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MAX BUPA HEALTH INSURANCE

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MAX Bupa Health Insurance

Overview
Max Bupa Health Insurance Company Ltd. (Max Bupa) strives with a vision to evolve into India’s most promising Health Insurance Company with its unparalleled health insurance schemes and policies. Max Bupa is a joint venture between Max India Limited, a multi business corporate in India and Bupa, a UK based international healthcare group. Bupa has been in the industry for six decades with over 29 million customers from across 190 countries. Thus Max Bupa brings in global experience and expertise to join hands with local knowledge and deliver the best of it all to their customers.

MAX Bupa Health Insurance at a Glance
  • Strong network of over 3500 top quality hospitals
  • Dedicated team of over 850 people and its network of offices across eleven cities
  • Services customers directly without third party involvement, through an in-house team of relationship managers
  • 24/7 health line for easy and friendly access to health advice
  • Excellent customer base of more than 57,000 people
Awards and Recognitions
Max India Limited
  • Max New York Life was declared a 'Superbrand' by Superbrands India in 2008'
  • CII-Exim Bank Commendation Certificate for Business Excellence
  • CIO 100 Award for technology implementation
BUPA
  • The Health Insurance Company of the Year Award - Awarded at the U.K. Health Insurance Awards 2009
  • Best International Private Medical Insurance Provider 2008 - Awarded at the U.K. Health Insurance Awards
  • Best Medical Insurer Company (2008, Bupa Arabia) - Awarded at the Jeddah Chamber of Commerce and Industry Health Committee Awards
  • Best Health care Provider of the Year - Awarded at the U.K. Corporate Adviser Awards 2009
  • Best Individual Private Medical Insurance Provider - Awarded at the U.K Money Marketing Awards 2009
Documents needed to apply for Max Bupa Health Insurance
  • Age proof - (Any One)
    Driving License, Passport, Voter ID Card, Birth Certificate, etc
  • Identity proof – (Any One)
    Driving License, Passport, Voter ID card, PAN Card, Aadhar Card, or any document which proves citizenship
  • Income proof
  • Address proof – (Any One)
    Driving License, Passport and Utility Bill should clearly mention the permanent address
  • Income proof – (Any One)
    Salary Slip, Form 16, ITR
  • Recent passport size photograph
Why Max Bupa Health Insurance?
Sum Insured You can choose an insured sum upon your requirements (1 lac - 1 crore)
Cashless hospitalisation All claims processed directly by Max Bupa’s customer service team without third party involvement. Cashless settlement at more than 3500 Network hospitals within 30 minutes
International Coverage International Cashless Treatment for 9 major critical illnesses like cancer and organ transplant through Bupa International’s global network in 190 countries
Maternity Benefits Max Bupa’s health insurance plans cover maternity, including complications that may arise during pregnancy, pre- and post-natal expenses. The waiting period is 24 months, which is one of the lowest. In this case, the child born will also automatically covered until the next renewal.
Discounts If you take a policy for two years then you get 12.5% discount on the second year premium.
Lifelong renewability Get insured with us once and your policy will be renewed for life without any extra charges, provided you pay the premiums without any break.
No Claim Bonus Max Bupa offers an Increase in Sum Insured @20% of Base Sum Insured subject to the maximum of 100% of Base Sum Insured for each claim free year with no penalization in case of a claim
Health Checkup Get health checkup for you and your family once in every two years (for variant 1) or annually (for variant 2 & 3)

Types of Max Bupa Health Insurance Plans
Max Bupa offers three different types of plans: Individual Plans, Plans for families/ extended families, fixed benefit plans

1)Heartbeat Individual - This is one of the best healthcare insurance plans for individuals. It offers comprehensive medical expenses coverage for individuals along with inpatient hospitalization and loyalty bonus at no extra cost.

2)Health Companion Individual - This is an ideal plan to offer you affordable and comprehensive medical expense coverage. This has been designed keeping in mind the individual as well the nuclear family’s (you, your spouse and up to 4 children) needs. A Direct claim settlement, cashless facility, and assured plan renewal for life are some of the key benefits.

