Niva Bupa Senior First Gold Plan
Niva Bupa Health Insurance
7.6/10
OneAssure Rating
7.6/10
OneAssure Rating
Highlighted Features
Advanced Medical Coverage
Includes immunotherapy, stem cell therapy, robotic surgeries, deep brain stimulation, and more, ensuring access to cutting-edge medical treatments.
Flexible Co-Payment Option
Standard 50% co-payment can be reduced to 0%, 20%, 30%, or 40%, offering customized cost-sharing options based on policyholder preference.
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Policy Wording
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Our Verdict
Niva Bupa’s Senior First Gold Plan is ideal for seniors needing comprehensive coverage. While it includes hospitalization and modern treatments, the mandatory 50% co-payment can lead to high out-of-pocket expenses.
About the Plan
Niva Bupa’s Senior First Gold Plan covers senior citizens (61-75 years) with ₹5 lakh or ₹10 lakh sum insured and mandatory 50% co-payment. It includes in-patient care, 60-day pre & 180-day post-hospitalization, all day care & AYUSH treatments, organ donor expenses, and modern treatments (₹1 lakh sub-limit on robotic surgeries). It also offers ambulance coverage (₹2,000 road, ₹2.5 lakh air) for comprehensive senior healthcare.
About the Plan
Product Stats
Rating
Features of the Product
Room Rent (Normal & ICU)
Normal: Shared Room
ICU: Covered up to the sum insured
Advanced Treatments
Immunotherapy
Stem Cell Therapy
Balloon sinuplasty
Oral Chemotherapy
Robotic Surgeries
Stereotactic Radio Surgeries
Deep Brain Stimulation
Bronchial Thermoplasty
IONM-( Intra Operative Neuro Monitoring)
Co-payment
50% is applicable
An optional benefit to reduce co-payment from 50% to 0%/20%/30%/40%
Waiting Periods
Initial Waiting Period -30 Days
Pre-Existing Diseases- 24 Months
Specific Diseases - 24 Months
30 Days free look period.
Cashless Healthcare Providers
10,000+ Cashless Network Hospitals
Day Care Treatments
Covered up to Sum Insured.
AYUSH Treatment
Covered up to Sum Insured.
Cover for Ayurvedic, Unani, Siddha and Homeopathic treatments.
Exclusions
Conditions present before policy inception are excluded until 24 months of continuous coverage.
Certain diseases and procedures have a 24-month waiting period before coverage begins.
A 30-day waiting period applies from policy start, excluding accidental injuries.
Treatment for injuries intentionally caused by oneself is not covered.
Medical expenses arising from alcohol or drug abuse are excluded.
Treatments for aesthetic purposes without medical necessity are not covered.
Injuries or illnesses due to war or related activities are excluded.
Injuries from engaging in dangerous sports or activities are not covered.
Treatments by practitioners not recognized by medical councils are excluded.
Medical expenses incurred for treatments outside India are not covered.
Exclusions
Co-payment Reduction - Modify the standard 50% co-payment to 40%, 30%, or 20%, reducing out-of-pocket expenses during claims.
Annual Aggregate Deductible - Opt for a deductible of ₹1 lakh to ₹5 lakhs, lowering premium costs by sharing initial claim expenses annually.
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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