The Activ Assure Diamond plan is a unique health insurance plan launched by Aditya Birla Health Insurance (ABHI) and was designed with an intent to not only protect you and your family against medical exigencies but also to ensure that you achieve a healthy state of living. It offers a comprehensive coverage ranging from regular medical checkups to hospitalisation care and even offers incentives in the form of cashbacks for staying fit. This cashback incentive benefit is termed as ‘Health Returns’ by ABHI and an individual can earn up to 30% of the premium amount as cashback that will be credited to his/her health account.
Another feature of the Activ Assure Diamond plan that makes it different from other health insurance plans is the benefit of a health coach or wellness coach. The health coach guides and motivates individuals to lead a fit, active lifestyle by providing tips and coaching through an online chat service and a call-back service. In a policy year, 2 coaching sessions can be availed by an individual aged above 18 years. Before we look at the other features offered by the Activ Assure Diamond Plan, let’s understand in detail about how ‘Health Returns’ works and how to earn it.
How can Health Returns be Earned?
To get started, the user has to download the Activ Health app and call ABHI customer care centre to take the health assessment test. The test will reveal your healthy heart score. Based on your score, you will be assigned a category of either red, amber or green. A green score indicates that you are indulged in a physical activity for more than 13 days in a month. If you fall in the green category, you are eligible to earn up to 30% of your premium as cashback. To increase your healthy heart score and improve your health score, you can get active by working out at the gym, doing yoga, swimming, walk a number of steps, etc. The app will record your physical activity like the number of steps you have walked per day when connected to a device. Your gym activity will be tracked when you do a ‘check-in’ at the gym. To track activities like swimming and yoga, a health checkup is done once every 6 months and the results are valid for a period of 6 months.
To earn at least 6% of the premium as cashback, an individual has to be active for just 4 days in a month. The cashback earned will be credited to the health account of the insured person. The amount earned can be utilised for pay policy premiums, buy medicines, pay for diagnostic tests or save it to use for any other health emergency.
Features and Benefits of the Activ Assure Diamond Plan:
Options in the sum insured - This plan offers the flexibility to choose the sum insured amount by providing as many as 16 options. The options range from Rs.2 lakh to Rs.2 crore. There is also the option to choose between the policy terms of 1, 2, and 3 years.
Cashless treatment facility - Policyholders can receive cashless treatment at network hospitals which means that the hospital bills will be directly settled between the insurance provider and the hospital. The network hospitals enlisted with the ABHI has a broad coverage to ensure wide accessibility.
Pre and Post-hospitalisation cover - Apart from the expenses incurred during hospitalisation of the policyholder, the policy also provides cover for expenses incurred 30 days before hospitalisation and 60 days after hospitalisation. Domiciliary treatments are also covered under the Activ Assure Diamond plan amounting to 10% of the sum insured. Intensive Care Unit (ICU) charges of 2% of the sum insured are covered for sum insured amount of Rs.2 lakh, Rs.3 lakh, and Rs.4 lakh, respectively. For sum insured above Rs.5 lakh, the policyholder is entitled to receive 100% of the sum insured.
Day care treatment cover - Under the Activ Assure Diamond plan, 586 day care procedures are covered up to 100% of the sum insured. Day care treatments are those which require less than 24 hours of hospitalisation. Some examples of day care treatments are dialysis, eye surgery, radiotherapy, piles/fistula, prostate, sinusitis, angiography, etc.
Cover for AYUSH treatments - The Activ Assure Diamond plan also covers alternative forms of treatment in Ayurveda, Unani, Siddha, Yoga and Naturopathy, and Homeopathy systems. Depending on the sum insured, an amount ranging from Rs.15,000 to Rs.50,000 is provided for the treatments.
Discounts on premiums - Policyholders can avail discounts on premiums ranging from 7.5% to 10%. For a 2-year policy, a discount of 7.5% can be availed while for a 3-year policy, it is 10%. A 5% discount can be availed for a 2-3 member individual policy while a 10% discount is applicable for more than 4 members multi-individual policy.
Organ donor expenses - If the policyholder undergoes an organ transplant or he/she is the donor, the expenses will be covered under the plan. The covered amount will be equivalent to 100% of the sum insured.
Road ambulance cover - The insurance provider, ABHI will reimburse the amount spent on road ambulance. The reimbursement amount can range from Rs.1,500 to Rs.5,000 per event depending on the sum insured.
Vaccination cover - This benefit is available only for policies where the sum insured is Rs.1 crore and above. The maximum amount covered is Rs.10,000.
Emergency assistance services - If the policyholder faces a medical emergency within or outside India and it requires him to be transferred to another medical facility, the insurance provider will bear the expenses for transportation of the patient. This will include the expenses of air ambulance.
Reload of sum insured - In cases where the policyholder has made a number of claims during a policy year and needs to be hospitalised again for an unrelated illness but the sum insured is insufficient, then he/she will get an additional 150% of the sum insured. The maximum amount that can be availed can go up to Rs.50 lakh.
Waiting period - Except for an accidental injury, there is a waiting period of 1 month before a claim can be made. Illnesses like cataract, hernia, joint replacement surgery, sinusitis, etc. there is a waiting period of 2 years.
No-claim bonus - For every claim-free year, the policyholder is eligible to earn a cumulative bonus of 10% of sum insured and the amount can go up to 50%. Similarly, with every claim the cumulative bonus reduces by 10% of the insured sum.
Daily cash allowance - An amount of Rs.500 will be paid as daily allowance for each day of hospitalisation and is applicable only for a maximum period of 5 days. This benefit is available only for policies with a sum insured up to Rs.4 lakhs.
Room upgrade - This is an optional cover and is only available for policies where the sum insured is above Rs.5 lakh. Under this cover, the policyholder can choose any type of hospital room without any restriction.
Reduction in waiting period - Pre-existing diseases normally have a waiting period of 4 years but this can be reduced to 2 years by opting for an optional cover.
Second opinion - Some critical illnesses like heart attack, kidney failure or cancer may require a second opinion of medical practitioners. Under the Activ Assure Diamond plan, policyholders have the option to avail the second opinion of a team of specialist doctors through an online medium. The opinion is based on the inputs provided by the policyholder.
Free health check-up - Depending on the sum insured and the age of the policyholder, a free health checkup is provided by the insurer every policy year.
Optional boosters - For an enhanced coverage, policyholders can opt for accidental hospitalisation and cancer hospitalisation boosters. These optional boosters will entitle policyholders with an additional sum to meet the expenses incurred due to an accident or cancer.
Eligibility for the Activ Assure Diamond plan:
To enrol under the Activ Assure Diamond plan, the minimum age of entry is 5 years. There is no restriction on the maximum entry age. However, if the entry age is above 61 years, a co-payment of 20% of sum insured needs to be made.
The Activ Assure Diamond plan doesn’t cover expenses for the below:
- Self-inflicted injury, injuries caused due to war or military acts
- Injuries caused due to drug abuse or use of hallucinogenic substances
- Cosmetic, aesthetic, and weight loss treatments
- Psychiatric or mental disorders
- Hearing aids, spectacles, and contact lenses
The Activ Assure Diamond plan has been well thought and created to meet all the health needs of you and your family members by providing a comprehensive financial coverage. It also ensures the wellbeing of your family and rewards you for maintaining an active lifestyle.