Max Bupa Health Insurance

Why Buy Max Bupa Health Insurance Policy?

Here are some reasons why customers prefer Max Bupa Health Insurance for their health insurance needs:

• Cashless hospitalisation: Max Bupa Health Insurance offers cashless hospitalisation at 3,500+ network hospitals across India within 30 minutes of receiving the request from the hospital.
• Comprehensive insurance cover: Max Bupa offers health insurance policies with a sum insured of up to Rs.1 crore. The insurance coverage has low waiting periods.
• International coverage: Max Bupa Heartbeat Platinum plan is a unique product that offers international cashless treatment for 9 major critical illnesses like organ transplant and cancer through its global network in over 190 countries. Outpatient Department cover is available under this plan.
• Maternity benefits: Health insurance plans offered by Max Bupa covers maternity related expenses after a 1-year waiting period. A baby born when a maternity claim is payable is automatically covered till the next policy renewal.
• Health plans for entire family: Max Bupa offers health insurance plans for the entire family from newborn babies to senior citizens under a single policy.
• Lifelong renewability: All health insurance plans offered by Max Bupa comes with a lifelong renewability option, provided continuous payment of insurance premium.

Benefits of Max Bupa Health Insurance:

• Daily cash benefit: For miscellaneous expenses, you can get a daily cash benefit of up to Rs.4,000 per day during the hospitalisation period up to 45 days.
• Direct claim settlement: There is no involvement of a TPA. Therefore, the claim settlement is direct and quick.
• World-wide coverage: Insured members can get cashless treatment at a network hospital of Max Bupa Health Insurance anywhere in the world.
• Renewability for life: All health insurance policies offered by Max Bupa have lifelong renewability option.
• Discount: Get a discount upon purchasing a 2-year policy. Discount on premium applicable on select policies offered by Max Bupa Health Insurance and that too only in the second year of the policy term.
• Critical illness plan: A lump sum amount will be paid to the insured in the case of diagnosis of a specified critical illness under the policy, provided he or she survives for 30 days post diagnosis.
• Personal accident plan: With this rider attached to your base policy, you can get sum insured payout benefit in the case of an accident death, permanent total disability or partial disability.
• Tax benefit: Get tax deduction on premium paid towards a health insurance policy under Section 80D of the Income Tax Act, 1961.

Types of Health Insurance Policies Provided by Max Bupa Health Insurance:

The different health insurance plans offered by Max Bupa Health Insurance are listed below: 

1. Max Bupa Health Companion Policy 
2. GoActive 
3. Health Premia 
4. Corona Kavach 
5. Reassure 
6. Money Saver 
7. Health Pulse 
8. Accident Care 
9. Criticare 
10. Heartbeat 
11. Super Saver 

Max Bupa Heartbeat Health Insurance Plan: 

Max Bupa Heartbeat Health Insurance Plan is all about simplifying the complexities associated with health insurance. The aptly named Heartbeat is an easy plan to understand, to buy, and provides comprehensive health coverage for you and your family, to the tune of Rs.1 Crore. 

Plan	Cover	Health Check-Up
Gold	Up to Rs.50 lakh	Up to Rs.2,500
Platinum	Up to Rs.1 crore	Up to Rs.5,000

Features 

The main features of the Heartbeat Health Insurance Policy are mentioned below: 

• Since no third-party agents are involved, claims are settled directly. 
• International coverage is provided. 
• Lifetime renewability. 
• Second medical opinion for any of the listed illnesses is provided under the Platinum plan. 
• Loyalty benefit is provided. 
• Refill benefits are provided. 

Max Bupa Health Companion Policy: 

Max Bupa’s Health Companion plan is designed for various eventualities, keeping you and your family protected with a robust health insurance, while also safeguarding your savings against the onslaught of unexpected medical expenses. 

Plans	Cover	Health Check-Up
Variant 1	Up to Rs.4 lakh	Once in 2 years
Variant 2	Up to Rs.12.5 lakh	Every year
Variant 3	Up to Rs.4 crore	Every Year

Features 

The main features of the Health Companion Policy are mentioned below: 

• Pre- and post-hospitalisation is provided 
• Health check-up 
• Tax benefits are provided under Section 80D of the Income Tax Act 
• Cashless facility is provided 
• Direct claim settlement 
• Refill benefits are provided 

GoActive 

The GoActive Family Health Insurance Plan is a digital plan that offers cashless diagnostic and OPD services.  

