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Insurance Plans Comparison

Niva Bupa Health Premia Gold vs Niva Bupa HeartBeat Platinum

Make an informed decision with our detailed side-by-side comparison of top health insurance policies. Compare...

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Niva Bupa

Health Premia Gold

Health Premia Gold offers ₹10-50 Lakh cover with 100% refill, 10% yearly loyalty additions, maternity cover and in-built single-trip travel insurance.

What Makes It Special:

Health Premia Gold is the mid-tier plan of Niva Bupa's Health Premia product. Along with hospitalisation up to Sum Insured (any room except suite), 90/180 days pre/post-hospitalisation and AYUSH cover, it adds LASER surgery cover and an in-built international cover of up to ₹30 Lakh for one trip of up...

Best For:

  • Extended families (Family First) wanting up to 19 relationships in one policy

  • Buyers who want a 100% refill plus 10% yearly loyalty additions regardless of claims

  • People who want LASER surgery and mental health cover included

  • Frequent-ish travellers who value in-built overseas emergency cover for one trip a year

  • Families wanting ₹10-50 Lakh cover with maternity and newborn benefits

VS
Niva Bupa

HeartBeat Platinum

Niva Bupa Heartbeat Platinum Plan Health cover from ₹15 lakh to ₹1 crore with OPD benefits, maternity cover, international emergency protection and up to 100% Loyalty Additions.

What Makes It Special:

Premium family health insurance with OPD benefits, international emergency coverage, maternity and newborn benefits, annual health check-ups, a 24-month pre-existing disease waiting period and Loyalty Additions of up to 100%.

Best For:

  • Customers who value additional benefits beyond hospitalisation: Platinum includes annual health check-ups, second medical opinions for specified conditions or procedures, Loyalty Additions and a Re-fill benefit.

  • People who want international emergency protection: The plan includes specified international emergency benefits, with an optional enhanced geographical scope for the USA and Canada.

  • Couples planning to have children: Eligible policy structures include maternity benefits, newborn cover and first-year vaccinations, subject to waiting periods and limits.

  • People who use outpatient healthcare regularly: The plan includes OPD treatment, diagnostic tests and prescribed medicines within the applicable annual limit.

  • Families seeking higher health cover: Platinum offers Individual/Family Floater Sum Insured options from ₹15 lakh to ₹1 crore, helping families plan for potentially expensive hospitalisation.

Insurance Plans Comparison

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Quick Decision Guide

Niva Bupa Health Premia Gold

  • Things to Consider: Domestic OPD cover and Second Medical Opinion are not included in Gold.

  • Things to Consider: Robotic surgery, some mental disorders and HIV/AIDS have sub-limits; mental illness has a 36-month waiting period.

  • Things to Consider: Non-payable items (consumables like gloves) need the paid Safeguard add-on.

  • Things to Consider: Choosing Zone 2 pricing means a 20% co-payment for treatment in Mumbai, Delhi NCR, Kolkata and Gujarat.

  • Things to Consider: Maternity cover is only for Family Floater / Family First policies and needs 24 months of continuous cover.

  • Reasons to Consider: In-built international cover (₹30 Lakh, one trip) and LASER surgery cover are included.

  • Reasons to Consider: PED waiting period is 24 months and specific disease waiting period is just 12 months.

  • Reasons to Consider: Pre and post-hospitalisation are covered for 90 and 180 days.

  • Reasons to Consider: A 100% Re-fill of Base Sum Insured is available once a year for any illness.

  • Reasons to Consider: Loyalty Additions grow your cover by 10% of Base Sum Insured every year (up to 100%), even if you make a claim.

Niva Bupa HeartBeat Platinum

  • Compare optional costs and policy limits: Evaluate deductibles, voluntary co-payment, room eligibility, disease sublimits and the Re-fill conditions. A lower premium may mean paying more out of pocket when making a claim.

  • Choose your geographical coverage carefully: Review Zone 1 and Zone 2 pricing and understand where the 20% co-payment applies. If international protection matters, check the optional USA and Canada geographical enhancement and its exclusions.

  • Read the maternity and newborn conditions: Check the applicable waiting period, maternity limit, eligible policy structure and newborn benefits before choosing the plan.

  • Calculate your likely OPD expenses: Compare the annual OPD limit with your expected spending on consultations, diagnostics and prescribed medicines. Review the carry-forward conditions and eligible expenses in the policy wording.

  • Select the right Sum Insured: Compare ₹15 lakh, ₹20 lakh, ₹50 lakh and ₹1 crore options against your family's medical needs, location and budget. Family First Platinum uses a different per-person and floater structure.

Insurance Plans Comparison

Detailed Features Comparison

Compare the key features of different health insurance plans

Health Premia Gold
Health Premia Gold

Health Insurance Plan

Brochure

Policy Wording

VS
HeartBeat Platinum
HeartBeat Platinum

Health Insurance Plan

Brochure

Room Rent

Health Premia Gold

Covered up to Sum Insured, any room except Suite or above (all Gold variants incl. Family First). Proportionate deduction applies if a higher room than eligible is taken

VS

HeartBeat Platinum

Covered up to Sum Insured for eligible room categories, excluding Suite or higher categories.

