Health Premia Family Health Insurance Plan
/content/maxbupa/in/en/bank,/content/maxbupa/en/in/digital/home/app-form2,/content/maxbupa/en/in/digital/home/thank-you1,partner.maxbupa.com
/content/maxbupa/in/en/agent
Img Full COVID-19 cover
MY POLICY GET A QUOTE

Maternity & New-born coverage

No additional premium for covering a new born baby from day 1 till policy year end

New-age treatment Coverage

Coverage for new-age treatments like laser assisted surgery & more

International Coverage

Insure your health even when you travel abroad under platinum plan

Inbuilt travel insurance

Coverage for loss of checked-in baggage, trip cancellation & more

Hospitalisation Coverage 

Coverage up to ₹3cr for you & your insured family members' hospitalisation

Health Check-up

Benefit of health check-ups for diagnostic tests from day 1

Find out what’s covered in the Max Bupa Health Premia insurance plan​

Simply search for your queries about Health Premia insurance plan or check out all the features listed below​

Hospitalisation
Arrow Arrow

IN-PATIENT CARE (HOSPITALISATION)

+ -

Get coverage for medical treatment post hospitalisation for all insured members    

HOSPITAL ACCOMMODATION

+ -

Get coverage of room rent up to base sum insured except for suite and above categories.    

PRE & POST HOSPITALISATION MEDICAL EXPENSES

+ -

The policy will cover pre and post hospitalisation expenses as well. The period of the treatment covered is 90 days before you get admitted to the hospital and 180 days after you get discharged from the hospital.    

DOMICILIARY HOSPITALISATION

+ -

The policy will reimburse you for the medical treatment taken at home on account of unavailability of a hospital bed or the doctor’s advice 

DAY-CARE TREATMENT COVERED

+ -

Your health insurance will cover a host of dental, ENT and other procedures    

EMERGENCY AMBULANCE

+ -

Get coverage for the ambulance expenses following an emergency to a hospital. These expenses are paid once the in-patient claims are approved    

ORGAN TRANSPLANT

+ -

Avail coverage for medical expenses incurred on the organ donor’s treatment as well    

OPD TREATMENT AND DIAGNOSTIC SERVICES

+ -

We cover expenses incurred for OPD Treatment and/or Diagnostic Services and/or prescribed medicines for the OPD Treatment taken within India for up to Rs 50,000.( Applicable under Platinum plan)

ALTERNATIVE TREATMENTS

+ -

We will indemnify the medical expenses incurred on the insured person’s hospitalization for Inpatient Care on treatment taken under Ayurveda, Unani, Siddha and Homeopathy.

Standout Features
Arrow Arrow

PREMIUM WAIVER

+ -

Get a free extension of 1 year if the policyholder (who is also an insured) passes away or is diagnosed with any of the specified illnesses    

EMERGENCY ASSISTANCE SERVICES

+ -

Get coverage for medical evaluation, referral, repatriation etc. when the insured is travelling within India. They must be at a minimum distance of 150 kms. from their residence and the trip must be for less than 90 days    

NEW AGE TREATMENT

+ -

Treatments like Cyber knife/ Robotics surgery, Laser surgery cover, Weight loss (Bariatric) surgery are covered

MATERNITY BENEFIT

+ -

The plan provides you maternity benefits for up to two deliveries. This benefit is available after both you and your spouse have been covered under the policy for two continuous years.

REFILL BENEFIT

+ -

In case you have exhausted your Base Sum Insured and Loyalty Additions / Enhanced Loyalty Additions (if any) partially or completely, you are entitled for an additional sum insured equal to the base sum insured for a subsequent claim in the same year. This benefit can be availed for both same and different illnesses.

LOYALTY ADDITIONS

+ -

Irrespective of your claim history, you will get an increase of 10% of expiring base Sum Insured every year, subject to maximum of 100% of base Sum Insured.

HEALTH CHECK-UP

+ -

You can avail health checkup for Diagnostic Tests purposes from Day 1 for any insured person (including children). You can undergo a health checkup through our service provider on cashless basis. You can choose tests of your choice up to a sub-limit as per the plan chosen.

Add on Features
Arrow Arrow

PERSONAL ACCIDENT COVER

+ -

Secure your family’s finances against personal accidents

CRITICAL ILLNESS COVER

+ -

Get coverage against illnesses like cancer, kidney failure etc. depending on the base sum insured

HOSPITAL CASH

+ -

The add-on pays hospital cash for up to 30 days of hospitalisation if hospitalised for more than 48 hours​

HEALTH COACH

+ -

Track your health parameters and get help from the virtual coach to reach your health goals

ENHANCED GEOGRAPHICAL COVER

+ -

Now you are entitled to avail international coverage in USA & Canada also.