3)Heartbeat Family Floater - A well designed plan to protect your family with comprehensive blanket coverage for the medical expenses incurred. This is applicable to you, your spouse and up to 4 children or Up to 19 family members

4)Heartbeat Family First - A plan ideal for large families. The Heartbeat Family First Plan offers medical expenses coverage for up to 19 family members with an individual sum insured for everyone, and a floating sum insured that is accessible to any family member.

5)Health Companion Family Floater - Health Companion is an affordable & comprehensive plan designed keeping in mind the individual and nuclear family (you, your spouse and up to 4 children) needs. A Direct claim settlement, cashless facility, and assured plan renewal for life are some of the key benefits.

6)Health Company Family First - This plan caters to the needs of the Indian joint family. You can get coverage for up to 19 people with individual sum insured for each member and a floater sum insured that can be used by any of the family members.

7)Criticare - Critical illness such as cancer, stroke, kidney failure or lung disease can ruin your life and destroy the dreams of an entire family. But prepare for any critical illnesses with Max Bupa Criticare health insurance and get the help you need to get back on your feet when your body lets you down.

8)Personal Accident Care Insurance - Max Bupa Accident Care Insurance Plan provides cover not just in the case of accidental death, but also for permanent total or partial disability, along with a host of other benefits.

MAX Bupa Health Insurance Plans

Individual Plans
1)Max Bupa Heartbeat Individual Health Insurance Plan
Plan Variants: Gold/ Platinum
Heartbeat Individual plan Gold Package
Entry age Any age enrolment
Type of Plan Individual
Sum Insured 5-50 Lacs
Coverage for Individual
Policy term 1-2 years
Coverage Options Rs. 5 lacs, Rs. 7.5 lacs, Rs. 10 lacs, Rs. 15 lacs, Rs. 30 lacs and Rs. 50 lacs

Inclusions, Benefits and Features
Pre-Hospitalisation - All medical expenses incurred 60 days prior to hospitalisation will be reimbursed.

Post-Hospitalisation – All medical expenses incurred 90 days after you get discharged from a hospital will be reimbursed

All Day-Care Treatments - All day care treatments covered, excluding the procedures in the outpatient department and diagnostic services

Alternative Treatments – All medical expenses incurred on treatment taken under Ayurveda, Unani, Sidha and Homeopathy will be covered

Loyalty Additions - Renewing the policy without any break will give 10% of base Sum Insured per annum maximum upto 100%.

Hospital Cash - Hospital Cash benefit option under which the Hospital Cash up to a maximum of 30 days of Hospitalization will be paid

Health Checkup – Expenses met for diagnostic tests can be reimbursed if it is through the empanelled service providers

Organ Transplant - All medical expenses for an organ donor is covered

Domiciliary Hospitalization - Expenses of treatments at home that continues for at least 3 consecutive days will be covered.

Emergency Ambulance – Expenses incurred for emergency ambulance services (upto Rs.3000) will be covered.

Free Look Period - A free look period of 15 days is provided within which your existing plan can be cancelled by stating the reason.

Basic Sum insured per insured person per policy year(Rs. in Lakhs) 5.00 7.5 10.00 15.00 20.00,30.00,50.00
Inpatient treatment Available
Pre-hospitalisation 60 days
Post-hospitalisation 90 days
Day Care procedures Covered except procedures not in the outpatient department and Diagnostic Services of a hospital.
Domiciliary treatment Covered
Emergency Ambulance Covered
Loyalty Additions Available
Hospital Cash Covered up to a maximum of 30 days of Hospitalization for each continuous period of 24 hours of Hospitalization, provided Insured person has been admitted in a Hospital for a minimum period of 48 hours continuously.
Any age enrolment Available
Free look period Available for 15 days
Health Checkup Covered if policy is renewed without any break

2) Max Bupa Health Companion Individual
Health Companion Individual Plan Available in 3 variants
Entry age Any age enrolment
Type of Plan Individual
Policy term 1-2 years

Inclusions, Benefits and Features
Hospital Accommodation - All types of hospital accommodations except suits or above room category will be covered.

Pre-Hospitalisation - All medical expenses incurred 30 days prior admission covered.

Post-Hospitalisation – All medical expenses incurred 60 days after discharge covered.

