What does Aditya Birla Health Insurance Coverage typically include?

Aditya Birla Health Insurance Coverage usually includes hospitalisation, day-care treatments, ambulance services, pre- and post-hospitalisation, and modern treatments depending on the chosen plan.

What are the unique Aditya Birla Health Insurance Benefits I can expect?

Key Aditya Birla Health Insurance Benefits include wellness rewards, annual health check-ups, chronic care management, and incentives for staying healthy.

Does Aditya Birla Health Insurance cover pre-existing diseases?

Yes, pre-existing illnesses are covered after a waiting period, which varies between 2–4 years depending on the plan.

Is OPD included in Aditya Birla Health Insurance Coverage?

Some plans offer OPD consultations, diagnostic tests, and pharmacy benefits as add-ons or built-in features.

Are modern surgeries covered under Aditya Birla Health Insurance?

Yes, treatments like robotic surgeries, stem cell therapy (as per policy), and minimally invasive procedures are included under many plans.

Do I get cashless treatment benefits?

Yes, one of the major Aditya Birla Health Insurance Benefits is cashless hospitalisation at thousands of network hospitals across India.

Are maternity expenses part of Aditya Birla Health Insurance Coverage?

Maternity and newborn benefits are available in select plans, usually with a waiting period.

What wellness rewards can I earn with Aditya Birla Health Insurance?

You earn HealthReturns™ by completing fitness goals, staying active, and maintaining healthy metrics—redeemable for premiums, OPD, or diagnostics.

Does the policy cover home treatments?

Yes, certain plans include domiciliary treatment when hospitalisation isn’t possible due to medical or logistical reasons.

Are COVID-19 treatments covered?

Yes, COVID-related hospitalisation is covered under standard Aditya Birla Health Insurance Coverage as per IRDAI guidelines.

Does Aditya Birla offer coverage for mental health treatments?

Yes, mental health consultations and hospitalisation are covered as per mandated regulations.

Can I enhance my Aditya Birla Health Insurance Coverage with add-ons?

Absolutely. Add-ons like room rent waiver, personal accident cover, wellness benefits, and OPD care can increase your coverage.

Is there coverage for alternative treatments like Ayurveda or Homeopathy?

Most plans offer AYUSH coverage for Ayurveda, Yoga, Unani, Siddha, and Homeopathy treatments.

Will I get annual health check-ups?

Yes, annual health check-ups are one of the valuable Aditya Birla Health Insurance Benefits, available in many plans.

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Aditya Birla Health Insurance

Coverage & Benefits

Aditya Birla Health Insurance & Coverage Benefits

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96%

Claim Settlement Ratio

8,000+

Network Hospitals

20 Lakh+

Claims Settled Since Inception

96%

Claim Settlement Ratio

8,000+

Network Hospitals

20 Lakh+

Claims Settled Since Inception

Aditya Birla Health Insurance & Coverage Benefits

Customer Testimonials

Real experiences from our valued customers who have chosen our insurance coverage.

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Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family…

…always been available to assist with any insurance/claim queries.

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verdict

Our Verdict: Aditya Birla Health Insurance Coverage

Pros

Flexible options: sum-insured reload, AYUSH, home treatment, and lifetime renewability.

Chronic disease support from day one in select plans.

HealthReturns™ rewards encourage wellness and can offset premiums.

Covers hospitalisation, day-care, domiciliary care, ambulance, and modern treatments.

Cons

Cashless hospital experience may vary by location.

Multiple add-ons may confuse policyholders.

Waiting periods apply for some benefits and chronic conditions.

Premiums for comprehensive plans can be high.

Pros

Flexible options: sum-insured reload, AYUSH, home treatment, and lifetime renewability.

Chronic disease support from day one in select plans.

HealthReturns™ rewards encourage wellness and can offset premiums.

Covers hospitalisation, day-care, domiciliary care, ambulance, and modern treatments.

Cons

Cashless hospital experience may vary by location.

Multiple add-ons may confuse policyholders.

Waiting periods apply for some benefits and chronic conditions.

Premiums for comprehensive plans can be high.

Final Verdict

Aditya Birla Health Insurance provides comprehensive, flexible, and wellness-oriented health coverage, designed to meet the needs of individuals and families seeking reliable protection. Its plans cover hospitalisation, day-care procedures, ambulance services, domiciliary care, and modern treatments, ensuring financial support during medical emergencies. Select plans also offer chronic disease management from...

Aditya Birla Health Insurance provides comprehensive, flexible, and wellness-oriented health coverage, designed to meet the needs of individuals and families seeking reliable protection. Its plans cover hospitalisation, day-care procedures, ambulance services, domiciliary care, and modern...