ENHANCED LOYALTY ADDITIONS

+ -

Irrespective of claim history, your sum insured increases by 20% pa; maximum up to 200% of expiring base sum insured

Exclusions
Arrow Arrow

PERMANENT EXCLUSIONS

+ -

•Ancillary hospital charges

•Hazardous activities

•Artificial life maintenance

•Circumcision

•AYUSH treatments, except inpatient treatments taken under Ayurveda, Unani, Sidha and Homeopathy

•Conflict & disaster

•External congenital anomaly

•Convalescence & rehabilitation

•Cosmetic and plastic surgery

•Dental/oral treatment

•Eyesight & optical services

•Experimental or unproven treatment

•Hormone Replacement Therapy

•Hospitalisation not justified

•Inconsistent, irrelevant or incidental diagnostic procedures

•Non-medical expenses

•Obesity and weight control programs

•Reproductive medicine & other maternity expenses

•Robotic Assisted Surgery, Light Amplification by Stimulated Emission of Radiation (LASER) & Cyber Knife Treatments

•Sexually transmitted infections & diseases

•Sleep disorders

•Substance related and addictive disorders

•Unlawful activity

•Treatment received outside India

•Unrecognised physician or hospital

Generally excluded expenses - Any costs or expenses specified in the list of expenses generally excluded at Annexure II of the Policy Document.    

PERMANENT EXCLUSION FOR PERSONAL ACCIDENT COVER (OPTIONAL)

+ -

We shall not be liable to make any payment under any benefits under the Personal Accident Cover if the claim is attributable to, or based on, or arise out of, or are directly or indirectly connected to any of the following:

• Suicide or self-inflicted injury, whether the insured person is medically sane or insane.

• Treatment for any injury or illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or leader), acts of terrorism.

• Service in the armed forces, or any police organisation, of any country at war or at peace or service in any force of an international body or participation in any of the naval, military or air force operation during peace time.

• Any change of profession after inception of the policy which results in the enhancement of our risk, if not accepted and endorsed by us on the policy schedule.

• Committing an assault, a criminal offence or any breach of law with criminal intent.

• Taking or absorbing, accidentally or otherwise, any intoxicating liquor, drug, narcotic, medicine, sedative or poison, except as prescribed by a medical practitioner other than the policyholder or an insured person.

•Participation in aviation/marine including crew other than as a passenger in an aircraft/water craft that is authorised by the relevant regulations to carry such passengers between established airports or ports.

• Engaging in or taking part in professional/adventure sports or any hazardous pursuits, such as speed contest or racing of any kind (other than on foot), bungee jumping, parasailing, ballooning, parachuting, skydiving, paragliding, hang gliding, mountain or rock climbing necessitating the use of guides or ropes, potholing, abseiling, deep sea diving using hard helmet and breathing apparatus, polo, snow, ice sports, hunting, etc.

• Body or mental infirmity or any disease except where such condition arises directly as a correspondence of an accident during the policy period. However, this exclusion is not applicable to claims made under the Permanent Partial Disability benefit.

PERMANENT EXCLUSIONS FOR CRITICAL ILLNESS COVER (OPTIONAL)

+ -

We shall not be liable to make any payment under Critical Illness Cover directly or indirectly caused by, based on, arising out of or howsoever attributable to any of the following unless specifically mentioned elsewhere in the Policy.

• AYUSH Treatment: Any covered Critical Illnesses diagnosed and/or treated by a Medical Practitioner who practices AYUSH Treatment.

• Conflict & Disaster: Treatment for any Injury or Illness resulting directly or indirectly from nuclear, radiological emissions, war or war like situations (whether war is declared or not), rebellion (act of armed resistance to an established government or leader), acts of terrorism.

•External Congenital Anomaly: Screening, counselling or treatment related to External Congenital Anomaly.

•Cosmetic and Reconstructive Surgery: Any Critical Illnesses arising due to treatment undergone purely for cosmetic or psychological reasons to improve appearance.    

•Experimental/ Investigational or Unproven Treatment:


a. Services including device, treatment, procedure or pharmacological regimens which are considered as investigative or Unproven / Experimental Treatment.

b. Biodegradable (bioresorbable, bioabsorbable) polymer drug eluting stents will be considered as experimental and investigational for all purpose.

•Hazardous Activities: Any claim relating to Hazardous Activities.

 HIV, AIDS, and related complex: Any condition directly or indirectly caused by or associated with Human Immunodeficiency Virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS), including any condition that is related to HIV or AIDS.    

• Reproductive medicine & other Maternity Expenses: Any Critical Illness arising out of , directly/ indirectly caused by, contributed to or aggravated by:

a. Pregnancy or Child Birth Pregnancy (including voluntary termination), miscarriage, maternity or child birth (including through caesarean section)

b. Birth Control Any type of contraception, sterilisation, abortions, voluntary termination of pregnancy or family planning;

c. Assisted Reproduction Infertility services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI, gestational surrogacy;

d. Sexual disorder and Erectile Dysfunction. Treatment of any sexual disorder including impotence (irrespective of the cause) and sex changes or gender reassignments or erectile dysfunction;

e. Any costs or expenses related to pregnancy, complications arising from pregnancy or medical termination of pregnancy unless caused by an Accident.

