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What you get
What you get
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Please click here to see premium illustration
No Room Rent Cap
In case of hospitalization, room rent is covered up to sum insured.*
Day Care Treatments
Your health insurance will cover host of day care procedures
International Coverage
Insure your health even when you travel abroad under platinum plan
OPD Consultations
Stay worry-free as we cover OPD treatments under platinum plan
Maternity & New-born coverage
No additional premium for covering a new born baby from day 1
Loyalty Bonus
Irrespective of claim history, get 10% more sum insured annually
Know what’s covered under Heartbeat Health Insurance Plan
Search for diseases covered in the HeartBeat health insurance plan or check out all the policy features
Hospitalisation
IN-PATIENT CARE (HOSPITALISATION)
+ -PRE & POST HOSPITALISATION MEDICAL EXPENSES
+ -The policy covers expenses 60 days before hospitalisation and 90 days post discharge
DOMICILIARY HOSPITALISATION
+ -ORGAN TRANSPLANT
+ -OPD TREATMENT AND DIAGNOSTIC TESTS
+ -Get reimbursements for expenses towards medically necessary treatments as an outpatient with a doctor under platinum plan
EMERGENCY AMBULANCE
+ -DAY-CARE TREATMENT COVERED
+ -Your health insurance will cover host of day care procedures
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
DIRECT CLAIM SETTLEMENT
+ -RENEWAL FOR LIFE
+ -INTERNATIONAL COVERAGE
+ -Covers specified illnesses and emergency hospitalisation and emergency medical evacuation outside India
LOYALTY BENEFIT
+ -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
MATERNITY & NEWBORN COVERAGE
+ -Avail maternity benefits and no additional premium for covering a new born baby from day 1 till policy year end
ENTRY AGE AND FAMILY COVERAGE
+ -The entry age for adults under this policy can be from 18 to 65 years. The entry age for dependent children is from 91 days to 21 years in a family floater policy. The policy can be taken individually or for the family. The family floater policy is available for husband, wife and a maximum of 4 children.
HEALTH CHECK-UP
+ -You can avail health checkup for Diagnostic Tests purposes post completion of 1st policy year, 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.
SECOND MEDICAL OPINION
+ -Second Medical opinion for listed specified illnesses or a planned surgery or procedure can be obtained under Platinum plan. There is one opinion available per insured person per specified illness/ planned surgery.
REFILL BENEFIT
+ -In case of exhaustion of the base sum insured, get 100% of your base sum insured as a refill for both different and same illness
Add on Features
Optional Benefits: |
Heartbeat individual and family floater health insurance – Gold plan |
Heartbeat individual and family floater health insurance– Platinum plan |
Hospital Cash |
Rs 3000/day |
Rs 6000/day |
E-Consultation |
Available |
Available |
Personal Accident Cover |
Available |
Available |
Critical Illness Cover |
Available |
Available |
Premium Waiver |
|
If an insured policy holder passes away or is diagnosed with a specified illness during the policy period, then the premium for next year will be waived |
Enhanced Geographical Scope for International coverage | Extend your hospitalisation & emergency medical evacuation cover in US & Canada. |
Exclusions
PRE-EXISTING CONDITIONS
+ -PERMANENT EXCLUSIONS
+ -Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded.
Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded.
Rest Cure, rehabilitation and respite care
Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes:
Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons.
Any services for people who are terminally ill to address physical, social, emotional and spiritual needs.
Obesity/ Weight Control
- Expenses related to the surgical treatment of obesity that does not fulfil all the below conditions:
- Surgery to be conducted is upon the advice of the Doctor.
- The surgery/Procedure conducted should be supported by clinical protocols.
- The member has to be 18 years of age or older and;
- Body Mass Index (BMI);
- greater than or equal to 40 or
- greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss:
- Obesity-related cardiomyopathy
- Coronary heart disease
- Severe Sleep Apnea
- Uncontrolled Type2 Diabetes
Change-of-Gender treatments
Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex.
Cosmetic or plastic Surgery
Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner.
Hazardous or Adventure sports
Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
Breach of law
Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent.
Excluded Providers
Expenses incurred towards treatment in any Hospital or by any Medical Practitioner or any other provider specifically excluded by Us and disclosed in Our website / notified to the Policyholders are not admissible. However, in case of life threatening situations or following an Accident, expenses up to the stage of stabilization are payable but not the complete claim.
