, Contact lens, and cost of spectacles All Dental treatments Mental health consultations Any Cosmetic treatments Nonprescription medicines and diagnostic tests Consultation, Medicines or diagnostic tests purchased out of network unless agreed in advance. Physiotherapy sessions Medicines, diagnostic tests on prescriptions written before scheme start date. Cost of Insulin Medicine, doctor consultation or diagnostic test cost covered by any insurance of beneficiary are outside the scope Cost of equipment for disabled people Orthopedic equipment cost Cost of dialysis (excluded for OPD but is included in In Patient as Day Care) Cost of Oral Cancer Drugs and cancer related diagnostics Abortion, Miscarriage, Termination of Pregnancy (Voluntary/Accidental) Medicines administered at hospital or medical facility.
33. Treatments excluded in 1st Year: Even if diagnosed after Subscription Inception.
List of Capping Ailments:
Compulsory deductions of 20% not applicable on capped ailment.
|
Hospitalization (IPD Benefits)
BENEFIT INTIMATION –
- Intimation given through Kenko app 7 days in advance in case of planned hospitalization.
- Immediate intimation shall be given on Kenko’s app within 48 hours of hospitalization
- Benefit will get rejected if intimation given after 48 hrs. of hospitalisation.
To avail of Hospitalization (IPD) benefits, a minimum of 24 hrs. of hospital admission is required except day Care Procedure.
Each subscription plan has different tiers of hospitalization benefits. Subscribers will be able to benefit their benefits, as offered by their subscription plan.
Note: If the subscriber has multiple plans, they can choose any of their active plans to avail themselves of the respective benefit. At the time of benefits, customers can benefit from only 1 plan and multiple plans cannot be clubbed together for the same order.
Online/Offline Benefits Process (Via App or Email/Call )
1.The member/ patient will log-in to their Kenko app (Android / iOS) and create a Hospitalization (IPD) ticket on the app (Under Hospital Admission). Kenko’s Customer Delight team will get in touch with the employee/ patient and guide them with next steps.
Alternatively, the member/ patient can also notify their Kenko Relation Manager (Kenko-RM) either by calling at our toll free number - 1800 1211 63177 OR by sending an email to care@kenko-health.in at least 5-7 days in advance of the hospitalization event.
2. The member/ patient will need to share the following documents (only soft copies) by sending an email to care@kenko-health.in
• Doctor's Diagnosis on Doctor's letterhead mentioning the need for hospitalization and an estimated cost of treatment.
• Any (and all) test reports supporting the need for the treatment or hospitalization, and
• Any other documentation, in-case there is a specific need for it, though it will not be a part of the standard process
3.When the member/ patients goes to the hospital, he/ she will be required to take a selfie in which the name and surrounding of the hospital are visible and share the same at care@kenko- health.in
4.Once the benefit documentation is validated, a payment link will be sent to the member/ patient via SMS to their registered mobile number, where the employee/ patient will have to fill up their Bank Account number and IFSC code. [For deposit and initial payments]
5. At the time of discharge, the following documents will have to be shared from member/ patient at care@kenko-health.in
• Deposit Slip
• Discharge card/summary,
• Full itemized bill,
• Any other documentation, incase there is a specific need for it, though it will not be a part of the standard process
6. Once the benefit documentation is validated, a payment link will be sent to the employee/ patient via SMS on their registered mobile number, where the member/ patient will have to fill up A/C no and IFSC code [For final payments]
7. The total admissible amount will be credited to the member/ patient's account.
OPD and Wellness Discount Benefits
Customers can raise the order request either through the Kenko App.
For Doctor Consultation –(no reimbursement, booking through app only)
• Plan Name and Member Name
• Date & Time of consultation
• Doctor Specialization
• Address & Location details
• Confirmation is sent through an email & SMS to the customer on the Doctor Consultation Appointment
• The benefit amount will be discounted value as per the subscription plan
For Medicine Order –(no reimbursement, booking through app only)
• Plan Name and Member Name.
• Medicine Name
• Prescription Upload
• Address & Location details
• Confirmation is sent through an email, SMS and Whatsapp to the customer on medicine Delivery
• The benefit amount will be discounted value as per the subscription plan
For Diagnostic–(no reimbursement, booking through app only)
• Plan Name and Member Name
• Date & Time of sample collection
• Test Name
• Address & Location details
• Confirmation is sent through an email, SMS and Whatsapp to the customer on the Diagnostic Order
• The benefit amount will be discounted value as per the subscription plan
Note:
• For medicine order, after an invoice is generated, a payment link would be shared with the customer. Post payment, medicines will be delivered within 24 hours. A delivery fee is applicable.