Plans	Cover	Health Check-Up
Individual	Up to Rs.25 lakh	Every year
Family	Up to Rs.25 lakh	Every year

Features 

The main features of the plan are mentioned below: 

• Refill benefits are provided 
• Claims are settled directly 
• You have the option to take a personal health coach 
• In case you are less than 35 years old, a discount will be provided on the premium that is paid in the first year 

Health Premia 

The Health Premia plan is a comprehensive health insurance policy that provides cover for your family. 

Plans	Cover	Health Check-Up
Silver	Up to Rs.7.5 lakh	Up to Rs.1,875 for each person
Gold	Up to Rs.50 lakh	Up to Rs.7,500 for each person
Platinum	Up to Rs.3 crore	Up to Rs.10,000 for each person

Features 

The main features of the Health Premia plan are mentioned below: 

• Refill benefits are provided 
• Maternity benefits are provided for up to two deliveries 
• Heath check-up benefits can be availed 
• Emergency assistance services 
• New age treatment 

Corona Kavach 

A health insurance policy that provides COVID-19 cover for you and your family members is the Corona Kavach policy. 

Plans	Cover	Home Care Treatment
Individual	Up to Rs.5 lakh	Sum insured
Family	Up to Rs.5 lakh	Sum insured

Features 

The main features of the Corona Kavach policy are mentioned below: 

• The policy period is flexible 
• AYUSH treatment will be provided 
• Home care treatment 
• Pre- and post-hospitalisation expenses are covered 

Reassure 

Reassure is a family combination policy that provides cover for up to six members. Modern treatments are covered under the policy. 

Plans	Cover	Health Check-Up
Individual	Up to Rs.1 crore	Every year
Family	Up to Rs.1 crore	Every year

Features 

The main features of the Reassure policy are mentioned below: 

• Emergency ambulance services are provided 
• Hospital accommodation is provided 
• All-day care treatment is covered 
• Pre- and post-hospitalisation expenses are covered 
• Tax benefits are provided 
• Lifetime renewability 
• Booster benefit is provided 

Money Saver 

Under the family health insurance plan, comprehensive coverage worth Rs.30 lakh is provided.  

Plans	Cover	Health Check-Up
Individual	Up to Rs.1 crore	Every year
Family	Up to Rs.1 crore	Every year

Features 

The main features of the Money Saver plan are mentioned below: 

• Free look period of 15 days from the date the policy is purchased 
• Life renewability 
• Tax benefits are provided 
• Claim settlements are direct 
• Cashless facility 

Health Pulse 

The Health Pulse policy is a pocket-friendly health insurance plan that provides cover for your entire family. 

Plans	Cover	Health Check-Up
Individual	Up to Rs.10 lakh	From the second year
Family	Up to Rs.10 lakh	From the second year

Features 

The main features of the Health Pulse policy are mentioned below: 

• The claims are settled directly 
• Tax benefits are provided 
• Cashless facility is provided 
• Lifetime renewability 
• Free look period of 15 days is provided from the date the policy is purchased 
• AYUSH treatment is provided 

AccidentCare 

A personal accident insurance policy that provides cover for your family in the case of an accident is the AccidentCare policy. 

Plans	Cover
Individual	Up to Rs.2 crore
Family	Up to Rs.2 crore

Features 

The main features of the AccidentCare policy are mentioned below: 

• Accidental death 
• Children education benefits 
• Permanent total disability 
• Permanent partial disability 

CritiCare 

Under the CritiCare policy, protection is provided from 20 major critical illnesses. 

Plans	Cover
Individual	Up to Rs.2 crore
Family	Up to Rs.2 crore

Features 

The main features of the CritiCare policy are mentioned below: 

• Free look period of 15 days is provided from the day the policy is purchased 
• Tax benefits are provided 
• Claims are settled directly 
• In case you take the policy for 2 or 3 years, discounts may be provided in the second and third terms 
• Assured renewal 

Super Saver 

A combo policy that offers advanced health cover at an affordable price is the Super Saver health insurance policy. 

Plans	Cover	Health Check-Up
Individual	Up to Rs.1 crore	Annually from the second year
Family	Up to Rs.1 crore	Annually from the second year

Features 

The main features of the policy are mentioned below: 

• Tax benefits are provided 
• Modern treatments 
• Lifetime renewability 
• Alternate treatments 

Max Bupa Health Insurance Renewal:

All health insurance policies offered by Max Bupa Health Insurance have to be renewed every policy year for continued policy benefits. A 30-day grace period will be given post premium payment due date to make renewal payment. However, policy benefits will not be available during the grace period. If the policyholder fails to renew the policy within the grace period, the policy will lapse. Policy renewal can be done online through the insurer’s website. Enter your policy number on the website to know the renewal premium amount and pay using net banking, credit card or debit card.

