Niva Bupa Health Premia Insurance Plan UIN MAXHLIP21176V022021
Niva Bupa’s Health Premia is an all-in-one health insurance plan that is crafted to meet all your healthcare expenses for yourself and your loved ones. Niva Bupa offers one of the best health insurance policies in India. It has 3 variants that fit the changing lifestyle and the expenses arising out of it. Niva Bupa Health Premia policy provides multiple health insurance benefits that certainly fulfills your requirements.
Plan name | Niva Bupa Health Premia Health Insurance Plan |
Policy type | Health insurance Plan |
UIN | MAXHLIP21176V022021 |
Key Features
The plan covers all the expenses done by the insured person for 60 days of pre-hospitalization. Not just pre but also the expenses incurred post 90 days of discharge from hospitalization is taken care through this plan.
The Health Premia plan provides insured with maternity benefits for up to two deliveries. This benefit is available if both you and your spouse have been covered under the health premia policy for two continuous years.
In case the insured person is diagnosed with a critical illness or specified illness, then the premium is waived for a period of one year.
- In case if the insured has exhausted the base sum insured and loyalty additions offered under the health premia plan partially or completely, then the insured person is entitled to receive an additional sum insured equal to the base sum insured for an upcoming claim in the same year. The refill benefit can be availed for treatment of both, same and different illnesses as well.
For example,
Mr. Jay has purchased a NIva Bupa Health Premia plan with a base sum insured of Rs. 5 lakhs and has been renewing the policy over a period of 3 years. With that said, he has received loyalty cumulative addition as well. Suppose, due to an unfortunate incident, Mr. Jay gets admitted and the total bill amount comes around say Rs. 10 lakhs. In this scenario, if the base sum insured and the loyalty addition accumulated gets exhausted, then My. Jay will be entitled to receive an additional sum insured of Rs. 5 lakhs which is equal to the base sum insured. This benefit can be availed for subsequent claims in the same year.
Niva Bupa Health Premia is a comprehensive health insurance plan that is enhanced to cover up to 20 critical illnesses such as heart surgery, cancer, kidney failure and more. The coverage is given as a lump sum payout on diagnosis of the illness.
The insured person under the Health Premia plan gets cashless facility at all the network hospitals of Niva Bupa. They can avail this facility by just presenting the health card at the time of admission at the hospital. To avail the cashless facility, the insured should be hospitalized for at least 24 hours.
One can avail a health check up for various diagnostic tests right from the day the policy is purchased. You can utilize the health check up facility on a cashless basis at any Niva Bupa Network Hospitals.
Treatments like Robotic surgery, laser surgery, weight loss surgery are also covered under Niva Bupa Health Premia plan.
Under this plan, the insured person can avail this additional cover. Personal accidental cover secures you and your family’s financial loss occurring due to accidents.
The expenses related to daycare treatments or even OPD treatments, diagnostic tests are all covered under the Niva Bupa Health Premia Plan.
Benefits
Irrespective of your past claims, under the Niva Bupa Health Premia plan, you get a 10% p.a. increase on the expiring base sum insured, maximum up to 100% of base sum insured. This benefit is accumulated over the years when the insured person renews the policy without any breaks
.
Say for example,
Mr.Rao, purchases the Niva Bupa Health Premia Plan of sum insured of Rs.5 lakhs and opts for Loyalty addition feature. He has been renewing the policy without any breaks.
If he doesn't claim throughout the year, in that case he will be eligible for Loyalty addition of 10% on Rs. 5 lakhs over and above the No Claim Bonus.
However, during the policy term, he is hospitalized and claims for Rs. 3 lakhs. Irrespective of his claims, he will get a 10% increase on expiring base sum insured i.e. Rs. 2 lakhs.
Whatever claims you might have made in the past years, with this additional feature, the sum insured increases by 20% p.a. Maximum up to 200% of the expiring base sum insured of the policy. This benefit is accumulated over the years when the insured person renews the policy without any breaks.
Now the insured person can get emergency assistance even during his travel within India. If the insured is within 150 km distance from his residence and has been on trip for less than 90 days and requires medical assistance, evaluation, and diagnosis then, they can avail the service provided through this plan.
Due to various circumstances such as unavailability of beds at the hospitals or due to not so severity of the medical condition, doctors might advise the insured person to take home medical treatment. In such situations, the expenses done by the insured in the treatment are reimbursed as per the Health Premia Insurance policy.