• Incase of grievance or dissatisfaction, you can reach out to us at grievance.jio@kenko-health.in
Some Useful Links:
Introduction to Kenko App : https://youtu.be/1Bd7iDeObkA
How to Get Benefit For Hospital Treatments : https://youtu.be/TJv1O-Ysujc
How to Get OPD Benefits : https://youtu.be/dtZVtx306vU
JIO
JIO is a Health / Wellness Company?
- No. JIO is NGO which run various scheme for the benefits of its community and members. and does not give any type of Plan. JIO is the Manager of this Plan. JIO has played the role of designing the scheme benefit and arranging the administering agencies for benefit of its Shravak/ Shravika Members
Is JIO is making profits from the Health plans?
NO
JIO is a Non profit organization and is formed with a noble objective of serving its Shravak / Shravika members as well as society at large. Under the Wellness Plan scheme, the Subscriptions are collected from the members and then same is used to provide the benefits to needy as per rules. In-fact, Gurudev has inspired several Jain Shravaks to donate partly towards the Subscriptions for members of their respective Samaj / Gnyati, who are financially troubled. Hence the health security could be availed by members of their Samaj at further discounted Subscriptions. This will immensely help such families to face the additional financial burden of medical expenses, if any.
Is the Enrolment process very complex?
NO
The enrolment process requires registering accurate details of the member and their family so that they do not face any trouble during the full year or at time of Benefit utilisation. The forms have been designed in a way to get the important details only.
Vado Mahajan has made available their offices where company representative will be available to assist you in enrolment.
Why so much importance is given to online process which may be difficult for a common man ?
JIO has pioneered in adopting to the latest technologies and online tool for your convenience and better service. The online enrolment process has the following major advantages:
- The data entry and processing time is saved.
- Accuracy of the data entered. This will also help in hassle free Benefits to the members.
- Enrol anytime from anywhere
- Immediate confirmation of enrolment completion.
Why JIO JAC number is compulsory?
JIO JAC is required not only for Benefit availment but also for other JIO schemes. JIO introduced the Jain Advantage Card (JAC) as a comprehensive scheme for benefit of its members through bulk buying.
JIO JAC is a unique and permanent identification for availing benefits of various schemes launched by JIO. Members can easily participate in the programs of JIO without having to provide various details every time.
JAC members can also connect with fellow Shravaks and take full advantage of the JIO Global network.
Why does the Benefit starts very late after payment of Subscription to JIO?
There is fixed enrollment period for members to enroll. Benefit start date is fixed and known in the advance.
Data reconciliation takes time at JIO end, hence docket creation takes time.
The above process takes lot of time and efforts; hence the commencement of plan is after necessary period from the date of payment.
Whether JIO is responsible for answering queries on Benefits disbursal and deductions?
All the queries regarding the Benefits process, status of Benefits, reasons of deductions from Benefit etc., are handled by the concerned Wellness Company and providers.
In cases, where the grievances of the plan members remain unresolved by the Wellness / Administrator, the members can escalate such urgent / important issues with the JIO officials. JIO in turn will take up these issues with the concerned providers. However, the Benefits will be decided on merits of the case and within the terms of the plan.
Kenko Health
Who is Kenko Health?
Kenko Health is a digital platform to offer solutions for doctor consultations, medicines, lab tests and other out of hospital healthcare services.
List down the key benefits given by Kenko Health?
Kenko offers prepaid benefits on all your medical expenses. OPD expenses include doctor consultation, medicines, lab tests etc.
Hospital expenses are provided by self-managed health scheme by JIO and Kenko health will help in administration of the self-managed scheme of the NGO.
How to avail Kenko OPD discount Benefits?
Just download the app and you’re done. All your health benefits are available at your fingertips as per designed by Jio.
Who would process our benefit ?
1. Self managed hospitalisation benefit scheme is run by Jain International Organisation for its members. Vidal Health will be running the adjudication as per scheme rules. Also, cashless will be processed by Vidal Health.
