Niva Bupa Health Premia Gold & Silver
Niva Bupa Health Insurance
Highlighted Features
Advanced Treatments Coverage
Covers CyberKnife, robotic surgeries, laser-assisted procedures, and bariatric surgery. Some treatments have waiting periods, like 36 months for laser surgeries, or require co-payments, such as 50% for robotic surgeries.
Co-payment
The Gold plan requires a 50% co-payment for advanced treatments like CyberKnife and robotic surgeries, while the Silver plan generally exempts standard treatments from co-payments. Reviewing policy terms ensures clarity on cost-sharing obligations.
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Policy Wording
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Our Verdict
The Niva Bupa Health Premia Gold and Silver Plans offer comprehensive coverage with options for higher sum insured in the Gold Plan. Ideal for individuals and families, they cover hospitalization, wellness benefits, and critical illness.
About the Plan
The Niva Bupa Senior First Gold and Silver Plans provide comprehensive health coverage for individuals aged 60 and above. The Gold Plan offers higher sum insured, covering hospitalization, pre- and post-hospitalization, daycare treatments, AYUSH, annual health check-ups, and wellness benefits. The Silver Plan is more affordable while covering essential healthcare needs, including hospitalization and cashless treatment. Both plans ensure lifelong renewability, making them ideal for seniors seeking financial security and reliable health protection.
About the Plan
Features of the Product
Room Rent (Normal & ICU)
Normal: single A/C private room
ICU: no limit, expenses incurred would be covered by the policy.
Advanced Treatments
Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
Balloon Sinuplasty
Deep Brain stimulation
Oral chemotherapy
Immunotherapy- Monoclonal Antibody to be given as injection
Intra vitreal injections
Robotic surgeries
Stereotactic radio surgeries
Bronchical Thermoplasty
Vaporisation of the prostrate (Green laser treatment or holmium laser treatment)
IONM - (Intra Operative Neuro Monitoring)
Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.
Co-payment
A 20% co-payment applies for treatments in Zone 2. Additionally, policyholders can opt for a 10% or 20% co-payment, which does not reduce the sum insured.
Waiting Periods
Initial Waiting Period: A 30-day waiting period applies from the policy's inception, during which claims are not admissible, except for those arising from accidents.
Pre-existing Disease Waiting Period: For the Silver plan, pre-existing diseases are covered after 48 months of continuous coverage. For Gold and Platinum plans, this period is reduced to 24 months.
Specific Disease/Procedure Waiting Period: For individuals above 45 years of age, certain listed illnesses and procedures are covered after a 24-month waiting period from the policy's inception.
Cashless Healthcare Providers
10675+ network hospitals
Day Care Treatments
The Medical Expenses for a day care procedure or surgery mentioned in the list of are Procedures in this Policy where the procedure or surgery is taken by the insured Person as an inpatient for less than 24 hours in a Hospital.
AYUSH Treatment
The Medical Expenses incurred on the Insured Person’s Hospitalization for Inpatient Care during the Policy Period on treatment taken under Ayurveda, Unani, Siddha and homeopathy will be covered by this policy.
Exclusions
Pre-existing conditions are not covered until 24 months of continuous coverage have elapsed since the policy's inception.
A 30-day initial waiting period applies, during which no claims are admissible, except for those arising from accidents.
Specific treatments, such as cataract, hernia, and spinal disorders, have a 12-month waiting period.
Mental disorder treatments and LASER surgery coverage have a 36-month waiting period.
HIV/AIDS coverage is subject to a 36-month waiting period.
Exclusions
Personal Accident Cover - Provides a lump sum payment in case of accidental death or permanent disability.
Critical Illness Cover - Offers financial protection against specified critical illnesses, such as cancer or kidney failure, by providing a lump sum upon diagnosis.
Hospital Cash - Pays a fixed daily amount for up to 30 days of hospitalization, applicable if the hospital stay exceeds 48 hours.
Health Coach - Provides personalized health coaching to help track health parameters and achieve wellness goals.
Enhanced Geographical Cover - Extends international coverage to include regions like the USA and Canada.
Add-ons
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About the Company
Niva Bupa Health Insurance, formerly known as Max Bupa Health Insurance, is a prominent health insurance provider in India. It is a joint venture between Bupa, a UK-based healthcare services expert, and True North, an Indian private equity firm. The company offers a diverse range of health insurance plans tailored to meet the varying needs of individuals and families. Their policies are designed to provide comprehensive coverage, ensuring financial protection against unforeseen medical expenses.
One of their notable offerings is the ReAssure 2.0 Health Insurance Policy, which covers a wide array of medical expenses, including hospitalization, surgeries, doctor consultations, and post-hospitalization care. With a network of over 10,000 trusted healthcare providers across India, Niva Bupa ensures that policyholders have access to quality medical care when needed. Their commitment to customer satisfaction is evident through streamlined claim processes and wellness benefits, aiming to deliver peace of mind and financial security during medical emergencies.
In June 2024, Niva Bupa announced plans to raise $360 million through an initial public offering (IPO), potentially valuing the company at up to $2.5 billion.
This move underscores their growth trajectory and commitment to expanding their services in the Indian health insurance market.
Krishnan Ramachandran serves as the Managing Director and CEO of Niva Bupa Health Insurance Company Limited. With over 24 years of experience in the health insurance, healthcare, and life sciences industries, Mr. Ramachandran has previously held leadership positions at Apollo Munich Health Insurance Company Limited and Apollo DKV Insurance Company Ltd.
About the Company
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