Activ Health Platinum Essential

Overview

Aditya Birla Activ Health Platinum Essential Plan is ideal if you are looking for a health insurance cover that protects you against chronic illnesses, provides hospitalization benefits, and a high sum insured. This health plan goes beyond hospitalization coverage. Activ Health Platinum Essential offers coverage against:

• 4 chronic conditions: Asthma, High Blood Pressure, High Cholesterol, and Diabetes (Type 1 and Type 2) from day 1.
• Automatic upgrade to the Chronic Management Program if you develop a chronic condition after buying the policy.
• Doctor consultations and diagnostic tests up to a defined limit in the policy schedule.
• Hospitalization expenses, including COVID-19 and daycare procedures.

The plan is available as an individual and family health insurance plan and provides multiple health benefits such as a wellness coach, annual health check-ups, and more.

Benefits of Aditya Birla Activ Health Platinum Essential

Cover Provided From Day One

Policyholders can avail of instant coverage without any waiting period under a chronic management program for conditions such as high blood pressure, diabetes (Type 1 and Type 2), high cholesterol, and asthma. This feature enables individuals to secure their health without having to wait to avail of services.

Earn Health Return Points

Policyholders can earn health return points by staying active, allowing them to earn up to 50% premium. This feature motivates policyholders to be active and take essential steps to improve their overall health consistently.

Expert Wellness Coaches

Under the plan, individuals may consult an expert wellness coach who will provide guidance toward a better quality of life through fitness tips, healthy diet plans, and more.

Cover for Mental Illness

The plan covers medical expenses incurred up to the specified limit mentioned in the policy schedule during hospitalization due to any mental illness. However, the plan does not cover any condition that is not clinically significant or is related to anxiety, bereavement, relationship or academic problems, acculturation difficulties, or work pressure.

Tax Benefits

Aditya Birla Activ Health Platinum Essential is eligible for tax benefits under Section 80D as per the Income Tax Act, 1961.

Inclusions

• In-patient hospitalization
• Out-patient hospitalization
• Daycare procedures
• Domiciliary or home care treatment
• Room rent
• ICU charges
• OT charges
• Doctor’s visit
• Annual/preventive health check-up

Exclusions

• Cosmetic/beautification treatment
• HIV/AIDS and STD conditions
• Attempted suicide or self-harm
• Diagnostic tests (except those specified in your policy document)
• War injuries, participation in riots/war-like situations, etc.
• Hearing aids (unless specified in your policy documents)
• Vision treatment, dental care, physiotherapy, etc. (except conditions mentioned in the policy)

How to Claim Aditya Birla Activ Health Platinum Essential Health Insurance

Follow these steps to claim your Aditya Birla Activ Health Platinum Essential:

1. Step 1: Claim Intimation

   Inform your TPA or Aditya Birla Health Insurance for planned hospitalization. For emergency hospitalization, you must inform the insurer within 24 hours of admission.

2. Step 2: Document Submission

   Submit the carefully filled and signed claim form along with policy documents and other details such as medical reports, doctor’s prescriptions, hospital bills, and discharge summary (for reimbursement claims).

3. Step 3: Approval Upon Verification

   If all submitted details are correct and align with the policy coverage, the insurer will initiate the claim settlement procedure to verify the authenticity of your claim.

4. Step 4: Cashless or Reimbursement Settlement

   If treatment is received at a network hospital, the insurer will settle medical bills directly with the hospital. For treatment at a non-network hospital, your insurer will reimburse your medical bills as per the policy terms.

In a Nutshell

Aditya Birla Activ Health Platinum Essential Plan provides protection to its customers from day 1 against personal accidents and chronic illnesses. It is an individual and family floater plan with affordable premiums and a plethora of features. It is an apt choice for those suffering from diabetes, hypertension, and other chronic diseases.