Niva Bupa Health Premia Plan (Formerly Known As Max Bupa Health Premia Plan)

Max Bupa Health Premia Plan is a comprehensive health insurance plan that provides maternity and newborn coverage to emergency medical treatments across India. The coverage involves advanced-age treatments and cashless facilities in 4800+ network hospitals.

Key Features of Max Bupa Health Premia Plan

The Insurance Company provides numerous benefits and coverage options. But the major question that pops in the head of the insured is about the Key Features of the policy that they hold. Let’s discuss the key features of Max Bupa Health Premia for a better understanding of the policy.

1. Offers High Coverage Options

   Every Individual’s requirements vary as per their lifestyle, health conditions, etc. With this plan, policyholders can insure a sum of up to Rs. 3 Crores. The higher coverage options give you the flexibility to choose coverage as per your requirements.

2. In-Patient Care

   Sometimes, medical treatment can drain all your hard-earned savings and may leave you in debt. Max Bupa Health Premia Plan covers medical expenses incurred in hospitalization such as room rent availability, consultations with a doctor, medicine expenses, daycare procedures/treatments, in-patient treatments, AYUSH treatments such as Ayurveda, Unani, Siddha, and Homeopathy.

3. Day Care Procedures/ Treatments

   Some of the treatments require hospitalization but some do not require you to stay at the hospital such as angiography, dialysis, endoscopy, and others. Max Bupa Health Premia is a comprehensive plan that provides coverage for these types of treatments.

4. Pre and Post Hospitalization

   Pre and post hospitalization expenses are covered up to the sum insured, for 90 days prior and 180 days post hospitalization respectively.

5. Maternity Cover Benefit

   This plan offers you a maternity cover benefit across the world post serving a waiting period. Additionally, your baby also gets covered with a newborn baby benefit from the very first day that involves the vaccinations.

Note: Maternity Cover Benefit is not available under Max Bupa Individual Health Premia Plan

After studying the key features of the Max Bupa Health Premia Plan, we have summarized the highlights of this plan in a table. Let’s explore them out for a better and smooth understanding.

Eligibility Criteria of Max Bupa Health Individual Premia Plan

Benefits of Max Bupa Health Insurance

1 Plan Variants

The Max Bupa Premia Plan by Max Bupa offers three plan variants based on the sum insured options, from Rs. 5 Lakhs to Rs. 3 Crore. The three variants are: Silver, Gold, and Platinum

2 Zonal Coverage

In India, the expenses incurred on healthcare can vary greatly across different cities. If you are a frequent traveler or are just looking for flexible treatment options anywhere in India, you should go for the Zone 1 Pricing option under this plan through which you can avail of a lower premium facility. If your work takes you across metro cities, the Zone 2 Pricing could be the better option for you as it covers treatment costs in Mumbai, Delhi-NCR, Thane, Kolkata, and Gujarat. There are other pricing options available as well. Please go through the policy documents and Max Bupa Health Premia brochures for more information.

3 Re-fill Benefit

This benefit can be availed if your Base Sum Insured and increased Sum Insured gets partially or completely exhausted during the Policy Year. In this case, the insurer will provide re-fill amount of up to 100% of the Base Sum Insured. This benefit can only be evoked once in a Policy Year.

4 Free Look Period

You have the option of discontinuing the insurance if you feel it is not the right policy for you and it does not suit your requirements. As per IRDAI, you can change your decision of availing this policy by discontinuing the services within 15 days.

5 Premium Waiver

Life is uncertain!! During the policy tenure, if an insured passes away or is diagnosed with a specified illness, then the premium will be waived off for the next year.

Note: Premium Waiver Benefit is not available under Max Bupa Individual Health Premia Plan

6 Policy Term

The policyholder can choose a policy of longer-term of up to 3 years.

7 Tax Benefits

This plan offers income tax benefits as per Section 80D of the Income Tax Act, 1961.

Additional Benefits

1. Critical Illness Cover

   Max Bupa Health Premia Plan provides enhanced protection coverage against 20 critical illnesses such as Heart surgery, Cancer, Kidney failure, Heart strokes, etc. Additional coverage is provided as a lump sum amount upon the first diagnosis of any of the illnesses.

2. Daily Hospital Cash Benefits

   This plan provides a lump sum amount daily in case of hospitalization and covers miscellaneous expenses incurred during hospitalization.

3. Personal Cover for accidents

   Using this optional cover, a lump sum amount is paid in case of permanent and partial disability or accidental death. Anyone from the family can opt for this cover who is aged 18 years or above.

4. Health Guide

   Max Bupa Health Coach App helps track your health parameters such as calorie intake, BMI, on a daily basis.

5. Waiting Periods

   Medical conditions such as cataracts, a spinal disorder, etc. will be subjected to 12 months of the waiting period.