2. Kenko will run the OPD discount program for its subscribers and help in administation of the self managed scheme of the NGO against fee which is charged as the scheme progresses.
Whom to contact in case of addition/deletion & Correction?
Please write on service@jio.net.in
Any blacklisted hospitals which are debarred by an?
Vidal healthcare has preferred network in consultation with JIO but benefit can be taken at any hospital
Where to send our Physical papers later on post completion of treatment?
We don’t expect our subscribers to send us any papers. Just upload everything on the app.
Can I get certificate of Insurance?
No,
This is not insurance scheme but community welfare scheme managed by JIO. Every member will get docket with terms & conditions on their registered mail ID.
Why so much emphases is given on registered mail ID?
To avoid multiple mail communications / fraudulent mail communications JIO has made compulsory to raised query from registered mail ID only. Team will not reply if they get mail from unregistered mail ID.
What will be the room rent ? Is proportionate deductions applicable ?
Room rent including associated charges is given in below table. Proportionate deductions applicable in this plan.
|
Benefit Limit |
Room, Boarding Expenses in Rs. |
|
|
|
Normal Room |
ICU |
|
2,00,000 |
1500 |
3000 |
|
5,00,000 |
3750 |
7500 |
|
10,00,000 |
7500 |
13000 |
|
In case, the person is admitted in a room with rent HIGHER than the eligible room rent limit, the total hospitalization Benefit shall be reduced in proportion of eligible room rent limit. e.g. If you are admitted in 4000 Room and you are eligible for 2000 Room rent, then your all Benefit will get deducted by 50%. |
||
How much will be compulsory deductions in this plan?
Compulsory deductions of 20% applicable on non-capped ailments subjects to maximum limit of Rs. 50,000 for treatment taken outside the list of JIO approved
network hospitals.
What will be deductions in case of delay intimation & submission?
Your Benefit may get rejected if intimation/submission not given within time line.
Processor may deduct 10% additional in case of delay.
Intimation / Submission : 10% deductions will be applicable over & above all terms & condition if intimation not done within 48 hrs. of admission.
10% deductions will be applicable over & above all terms & condition if submission not done within 30 days of discharge.
What is the capping in the scheme?
|
Maximum Amount payable per person for Ailments/ procedure. (INCL. Pre/post expenses) |
Benefit Limit – 200000 |
Benefit Limit - 500000 |
Benefit Limit - 1000000 |
|
Cataract per eye |
15,000 |
18,000 |
22,000 |
|
All expenses related to Disorder of Nervous system |
75,000 |
1,80,000 |
2,25,000 |
|
All expenses related to Cardiovascular Disease |
1,00,000 |
2,00,000 |
2,25,000 |
|
Expenses related to Cancer excluding Radio therapy & chemotherapy |
1,20,000 |
2,20,000 |
2,80,000 |
|
Expenses related to Radio therapy / chemotherapy & Dialysis - Per Ailments |
75,000 |
1,00,000 |
2,00,000 |
|
Expenses related to Renal disease excluding Dialysis |
75,000 |
1,80,000 |
2,25,000 |
|
Expenses related to Prostate enlargement, Hysterectomy & stone removal - Per Ailments |
40,000 |
50,000 |
60,000 |
|
Expenses related to Musculoskeletal System excluding Joint & or Knee replacement. |
1,00,000 |
2,00,000 |
2,50,000 |
|
Joint & or Knee Replacement and implants (Maximum payable - per family per year) |
1,00,000 |
2,00,000 |
2,25,000 |
When do the new phase are introduced and how will the Shravaks be informed about the same?
The introduction of new phases is not as per a planned schedule. JIO receives proposals from different Wellness Provider companies and if JIO is convinced about the suitability of the terms, the new phase will be announced through SMS, e-mails and website to all JIO JAC members.
Whether the Health and wellness plan is a temporary affair or will continue for several years to come?
The JIO community plan is NOT a temporary affair and will continue in future like all other Plan.
However, as discussed earlier, the terms of the welfare scheme are subject to change at the time of each year based on past experience & analysis.
JIO community Benefit plan was started with a noble vision of giving financial security in medical emergency to all the Shravak / Shravika families. Therefore, JIO will endeavor to continue the scheme.
What is the procedure for continuing the benefit year on year?
