Niva Bupa Health Premia Plan
Overview
With a vision to become Indias most admired Health Insurance Company, Max Bupa Health Insurance Company Ltd came into being in 2010. It is a joint venture between True North, a leading Indian private equity firm, and the UK’s 70-year-old healthcare services expert, Bupa. While on the one hand, Bupa brings its vast and varied experience, on the other hand, True North adds the insights and understanding of the Indian healthcare market and its capability of transforming business. Together, they strive to make Niva Bupa one of the best medical insurance companies in the country
Highlights for Niva Bupa Health Premia Gold & Silver
Room Rent
Maternity benefit
Ambulance
PED Cover
Features
Sub-limits
No sub-limits
Pre-Hospitalisation : 90 Days
The amount of expenses incurred during this period prior to hospitalisation such as diagnostic tests, doctor fees, medicines, etc. for investigiation purpose are also payable by the insurer
Post Hospitalisation : 180 Days
The amount of expenses incurred during this period after discharge from hospitalisation for the purpose of recovery such as follow-up tests, doctor fees, medicines, etc. are also payable by the insurer
Pre existing Disease cover : Pre-existing diseases covered after 24 months of renewal.
Coverage for all Pre-Existing Diseases covered after a certain specified waiting period with continuous renewal.
Waiting Period- Initial : 30 Days
No claims are accepted within this period except due to accidents/ injury.
Waiting Period- Specific : 24 Months
Listed specific illness
Waiting Period- PED : 24 Months
No pre-existing ailment related claims are accepted within this period.
Room Rent : Upto Sum Insured(except Suite or above room Category)
Room rent for in-patient hospitalisation
ICU Charges : Upto Sum Insured
Charges for ICU hospitalisation
Co pay : No
% of the claim that the policyholder needs to pay out-of-pocket
Restore Benefit/ Recharge/ Refill : Upto to Base sum insured
If the sum insured is exhausted due to hospitalisation expenses of one or more members, there is an automatic restoration of the sum insured for related or unrelated ailments.
Health Check up : Annual tests covered up to worthRs7,500per Insured Person
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
No Claim Bonus : Increase of 10% of expiring Base Sum Insured in a Policy Year; maximum up to 100% of Base Sum Insured
% of the sum insured that rises every claim free year.
Video/telephone consultation : Unlimited
E-consultation with expert doctors empanelled with the insurer for a second opinion.
Domiciliary hospitalization : Upto Sum Insured
Home care treatment where there are no beds in the hospital or paitient is not in a condition to be moved to the hospital, This treatment is provided under the supervision of a registered medical practitioner.
Ambulance : Network hospital: Upto Upto Sum Insuredand for Non-Network hospital is Rs. 2000
Transportation of the patient to the hospital and back home
Convalescence benefit : 5000Rs/day
A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.
Organ Donor : Upto Sum Insured
The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.
Bariatric cover : Upto Sum Insured
Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.
Daycare : Upto Sum Insured
Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments
AYUSH : Upto Sum Insured
Alternative treatment coverage such as ayurvedic, unani, sidha and homeopathy which leads to hospitalisation.
Congenital Coverage : No
Covers medical expenses related to diagnosis and treatment of heriditary and internal congenital ailments/ conditions/ traits that exist from birth.
Modern Treatments : Covered up to Sum Insured with sub-limit of Rs. 1 Lac on few robotic surgeries
All advanced treatment with upgrade in technology.
Health Management/ Wellness : No
Benefits provided for staying fit and managing health
Maternity Benefit : Covered up to Rs 1,00,000
All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.