Max Bupa Health Insurance Premium Calculator:

With Max Bupa Health Insurance premium calculator, you can assess your insurance needs and choose a suitable health insurance policy for you and your family. The online premium calculator is simple and easy to use. It is available on the insurer's website. All you have to do is choose a specific plan, enter the chosen sum insured, your personal details such as name, date of birth, city, phone number, and email ID. If you choose co-pay, list how much percentage you are willing to pay. Click on Calculate Premium and get the premium details instantly.

Max Bupa Health Insurance Customer Care:

For any policy-related queries or assistance with purchasing a policy from Max Bupa Health Insurance, call toll-free number 1800 3010 3333 or 011 66326666. You can also email customercare@maxbupa.com or send a letter to Max Bupa Health Insurance Company Limited, B-1/I-2, Mohan Cooperative Industrial Estate, Mathura Road, New Delhi - 110044.

• Branch Office: Visit the official website of Max Bupa Health Insurance and click on ‘Contact Us’ tab on the top right-hand corner of the page. A list of contact details of the branch offices of Max Bupa will be displayed on the screen.
• Network hospital: Locate a network hospital in your area by selecting a state and city from the dropdown box. You can also view the map for directions to the nearest network hospital.
• Customer Support: Under the Customer Support option, you can find the following services:
  • Track your claim status
  • Information on claim process
  • Download claim forms
  • Grievance redressal
  • Change your contact details
  • Policy documents
• Tax receipt: You can access your tax receipt by entering your policy number, date of birth, and email ID.
• Portability: You can find information on how to port your health insurance policy from one insurer to another without losing your accrued policy benefits such as waiting period and No-Claim Bonus.

Max Bupa Cashless Network Hospitals:

Max Bupa Health Insurance offers cashless facility at more than 3,500 network hospitals across India. If you have opted for cashless hospitalisation, then locate a network hospital near you using the online network hospital locator tool. Just enter your place of residence such as city and state. The tool will give you a list of network hospitals in your area with its contact details. Max Bupa approves cashless hospitalisation request within 30 minutes of receiving the form from the hospital.

How to file a claim with Max Bupa Health Insurance?

There are 2 types of claims you can file with Max Bupa:

• Cashless Claim: Visit a network hospital and show your health card with policy number and a valid photo identity at the hospital desk. The network hospital will verify your identity and submit a pre-authorisation request to the insurer or TPA. The insurance company or its Third-Party Administrator will process the request and send approval to the hospital. In the case of a rejection, the insured member can get treated at the same hospital but has to pay the medical bills out of his or her pocket, and later make a reimbursement claim for the expenses incurred. In the case of approval, the insurance company will settle the bill directly with the hospital.
• Reimbursement Claim: In the case of planned hospitalisation, intimate the insurer 48 hours prior to admission. Pay the medical bills upfront, out of your pocket. At the time of discharge, collect all the original medical documents and submit it to the insurer along with a duly-filled and signed claim form which is available on the insurance company's website. The claim will be processed and approved as per the terms and conditions of the policy.

Incurred Claims Ratio of Max Bupa Health Insurance for the Year 2017-18

Net Earned Premium (in Crore)	Net Claims Paid (in Crore)	Incurred Claims Ratio (in %)
Rs.575.85 crore	Rs.289.02 crore	50.19%

Max Bupa Health Insurance FAQs:

1. Why is it important to buy health insurance policy?

   A health insurance policy helps you to save money by paying off all your medical expenses. With the rising medical expenses, it is a wise move to insure you and your family’s health by buying health insurance policies. You can get cashless hospitalization for more than 24 hours with the help of these policies.

2. What is a health card?

   A health card is a part of your health insurance policy. This card enables you to enjoy the benefits of your health insurance policy.

3. How do I get cashless hospitalization?

   You can get cashless hospitalization only in the network hospitals of Max Bupa by showing your health card to the hospital authority.

4. What the difference between a network and non-network hospital?

   A network hospital is a hospital with which your health insurance provider has an official connection. You can enjoy cashless hospitalization in a network hospital. In a non- network hospital, you cannot avail cashless hospitalization and with this hospital, your health insurance provider does not have any tie up.

5. As I already have health insurance for myself and my wife from my employer, do I need to buy a separate policy?

   It’s good to buy an alternative health insurance policy to be on the safe side. Because, once you leave or change your present job, your company insurance policy will not cover you and your wife’s medical expense. Beside, a separate policy can be an added advantage in case your medical expense is higher than your existing coverage level.

6. What is a family floater plan?

   It is a plan under which you can include the hospitalization expense of your entire family.