A member is required to visit the designated website for enrollment and login with JIO JAC ID. The details of proposer, family members will be reflected for last year Existing Members Only. The member is required to confirm the complete details before proceeding. The member can also read the detailed terms and conditions of the new plan. On acceptance of the terms of the plan the member can make payment and complete the process.
Whether Physical Submission of forms is allowed?
Physical forms will not be accepted at all for the renewal of plan. All the information has to be provided online.
What are the options for making payment of Subscription amount?
Only through Online payment by credit / debit card or net banking
If a member is not aware about the online process or the working on internet and computers, how will they be able to renew?
Advised to approach young members in their family for help in completing the online process.
I am a Jain, but my wife is not a Jain? Can my wife enroll?
Yes.
Can I and my brother / sister add our parents under our subscription?
Yes, you can but any person can't take benefit more than once under whole group in JIO Plan. If declared more than once, benefit would be payable under one benefit amount only.
Can I add my married daughter in scheme?
No, because she is now not part of your family.
Is this Applicable on Pan India basis?
Yes, this plan is for Pan India, Jain population only. All covered members have to be Jain.
What if I am or my family member is already suffering from a disease? Can I yet get myself or my family members covered?
There is a waiting period of one year for Pre-existing disease if you are subscribing for the first time subject to terms & conditions.
In my family few are having Jain certificate, but my parents don't have any proof? Then what I can do?
Please get a confirmation from your Sangh / Gyati that you are a Jain.
How do I enroll?
Please follow the below mentioned steps
Please go on https://jio.net.in/jio-vado-23-24.php
Read revise Terms & Conditions carefully
Select "Apply Now"
Enter JIOJAC ID
Fill your enrolment details.
Make payment ONLINE.
If I don't have JIO JAC Id, can I opt for health scheme?
No, JIOJAC ID is compulsory for proposer. Please register online for JIOJAC ID.
What is the Subscription?
Subscription details are available in T & C section.
When will I be eligible for my maternity Benefit?
Please read terms & conditions carefully.
Are pre & post-natal expenses under Maternity benefits covered?
Please read terms & conditions carefully.
Can I submit physical form?
No, You have to do enrolment online only. You may visit designated centers for assistance.
Do we get no Benefit bonus if we do not Benefit in the existing year?
No
If my wife is Jain can she add her parents?
Yes, only if she is a Jain by birth.
Whom to contact for benefit utilization?
You can inform us on the app that is available on the play store and app store or email us at care@kenko-health.in or connect with us on our toll-free number 1800 1211 63177.
Whom to approach in case of Grievance or dissatisfaction?
You can reach out to us at grievance.jio@kenko-health.in
How benefits are Utilised -Reimbursement basis ?
We are one step ahead. We do prepaid benefits transfer by cashless claim settlement. Reimbursement claims are also allowed.
How to pay the Health Subscription?
Your JIO Enrollment fees can be paid by visiting this website https://jio.net.in/jio-vado-23-24.php.
Click on apply now and proceed to payment.
How to use Kenko App?
Introduction to Kenko App : https://youtu.be/1Bd7iDeObkA
How to Get Benefit For Hospital Treatments : https://youtu.be/TJv1O-Ysujc
How to Get OPD Benefits : https://youtu.be/dtZVtx306vU
When will the JIO benefit start?
Your subscription will start on a common date notified by JIO & not from the payment of subscription amount.
I am Thankful.
- I appreciate JIO for being a facilitator for this highly beneficial Community health & OPD Wellness Subscription Plan for the social and health upliftment of the Community.
- Jain International Organization (JIO) is NOT an Agent, a Broker, or an Insurer but JIO is an Non Profit organization who has selected Wellness Service Partners for the well-being of its members.
- This is Self-managed hospitalisation benefit scheme, run by Jain International Organisation for its members. Vidal Health will be running the adjudication as per scheme rules
- Kenko will run the OPD discount program for its subscribers and help in administration of the self managed scheme of the NGO against fee
- This is a community health subscription plan. It will start from a common date and not from the date you pay the subscription fee.
- Subscription Period: Membership benefit will start from 2nd Aug 2023 to 1st Aug 2024.
I UNDERSTAND THIS AND ACCEPT that if the services of providers are found to be improper, I would be bounded by the decision of the scheme administrator (including the agencies administrator appoints for scheme management and waive any right to legal or any remedy in all judicial or semi judicial forums. Benefits are processed by Kenko Health Tech, JIO has no role in benefit processing.