Niva Bupa (Formerly known as Max Bupa) Go Active Health Plan

Niva Bupa (Formerly known as Max Bupa) Go Active Health Plan

To lead a happy life it is important to be healthy. Niva Bupa (Formerly known as Max Bupa) GoActive a comprehensive health insurance plan is one such measure to help you maintain your overall health and avail the best possible treatment in India.

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The plan is customizable as per your needs, you can select from varied benefits for you and your family. It is an economical health insurance plan under which you can get insurance for yourself and your family including spouse and up to 4 children.  Let’s check out the plan benefits and features in detail below:

Features Niva Bupa (Formerly known as Max Bupa) Go Active Health Plan

• The plan comes in two variants i.e. Niva Bupa (Formerly known as Max Bupa) Go Active Individual Health Plan and Niva Bupa (Formerly known as Max Bupa) Go Active Individual Family Floater Health Plan
• The sum insured amount ranges from Rs. 4 lakh to 25 lakh
• Easy online purchase for those who do not require any medical screening or underwriting
• Behavioral Assistance Program for you to take counseling or psychotherapist sessions. It includes pre-marital counseling, stress management, parenting, childcare, nutrition, etc.
• If the age of the eldest member is less than 35 years at the time of policy commencement then there is a discount of 10% on the base premium (in the first year)
• Tax saving on the insurance premium
• Cashless facility is available
• 15-days of the free look period
• Direct Claim Settlement
• Lifetime policy renewal
• Various optional benefits available
• Zonal coverage option ( check policy wordings for detail)

Eligibility Criteria to Buy Niva Bupa (Formerly known as Max Bupa) Go Active Health Plan

The entry age criterion for adults is from 18 years to 65 years. Dependent children between the age group of 91 days and 21 years can be insured.

You can buy an individual plan or a family floater policy in the following combinations:

• 2 Adults
• 1 Adult + 1 Child
• 1 Adult + 2 Children
• 2 Adults + 1 Child
• 2 Adults + 2 Children
• 2 Adults + 3 Children
• 2 Adults + 4 Children

Inclusions of Niva Bupa (Formerly known as Max Bupa) Go Active Health Plan

The plan helps you get rid of the financial pressure that may arise due to an illness or injury requiring hospitalization. The costs of medical treatments that are covered by the policy are listed below:

• In-Patient care
• Hospital room charges
• Pre & post hospitalization cost
• Home health care services
• Domiciliary treatment costs
• Daycare treatments
• OPD consultation charges
• Organ transplant cover
• Pharmacy and diagnostic services
• Second medical opinion for planned surgery, specified illness, and surgical procedure
• Emergency ambulance cover
• Cost of health checkups / diagnostic procedures
• Restoration benefit

Optional Covers in Niva Bupa (Formerly known as Max Bupa) Go Active Health Plan

You can further enhance your coverage by opting for these optional features:

• I-protect-The sum insured is increased by 10% of the base sum insured upon every renewal
• Health Coach- The plan also offers customized health coaching services to maintain your health. On the basis of your health, there is an additional 20% discount on the base premium at the time of renewal
• Personal Accident Cover: It offers protection against accidental death, permanent total, and partial disabilities
• Top-up with Annual Aggregate Deductible options : Rs.25,000/50,000/1 lakh/2 lakh/ 3 lakh/5 lakh/ 10 lakh

Niva Bupa (Formerly known as Max Bupa) Go Active Health Plan Waiting Periods

• There is a waiting period of 36 months for pre-existing diseases.
• There is a waiting period of 30 days from the policy commencement date except for accidental injuries.
• Some specific diseases shall be covered after a waiting period of 24 months unless the condition is resulting due to cancer (to be covered after 30-days of waiting period) and accidental cases to be covered from the day 1.
• Waiting Periods is not applicable on out-patient consultations, annual health checkups and diagnostic tests, second medical opinion, counseling sessions, and other optional benefits.

Exclusions of Niva Bupa (Formerly known as Max Bupa) Go Active Health Plan

• Ancillary hospital charges
• Conflict & disaster
• Artificial life maintenance
• Hazardous activities
• Behavioral issues
• Neurodegenerative and Neurodevelopmental Disorders
• Dental/oral care
• Treatment received outside India
• Circumcision is not covered
• AYUSH treatments, apart from in-patient treatment under Ayurveda, Sidha, Unani, and homeopathy
• Convalescence & rehabilitation
• External congenital anomaly
• Cosmetic and reconstructive surgery
• HIV, AIDS, and related health conditions
• Treatment required for sleep-related disorders
• Off- label drug or treatment
• Eyesight & optical services
• Experimental treatments
• Inconsistent, or irrelevant diagnostic procedures
• Mental and psychiatric conditions
• Non-medical expenses are not covered under this plan
• Obesity/weight control programs
• Unrecognized hospital or physician
• Menopause and puberty related disorders
• Maternity expenses/reproductive medicine
• Robotic-assisted surgery
• LASER treatments
• Sexually transmitted diseases
• Unlawful activity

For other detailed exclusions please refer to the policy wordings.

Niva Bupa (Formerly known as Max Bupa) Go Active Health Plan Claim Process

To file a claim you need to follow the process as enumerated below:

• Select and approach corporate/insurance/TPA helpdesk of the network hospital (it is suggested to inform the insurer at least 72 hours before hospitalization)
• Carry your identity proofs with you such as Voter card, passport, driving license or PAN card
• You also need to furnish your Niva Bupa (Formerly known as Max Bupa) health card or policy number
• Once the network hospital cross-verified your documents, they will submit a pre-authorization form to the insurer
• The insurer will give approval or rejection to the hospital within 4 hours if all the required documents are submitted in time
• Max BUPA may also assign a relationship manager to ease the hospitalization process
• You can start with the treatment, sign all the forms, documents, and invoices upon discharge
• For pre-approved treatments, the insurer will settle the bill with the hospital as per the policy terms and conditions