Overview

With a vision to become Indias most admired Health Insurance Company, Max Bupa Health Insurance Company Ltd came into being in 2010. It is a joint venture between True North, a leading Indian private equity firm, and the UK’s 70-year-old healthcare services expert, Bupa. While on the one hand, Bupa brings its vast and varied experience, on the other hand, True North adds the insights and understanding of the Indian healthcare market and its capability of transforming business. Together, they strive to make Niva Bupa one of the best medical insurance companies in the country

Highlights For

Niva Bupa Heartbeat Gold

Room Rent

Maternity benefit

Restore benefit Recharge Refill

product highlights for Niva Bupa Heartbeat Gold

Features

Sub-limits

Pre-Hospitalisation : 60 days

The amount of expenses incurred during this period prior to hospitalisation such as diagnostic tests, doctor fees, medicines, etc. for investigiation purpose are also payable by the insurer

Post Hospitalisation : 90 days

The amount of expenses incurred during this period after discharge from hospitalisation for the purpose of recovery such as follow-up tests, doctor fees, medicines, etc. are also payable by the insurer

Pre existing Disease cover : 48 months

Coverage for all Pre-Existing Diseases covered after a certain specified waiting period with continuous renewal.

Waiting Period- Initial : 30 Days

No claims are accepted within this period except due to accidents/ injury.

Waiting Period- Specific : 24 months

Listed specific illness

Waiting Period- PED : 48 months

No pre-existing ailment related claims are accepted within this period.

Room Rent : Upto Sum insured

Room rent for in-patient hospitalisation

ICU Charges : Upto Sum insured

Charges for ICU hospitalisation

Co pay : No

% of the claim that the policyholder needs to pay out-of-pocket

Restore Benefit/ Recharge/ Refill : In case of exhaustion of the base sum insured, get 100% of your base sum insured as a refill for both different and same illness

If the sum insured is exhausted due to hospitalisation expenses of one or more members, there is an automatic restoration of the sum insured for related or unrelated ailments.

Health Check up : Avail health checkup for Diagnostic Tests purposes post completion of 1st policy year

Free annual health check-up for all insured members according to the list of tests specfied in the policy document.

No Claim Bonus : Irrespective of claim history, get 10% more sum insured annually

% of the sum insured that rises every claim free year.

Video/telephone consultation : No

E-consultation with expert doctors empanelled with the insurer for a second opinion.

Domiciliary hospitalization : The policy will reimburse you for the medical treatment taken at home on account of unavailability of a hospital bed or the doctor’s advice

Home care treatment where there are no beds in the hospital or paitient is not in a condition to be moved to the hospital, This treatment is provided under the supervision of a registered medical practitioner.

Ambulance : No

Transportation of the patient to the hospital and back home

Convalescence benefit : No

A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.

Organ Donor : No

The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.

Bariatric cover : No

Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.

Daycare : Health insurance will cover host of day care procedures

Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments

AYUSH : Yes

Alternative treatment coverage such as ayurvedic, unani, sidha and homeopathy which leads to hospitalisation.

Congenital Coverage : No

Covers medical expenses related to diagnosis and treatment of heriditary and internal congenital ailments/ conditions/ traits that exist from birth.

Modern Treatments : No

All advanced treatment with upgrade in technology.

Health Management/ Wellness : Yes

Benefits provided for staying fit and managing health

Maternity Benefit : Up to ₹ 1,00,000/- (Only for family floater plan)

All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.