How does the waiting period affect my coverage?

Niva Bupa Senior First Gold has a 30-day initial and 24-month pre-existing & specific disease waiting periods.

What happens if I don’t use my health insurance benefits for the entire year?

If no claims are made during the policy year, the Senior First Gold policy does not offer a No Claim Bonus (NCB) or any cumulative benefits for claim-free years.

Will my health insurance cover treatment abroad?

This policy excludes international treatment; only India-based medical expenses within the covered hospital network are reimbursed.

How to avail cashless hospitalization under Niva Bupa Senior First Gold?

Visit a network hospital, show your health card and ID, hospital sends pre-authorization; upon approval, treatment proceeds cashless.

OneAssure

Health Insurance

Niva Bupa

Senior First Gold

Niva Bupa Senior First Gold

Experience India's most trusted health insurance with Niva Bupa Health Insurance. Get instant cashless treatment at 10000 network hospitals with sum insured up to ₹50 lakhs.

92.02%

Claim Settlement Ratio

10000+

Network Hospitals

7.6

Customer Rating

Brochure

Policy Wording

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92.02%

Claim Settlement Ratio

10000+

Network Hospitals

7.6

Customer Rating

Brochure

Policy Wording

Our Verdict

Expert Review: Niva Bupa Health Insurance

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Final 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

About Niva Bupa Health Insurance

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.

Inclusions and Exclusions

Inclusions and Exclusions of Niva Bupa Insurance Company Limited

Advanced Treatments

ImmunotherapyStem Cell Therapy Balloon sinuplasty Oral Chemotherapy Robotic Surgeries Stereotactic Radio SurgeriesDeep Brain Stimulation Bronchial Thermoplasty IONM-( Intra Operative Neuro Monitoring)

AYUSH Treatment

Covered up to Sum Insured.
Cover for Ayurvedic, Unani, Siddha and Homeopathic treatments.

Cashless Healthcare Providers

10,000+ Cashless Network Hospitals

Co-payment

50% is applicable 
An optional benefit to reduce co-payment from 50% to 0%/20%/30%/40%

Waiting Period

Initial Waiting Period -30 Days Pre-Existing Diseases- 24 MonthsSpecific Diseases - 24 Months30 Days free look period.

Daycare Treatment

Covered up to Sum Insured.

Room Rent

Normal: Shared Room ICU: Covered up to the sum insured

Advanced Treatments

ImmunotherapyStem Cell Therapy Balloon sinuplasty Oral Chemotherapy Robotic Surgeries Stereotactic Radio SurgeriesDeep Brain Stimulation Bronchial Thermoplasty IONM-( Intra Operative Neuro Monitoring)

AYUSH Treatment

Covered up to Sum Insured.
Cover for Ayurvedic, Unani, Siddha and Homeopathic treatments.

Cashless Healthcare Providers

10,000+ Cashless Network Hospitals

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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.

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About the company

Niva Bupa Health Insurance Company Ltd. (formerly Max Bupa) is a standalone health insurer in India, formed through a joint venture between the UK-based Bupa Group and Indian private equity firm True North. Established in 2008, the company offers a comprehensive range of health insurance products for individuals, families, and senior citizens, designed to make quality healthcare more accessible and affordable. The company operates with a nationwide network of over 10,000 hospitals and provides coverage across hospitalization, surgeries, consultations, and post-hospital care. Under the leadership of Managing Director and CEO Krishnan Ramachandran, Niva Bupa has expanded its presence and strengthened its digital and service capabilities to enhance the customer experience. Listed on both the BSE and NSE after its November 2024 IPO, Niva Bupa reflects...

Niva Bupa Health Insurance Company Ltd. (formerly Max Bupa) is a standalone health insurer in India, formed through a joint venture between the UK-based Bupa Group and Indian private equity firm True North. Established in 2008, the company offers a comprehensive range of health insurance products for individuals, families, and senior citizens, designed to make quality healthcare more accessible and affordable. The company operates with a nationwide network of over 10,000 hospitals and provides coverage...