ICU Charges

Health Premia Gold

Covered up to Sum Insured as part of In-patient Care; no separate ICU cap stated

VS

HeartBeat Platinum

Covered up to Sum Insured as part of inpatient care, subject to policy terms.

Co-payment

Health Premia Gold

No mandatory co-payment with Zone 1 pricing. With Zone 2 pricing, 20% co-pay applies to treatment in Mumbai (incl. Navi Mumbai & Thane), Delhi NCR, Kolkata and Gujarat. OPD claims under International Coverage have 20% co-pay

VS

HeartBeat Platinum

No mandatory co-payment with Zone 1 pricing, which offers all-India coverage. Under Zone 2 pricing, a 20% co-payment applies to treatment in Mumbai, including Navi Mumbai and Thane, Delhi NCR, Kolkata and Gujarat. Optional voluntary co-payment of 10% or 20% is available for a premium discount.

Disease-wise sublimits

Health Premia Gold

No sublimits on common conditions like cataract or joint replacement. Sublimits apply to: robotic surgeries (₹1 Lakh, with exceptions), specified mental disorders (₹50,000), HIV/AIDS (₹50,000 per year), LASER surgery (up to ₹50,000), non-network road ambulance (₹2,000 per event)

VS

HeartBeat Platinum

HIV/AIDS: up to ₹50,000 after a 4-year waiting period. Mental disorder treatment: covered up to SI, with a ₹50,000 sublimit for specified conditions after a 3-year waiting period. Maternity limits apply as listed above. Non-network emergency ambulance: up to ₹2,000 per event; network ambulance: up to SI.

Cashless Healthcare Providers

Health Premia Gold

Cashless treatment at Niva Bupa network hospitals across India; 10,000+ network hospitals (approximate, per Platinum brochure and Annual Report FY 2024-25; subject to change). Pre-authorisation target of 30 minutes

VS

HeartBeat Platinum

Cashless treatment is available at Niva Bupa network hospitals. The HeartBeat brochure refers to 10,000+ hospitals, an approximate network figure. Niva Bupa also advertises a 30-minute cashless pre-authorisation commitment, subject to the applicable process and required documents.

Restoration Benefit

Health Premia Gold

Re-fill Benefit: up to 100% of Base Sum Insured once per policy year, for the same or a different illness, after the Sum Insured is partly or fully used. Not available under the Family First variant

VS

HeartBeat Platinum

Re-fill Benefit: once per policy year, up to 100% of Base SI when Base SI and Loyalty Additions are partly or fully used. It can be used for subsequent claims for the same or a different illness, subject to policy conditions. The benefit is not available under Family First.

Cumulative Bonus

Health Premia Gold

Loyalty Additions of 10% of expiring Base Sum Insured every policy year, up to 100%, even if you claim. Optional Enhanced Loyalty Addition: 20% per year, up to 200%

VS

HeartBeat Platinum

Loyalty Additions increase the expiring Base Sum Insured by 10% at each renewal, up to a maximum of 100% of Base SI, irrespective of claims. The increase does not raise benefit sublimits

Daycare Treatment

Health Premia Gold

All listed day care procedures (Annexure III) covered up to Sum Insured

VS

HeartBeat Platinum

All eligible day-care treatments are covered up to Sum Insured, subject to policy terms.

Consumable Cover

Health Premia Gold

Allowable consumables paid within hospital bills; IRDAI non-payable items are not covered in the base plan. Covered with the optional Safeguard (List I) or Safeguard+ (Lists I-IV) add-on (Add-on UIN NBHHLIA24109V022324)

VS

HeartBeat Platinum

Allowable consumables during hospitalisation are covered. Items included in the applicable non-payable list are excluded.

AYUSH Treatment

Health Premia Gold

In-patient Ayurveda, Unani, Siddha and Homeopathy treatment in an AYUSH hospital covered up to Sum Insured, with 90/180 days pre/post-hospitalisation

VS

HeartBeat Platinum

Covers eligible inpatient treatment under Ayurveda, Unani, Siddha and Homeopathy up to Sum Insured, subject to policy terms.

Initial Waiting Period

Health Premia Gold

30 days (not for accidents or renewals)

VS

HeartBeat Platinum

30 days for illnesses. Accidents are covered from day one. The initial waiting period is waived for insured persons with 12 or more months of continuous coverage, subject to policy terms.

Specific Waiting Period

Health Premia Gold

12 months for listed conditions (e.g. cataract, hernia, joint/spine disorders, piles). Accidents covered from day 1; cancer after the 30-day wait. Mental illness and LASER surgery: 36 months. HIV/AIDS: 48 months

VS

HeartBeat Platinum

24 months for listed conditions such as cataract, hernia, joint replacement, piles and stones. This applies only to insured persons above 45 years at first policy inception. No specific waiting period applies to those aged 45 or below at entry.