All Day-Care Treatments - All day care treatments excluding the procedures in the outpatient department and diagnostic services of a hospital covered.

Refill Benefits - You are entitled for an additional sum insured equal to the base sum insured for a subsequent claim in the same year, provided it is for an unrelated illness.

Alternative Treatments – Medical expenses incurred on treatment taken under Ayurveda, Unani, Sidha and Homeopathy (AYUSH) will be covered.

2 Year Policy Tenure Option - 12.5% discount on the second year premium in case of opting for 2 year policy.

Newborn baby - Newborn babies will be covered if the maternity claim is admissible

Any age enrolment - The policy is applicable for all age groups.

Hospital Cash - Hospital Cash up to Rs.2000 for a maximum of 30 days of Hospitalization

Health Checkup - Cost of health checkup (only for diagnostic tests) availed through empanelled service providers Organ Transplant - All medical expenses for an organ donor is covered

Domiciliary Hospitalization - Expenses of treatments at home that continues for at least 3 consecutive days will be covered.

Vaccination In Case Of Animal Bite - Medical expenses of OPD treatment up to Rs. 5000 for taking vaccinations or immunisation against animal bite

Emergency Ambulance – The ambulance expenses incurred up to Rs. 3000 will be reimbursed.

Plans for families or extended families

3) Max Bupa Heartbeat Family Floater Platinum
Heartbeat Family Floater Plan Gold / Platinum
Entry age Any age enrolment (including newborns)
Type of Plan Family/ extended family
Sum Insured 15 lacs - 1 crore
Coverage for You, your spouse and up to 4 children or Up to 19 family members
Policy term 1-2 years

Features, benefits and inclusions
  • Hospital Cash - Up to 30 days of hospitalization for each continuous period of 24 hours cash will be paid
  • Pre-Hospitalization - Up to 60 days
  • Post Hospitalization - Up to 90 days
  • No limit on the hospital room category
  • All Day-Care Treatments
  • Newborn Baby cover
  • Maternity Benefits upon accepted terms and conditions
  • Any Age Enrollment
  • Organ Transplant expenses
  • Domiciliary Hospitalization
  • Second Opinion expenses
  • Child Care Benefits - Specified vaccination expenses for children under 12 years will be covered
  • Emergency Ambulance - Reasonable transportation cost will be covered
  • International Treatment Support for Specified Illness - Medical expenses incurred for treating specified some dread diseases like Leukemia, Heart attack, brain surgery. (Treatment in USA and Canada include additional premium).
  • OPD Treatment and Diagnostic Services
  • Emergency medical evacuation and hospitalization - Covers costs of transportation of the Insured Person.
4) Max Bupa Heartbeat Family First Health Insurance Plan
Plan Variants: Silver/ Gold/ Platinum
Heartbeat Family First Plan Gold
Entry age Any age enrolment (including newborns)
Type of Plan Family/ extended family
Sum Insured 1-3 lacs
Coverage for Up to 19 family members
Policy term 1-2 years

Features, benefits and inclusions
  • In-Patient Care Hospitalisation
  • Pre-Hospitalisation - up to 60 days
  • Post-Hospitalisation – up to 90 days
  • All Day-Care Treatments
  • Alternative Treatments
  • Maternity Benefits - For adult females who has been covered under the policy for two continuous years.
  • Newborn Baby - Insured from birth without additional premium if the maternity claim is admissible under the policy.
  • Any age enrolment
  • Health Checkup -Expenses for Diagnostic tests will be covered if policies are renewed without any breaks.
  • Organ Transplant – donor expenses
  • Domiciliary Hospitalization - Expenses of treatments at home that continues for at least 3 consecutive days will be covered.
  • Emergency Ambulance - Expenses for emergency ambulances will be covered once we accept the inpatient claim
5) Max Bupa Health Companion Family Floater
Plan Variants : Variant 1/ Variant 2/ Variant 3
Heartbeat Companion Family Floater Variant 2
Entry age Any age enrolment (including newborns)
Type of Plan Family/ extended family
Sum Insured 5-10 lacs
Coverage for You, your spouse and up to 4 children
Policy term 1-2 years
Sum Insured Options Rs.5 Lakhs, Rs.7.5 Lakhs, Rs.10 Lakhs, rs.12.5 Lakhs
Top up with Annual Aggregate Deductible Option Rs.1 Lakh, Rs.2 Lakh, Rs.3 Lakhs, Rs.4 Lakhs, Rs.5 Lakhs, Rs.10 Lakhs

