Niva Bupa Health Premia Gold
Niva Bupa
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
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.
Daycare Treatment
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.
Cashless Healthcare Providers
10675+ network hospitals
Waiting Period
- 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.
- 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.
Room Rent
- Normal: single A/C private room
ICU: no limit, expenses incurred would be covered by the 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
Related Variants
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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 strong financial performance and market confidence.
About the Company
Still Confused ?
FAQs
Frequently Asked Questions
Got questions about health insurance? You’re not alone. Here are some of the most commonly asked questions to help you understand plans, coverage, claims, and benefits better.
Got questions about health insurance? You’re not alone. Here are some of the most commonly asked questions to help you understand plans, coverage, claims, and benefits better.
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