Have you heard about Niva Bupa Health Insurance Company’s latest offering, the Niva Bupa Aspire Health Insurance plan? This plan is specifically designed to cater to the healthcare needs of the younger generation. It introduces some fantastic perks such as Lock the Clock and Booster+.
Let me walk you through what makes this plan stand out:
- Lock the Clock ensures that your premium remains steady until a claim is made.
- Booster+ allows you to carry over unutilized base sum insured up to 10 times of the sum insured.
- And there’s M-iracle, which covers expenses related to childbirth, adoption, maternity, and surrogacy.
This plan packs some unique benefits tailor-made for your healthcare needs. Pretty impressive, right?”
| Particulars | Value/Benefits |
|---|---|
| Sum Insured | Rs 3 lakh to Rs. 1 Crore |
| Policy Tenure | 1 year, 2 years, 3 years |
| Network Hospitals | 10,000+ |
| Claim Settlement Ratio | 91.6% |
| Initial Waiting Period | 30 Days |
| Pre-Existing Diseases Waiting Period | 1 Year/ 2 Years/ 3 Years/ 4 Years |
| Specified Disease Waiting Period | 1 Year/ 2 Years |
| M-iracle Waiting Period | 9 months/ 2 Years/ 4 Years |
Niva Bupa Aspire Insurance Benefits
The Niva Bupa Aspire Health Insurance plan offers various benefits, ensuring comprehensive coverage for policyholders:
- M-iracle Benefit – This feature covers childbirth-related expenses, encompassing maternity, surrogacy, adoption, and childbirth costs under the Niva Bupa Aspire Health Insurance plan.
- Lock the Clock+ Benefit – With this benefit, policyholders pay the premium amount fixed at the time of plan purchase until they file a claim. Notably, the M-iracle Benefit doesn’t affect the Lock the Clock+ Benefit.
- Booster + Benefit – The Aspire health plan’s Booster+ Benefit allows carrying forward the insured balance to the subsequent year, up to 10 times the base sum insured based on the primary policyholder’s entry age.
- Borderless Benefit – Under this benefit, policyholders of Niva Bupa Aspire Insurance receive treatment regardless of their current location.
- Second Medical Opinion Benefit – In cases of serious illness diagnoses, policyholders can seek a second medical opinion multiple times within a policy year as part of the insurance coverage.
- Hospitalization: The hospitalization requirement is a minimum of 2 hours.
- Maternity Cover: Policyholders receive extensive maternity benefits.
- Ambulance Cover: Air ambulance expenses are covered up to the sum insured.
Niva Bupa Aspire Eligibility Criteria
| Parameters | Eligibility Criteria |
|---|---|
| Minimum Entry Age | Adult – 18 years |
| Child – 1 day | |
| Maximum Entry Age | Adult – 46 years |
| Coverage Type | Individual and Family Floater |
| Renewability | Lifelong |
Niva Bupa Aspire Health Insurance Inclusions
The Niva Bupa Aspire medical insurance encompasses various inclusions to provide comprehensive coverage:
- Annual Health Check-up: This benefit covers medical test facilities through a mobile app on a cashless basis for the insured, providing an annual health check-up.
- Live Healthy: Offers a 30% renewal discount by earning health points through the app at the time of renewal.
- Second Medical Opinion: Allows for seeking a second medical opinion from any medical care provider, with expenses covered under hospitalization.
- Hospitalisation Expenses: Covers expenses during hospitalization for 2 hours or more and a minimum of 24 hours for AYUSH treatment at an AYUSH Hospital.
- Road Ambulance: Covers expenses for transportation to the nearest hospital via a road ambulance.
- Air Ambulance: Covers emergency air ambulance expenses up to the base sum insured.
- Domiciliary Treatment: Covers medical treatment at home by a practitioner when required.
- Pre-Hospitalisation: Covers expenses like diagnostic tests and medicines up to 60 days before hospitalization.
- Post-Hospitalisation: Can be claimed within 180 days after discharge.
- Modern Treatments: Covers expenses for modern treatments like balloon sinuplasty, stem cell therapy, etc.
- Organ Donor and Harvesting: Covers expenses for organ donation and harvesting.
- Safeguard+: Covers non-payable items and maintains benefits for smaller claims.
- Personal Accident: Provides coverage up to 5 times the base sum insured, up to Rs 1 crore.
- Annual Aggregate Deductible: Provided based on expenses incurred to reach the hospital.
- Hospital Cash: Offers an additional fixed amount for each day of hospital stay, up to 30 days.
- Reassure+ and Reassure X Benefits: Provide unlimited sum insured when policy conditions are met.
- Cash-Bag Benefit: Offers cashback on claim-free years, aiding in paying OPD, deductibles, etc.