The complete list of excluded providers can be referred to on our website.
Treatment for, alcoholism, drug or substance abuse or any addictive condition and consequences thereof.
Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons.
Dietary supplements and substances that can be purchased without prescription, including but not limited to vitamins, minerals and organic substances unless prescribed by a Medical Practitioner as part of Hospitalization claim or Day Care procedure
Refractive Error
Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres.
Unproven Treatments
Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.
Sterility and Infertility
- Expenses related to sterility and infertility. This includes:
- Any type of contraception, sterilization
- Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI
- Gestational Surrogacy
- Reversal of sterilization
Maternity
Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during Hospitalization) except ectopic pregnancy;
Expenses towards miscarriage (unless due to an Accident) and lawful medical termination of pregnancy during the Policy Period.
Ancillary Hospital Charges
Charges related to a Hospital stay not expressly mentioned as being covered. This will include charges for admission, discharge, administration, RMO charges, night charges, registration, documentation and filing, surcharges and service charges levied by the Hospital.
Circumcision:
Circumcision unless necessary for the treatment of a disease or necessitated by an Accident.
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, counseling or treatment related to external Congenital Anomaly.
Dental/oral treatment:
Treatment, procedures and preventive, diagnostic, restorative, cosmetic services related to disease, disorder and conditions related to natural teeth and gingiva except if required by an Insured Person while Hospitalized due to an Accident.
Hormone Replacement Therapy:
Treatment for any condition / illness which requires hormone replacement therapy.
Multifocal Lens and ambulatory devices such as walkers, crutches, splints, stockings of any kind and also any medical equipment which is subsequently used at home.
Sexually transmitted Infections & diseases (other than HIV / AIDS):
Screening, prevention and treatment for sexually related infection or disease (other than HIV / AIDS).
Sleep disorders:
Treatment for any conditions related to disturbance of normal sleep patterns or behaviors.
Any treatment or medical services received outside the geographical limits of India.
Unrecognized Physician or Hospital:
- Treatment or Medical Advice provided by a Medical Practitioner not recognized by the Medical Council of India or by Central Council of Indian Medicine or by Central council of Homeopathy.
- 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.
- Treatment provided by Hospital or health facility that is not recognized by the relevant authorities in India.
Artificial life maintenance for the Insured Person who has been declared brain dead or in vegetative state as demonstrated by:
- Deep coma and unresponsiveness to all forms of stimulation; or
- Absent pupillary light reaction; or
- Absent oculovestibular and corneal reflexes; or
- Complete apnea.
AYUSH Treatment
Any form of AYUSH Treatments, except as mentioned in your policy document.
WAITING PERIODS
+ -- Pre-existing disease waiting period of 48 months (silver plan) / 24 months (gold and platinum plans) 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 24 months for persons above 45 years of age, 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).
- For mental disorder treatment cover, there will be a waiting period of 36 months since inception of the Policy and subject to continuous renewal.
- 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 Heartbeat?
Doctors Speak
Live well with Niva Bupa
Check out what the doctors and the experts have to say about your health and health insurance
03 February 2020
Niva Bupa Health Insurance
Picking the right health insurance for you
Choosing the right health insurance plan is not easy. Niva Bupa can help you in choosing the right health insurance policy in India based on your requirements.
21 January 2020
Niva Bupa Health Insurance
Everything you need to know about health insurance
It is important to have a comprehensive health insurance. Know all about the types of health insurance, it's benefits & understand how to make the best of your medical insurance policy.
Calculate Medical Expenses
Painless renewals
Assured plan renewal for life
Get 10% added sum insured on each renewal*
Get cashless health check-ups
Carry forward 80% unutilized amount for diagnostic tests
You will get 10% of expiring base sum insured each policy year
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?
IS COVID-19 COVERED UNDER HEART BEAT FAMILY FLOATER PLAN ?
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 Niva 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 Niva Bupa Promise
Your everyday health partner
Hassle-free claims
Get admitted
Visit us at one of our hospitals
Use your health card
Identify yourself with your NivaBupa health card
Get validated
After validation your request will be sent directly to us
In-house claims review
No third party involved!
Claim Processing
In as less as 30 minutes!
Get a quote
Tell us a little about yourself and we’ll get you the right quote.
Compare plans
Not sure if it’s the right plan for your family? Compare it with other similar plans.
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