Key Coverages & Benefits Offered Under Aditya Birla Health Insurance

Learn the main coverage and exclusions of Aditya Birla Health Insurance to confidently select a plan that suits your requirements.

Inclusions

Cashless claims at network hospitals.

Wellness rewards through HealthReturns™.

Modern and alternative treatments like AYUSH and home care.

Maternity and newborn care in eligible plans.

Chronic disease management for select conditions like diabetes and hypertension.

Day-care procedures not requiring 24-hour admission.

Hospitalisation expenses including room rent, ICU, and surgeries.

Exclusions

Pre-existing conditions during the initial waiting period.

Routine vision correction, hearing aids, and dental care unless medically necessary.

Experimental, unproven, or alternative therapies not recognised medically.

Sexually transmitted diseases, HIV/AIDS, and related complications.

Self-inflicted injuries or conditions caused by alcohol or drug use.

Infertility treatments, IVF, or elective sterilisation procedures.

Cosmetic or aesthetic procedures performed for appearance enhancement.

Inclusions

Cashless claims at network hospitals.

Wellness rewards through HealthReturns™.

Modern and alternative treatments like AYUSH and home care.

Maternity and newborn care in eligible plans.

Chronic disease management for select conditions like diabetes and hypertension.

Day-care procedures not requiring 24-hour admission.

Hospitalisation expenses including room rent, ICU, and surgeries.

Exclusions

Pre-existing conditions during the initial waiting period.

Routine vision correction, hearing aids, and dental care unless medically necessary.

Experimental, unproven, or alternative therapies not recognised medically.

Sexually transmitted diseases, HIV/AIDS, and related complications.

Self-inflicted injuries or conditions caused by alcohol or drug use.

Infertility treatments, IVF, or elective sterilisation procedures.

Cosmetic or aesthetic procedures performed for appearance enhancement.

Claims Process

How to file Aditya Birla Health Insurance claims?

Aditya Birla Health Insurance & Coverage Benefits

How Coverage and Benefits Vary in Aditya Birla Health Insurance

Plan Type & Sum Insured Options

Coverage varies depending on the plan you choose and the sum insured selected. Higher coverage limits offer broader protection, including advanced treatments and higher room rent eligibility.

Age, Medical History & Underwriting

Benefits can change based on your age, existing conditions, and medical disclosures. Certain illnesses may have waiting periods or customised terms depending on your risk profile.

Add-Ons & Optional Covers

Aditya Birla Health Insurance allows you to enhance your base plan with add-ons. These optional benefits can extend coverage for modern treatments, home care, or restoration features.

Plan Type & Sum Insured Options

Coverage varies depending on the plan you choose and the sum insured selected. Higher coverage limits offer broader protection, including advanced treatments and higher room rent eligibility.

Age, Medical History & Underwriting

Benefits can change based on your age, existing conditions, and medical disclosures. Certain illnesses may have waiting periods or customised terms depending on your risk profile.

Add-Ons & Optional Covers

Aditya Birla Health Insurance allows you to enhance your base plan with add-ons. These optional benefits can extend coverage for modern treatments, home care, or restoration features.

How to Choose

How to Choose the Right Health Insurance Coverage

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What is the Waiting Period in Aditya Birla Health Insurance?

A waiting period is the mandatory time you must wait after purchasing your Aditya Birla Health Insurance policy before certain treatments, illnesses, or benefits become eligible for claims. During this period, you cannot file a claim for those specific conditions.

Initial Waiting Period

Most plans come with a 30-day initial waiting period for all illnesses, while accidental hospitalisation is covered from day one.

Pre-Existing Disease (PED) Waiting Period

Depending on the plan, the waiting period for pre-existing conditions typically ranges from 24 to 36 months of continuous coverage.

Specified Disease / Procedure Waiting Period

Certain treatments, such as cataract, hernia, joint surgeries, and other listed procedures—carry a waiting period of 18 to 36 months, depending on the policy variant.

Bariatric Surgery Waiting Period

In plans where bariatric surgery is covered (such as Aditya Birla Guardian), the waiting period is usually 2 years.

Organ Transplant Waiting Period

Some plans include a 3-year waiting period before organ transplant benefits become claimable.

Newborn Baby Cover Waiting Period

Where applicable, newborn baby cover may have a 1-year waiting period.

Maternity Waiting Period

For plans offering maternity benefits, the waiting period varies. For example, some plans have a 2-year maternity waiting period if both parents are covered, and 4 years when only the woman is insured.