- Future Ready: Ensures future spouse’s guaranteed issuance and waiting period continuity.
- Fast Forward: Carries forward the base sum and m-iracle sum insured amount.
Niva Bupa Aspire Exclusions
- Investigating or evaluating suspected health issues or diseases.
- Rest, cure, rehabilitation, or respite care of the insured.
- Weight control or obesity treatments.
- Cosmetic or plastic surgery, except in life-saving cases.
- Dental treatments.
- Treatments at non-empanelled hospitals or from excluded providers.
- Participation in adventure sports or hazardous activities.
- Events related to war or nuclear occurrences.
FAQs (Frequently Asked Questions)
What does the Annual Health Check-up cover in the Niva Bupa Aspire plan?
Answer: The Annual Health Check-up benefit includes medical test facilities provided through a mobile app. These tests must be booked via the app and are exclusively available on a cashless basis without reimbursements.
How can I avail the Live Healthy benefit and what discount does it offer during renewal?
Answer: To avail the Live Healthy benefit, policyholders can download the app and earn health points. This benefit offers a 30% discount at the time of renewal.
Could you explain the Second Medical Opinion benefit and its coverage under hospitalization expenses?
Answer: The Second Medical Opinion benefit allows policyholders to seek a second opinion from any medical care provider. The expenses for this are covered under hospitalization expenses.
What are the specific criteria for Hospitalisation Expenses coverage in the Niva Bupa Aspire plan?
Answer: Hospitalisation Expenses cover incurred expenses when the insured is admitted, including hospital stays for 2 hours or more and at least 24 hours for AYUSH treatment at an AYUSH Hospital.
Are both Road Ambulance and Air Ambulance Benefits included in the policy, and up to what extent are these expenses covered?
Answer: Yes, the policy covers Road Ambulance Benefits for transportation to the nearest hospital and Air Ambulance Benefits in emergency situations, up to the base sum insured.
Under what circumstances does the Domiciliary Treatment benefit apply, and what does it cover?
Answer: The Domiciliary Treatment benefit applies when the insured requires medical treatment at home under a medical practitioner’s care and supervision.
What expenses are covered under the Pre-Hospitalisation and Post-Hospitalisation Benefits?
Answer: Pre-Hospitalisation Benefits cover expenses like diagnostic tests, medicines, and other tests for up to 60 days before hospitalization. Post-Hospitalisation Benefits can be claimed within 180 days after discharge.
Can you provide examples of treatments covered under the Modern Treatments Benefit?
Answer: Modern Treatments Benefit covers expenses for treatments such as balloon sinuplasty, stem cell therapy, deep brain stimulation, and oral chemotherapy.
What are the specific provisions for Organ Donor and Organ Harvesting Benefits in the policy?
Answer: Organ Donor Benefits cover expenses for the donated organ, applicable only during hospitalization. Organ Harvesting Benefits cover expenses for harvesting the required organ from the insured.
How do Reassure+ and Reassure X Benefits differ, and what conditions must be met to avail of the unlimited sum insured?
Answer: Reassure+ offers unlimited sum insured, activated when the insured pays the first claim and maintains continuous policy renewals. Reassure X needs uninterrupted policy renewal for an unlimited sum insured.
How does the Cash-Bag Benefit work, and what expenses can I use the accumulated cashback for?
Answer: The Cash-Bag Benefit provides cashback on claim-free years, usable for paying OPD, deductibles, co-payments, and other plan-related expenses.
Could you elaborate on the Future Ready benefit and its implications for future spouses?
Answer: Future Ready ensures future spouses receive guaranteed issuance and continuity benefits, including waiting period continuation.
What does the Fast Forward benefit entail regarding carrying forward sums insured?
Answer: Fast Forward carries forward the base sum and m-iracle sum insured amount for the policyholder.
Can you explain Safeguard+ and how it ensures continuity of benefits in certain claim scenarios?
Answer: Safeguard+ covers non-payable items and maintains benefits for smaller claims, ensuring no impact on Booster+ and Safeguard+ benefits for claims less than Rs 1 lakh.
What is covered under the Personal Accident inclusion, and how is the coverage amount determined?
Answer: Personal Accident covers an amount up to 5 times the base sum insured or up to Rs 1 crore, providing compensation in case of an accident.
How is the Annual Aggregate Deductible calculated, and how does it affect policy coverage?
Answer: The Annual Aggregate Deductible is based on expenses incurred before hospitalization and can affect the overall coverage of the policy.
Could you explain the Hospital Cash benefit and the duration for which it is provided during hospital stays?
Answer: Hospital Cash provides an additional fixed amount for each day of hospital stay, applicable for up to 30 days.