Comparison between Max Bupa Health Premia: Silver, Gold, and Platinum

Sample Rates of Premium

1. Max Bupa Health Premia Silver Plan

   Here, the table illustrates the Premiums Payable by individuals and families for the Sum Insured Rs. 5 Lakhs assuming the age to be: Self - 30 years, Spouse: 28 years, Children: 10 and 5 years.

   Age	Premiums for Individuals	Premiums for Family Plan
   30	12274	29509
   40	16953	33447
   50	27750	49532

   Go through the graph for a quick and better understanding of the premiums of the Max Bupa Premia Silver Plan.

   Premiums payable by individual and family at different ages under Max Bupa Health Premia Plan

   

2. Max Bupa Health Premia Gold Plan

   Here, the table illustrates the Premiums Payable by individuals and families for the Sum Insured Rs. 10 Lakhs assuming the age to be: Self - 30 years, Spouse: 28 years, Children: 10 and 5 years.

   Age	Premiums for Individuals	Premiums for Family Plan
   30	16436	40336
   40	22081	45143
   50	35708	64935

   Premium payable by individual and family at different ages under Max Bupa Health Premia Gold Plan

   

3. Max Bupa Health Premia Platinum Plan

   Here, the table illustrates the Premiums Payable by individuals and families for the Sum Insured Rs. 1 Crore assuming the age to be: Self - 30 years, Spouse: 28 years, Children: 10 and 5 years.

   Age	Premiums for Individuals	Premiums for Family Plan
   30	52391	119697
   40	63627	129847
   50	93994	174752

   Premium payable by individual and family at different ages under Max Bupa Health Premia Platinum Plan

   

We have compared the three variants based on premium rates at different ages. Every variant offers different sum insured options. Platinum plan offers coverage up to Rs. 3 Crore. The selection of the plan depends on your needs and the sum insured option you are looking for your financially stable and happy life.

Exclusions of Max Bupa Health Premia Plan

As per the policy, benefits will not be available until 24 months (continuous coverage) from the first date when the policy starts.It does not cover the treatments which are done during the first 30 days of the plan Hazardous activitiesSexually Transmitted Infections and DiseasesUnlawful activitySleep disordersTherapies related to Hormone Replacement CircumcisionExternal Congenital AnomalyInjuries due to warSelf-inflicted injuries

How to Buy Max Bupa Health Premia Plan?

Following are the steps required to buy the Max Bupa Health Premia plan:

Max Bupa Company's Website

• Visit the official website of Max Bupa and fill the application form.
• It is important to disclose all information to the insurer to ensure smooth claim processing.
• Check pre-policy medical check-up (if they are applicable at network hospitals).
• After evaluating your case, the insurance company will send you the offer.
• Read the offer letter carefully and check all the details about the policy features, benefits, and exclusions.

PolicyX.com

• On the top right corner of this page, search for the 'Calculate Max Bupa Health Insurance Premium' form.
• Fill in the necessary details to get the list of quotes.
• Choose the desired Max Bupa health plan and pay the premium.
• After the payment, the policy will be shared on your registered email address.

How Can I Renew My Max Bupa Health Insurance?

Let's discuss the Max Bupa health insurance renewal process. Follow the below steps to renew your policy easily:

• Visit the company's website and click on the 'Renew' option.
• Enter your 14 digit policy number and click 'Submit'.
• You will get the renewal premium amount.
• Click on the 'Pay now' option to make the payment.
• On successful payment, you will receive a policy transaction number. A new policy kit will be emailed to you within 48 hours.

Claim Process at Max Bupa

Cashless Claims

• Get admitted to any one of the network hospitals associated with Max Bupa. You can check the list of network hospitals on the company's website.
• Use your Max Bupa Health Card and show them your identification proof.
• After validating your identity, the network hospital will submit the pre-authorization request form to the company.
• The company will review your request and provide the confirmation to the network hospital by fax or email and share the same with you via text or email.
• The company will settle the claim with the hospital after the completion of all formalities.

For Reimbursement Claims

• If admitted to a non-network hospital, notify Max Bupa within 48 hours of hospitalization. In emergency cases, inform them within 24 hours of hospitalization.
• You need to pay the treatment expenses to the hospital. During discharge, collect all the necessary documents, invoices, medical reports, and discharge certificates from the hospital.
• Send the completed claim form (available on Max Bupa's website) along with the required documents to Max Bupa.
• Max Bupa Health Insurance will review the documents and settle the claim (if approved) by reimbursing you for the amount.

Documents Required For The Claim Process

• Valid ID proof.
• The claim application form that is duly signed along with KYC documents
• Summary of final hospital discharge documents
• Consultation notes and/or reports of investigation outside the hospital.
• All medical records since the start of the complaint.
• Copy of Medico Legal Certificate. The certificate is duly attested by the concerned hospital.
• FIR i.e., First Information Report.
• Original reports of diagnostic tests, radiology reports, and payment receipts.
• Original hospital bills and discharge certificate signed by the medical practitioner.
• Others requested by the company