Features, benefits and inclusions
  • In-Patient Care Hospitalisation
  • Pre-Hospitalisation - up to 30 days
  • Post-Hospitalisation – up to 60 days
  • All Day-Care Treatments
  • Alternative Treatments
  • Vaccination in case of animal bite - up to Rs. 5000
  • Health Checkup - Avail Health Checkup for yourself and your family once in two years (for variant 1) or annually (for variant 2 & 3)
  • Organ Transplant – Donor Expenses
  • Domiciliary Hospitalization
  • Emergency Ambulance - Up to Rs.3000
6) Max Bupa Health Companion Family First
Health companion family first Variant
Entry age Any age enrolment (including newborns)
Type of Plan Family/ extended family
Sum Insured 1-20 lacs
Coverage for Up to 19 relationships
Policy term 1-2 years
Individual Base Sum Insured Rs. 1 Lakh, Rs.2 Lakh, Rs. 3 Lakh, Rs.4 Lakh, Rs.5 Lakh, Rs.10 Lakh
Floater Base Sum Insured Rs.3 Lakhs, Rs.4 Lakhs, Rs. 5 Lakhs, Rs.10 Lakhs
Top up with aggregate deductible options Rs.1 Lakh, Rs.2 Lakhs, rs. 3 lacs, Rs.4 Lakhs, Rs.5 Lakhs, Rs.10 Lakhs

Features, benefits and inclusions
  • In-Patient Care Hospitalisation
  • Pre-Hospitalisation - up to 30 days
  • Post-Hospitalisation – up to 60 days
  • All day care treatments - Except the procedures in the outpatient department
  • Alternative Treatments
  • Vaccination in case of animal bite - up to Rs. 5000
  • Organ Transplant –Donor expenses
  • Domiciliary Hospitalization
  • Emergency Ambulance - Up to Rs.3000
Fixed Benefit Plans
7) Max Bupa Criticare
Criticare  
Entry age Any age enrolment (including newborns)
Type of Plan Individual/ Floating
Sum Insured 3 lacs to 2 crore
Coverage for Individual or family
Policy term 1-3 years

Features, benefits and inclusions
  • Direct Claim Settlement
  • 2 or 3 year policy tenure options
  • Assured Policy Renewal
  • 20 Critical illness covered
Benefit Option: Two options are available which cannot be changed later
  • Benefit Option 1: Sum insured payable as lump sum
  • Benefit Option 2: Sum insured payable as lump sum plus additional 10% of the sum insured payable each year for subsequent 5 years.
8) Max Bupa Personal Accident Care Insurance
Personal Accident Care Insurance  
Entry age Any age enrolment
Type of Plan Individual/ Family
Sum Insured 5 lacs to 2 crore
Coverage for Individual or family
Policy term Immediate coverage from the policy start date

Features, benefits and inclusions
Accidental death -100 % sum assured will be paid to the insured for accidental death.

Permanent Total Disability - 125% of the sum will be paid to the insured in case of permanent total disability.

Permanent Partial Disability - 100% sum will be paid to the insured for Permanent Partial Disability

Child Education Benefit - In case of accidental death or permanent total disability, minimum of 5% of your sum insured or Rs. 50,000 (for sum insured up to 25 lacs) / Rs. 500,000 (for sum insured more than 25 lacs) per child, is paid toward your child’s education. This is only applicable for plans where children are covered.

Funeral Expenses - Any funeral expenses are covered up to Rs. 5000 (for sum insured up to 25 lacs) / Rs. 50,000 (for sum insured more than 25 lacs), in the case of the accidental death of any insured member.

Temporary Total Disability - In case of temporary total disability, 1% of Temporary Total Disability sum insured is payable per week for a maximum of 100 continuous weeks. This benefit can be availed by salaried individuals only.