Initial Waiting Period

Most plans come with a 30-day initial waiting period for all illnesses, while accidental hospitalisation is covered from day one.

Pre-Existing Disease (PED) Waiting Period

Depending on the plan, the waiting period for pre-existing conditions typically ranges from 24 to 36 months of continuous coverage.

Specified Disease / Procedure Waiting Period

Certain treatments, such as cataract, hernia, joint surgeries, and other listed procedures—carry a waiting period of 18 to 36 months, depending on the policy variant.

Bariatric Surgery Waiting Period

In plans where bariatric surgery is covered (such as Aditya Birla Guardian), the waiting period is usually 2 years.

Organ Transplant Waiting Period

Some plans include a 3-year waiting period before organ transplant benefits become claimable.

Newborn Baby Cover Waiting Period

Where applicable, newborn baby cover may have a 1-year waiting period.

Maternity Waiting Period

For plans offering maternity benefits, the waiting period varies. For example, some plans have a 2-year maternity waiting period if both parents are covered, and 4 years when only the woman is insured.

Diseases Covered/not Covered

Diseases Covered/Not Covered Under Aditya Birla Health Insurance

Diseases Covered

Accidental Injuries

Day-Care Procedures

Critical Illnesses & Major Treatments

Surgical Procedures & Hospitalisation

General Illnesses & Injuries

Chronic Diseases (Post-Waiting Period)

Diseases Not Covered

Non-Medically Necessary Treatments

Experimental or Alternative Therapies

Substance Abuse & Alcohol/Drug-Related Conditions

Sexually Transmitted Diseases and HIV/AIDS

Infertility and Reproductive Treatments

Cosmetic or Aesthetic Procedures

Pre-Existing Diseases (Initial Phase)

Diseases Covered

Accidental Injuries

Day-Care Procedures

Critical Illnesses & Major Treatments

Surgical Procedures & Hospitalisation

General Illnesses & Injuries

Chronic Diseases (Post-Waiting Period)

Diseases Not Covered

Non-Medically Necessary Treatments

Experimental or Alternative Therapies

Substance Abuse & Alcohol/Drug-Related Conditions

Sexually Transmitted Diseases and HIV/AIDS

Infertility and Reproductive Treatments

Cosmetic or Aesthetic Procedures

Pre-Existing Diseases (Initial Phase)

Pre-existing Diseases

Pre-Existing Diseases Covered Under Aditya Birla Health Insurance

Diabetes Mellitus

Covered under the Chronic Management Program (CMP) in several plans. Hospitalisation for diabetes‑related complications may require a waiting period.

Hypertension (High Blood Pressure)

Chronic high blood pressure is included in CMP. Both OPD management and in‑patient hospitalisation (after waiting) are possible.

Hyperlipidaemia / High Cholesterol

Raised lipid levels (cholesterol / triglycerides) are covered in CMP for OPD care, and in-patient treatment after the waiting period, depending on the plan.

Asthma

Chronic care coverage for asthma is provided under CMP. Severe or hospital-required flare-ups are also covered under eligible plans.

Chronic Obstructive Pulmonary Disease (COPD)

Covered in some variants under chronic-care benefits. OPD services for COPD are part of the Chronic Management Program.

Obesity-Related Conditions

Obesity is covered in some plans for chronic-care management, especially when linked with other health risks or hospitalisation requirements.

Coronary Artery Disease (post-PTCA)

Certain plans provide coverage for coronary artery disease, particularly if PTCA (angioplasty) was done more than a year ago, under chronic-care or specialised add-ons.

Diabetes Mellitus

Covered under the Chronic Management Program (CMP) in several plans. Hospitalisation for diabetes‑related complications may require a waiting period.

Hypertension (High Blood Pressure)

Chronic high blood pressure is included in CMP. Both OPD management and in‑patient hospitalisation (after waiting) are possible.

Hyperlipidaemia / High Cholesterol

Raised lipid levels (cholesterol / triglycerides) are covered in CMP for OPD care, and in-patient treatment after the waiting period, depending on the plan.

Asthma

Chronic care coverage for asthma is provided under CMP. Severe or hospital-required flare-ups are also covered under eligible plans.

Chronic Obstructive Pulmonary Disease (COPD)

Covered in some variants under chronic-care benefits. OPD services for COPD are part of the Chronic Management Program.

Obesity-Related Conditions

Obesity is covered in some plans for chronic-care management, especially when linked with other health risks or hospitalisation requirements.

Coronary Artery Disease (post-PTCA)

Certain plans provide coverage for coronary artery disease, particularly if PTCA (angioplasty) was done more than a year ago, under chronic-care or specialised add-ons.

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