Niva Bupa Health Premia Health Insurance

The minimum entry age for this health insurance is 18 years for adult and 90 days for children.

Inclusions of Niva Bupa Health Premia Health Insurance

Following are the inclusions of Niva Bupa Health Premia Health Insurance:

• In-patient Care: The policy covers the medical expenses post hospitalisation for all the insured members.
• Hospital Accommodation: The policy covers room rent up to the base sum insured except for suite and above categories.
• Pre and Post Hospitalisation Expenses: The policy covers medical expenses incurred 90 days before getting admitted to the hospital and 180 days after getting discharged from the hospital.
• Day Care Treatment: The policy covers day care treatment expenses.
• Medical check-ups: The policy covers medical treatments taken at home in absence of hospital bed.
• Emergency ambulance: The policy covers ambulance charges once the in-patient claims are approved in case of emergency.
• Transplants: The policy covers expenses incurred in case of organ transplant.
• Ayurveda Treatments: The policy covers expenses incurred for Ayurveda, Unani, Homeopathy, and Unani treatments.
• OPD treatments: The policy covers expenses incurred on OPD treatments.

Exclusions of Niva Bupa Health Premia Health Insurance

Following are the exclusions of Niva Bupa Arogya Sanjeevani policy:

• The policy does not include expenses incurred on hospital admission for diagnostic reasons.
• The policy does not include weight control treatments that does meet the below mentioned criteria:
  • The patient is above 18 years of age.
  • The surgery is within clinical protocols and is performed on doctor's advice.
  • The Body Mass Index (BMI) of the patient is greater than or equal to 40.
  • In case of severe co-morbidities along with failure of less invasive methods of weight loss, the BMI should be greater than or equal to 35.
  • The surgery is performed under doctor's supervision.
• The policy does not cover Ayush treatment, unproven treatment and cosmetic/ plastic surgery expenses.
• The policy does not include injury caused during war-like occurrence (whether declared or not) or use of nuclear, biological or chemical weapons.
• The policy does not include injury caused during adventurous sports.
• The policy does not cover self-inflicted injuries.

Waiting period for Niva Bupa Health Premia Health Insurance

1. The waiting period for pre-existing diseases is 24 months since the policy inception and continuous policy renewal.
2. The waiting period for pre-existing critical diseases is 48 months along with survival period exclusion of 30 days.
3. The initial waiting period is of 30 days unless it is an accident case.
4. The waiting period for HIV/AIDS is 48 months since inception, subject to continuous renewal.
5. The waiting period for Bariatric surgery, mental disorder treatment, and laser surgery has a waiting period of 36 months.

GST rate of 18% applicable for all financial services effective July 1, 2017.