Accidental Hospitalization(Optional) - In case of hospitalization due to an accident, medical expenses incurred shall be payable up to 2% of Accident Care sum insured.

Individual and Family Coverage - You are entitled to 100% of the amount, your spouse is entitled to 50% or Rs. 10 Lacs (whichever is lower), and your children are entitled to 20% of the amount or Rs. 5 Lacs (whichever is lower).

Max Bupa Login
For Individuals: Log into Max Bupa Health Insurance website with your name, Email ID.
For service providers: Register using your name, hospital name, mobile number, email id, state and city.

Max Bupa Policy Renewal
  • Go to Max Bupa health insurance page and click on the Renew tab from top of the page
  • Now enter your policy number and click submit
  • Get to know the premium amount for this year
  • Click on the pay button go make the payment
Max Bupa Health Insurance Claim Settlement
Cashless Reimbursement Claim
Get admitted to any one of the network hospitals. For a list of network hospitals visit www.maxbupa.com In case of hospitalization notify the insurer within 48 hours of admission in our network or non-network hospital. After getting admitted pay directly to the hospital.
Use your Max Bupa Health Card or share your Policy number and Passport / PAN card / voter’s ID for identification purposes On discharge, please ensure you collect all relevant documents, invoices, medical reports and discharge certificate from the Hospital in originals.
The Network Hospital will check your identity for validation and submit the pre-authorisation request form Send these documents and the completely filled and signed claim form to the company along with your valid ID proof and age proof. The claim form is available on our website www.maxbupa.com and in your policy document as well.
Form will be reviewed and confirmation will be provided to the Network Hospital by fax and E-mail. A text message and an E-mail will be sent confirming the same to you. Requests will get a response within 30 Minutes. Your claim request will be reviewed and will be approved, queried or rejected accordingly (as per policy terms & conditions).
Settle the claim (as per policy terms & conditions) with the hospital after completion of all formalities Settle the claim (as per policy terms & conditions) and reimburse the approved amount.

Max Bupa Insurance FAQ’s:
1)How can I buy Max Bupa Health Insurance policy?
There are mainly two ways in which you can buy this policy:
Online: When this plan is purchased the policy will be generated instantly along with the policy kit and card. Though all our policies are available for purchase via online, our online special plan Health Companion Health Insurance Plan - Health Companion can be bought only through this mode.
Telephone: Call our specially trained sales team by dialing 1800 3010 to know more about the plans and policies.

2) Is a medical checkup required before buying a policy?
Medical checkup may be necessary while signing up for a new policy if in case you are above 40-50 (depends on the policy term) or in case of any pre-existing diseases, but it’s not required for renewing the policy.

3) What are the minimum and maximum policy durations?
Policy durations can be for a period of one or two years. You will be getting discounts if the policy is purchased for two years. This is applicable for Heartbeat and Health Companion Health Insurance Plan - Health Companion (Individual and Family Floater).

4) Can my friend living in India buy an insurance policy if they he/she is not an Indian national?
Yes. Foreigners living in India can avail the benefits of our policies. However this will be applicable only when they are in India.

5) Is there any chance of availing tax benefits while purchasing a health insurance policy?
Yes, you can get tax benefits available under section 80D of the Income Tax Act 1961. However tax benefits are viable to changes under tax laws.

6) My wife resides in a different city? Can i cover both of us in one policy?
Yes, if both of you are residing in India, then a single policy can cover you and your wife.

7) Is vaccination covered under OPD benefit?
Yes, vaccination is covered under OPD benefits provided it is supported by a medical prescription.

8) If i need to get treatment outside will that be covered?
Medical expenses incurred for treating specified some dread diseases like Leukemia, Heart attack, brain surgery up to opted insured sum will be covered (except for treatment in USA and Canada). Treatment in USA and Canada include additional premium.

9) In case of organ transplant can the donor’s medical expenses be covered ?
Yes, the medical expenses for the organ donor will be covered provided the organ is being transplanted for the insured person.

10) Is cashless facility feature available all through India?
Yes, but you can use the cashless facility feature only in your nearest hospitals.

11) Can i choose multiple sum insured for my family members?
Yes, multiple sum can be insured for your family members within the chosen variant.