One of additional features that you can avail in Niva Bupa Health Premia Health Plan is the virtual guide to track your health, and stay fit and illness free
AYUSH stands for Ayurveda, Unani, Siddhi, and Homeopathy treatments, which are covered under this plan. Expenses related to any of such treatments are covered even if you are going through an in-patient treatment.
Variants
Let us understand the differentiating points between this three variants under the Niva Bupa Health Premia policy:
Parameters | Silver | Gold | Platinum |
Sum insured | 5 to 7.5 lakhs | 10 to 50 lakhs | 1 to 3 Cr. |
Health Check up | Upto Rs.1,875 per person | Upto Rs. 7,500 per person | Upto Rs. 10,000 per person |
Maternity Benefits | Upto Rs. 60,000 | Upto Rs. 1 lakh | Upto Rs. 2 lakhs across the world |
Hospital cash | Rs. 3,000 / day | Rs. 5,000 / day | Rs. 7,500 / day |
Loyalty Bonus | Offers 10% increase on the expiring Sum insured amount yearly | NA | NA |
Enhanced Loyalty Addition | Offers 20% increase on the expiring Sum insured amount yearly | NA | NA |
Eligibility
- Niva Bupa Health Premia Policy can be issued to an individual person, a family (family floater) and/or extended family as well.
- The entry age for adults under the health premia policy has to be from 18 to 65 years. The entry age for dependent children is from 91 days to 30 years in a family floater plan of the policy.
- In a family floater policy, persons insured are husband, wife and a maximum of 4 children.
- If you opt for a Family First Plan, it offers coverage for up to 19 relationships with an individual sum insured for everyone in the family, and a combined sum insured that can be availed by any family member.
Exclusions
- Pre-existing conditions: Under the Niva Bupa Health Premia plan, pre-existing conditions will not be covered as per your policy plan until 24 months of continuous coverage from the commencement of the policy.
- 30 days initial waiting period: If an insured person applies for a claim under 30 days of purchasing the policy, the claim shall not be considered, unless the treatment needed is due to an accident. However, this waiting period is not applicable on renewal of the policy.
- Specific Waiting Periods:
- Under the Niva Bupa Health Premia, there are a few conditions like cataract,hernia,internal congenital anomaly,spinal disorder,etc. that are subject to a minimum waiting period of 12 months.
- Certain illnesses will have a waiting period of 36 months since purchase of the policy and also subject to continuous renewal. Such illnesses include weight loss surgery, Mental disorder treatment, and Laser surgery cover.
- For illnesses such as HIV/AIDS, the insured person will get a cover but with a waiting period of 48 months after the purchase of policy.
FAQs
You can visit MyInsuranceClub.com and our trained and certified insurance experts will guide you through the purchase of the Niva Bupa Health Premia Insurance plan. You can compare health insurance plans for your family.
A medical checkup might be necessary when you purchase a new health insurance policy, depending on the age criteria and the base sum insured you choose. However, if the policy gets rejected by the actuaries, then the medical test cost shall be deducted and the balance amount of the first premium paid will be transferred back to the individual.
Pre-existing illnesses are covered after 24 months of a continuous renewal of the Health Premia plan.
One needs to present the following documents at the time of submitting the claim:
#Proof of Identity: Aadhar card, PAN, Voter ID, Driving License, Passport.
#Proof of Address: Aadhaar, Passport, Driving License, Voter ID, electricity bill, telephone bill, water bill, gas bill, Ration Card, bank statement, copy of insurance policy are all acceptable documents.
#Proof of Age: Aadhaar, School Leaving Certificate, Passport, Driving License.
The Health premia policy offers you additional coverage say 10% or 20% of base sum insured, as per the terms and conditions of the policy, on successfully renewing every year.
Yes, you will be entitled to get a tax benefit for the premiums paid under Section 80D of the Income Tax Act. You can avail a tax deduction of Rs. 15,000 every year from the taxable income on health insurance premium for your spouse, dependent children or even self. The senior citizens having a Health Premia policy can avail a tax deduction of Rs. 20,000.
Yes, expenses related to maternity and newborn babies coverage are available under the Niva Bupa Health Premia plan. One can utilize the coverage depending upon the type of variant they choose and on completion of the waiting period.