PED Waiting Period

Health Premia Gold

24 months of continuous cover

VS

HeartBeat Platinum

24 months of continuous coverage for declared pre-existing diseases.

Modern Treatment

Health Premia Gold

Covered up to Sum Insured (12 listed procedures, e.g. robotic surgery, oral chemotherapy, immunotherapy, stem cell therapy). Robotic surgeries capped at ₹1 Lakh, except robotic radical prostatectomy, cardiac, partial nephrectomy and cancer surgeries

VS

HeartBeat Platinum

Covers 12 listed modern treatments, including robotic surgery, oral chemotherapy, immunotherapy and stem cell therapy, up to Sum Insured. A ₹1 lakh sublimit applies to certain robotic surgeries.

Annual Health Checkup

Health Premia Gold

Annual from Day 1: tests up to ₹2,500 per insured (₹10-20L SI), ₹5,000 (₹30L), ₹7,500 (₹50L). Family First Gold: ₹2,500

VS

HeartBeat Platinum

Annual health check-ups from the second policy year, on a cashless basis through empanelled providers. Test value: ₹3,750 for ₹15 lakh SI and ₹5,000 for ₹20 lakh, ₹50 lakh and ₹1 crore SI. Family First Platinum provides ₹5,000 per insured person.

Pre-Hospitalisation

Health Premia Gold

Up to 90 days before admission, covered up to Sum Insured

VS

HeartBeat Platinum

Covered for 60 days, up to Sum Insured.

Post-Hospitalisation

Health Premia Gold

Up to 180 days after discharge, covered up to Sum Insured

VS

HeartBeat Platinum

Covered for 90 days, up to Sum Insured.

Outpatient Department Cover (OPD Expense)

Health Premia Gold

Domestic OPD: Not available under Gold. (OPD abroad is covered only within the in-built International Coverage, with 20% co-pay). Unlimited e-consultations included in all plans

VS

HeartBeat Platinum

Covers eligible outpatient treatment, diagnostic tests and prescribed medicines. Limits: ₹15,000 for ₹15 lakh SI; ₹20,000 for ₹20 lakh SI; ₹35,000 for ₹50 lakh SI; ₹50,000 for ₹1 crore SI. Family First Platinum: ₹35,000. Subject to policy terms.

Deductible Option

Health Premia Gold

Not available (the policy wording has no deductible option for Health Premia)

VS

HeartBeat Platinum

Optional annual aggregate deductible options are available for eligible Individual/Family Floater policies: ₹10,000, ₹20,000, ₹30,000, ₹50,000, ₹1 lakh, ₹2 lakh, ₹3 lakh, ₹4 lakh, ₹5 lakh or ₹10 lakh.

Coverage Options

Health Premia Gold

Individual / Family Floater: ₹10, 15, 20, 30 or 50 Lakh Base Sum Insured. Family First variant: Base Individual SI ₹5-10 Lakh per person with a shared floater layer on top. Policy types: Individual, Family Floater (up to 6 members, max 4 children) and Family First (up to 19 relationships). Entry age: adults 18-65, children 91 days-30 years. 1, 2 or 3-year terms; lifelong renewal

VS

HeartBeat Platinum

Individual/Family Floater Platinum offers Base SI of ₹15 lakh, ₹20 lakh, ₹50 lakh and ₹1 crore. Family First Platinum has a separate per-person and floater Sum Insured structure. Policy terms of 1 or 2 years are available, subject to the applicable option.

Claim Settlement Ratio

Health Premia Gold

93.5% of claims settled (by number) for Health Premia in FY 2025-26. Source: Niva Bupa Public Disclosures FY2025-26 (Form NL-47), https://transactions.nivabupa.com/pages/doc/pub-dis/quarterly-reports/Website-Public-Disclosures-Mar-2026.pdf. Company-level: 94.4% (Niva Bupa Annual Report FY 2025-26)

VS

HeartBeat Platinum

96.0% of HeartBeat claims settled by number in FY 2025-26, according to the insurer's product-level public disclosure. Company-level figure reported in the annual report: 94.4%.

Maternity Cover

Health Premia Gold

Covered only under Family Floater / Family First (not Individual), after 24 months continuous cover, up to 2 pregnancies/terminations: ₹70,000 (₹10L), ₹75,000 (₹15L), ₹80,000 (₹20L), ₹1,00,000 (₹30L/₹50L); Family First Gold ₹50,000. New born covered up to SI till end of policy year; newborn vaccination in first year

VS

HeartBeat Platinum

Covers up to two pregnancies or terminations under eligible policy structures after the applicable waiting period. Individual/Family Floater Platinum limits: ₹1.2 lakh for ₹15 lakh SI; ₹1.6 lakh for ₹20 lakh SI; ₹2 lakh for ₹50 lakh and ₹1 crore SI. Newborn cover and first-year vaccinations are included subject to policy conditions.

Insurance Plans Comparison

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