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Aditya Birla Health Insurance Plan Detailed Review
Aditya Birla Health Insurance
Activ Health Platinum Essential
A family health insurance plan that gives you coverage against chronic ...Read More
Up to 1 Cr
Sum insured
1
No. of plans
4800+
Pan India presence
96%
Claim settlement ratio
🛡️ IRDAI Approved
⭐ 4.4/5 · 2,709 reviews
🏥 12,900+ hospitals
📊 1.88 solvency ratio
✅ 96% claim settlement
About Activ Health Platinum Essential
A quick read on what this Aditya Birla Health Insurance plan covers and why it might be a fit for you.
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.
Plan at a glance
Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.
Entry age
Minimum: 91 days, Maximum: No limit
Plan type
Individual and Family Health Insurance
Sum insured options
₹50 L, ₹70 L, ₹1 L, ₹5 L, ₹10 L
Waiting period
30 days
Renewability
Lifelong
Policy term
1/2/3 Years
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
Pros & cons
A quick honest summary — the strengths and the trade-offs.
Pros
- Health returns cover
- Chronic management program
- Mental illness cover
- Home care treatment
- Obesity treatment
Cons
- Illness due to intoxicants
- Change of gender treatment
- Hazardous activities not covered
- HIV/AIDS not covered
- Cosmetic surgery unavailable
What's covered
Every CMS-driven coverage flag from the plan wording — only items with a published value render below.
Hospitalization
- Room rent Covered
- ICU charges Covered
- Pre-hospitalization Covered
- Post-hospitalization Covered
- Domiciliary hospitalization Covered
- Day-care treatment Covered
- OPD charges Not covered
- Covid-19 treatment Covered
- Cataract Covered
Bonuses & restoration
- No-claim bonus Covered
- Automatic restoration of SI Not covered
- Daily hospital cash Covered
Family & special care
- Maternity cover Covered
- New-born baby cover Covered
- IVF treatment Not covered
- AYUSH treatment Covered
- Organ donor expenses Not covered
Modern & preventive care
- Modern treatment Covered
- Road ambulance Covered
- Air ambulance Not covered
- E-consultation Not covered
- Health check-up Covered
- Second medical opinion Covered
- Vaccination Covered
Conditions & global
- Co-payment Covered
- Sub-limits Not covered
- Compassionate travel Not covered
- Global coverage Not covered
Video reviews
Walkthroughs from the PolicyX team — pros, cons, real claim experiences and who should buy.
Aditya Birla Health Insurance
Benefits of Aditya Birla Activ Health Platinum Essential
Activ Health Platinum Essential offers a multitude of benefits to policyholders:
-
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.
Aditya Birla Health Insurance Network Hospital List
Aditya Birla Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, Aditya Birla Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
Inclusions & exclusions
What the plan pays for, and what it doesn't.
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)
Who can buy this plan
Eligibility criteria pulled straight from the policy wording.
- Entry age: Minimum 91 days
- Maximum: No age limit
Other features & benefits
How to Claim Aditya Birla Activ Health Platinum Essential Health Insurance
Follow these steps to claim your Aditya Birla Activ Health Platinum Essential:
-
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.
-
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).
-
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.
-
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.
Aditya Birla Platinum Essential Plan: FAQs
The 3 most-asked questions about Activ Health Platinum Essential, answered.
The minimum entry age for the plan is 91 days and the maximum entry age has no limits.
Yes, the plan offers coverage from day 1 for illnesses such as Diabetes, High Blood Pressure, Asthma, and High Cholesterol.
It is an initiative provided by the company that motivates insurance holders to stay fit and healthy.
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