7. How can I buy Max Bupa Health Insurance Policy?

   There are many options of buying Max Bupa health insurance policies. You can buy them online.Then you will get your policy instantly. But online facility is available for those people only, who do not need any medical examination. You can also buy Max Bupa health insurance policies over phone or by visiting your nearest branch.

8. Do I need to undergo medical examination to buy Max Bupa health insurance policies?

   You need to undergo medical checkup, if you are buying a new health insurance policy offered by Max Bupa. But for the renewal of your existing policies, you need not go for medical examination.

9. What is the duration of health insurance policies offered by Max Bupa Health Insurance?

   Ideally, you can buy a policy for a period of 1 or 2 years. If you purchase a policy for two years, you will get discount. This offer is applicable for Heartbeat and Health Companion Health Insurance plans only.

10. Can a non- Indian person buy Max Bupa Health Insurance policy?

    Yes, a non – Indian or a foreigner living in India can also buy health insurance policies offered by Max Bupa. But, the person can claim coverage only within India.

11. How to claim Max Bupa Health Insurance?

    Max Bupa Health Insurance offers a seamless claims procedure:

    • Cashless claim procedure: Cashless hospitalisation can be availed only in a network hospital. For planned hospitalisation, inform the insurer 48 hours prior to admission and for emergency hospitalisation, intimate the insurer within 24 hours of admission. Display your Max Bupa Health Card at the hospital desk. The hospital will submit a pre-authorisation request to the insurer. The approval or rejection of the request will be conveyed to the hospital via fax or email within 30 minutes. The claim will be settled as per the terms and conditions of the policy.
    • Reimbursement claim procedure: Intimate the insurer within 48 hours of hospitalisation. Submit a claim form along with supporting documents such as original hospital bills, prescription, pharmacy bills, and discharge summary to the insurer. The claim form can be downloaded from Max Bupa Health Insurance website. The insurance company will review the claim request and according approve or reject it. Claim settlement will be done as per the terms and conditions of the policy.
12. How good is Max Bupa Health Insurance?

    Max Bupa is one of the top health insurance providers in the country. The health insurance plans offered by Max Bupa are designed for individuals, couples, senior citizens, and families. The health plans offer a comprehensive cover and a wide sum insured range. The policies come with a lifelong renewability option. The claim process is hassle-free with no TPA involved.

13. What is the tenure of a health insurance plan offered by Max Bupa?

    Max Bupa Health Insurance plans are available for 1 to 2-years policy period. The policy has to be renewed every year for continued benefits over the policy term. You can get discounts on purchasing a policy for 2 years. The premium discount is applicable for second year for Heartbeat and Health Companion Health Insurance plans.

14. What types of medical expenses are compensated by Max Bupa Health Insurance?

    All treatment expenses during hospitalisation are covered under Max Bupa Health Insurance plans including room rent charges.

15. Is it necessary to undergo a medical checkup before buying Max Bupa Health Insurance?

    A medical checkup may be required at the time of purchasing a policy but not at the time of renewal. It is advisable to undergo a medical checkup and disclosing any pre-existing conditions at the time of policy inception to avoid any hassle when making a claim.

16. Can I avail cashless facility across all the hospitals?

    No, cashless hospitalisation can be availed only at a network hospital of Max Bupa Health Insurance.

17. What is the procedure to avail medical benefits under insurance policy?

    Max Bupa Health Insurance offers a hassle-free claim process whether it is a cashless claim or reimbursement claim. In the case of a cashless claim, the network hospital has to send a pre-authorisation request to the insurer. In the case of a reimbursement claim, after discharge, you can submit the duly-filled claim form along with the original hospital bills to the insurer. In both cases, the insurer will review your claim request and approve or reject the claim accordingly.

18. Who is TPA of Max Bupa Health Insurance?

    Max Bupa Health Insurance doesn’t have a Third-Party Administrator. This way, the claim settlement solutions are direct and quicker.

19. What is a pre-existing disease or condition under Max Bupa Health Insurance?

    Any illness, injury, disease or condition detected, treated or diagnosed before 48 hours of purchasing the policy is considered a pre-existing condition.

20. Does Max Bupa Health Insurance cover the hospitalization expenses incurred during a medical emergency?

    Insurance cover of a health insurance policy offered by Max Bupa is only for medical expenses.

Examples of Network Hospitals in Major Cities

CITY	NAME OF HOSPITAL
Kolkata	Columbia Asia Hospital
DELHI	Action Cancer Hospital
BANGALORE	Columbia Asia Hospital
CHENNAI	Fortis Malar Hospital
Mumbai	Hinduja Hospital

*Disclaimer - This is not an exhaustive list but an indicative representation of hospitals that form a part of the company's wider network.