• Sexually transmitted Infections & Diseases: Screening, prevention and treatment for sexually related infection or disease.

• Substance related and Addictive Disorders: Treatment and complications related to disorders of intoxication, dependence, abuse, and withdrawal caused by drugs and other substances such as alcohol or nicotine.

•Traffic Offences & Unlawful Activity: Any condition occurring as a result of breach of law by the Insured Person with criminal intent.

• Unrecognised Physician or Hospital:


a. Treatment or Medical Advice provided by a Medical Practitioner not recognised by the Medical Council of India or by Central Council of Indian Medicine or by Central council of Homeopathy or by relevant authorities in the area or country where the treatment is taken.

b. Treatment or Medical Advice related to one system of medicine provided by a Medical Practitioner of another system of medicine.

c. Treatment provided by anyone with the same residence as an Insured Person or who is a member of the Insured Person’s immediate family or relatives.

d. Treatment provided by Hospital or health facility that is not recognised by the relevant authorities in India or any other country where treatment takes place.

e. Treatment or services received in health hydros, nature cure clinics or any establishment that is not a recognised Hospital or healthcare facility    

WAITING PERIODS

+ -
  • Pre-existing disease waiting period of 24 months since inception of the policy and continuous renewal. For Critical Illness cover, pre-existing disease waiting period would be 48 months along with a Survival Period exclusion of 30 days for all conditions.
  • Initial waiting period of 30 days unless the treatment needed is the result of an Accident. For Critical Illness cover, initial waiting period would be 90 days.
  • Specific waiting period of 12 months, since the inception of the first policy with us, for some listed illnesses, unless the condition is directly caused by Cancer (covered after Initial Waiting Period of 30 days) or an Accident (covered from day 1).
  • The following benefits will have a waiting period of 36 months since inception of the Policy and subject to continuous renewal:

    • Weight loss (Bariatric) surgery
    • Mental disorder treatment
    • LASER surgery cover
  • For HIV / AIDS cover, there will be a waiting period of 48 months since inception of the Policy and subject to continuous renewal.

Please do read more about the common exclusions in the policy

Why choose Health Premia?

Doctors Speak
Arrow Arrow

Live well with Max Bupa

Check out what the doctors and the  experts have to say about your health and health insurance

Calculate Medical Expenses
Arrow Arrow
Financial-calc-benefit-1
Painless renewals
Arrow Arrow

Assured plan renewal for life

Get 10% added sum insured on each renewal*

Get cashless health check-ups

You will get 10% of expiring base sum insured each policy year

Hassle-free 5 minutes renewal process

Seamless renewal options

Click here>>
Frequently Asked Questions
HOW CAN I BUY THIS POLICY?
WHAT ARE THE MINIMUM AND MAXIMUM POLICY DURATIONS?
IS THERE ANY TAX BENEFIT THAT ONE CAN AVAIL OF WHILE PURCHASING HEALTH INSURANCE?
IS A MEDICAL CHECK-UP NECESSARY BEFORE BUYING A POLICY?
WHAT IS ANNUAL INSURANCE COVER?
HOW CAN I BUY THIS POLICY? - +

There are various ways in which you can purchase this policy:

Online:On purchase of this plan online your policy will be generated almost instantly along with your policy kit and card. This is applicable for cases which do not require further underwriting or medical checkup.

Telephone:If you wish to know more about Max Bupa’s Health Insurance Plans, please speak to our specially trained sales team or your local advisor. Call us on Phone 1860 500 8888 (Toll Free) between 9 am and 6 pm IST (Monday to Saturday) or click on ‘Click to arrange a call’ to buy the policy over the phone or to fix up an appointment.

Branch: Please visit our branch in your city. The complete list of branch locations is available in the Contact Us section of the website

The Max Bupa Promise
Arrow Arrow
The Max Bupa Promise

30 Minute cashless claims processing

Spend less time on paperwork and more with your family

Health network beyond hospitals

A cashless network of 4800+ hospitals & 2000+ doctors

No third-party agents! Direct claim settlement

No TPA involvement in processing your claim

Cashless OPD & Paperless reimbursements

No paper, no hassle. Get online reimbursements

Your everyday health partner
Arrow Arrow
your everyday health partner-compressed

Max Bupa Health App

Track your health, manage your policy & renewals

Consult Now >

Click here to get free E-consultation

A quick & painless way to consult a doctor

Download App Now >

Document locker

Store & access all your medical records with a few taps

Download App Now >

Book Cashless OPD Online!

Doctor’s appointment through our cashless health network

Know More >
Hassle-free claims
Arrow Arrow
Hassle-free claims
Get admitted

Visit us at one of our hospitals

Use your health card

Identify yourself with your MaxBupa health card

Get validated

After validation your request will be sent directly to us

We Review

No third party involved!

Claim Settled

In as less as 30 minutes!

Get a quote

Tell us a little about yourself and we’ll get you the right quote.

Find the right plan now>

Compare plans

Not sure if it’s the right plan for your family? Compare it with other similar plans.    

Compare now>